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Old 06-05-2009, 09:53 AM   #1
dude1394
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Default On Deck : Government Universal Health Care

Since the topic of Universal Health Care has begun to come up, we need someplace to post/rant/curse and belittle each other. Here it is.

I'll start off with a couple of thoughts and posts/articles.

First...Health Care is busted. It has been completely divorced from cost/benefit and market forces. The first article is extremely interesting. It describes the Medicare costs in McAllen Texas and compares it to El Paso and also places where medicare costs are much less.

One of the most interesting things noted was the less medical procedures and "care" you got, the healthier you are, even if you are the same demographic. Funny...

http://www.newyorker.com/reporting/2...urrentPage=all

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The second point is the political one that is on-going. Whereby Obama is suggesting that we do a BAC-type take it or leave it based on the recommendations of I think it's called the CEA. What some are suggesting is that if they think they can cut the cost of medicare (and ultimately the as-yet-unapproved Universal Health Care) then do it. Use Medicare as the pilot-program to show that these savings can be achieved and that they are viable. Sounds reasonable to me. The CEA states..
""Nearly 30 percent of Medicare’s costs could be saved without adverse health consequences.""

http://www.dynamist.com/weblog/archives/003001.html
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Old 06-05-2009, 09:57 AM   #2
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I'd absolutely love if wealthier people than myself paid for my healthcare...

(I have a car payment & some student loans that could use their help too!)
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Old 06-05-2009, 10:05 AM   #3
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It would be nice if the wealthier people would buy my groceries. I promise I'd eat healthier food, thereby reducing my medical needs (and my need for their money), in the long run.
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Old 06-05-2009, 10:43 AM   #4
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Originally Posted by dude1394 View Post
...

One of the most interesting things noted was the less medical procedures and "care" you got, the healthier you are, even if you are the same demographic. Funny...


http://www.dynamist.com/weblog/archives/003001.html
i haven't read the linked piece... but as to this point, of course this is true. The problem is the direction of causality you you are trying to infer....

Q: who gets lots of medical procedures, and care...?
A: people who are sick.

if you are an 18 year old with cystic fibrosis you are going to get TONS of procedures and care... and then you are going to die young. If you are a healthy 18 year old... you will probably avoid the doctor's for the next 20-30 years... and be fine.
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Old 06-05-2009, 10:59 AM   #5
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is there a plan in which "wealthier people" are going to provide the $ as an answer to the healthcare issue? not that I'm aware of...

the answer to the issue is to stop the spiraling costs of healthcare. oue country spends much more per person for mediacl care than other similar societies, yet we are not healthier nor do we get better care.

the first article hit the nail on the head imo. the quote was something about how medical care costs less when the providors act like doctors and stop acting like businessmen...

a good question is if for-profit medical facilities are the illness. can medical costs be reduced if the providors do not have any financial interest in the facilities? that seems to be what the data says.

one thing that is true...the fact that over 17% of our income is spent on healthcare, and that figure is increasing, is as large an issue to our continued prosperity as any issue out there. we cannot as a country continue to do the same thing going forward, our system needs to be reformed.
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Old 06-05-2009, 11:15 AM   #6
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i haven't read the linked piece... but as to this point, of course this is true. The problem is the direction of causality you you are trying to infer....

Q: who gets lots of medical procedures, and care...?
A: people who are sick.

if you are an 18 year old with cystic fibrosis you are going to get TONS of procedures and care... and then you are going to die young. If you are a healthy 18 year old... you will probably avoid the doctor's for the next 20-30 years... and be fine.
Actually I'm not trying to infer anything other than more tests,procedures,therapies for the same illness doesn't equate to better health. What was interesting was that two people with the same symptoms in one case were given extensive tests, procedures, etc.. The people getting the procedures turned out to do worse than the others because of the inherent risk of those procedures.

Your age-related comment is not the case that is being made.
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Old 06-05-2009, 11:33 AM   #7
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Personally, I support the current health-care that I am under. But that's just me, and I acknowledge that there are others who have a genuine need for improved care/services at a better cost.

Having said that, I absolutely do NOT want Government involvement in managing health care. The closest example or experience I have with this has been my experience in the military. Great quality care (Doctors etc...), but the red tape to get to the doctor was a major pain and ofter times not worth the hasstle.

I've also had friends and family from other countries (France/Canada), who have shared several nightmare stories of long wating times to be seen (Months and Months waiting for an appointment, or being flat out rejected)

I have also had friends/family who have had excellent care here in the USA, getting to choose what hospital they went too and actually getting to pick one, that has some better rooms, visitor hours...things associated with stronger recovery support.

Under a universal government healthcare program, I have major concerns as to the choices that people will have...it appears as though the choice will become more limited than we have today.

