Sick and Wrong; Matt Taibbi in Rolling Stone
 

This seven pager is worth the read (IMHO). It blasts everything that's wrong with the Health Care Initiative now failing in Congress. He's not kind to any of the players.

Sick and Wrong

Holy s**t! I didn't realise that the healthcare reform was being actively sabotaged to that degree. If that thing passes, it'll be worse than the current situation. Well, for everyone but the insurance companies.

As I see it, the article serves to highlight the core problem with democracy these days (in the US and UK at least). Put simply, the vast majority of those in power see themselves as there to benefit their financial backers, instead of the people who voted for them. Until there is a blanket ban on all forms of political funding (or very strict limits, e.g. $10k per entity*), I fear this will continue.

* by entity, I mean company or organisation, not individual donors. Thus, a single company cannot "give" more than the limit by using subsidiary or shell corporations, or by having multiple employees donate (for example).

The article also contained a very interesting point which I also believe is all too true these days:

That is, the government just wants to look like they are doing something, without actually doing it. And people wonder why there are such high levels of voter apathy?

"What our government is good at is something else entirely: effecting the appearance of action, while leaving the actual reform behind in a diabolical labyrinth of ingenious legislative maneuvers."

This is typical behavior in the Canadian government, the government of Nova Scotia, and the municipal government in Halifax. I suspect it's the norm today at every level.

New MACOSXHINTS user. I have found many great tips on this site over the last 2 years, thank you all.

I'm writing because I agree Matt Taibbi's article is the best I've read on the subject of heath care. I learned about who is trying to do what in our Congress.

Also this... on 9.9.2009 Mr. Reid, author, was interviewed by the Santa Fe Radio Cafe about health care around the world. The show is about an hour in length but it is a global perspective of health-care systems, I learned a ton here too.

http://www.santaferadiocafe.org/podcasts/
(then go to September 9th)

Thanks,

Steve in Santa Fe

Whose bottom line?
 

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The respected investment bank Goldman Sachs has weighed in with its analysis of the various alternatives being considered for Health Care Reform. Naturally, the focus of its study -- which was never intended for public consumption -- is to analyse the effect on the bottom line of its clients and potential clients, i.e. the top insurance companies whose shares are traded on wall street. (Aetna, UnitedHealth, WellPoint, CIGNA and Humana)

Their conclusions in order of preference?

1. No health care reform is best
2. A watered-down version of the Senate Finance Committee’s bill scores a close second
3. The legislation considered and (to a certain extent) passed by the House of Representatives is much worse

How does this translate into the numbers that matter? Here are Goldman Sach’s projections:

1. The study's authors advise that if no reform is passed, earnings per share would grow an estimated ten percent from 2010 through 2019, and the value of the stock would rise an estimated 59 percent during that time period.
   
2. Under the Senate Finance Committee bill, the earnings per share for the top five insurers would grow an estimated five percent from 2010 through 2019. And yet, the value of the stock is projected to drop four percent.
   
3. Under the House of Representatives bill, earnings per share would decline an estimated one percent from 2010 through 2019 and the variance with current valuation is projected to be negative 36 percent.

So what’s the bottom line for the uninsured and for the taxpayers that helped bail out Goldman Sachs when they needed it? Overall, Goldman calculates the probability of some sort of reform passing Congress to be 75 percent.

However, barring significant health care reform, the best health insurance policy you can have may well be stock investments in these five health insurance companies!
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many people over here criticize the nhs..but i dont think we realize how lucky we are to have a national health service.

USA spends twice as much as UK on health care
 

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The same thing holds true for Norway.

I recently read The Independent’s comparison between the UK’s NHS and health care in the USA. One figure stood out: the United Kingdom uses half as much as the USA on health care when computed as percentage of GDP.

Half!

The difference can be attributed to two factors: corporate profits and less efficiency -- most of it being profits.
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In the USA at least, it seems that profits are much more important than the health and welfare of its citizens! It really is becoming a corporate oligarchy.

becoming...? :D

I hate to say it out loud, but the fact is the US has always had an economy driven by the same principles as chattel slavery. Back in the days of the founders, of course, it was overt slavery, but even after abolition we somehow retained the attitude that the only meaningful health concern was maintaining a viable workforce. that's why (IMO) Male ED drugs available in every health plan but abortion and contraception aren't; more children means more competition for future jobs, which drives down wages... From the corporate perspective, healthcare is an incentive: it's only value lies in attracting and retaining workers of a certain quality. The corporation has no interest in the health and well-being of anyone who do not meet that 'certain quality' criteria, and the government in the US has adopted (totally and completely) the corporate perspective.

heck, the only reason that the Republicans could raise that idiotic 'Death Panel' issue is that a sub-rosa version of death panels is the norm in our country, as well as a regular Republican platform (usually under the guise of fiscal responsibility in medicine).

I mean really: if it came down to it, which would you prefer

1. End-of-life counseling, where some doctor explains to you that further treatment is unlikely to have any effects that merit the costs involved, and you can choose to refuse the treatment, or
2. What we currently have, where your insurance company refuses to pay for your treatment because they decide it's unwarranted, and you get to spend your last days feeling like you're being murdered by a corporation.

but that's an aside...

Until the government decides that actual flesh-and-blood people have some intrinsic value, it aint gonna change.

I don't believe you hated it at all. :)

true, but it's important to be polite about these things. ;)

The difficulty, of course, is that until relatively recently the culture you describe has been a tide raising all boats -- the USA has had a world-leading standard of living for a long time now; even the low end of the scale is above many places in the world. How that went astray is easy enough to see, but how to fix it is not.

Actually, that's not true (IMO). fixing the issue is easy to conceptualize and easy to do, and really we all know the answer. in a nutshell, it comes down to getting politicians, and business people, and advocates on both the liberal and conservative sides to stop acting like spoiled preadolescents (e.g. gloaty and self-centered when they're winning, tantrummy and vindictive when they're losing). Honestly, this is why I usually support the Democrats: they are generally just a bit less snot-nosed than the Republicans. the reason it doesn't happen, of course, is that people see it as a political issue (over which they feel powerless) and not as a parenting issue (over which they'd feel like they had some control). I tell you, if even 2% of the people in this country started to see their representatives in a parental way (i.e., where they feel that their personal and family reputations can be damaged by what their representative does, and feel that it