On the flip side...I wonder if we can influence individuals who have the ability to gain some better health through preventative measures. For example, I'm 'Fat' ... 5'11", 40 years of aga, at 260 pounds...I can stand to lose about 70 pounds before my health becomes a medical issue. I would imagine that their are many others out there who could stand to do some of the same.

Now the cost of healthy foods, Gym membership, Personal Coach, etc...can be rather prohibitive...thus a tax credit or tax break, provided using this obtains some type of measurable results...would that not help contribute to a drop in actual health care due to lower needs of medical attention?


I am nowhere near an expert on any of this stuff, but it seems to me that much of this appears to be getting more complicated than it needs to be.

I say we get all of us who post on DM.com together in a room, give us 72 hours to hash out a plan, and I am willing to bet, we would have as close to the best plan as anyone in office, in the medical industry or in the private sector.

There you go, let's start up our own "Lobby"...we can send Mavdog and Flaco as our lobbiest!!!

Anyone else support this measure?

Of course alexamenos and arne would be on standby :-)
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Old 06-05-2009, 11:35 AM   #8
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Here is the bottom line that many don't want to face. I know this because I have spent the last 7 years working in both county hospitals and now for a private hospital.

Private hospitals provide better care. People are paid better. Doctors are paid better. Facilities look nicer. Workers like it better.

Public/County hospitals can't do these things because they provide so much free care. People want less expense, but hospital/healthcare charges the ones who pay drastically more because of indigent care costs. Add to that the marketing that has to be done now because of "so" many choices.

It is exactly like the public/private school issue. You get what you pay for.

The system isn't broke, it is working exactly as a free market system is designed. If you have the $$$$, you get the better stuff. Why do you expect a Lexus when you have the budget of a Yugo?
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Old 06-05-2009, 12:23 PM   #9
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dalmations, I can see you point to some extent...

however, underlying that point is ALSO the fact that the current system is getting bogged down because SOMEBODY already has to provide care for those that are outside the system. The hodgepodge way we do it now is retarded, and and tries to overtly ignore the situation and instead addresses the problem as an afterthought plugged into the side of the general system.

Clearly that doesn't work very well. It is also clear (to me at least) that we can't just exclude medical services from a large swathe of the population... even if you ignore the humanitarian aspects of that decision, the external and spillover costs of having an uncovered portion of the population are too high.

so you have to divide the question into two parts. One, what is the problem? (which you addressed) and two, What is the best way to solve this problem? (which you didn't)

i don't think ignoring the un-covered is an option.
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Old 06-05-2009, 12:55 PM   #10
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dalm mentions one of the biggest issues, the cost that the county hospitals incur to take care of the "indigent", those without coverage.

take parkland for example, which is one of only 2 (?) hospitals that will provide services to indigent patients. patients from outside of dallas county get care, but the cost falls on dallas county taxpayers.

that needs to be corrected, and it seems the onpy manner to accomplish this is by way of universal coverage for all americans.

universal coverage does not equate to government run healthcare. private insurers can be used to provide this coverage and private institutions can be used to deliver the services.

likewise individuals can continue to pay for the insurance that allows thenm to choose which doctors and which facilities they use.

we don't need to reinvent the system, we need to repair it.
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Old 06-05-2009, 01:00 PM   #11
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Originally Posted by mcsluggo View Post
dalmations, I can see you point to some extent...

however, underlying that point is ALSO the fact that the current system is getting bogged down because SOMEBODY already has to provide care for those that are outside the system. The hodgepodge way we do it now is retarded, and and tries to overtly ignore the situation and instead addresses the problem as an afterthought plugged into the side of the general system.

Clearly that doesn't work very well. It is also clear (to me at least) that we can't just exclude medical services from a large swathe of the population... even if you ignore the humanitarian aspects of that decision, the external and spillover costs of having an uncovered portion of the population are too high.

so you have to divide the question into two parts. One, what is the problem? (which you addressed) and two, What is the best way to solve this problem? (which you didn't)

i don't think ignoring the un-covered is an option.
No argument from me at all.

There is an issue that needs addressing. The question, at least to me, is not if there is a problem, but how to address the issue.

I want the care that private healthcare provides. Being ex-military, I have seen how the military does it, and it isn't pretty. Go visit the VA hospital sometime, and see what you are getting with free service.

I have worked in a county hospital, in a semi-poor county. Everyone with insurance goes to the "other" hospitals in the metroplex because they get better care. This leaves even more indigent care for that hospital, and even less money coming in because they don't get the $$$$ from the insurance. They only get paid by medicare and medicaid or self-pay. They also get paid less by medicaid/medicare for the same services because they are classified as a rural hospital, even though they provide the exact same service ie MRI, and the cost of the machine is the same.

I moved to a better county hospital in the suburbs of the metroplex to get paid. We were and are a better hospital totally due to the money we get and are willing to spend. Then we were bought out and privatized. We now work on profit, but we provide much better service. We have much better scores. We rank up there with Baylor and Harris (better in some things) now that we have even more $$$$ to spend.

The downside is that we don't take indigent care now. If you come to this hospital's ER and don't have insurance, medicaid, medicare, or proof of cash, then we will stabilize and send you to the county clinic. Have the flu, don't come to our ER without ability to pay. Anything not life threatening -- same thing. This has caused many issues with some people. Metal fragment in the eye hurts greatly, but isn't life threatening....see the issue.

Because the hospital gets paid so well, and yes we charge outrageously...then people think it is OK to gouge the hospital. Before I got here one business was charging 9K a server to the hospital -- when I could get the same server off Dells site w/o the HPG discount for $2800. I know we get gouged on lots of products solely because we are a hospital and we have to have certain things.

People also don't realize how many people it takes to take care of a person for 24 hrs a day. 5 shifts minimum in a week for nurses. Nurses, Doctors, Pharmacist, Lab, Computer, Billing, all the Health information coding, Maintenance of the building, Clean-up, Cooks, etc. Not to mention the QC people (to make sure no one screwed up) and the ones that do all the credentialing to make sure you are getting certified people and that they keep their certifications up to date. Add to that the marketing groups to try and drive a little more business this way, the recruiting people who try and get the best talent here, and the accounting people to keep the product coming in the doors, and everyone getting paid. It is a nightmare of people that are involved, just to keep 1 person in one bed for 1 week.

And remember, everyone wants paid, since most positions here require a bachelors degree, just to get interviewed.

** Just a note, I get paid half what I made when working in the business world. I stay working here because it is home, and I feel like I am actually helping people.

With all of this said. Socialized medicine doesn't work. I am interested in someone coming up with a better answer though, if we are to continue to be a society that stays with a free market system.
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Old 06-05-2009, 01:15 PM   #12
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Mavdog,

we might actually be able to find a happy medium.

1) Keeping a portion of the system to be addressed by the private sector and basically through insurance as it is today.
2) Finding a way to enhance the availability to those who are uninsured and ensuring that one city/county or community is not overly burdened in supporting a hospital (Taxes from Dallas for patients from Ft. Worth)

Perhaps setting up some type of "ID" card where legal citizens can proove who they are and get care in a faility such as "Care Now" for the initial screening. If they are uninsured, they can still be seen and then referred to the local "Public" hospital...if the patient is unable to get there on their own, perhaps a connection with DART or an Ambulance can be made to pick up the patient and take them to this Public Hospital.

Those with Private Insurance would continue to do business as usual.

Facilities like a Care Now, can have two lobbies, one for private insurance and the other for Public Care. This would allow for equal 'Care' from the physician, but also allow for more effecient processing time for "Privately Insured" Patients.

In concept, I think we can find a compramise that works for the nearly everyone, so that they at the very least get the care they need and at the most, for those who have the resources, they can get the little perks that come with paying for it.
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Old 06-05-2009, 01:19 PM   #13
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Mavdog,

we might actually be able to find a happy medium.

1) Keeping a portion of the system to be addressed by the private sector and basically through insurance as it is today.
2) Finding a way to enhance the availability to those who are uninsured and ensuring that one city/county or community is not overly burdened in supporting a hospital (Taxes from Dallas for patients from Ft. Worth)

Perhaps setting up some type of "ID" card where legal citizens can proove who they are and get care in a faility such as "Care Now" for the initial screening. If they are uninsured, they can still be seen and then referred to the local "Public" hospital...if the patient is unable to get there on their own, perhaps a connection with DART or an Ambulance can be made to pick up the patient and take them to this Public Hospital.

Those with Private Insurance would continue to do business as usual.

Facilities like a Care Now, can have two lobbies, one for private insurance and the other for Public Care. This would allow for equal 'Care' from the physician, but also allow for more effecient processing time for "Privately Insured" Patients.

In concept, I think we can find a compramise that works for the nearly everyone, so that they at the very least get the care they need and at the most, for those who have the resources, they can get the little perks that come with paying for it.
Should we just go ahead and tatoo a number/barcode on their hand or forehead, so we can tell exactly who they are, and if they have the cash, insurance, etc and to what place we should take them?

This way everyone gets what they want/deserve................
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Old 06-05-2009, 01:55 PM   #14
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Should we just go ahead and tatoo a number/barcode on their hand or forehead, so we can tell exactly who they are, and if they have the cash, insurance, etc and to what place we should take them?

This way everyone gets what they want/deserve................

Nope...the ID card would work fine, heck let it double as a Voter ID card while we are it.

It's like traveling, you have different levels of travlers, from the first time or casual vacationer going on thier one flight for the year to the frequent flyer who goes on say 10 flights a year, to the 'GOLD' traveler who catches some 25 or more flights...to the Platinum who goes upwards of 50 flights or more.

Each level has different perks...but everyone understands what it takes to get to the next level of perks, and if we are willing and have the means, we can get to that milestone.

Now obviously, we don't want "Frequent Patient" programs, after all the goal is to get everyone cured from the medical condition that ails them.

However there are different levels of 'Insured'

What I'm proposing is that the uninsured don't have to ONLY go to Parkland, but rather have some locations that are easier to get to...they may be within a block to a couple of miles away. Our family happens to use Care Now and Prima Care facilities, when needed. The do require payment/insurance upfront. So if someone doesn't have insurance, they have to pay a pretty hefty amount...or work their way over to a Parkland, which can be another hastle all to itself.

So if Tax dollars are covering the uninsured at Parkland, why not allow these funds to be available on an even more local level and allow people to go to a Care Now type of facility for the initial assessment.

This however would create a bit of a burden on the Care Now facility by adding an increased "Wait" time. As it is now, you can call in, set up an appointment and minimize your wait time...but you can still walk-up and wait.

My thought with two waiting rooms, is that if someone on the public troff, were waiting in the waiting room for 3-4 hours, but someone on the insurance system called in, then showed up and saw the docter with 15 minutes...well some folks could get a bit bent out of shape. Now the person who called may have called 6 hours earlier and scheduled an appointment, still it could create some hard feelings.

So the setting up of two waiting rooms is to the benefit of everyone. But hey its just an idea.

Maybe you have another idea on how to provide perks for those who pay for insurance. After all, this is still a bit of getting what you paid for.

Does anyone object to getting what you pay for?

So if someone is paying insurance and another is getting free care, should there not be some type of benefit to having and paying for insurance?

Overall, this provides for all citizens to be covered, and gives perks to those who have the option to pay and have insurance.

Obviously the big pink elephant becomes...what do you do with NON-Citizens? How do we show compassion to our fellow human, while protecting the pocket books of the nation?

If they are here legally, then treat them and send the bill back to their nation...if they here illegally, treat them, send them home and send the bill to their nation.

Again, everyone received medical care, while extended financial responsibility back to the nations of the individuals who visit America.
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Old 06-05-2009, 02:40 PM   #15
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<snip>
Does anyone object to getting what you pay for?
(because I love the debate, I'll take this side right now)

The answer is essence is YES.

If my child needs a new heart, and I make 100K a year, and you tell me that it will run 500K and insurance won't cover it -- I still want the heart for my child.

I don't want to be told that I can't afford it, and my child will die. I don't want a doctor doing the surgery that graduated in the bottom 10th of his class. I want my child to be treated by the best there is, because I want them to survive.

Just because I was laid off, didn't get the promotion, wasn't born into money, or can't get insurance because of a pre-existing condition doesn't mean that I don't WANT the best available care for my child.

So yes, I have problem if my child is passed over for a heart because someone else has a little more money.

My child is worth more than Money.
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Old 06-05-2009, 03:06 PM   #16
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Originally Posted by dalmations202 View Post
(because I love the debate, I'll take this side right now)

The answer is essence is YES.

If my child needs a new heart, and I make 100K a year, and you tell me that it will run 500K and insurance won't cover it -- I still want the heart for my child.

I don't want to be told that I can't afford it, and my child will die. I don't want a doctor doing the surgery that graduated in the bottom 10th of his class. I want my child to be treated by the best there is, because I want them to survive.

Just because I was laid off, didn't get the promotion, wasn't born into money, or can't get insurance because of a pre-existing condition doesn't mean that I don't WANT the best available care for my child.

So yes, I have problem if my child is passed over for a heart because someone else has a little more money.

My child is worth more than Money.
People that have the need of "Heart Transplant" are put into a list to find a donor that matches. To my understanding the best people perform the surgery...I don't believe that this is where you get what you pay for, the perks come in the form of what some deem non-medical.

In other words, your wait time in the lobby is shortened, your room is perhaps a bit more comfortable (5 Star hotel versus 2 star hotel)...

Free Care, or Tax paid care, provide everyone with the opportunity to received care, period. My lot in life is what it is and if that only provided me with Tax paid care and it happened to be a doctor in the bottom 10% of his peers...but he did graduate and he does meet the standards, then so beit.

When I travel, I sit in coach...I would love to sit in 1st class, but guess what...I can't afford it, thus I adjust and sit in coach.

I drive cars that suffice, but they are not the best cars on the road, I would love to drive the best, but I cant afford it.

I live in a comfortable home...not the best around...heck I would love to have the house that Mark Cuban owns, but I can't afford it.

I would love to have the absolute BEST medical care, heck my own private doctor and staff...but I adjust based on what I can afford, I've been without insurance and with insurance, either way, I adjusted to what my means where at the time. That big time personal Medical Staff living in my home...I can't afford it.

We accept our lot in life, we strive to improve our lot, and I would imagine that for most of us here, we do our best to help others improve their lives...providing support for those in need.
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Old 06-05-2009, 03:34 PM   #17
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People that have the need of "Heart Transplant" are put into a list to find a donor that matches. To my understanding the best people perform the surgery...I don't believe that this is where you get what you pay for, the perks come in the form of what some deem non-medical.

In other words, your wait time in the lobby is shortened, your room is perhaps a bit more comfortable (5 Star hotel versus 2 star hotel)...

Free Care, or Tax paid care, provide everyone with the opportunity to received care, period. My lot in life is what it is and if that only provided me with Tax paid care and it happened to be a doctor in the bottom 10% of his peers...but he did graduate and he does meet the standards, then so beit.

When I travel, I sit in coach...I would love to sit in 1st class, but guess what...I can't afford it, thus I adjust and sit in coach.

I drive cars that suffice, but they are not the best cars on the road, I would love to drive the best, but I cant afford it.

I live in a comfortable home...not the best around...heck I would love to have the house that Mark Cuban owns, but I can't afford it.

I would love to have the absolute BEST medical care, heck my own private doctor and staff...but I adjust based on what I can afford, I've been without insurance and with insurance, either way, I adjusted to what my means where at the time. That big time personal Medical Staff living in my home...I can't afford it.

We accept our lot in life, we strive to improve our lot, and I would imagine that for most of us here, we do our best to help others improve their lives...providing support for those in need.
But if this is the case, then nothing is broken. What you describe is what happens now. Why make any changes at all?

Do we all agree now that nothing is broken, and we have no need to fix healthcare?
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Old 06-05-2009, 05:36 PM   #18
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There must be SOME sort of governing (notice not guverning) action. In more socialized states that is rationing or the lack of expensive procedures/surgeries/equipment. In this country that is....well....nothing really that I can readily think of except for HMOs. Medicare limits it somewhat in that it only covers so much, but it pretty much covers everything I believe.

So no limits means no way to curtail any spending or increase in services. IMO I don't see the limiter anywhere.
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Old 06-15-2009, 04:38 PM   #19
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A bullseye...

Quote:
olds
ROBERT SAMUELSON: “It’s hard to know whether President Obama’s health-care ‘reform’ is naive, hypocritical or simply dishonest. Probably all three. The president keeps saying it’s imperative to control runaway health spending. He’s right. The trouble is that what’s being promoted as health-care ‘reform’ almost certainly won’t suppress spending and, quite probably, will do the opposite.” How about fixing Medicare first?
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Old 06-15-2009, 05:01 PM   #20
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I live in a god forsaken country that has implemented a national health care system. Now my taxes go to help for 17 year olds to get boob jobs.

http://www.dailymail.co.uk/femail/ar...ove-flaws.html
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Old 06-15-2009, 05:22 PM   #21
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I live in a god forsaken country that has implemented a national health care system. Now my taxes go to help for 17 year olds to get boob jobs.

http://www.dailymail.co.uk/femail/ar...ove-flaws.html
I fail to see the problem here...

(seriously, there are worse ways to spend your taxes - "boobs not bombs!")
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Old 06-16-2009, 09:42 AM   #22
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Yeah! More boobs for seventeen year old girls, fewer meds for old folks. Sounds like a winning campaign platform.
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Old 06-25-2009, 08:58 AM   #23
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Ah Barry...say it ain't so. Let 'em eat cake. Heh...

Quote:
OBAMA’S MICHAEL DUKAKIS MOMENT on health care. “If ObamaCare isn’t good enough for Sasha, Malia, or Michelle, then it’s not good enough for America.”
Quote:
President Obama struggled to explain today whether his health care reform proposals would force normal Americans to make sacrifices that wealthier, more powerful people — like the president himself — wouldn’t face.


The probing questions came from two skeptical neurologists during ABC News’ special on health care reform, “Questions for the President: Prescription for America,” anchored from the White House by Diane Sawyer and Charles Gibson.


Dr. Orrin Devinsky, a neurologist and researcher at the New York University Langone Medical Center, said that elites often propose health care solutions that limit options for the general public, secure in the knowledge that if they or their loves ones get sick, they will be able to afford the best care available, even if it’s not provided by insurance.


Devinsky asked the president pointedly if he would be willing to promise that he wouldn’t seek such extraordinary help for his wife or daughters if they became sick and the public plan he’s proposing limited the tests or treatment they can get.


The president refused to make such a pledge, though he allowed that if “it’s my family member, if it’s my wife, if it’s my children, if it’s my grandmother, I always want them to get the very best care.["]

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Old 06-25-2009, 02:59 PM   #24
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Hmm...maybe not a bad idea. You want universal coverage Barry...then man up.

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Sauce for the People is Sauce for the Politicians

Posted by Shannon Love on June 25th, 2009 (All posts by Shannon Love)
One of the greatest dangers of socialism is the creation of a privileged class of wealthy political insiders who live under different rules than the rest of the citizenry.



Ed Morrisey suggest the Obama had a “Dukakis Moment” when he refused to say that he would leave his own family dependent on politically-managed health care. [h/t Instapundit]
I don’t think we should leave him any choice.



We should create a legal requirement that political elites have to use the same system they foist on everyone else. They should have to wait for hours in doctors offices. They should have to wait weeks or months for test. They should be fobbed off on emergency rooms if they get sick over the weekend. They should be denied any hail-mary test , medications and procedures. They should get the entire politically-managed health care experience.



This standard should extend to all elected officials, political appointees and their immediate family.
Such a law would create a built-in feedback loop that would prevent politicians from ignoring the health of the people.
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Old 06-25-2009, 08:06 PM   #25
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the proposal isn't for one size fits all health coverage. people can purchase the type of coverage they want.

these criticisms do not have any basis. the attempt at class warfare reflects poorly on the source.
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Old 06-25-2009, 11:17 PM   #26
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I am not sure how I feel, but I am self employed which basically means I can't afford any kind of health care at this moment. I am starting a new business, and it is tough. I expect nothing, but am scared of the what if...

Hopefully soon for myself and any employees
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Old 06-26-2009, 07:55 AM   #27
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the proposal isn't for one size fits all health coverage. people can purchase the type of coverage they want.

these criticisms do not have any basis. the attempt at class warfare reflects poorly on the source.
As soon as a viable guvment run public option exists I would expect a ton of companies will run that way. My company already does it once you reach medicare status.

You are dreaming.
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Old 06-26-2009, 09:05 AM   #28
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As soon as a viable guvment run public option exists I would expect a ton of companies will run that way. My company already does it once you reach medicare status.

You are dreaming.
"a guvment [sic] run public option exists I would expect..."????

the conjecture of that statement reveals all that needs to be said.

instead of rhetoric that wails about some perceived class breakdown in a new plan, why don't those who want to sling arrows discuss the specifics, the actual facts?

answer: because they would be shown to be falacious arguments, there is no more economic class discrimination than currently exists, in reality there would be less as those who currently can't get health coverage will be able to. the plan is not a "one size fits all", people will have choices.

I'm not dreaming, and you're deceiving.
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Old 06-28-2009, 11:15 AM   #29
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Which public option do you think barry is talking about here? What conjecture are you talking about? Or is it not allowed to take Barry at his word on anything?
http://www.nytimes.com/2009/06/28/bu...er=rss&emc=rss

Quote:
President Obama has made his own preferences clear. In a letter to Senators Edward M. Kennedy of Massachusetts and Max Baucus of Montana, the chairmen of two key Senate committees, he wrote: “I strongly believe that Americans should have the choice of a public health insurance option operating alongside private plans. This will give them a better range of choices, make the health care market more competitive, and keep insurance companies honest.”
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Old 06-28-2009, 08:29 PM   #30
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No need for socialized healthcare. Just make medical expenses tax deductible.
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Old 06-28-2009, 09:08 PM   #31
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Which public option do you think barry is talking about here? What conjecture are you talking about? Or is it not allowed to take Barry at his word on anything?
http://www.nytimes.com/2009/06/28/bu...er=rss&emc=rss
Quote:
President Obama has made his own preferences clear. In a letter to Senators Edward M. Kennedy of Massachusetts and Max Baucus of Montana, the chairmen of two key Senate committees, he wrote: “I strongly believe that Americans should have the choice of a public health insurance option operating alongside private plans. This will give them a better range of choices, make the health care market more competitive, and keep insurance companies honest.”
the conjecture is your assertion that "companies" would "run" to a public health alternative to a private insurance option. companies must compete for talent, the proposed public insurance is not the same as the private policies. why you believe that private companies would not need to compete for the most talented workers by offering benefits- which is what happens every day- is poorly based conjecture.

and btw thanks for showing exactly what I've been saying is true. there will be choices for everybody to select from, but the most critical element will be that everybody will have coverage. one size will not fit all. insurance providors will need to compete for the business.

[/QUOTE]
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Old 06-29-2009, 09:33 AM   #32
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Hmm..not sure what happened to my last post. But in general I just disagree and I think you are thinking like an elitist. Like FannieMae/FreddieMac took over 50% of the mortgages in this country, the public option will quickly crowd out private insurers. Then the guvment will increase those perks to buy votes.. Contributing to the already overwhelming unfunded committments that medicare/medicaid already have.

There is a sort of silver lining I guess. Now lefties can quit bitching about wal-mart not providing affordable health care, as they won't have to.

The companies imo will quickly move to the public option and only the uber-priviledged like Barry will have private care. Your assertion might be true for the top 10% wage-earners imio.
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Old 06-29-2009, 10:49 AM   #33
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Hmm..not sure what happened to my last post. But in general I just disagree and I think you are thinking like an elitist.
there you go again, tossing out accusations of "elitist", but without any rationale. this is the very same line of thought used above about obama, and you couldn't back it up then either.

let's see, there are private health insurance option available, there are still going to be employer provided benefits of family health insurance available, and for those who cannot get coverage there will be a public plan.

how is that in any way "elitist"? is our current structure "elitist"? it's not.

ridiculous accusation.

Quote:
Like FannieMae/FreddieMac took over 50% of the mortgages in this country, the public option will quickly crowd out private insurers. Then the guvment will increase those perks to buy votes.. Contributing to the already overwhelming unfunded committments that medicare/medicaid already have.
gee, if fannie and freddie have 50%, that means there are 1 of every 2 mortgages that are not freddie or fannie. guess what? that means half of all mortgages are NOT freddie or fannie.....to say that this "crowd[s] out" other mortgage companies is absurd.

Quote:
There is a sort of silver lining I guess. Now lefties can quit bitching about wal-mart not providing affordable health care, as they won't have to.
they will have to if those other employers offer health insurance benefits, wlamart will need to compete for the workers.

Quote:
The companies imo will quickly move to the public option and only the uber-priviledged like Barry will have private care. Your assertion might be true for the top 10% wage-earners imio.
like I said, you like to use conjecture to support your point. you put out 10% without any factual basis.

currently the vast amjority of emploers provide health insurance benefits to attract and keep their talent. these companies offer multiple choices of health insurance plans, from ppo to hmo. there is no reason that you or anyone else have put forth on why this dynamic will change.
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Old 06-29-2009, 11:08 AM   #34
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Originally Posted by dude1394 View Post
Hmm..not sure what happened to my last post. But in general I just disagree and I think you are thinking like an elitist. Like FannieMae/FreddieMac took over 50% of the mortgages in this country, the public option will quickly crowd out private insurers. Then the guvment will increase those perks to buy votes.. Contributing to the already overwhelming unfunded committments that medicare/medicaid already have.

There is a sort of silver lining I guess. Now lefties can quit bitching about wal-mart not providing affordable health care, as they won't have to.

The companies imo will quickly move to the public option and only the uber-priviledged like Barry will have private care. Your assertion might be true for the top 10% wage-earners imio.
fannie and freddie became the SECONDARY destination for 50% of mortgages. The originating banks had it just EXACTLY how they wanted. they still originated (and got the fees for that) and they, or some other private sector party, manged the mortgage (got day-to-day payments, etc...) and fannie or freddie packaged the underlying obligations into an MBS (mortgage backed security) or simply held onto several tranches of the risk themselves in house. YOu could argue that fannie/freddie squeezed out AIG or lehman etc... as the ultimate back-stop for the obligations, but there was plenty of room for those guys to come in shoulder to shoulder with fannie/freddie in those tranches of risk ... and unfortunately AIG jumped into that with both feet, and proved to be an inadequate counterparty.

in terms of health insurance... if there is rationing by queues, as you assert there will be, then there should be PLENTY of demand for supplemental coverage, no?

the arguments against the plan seem to simultaneously be:

1) it will be dreadfully inefficient, and we will all have to plan our heart attacks 6 months in advance to work our way through the bureaucracy...

and

2) it will be so efficient and inexpensive that all people will flock to it and abandon the private providers.
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Old 06-29-2009, 11:27 AM   #35
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I actually think the most powerful argument is the financial disaster that is medicare. What exactly in that program are we wanting to replicate? If we weren't trying to rahm it through, we'd fix that program and then roll it out. It's certainly big enough to provide an accurate pilot.

Your recitations of my opinion(if that is what you are doing) is incorrect.
1. I expect it will be pretty inefficient. But that's what it is going to take to get medical costs down. Like Canada from all that I've read, there isn't an open MRI on every corner, nor other facilities. So you wait or in their case, go over the border. I'm not sure where Americans will go when they cannot get a facility. ??? So rationing will occur if we want to get costs down, it has to.

2. I'm not saying it will be efficient but that it will be quite inexpensive, because the taxpayers will provide the dollars instead of employers. That's all. To think that an employer will continue to provide health coverage when they do not have to is naive imo.

I also am not terribly upset with the general idea of the guvment providing health care if they would fix medicare first and show me that it's anything but the current cluster. I KNOW that medical markets are different, there is no cost constraints when your kiddo or yourself's health is involved. But there is going to HAVE to be some put into the system, I don't really think private enterprise may be able to do it.

I am pretty disgusted with the rush to disaster in just about all of barry's proposals. There's not a one that I can see that will stand up to the scrutiny of open-debate, but since it's a manufactured crisis we are voting on bills that havent' even been collated yet. (I know it's a change of subject).

You sound like you think most people purchase their own insurance...I don't think so.

Just put it to yourself. You are running a business and you can either provide health insurance yourself or let the guvment do it for you. Why would you? Mavie thinks it's to attract the best and brightest. I can agree with that to an extent but the best and brightest are 10% of the wage earners or somesuch. Health coverage is a checkbox for most companies.

I would be very surprised if prospective employees go through the health care coverage before accepting a position.
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Old 06-29-2009, 12:22 PM   #36
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ok. fair enough, and I mostly agree with the basic premises you state.

That said, two points.

1) Medicaid is welfare. It is providing a service to people that can't get it for themselves. THat is expensive (money flowing out, no money flowing in). Ideally a more universal coverage would automatically make the bottom segment of coverage more efficient by integrating it more seamlessly with the overall helth care provision network, rather than the abomination plastered to the side of the system we have now.

2) private sector provision of healthcare can and will fit in in some way or another. If your worst dreams come true and 90% of the population have coverage through the government providers, then a supplemental market will emerge, to get things like MRIs or whatever where ques form because it is not considered a core coverage (i assume you are talking about for knees or shoulders or whatnot...?)

btw... these arguments are for generalized healthcare in GENERAL... I don't understand the specific obama proposals well enough to assess them on way or another.
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Old 06-29-2009, 12:41 PM   #37
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McSluggo..I was talking medicare, not medicaid in case that wasn't clear. Having said that I would expect that Medicare is much more expensive of a program than medicaid per capita, if nothing else than medicaid folks may/may not know what their options are and/or don't seek treatment that quickly because of the difficulty. Just the plight of the poor. I could be wrong but I'm expecting not.

You may be correct that integrating universal coverage would be more efficient but I kinda doubt it as a very large (if not the largest) portion of healthcare in the country is provided under medicare.

Per this article
http://en.wikipedia.org/wiki/Medicare_(United_States)#Costs_and_funding_challen ges
Medicare costs have been doubling every 4 years or so. And right now it's huge. I would expect that size program could easily be used to pilot proposed spending cuts.
Quote:
Total Medicare spending reached $440 billion for fiscal year 2007, or 16% of all federal spending. The only larger categories of federal spending are Social Security and defense.

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Old 06-29-2009, 01:01 PM   #38
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there you go again, tossing out accusations of "elitist", but without any rationale. this is the very same line of thought used above about obama, and you couldn't back it up then either.

let's see, there are private health insurance option available, there are still going to be employer provided benefits of family health insurance available, and for those who cannot get coverage there will be a public plan.

how is that in any way "elitist"? is our current structure "elitist"? it's not.

ridiculous accusation.
It's not elitist when other people have access to it, like they do now. However, when the public option gets approved and rationing begins, it will become elitist. Sorry...might sting a little, but it will.

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gee, if fannie and freddie have 50%, that means there are 1 of every 2 mortgages that are not freddie or fannie. guess what? that means half of all mortgages are NOT freddie or fannie.....to say that this "crowd[s] out" other mortgage companies is absurd.
True...not saying that those programs are "crowding" out the others, only making a point that even in a profitable business model, those programs have become the biggest providers, why? It's not because they are the best at it, I"m sure. If I understand it, it's because they have cheaper access to capital than public companies...in other words having it run by the government gives it an inherent advantage....which will also occur with the public option.
Edit: Actually the more I think about it, capturing 50% of the market with a government agency might be defined as crowding out quite a large chunk of the market. Especially when there is no inherent reason for it to be doing so.

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they will have to if those other employers offer health insurance benefits, wlamart will need to compete for the workers.
They will not have to imo.

Quote:
like I said, you like to use conjecture to support your point. you put out 10% without any factual basis.

currently the vast amjority of emploers provide health insurance benefits to attract and keep their talent. these companies offer multiple choices of health insurance plans, from ppo to hmo. there is no reason that you or anyone else have put forth on why this dynamic will change.
The 10% is just a number of folks making 100K or more, the best and brightest as it were. Here...the exact number is 15.82% or so making 100K, feel better?
http://en.wikipedia.org/wiki/Househo..._United_States

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Old 06-29-2009, 03:22 PM   #39
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you talk in circles. on the one hand you say that there isn't any rationing today because people have access to different choices in healthcare coverage, but in the future after the changes are made there will be "rationing", while you also have provided information that there will still be choices available to people beyond the government program, but these private plans will be "crowded out" by the government plan that doesn't offer as much as the bare bones government plan...

sheesh.

you can criticize the proposed plan as too costly, you can criticize the government plan for not providing enough coverage, but it is inaccurate to criticize the plan as not allowing choices (as it does), or for forcing people to enroll in it (which it doesn't), or to call it elitist (when it isn't), or to say it replaces private health plans (which it doesn't).

the plan is intended to provide coverage to people who don't or can't get private coverage. that's all it is, and it is not nationalized healthcare.
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Old 06-29-2009, 03:53 PM   #40
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Originally Posted by Mavdog View Post
the plan is intended to provide coverage to people who don't or can't get private coverage. that's all it is, and it is not nationalized healthcare.
Quoted for posterity. That is exactly what it will turn out to be, no matter what is being spun.
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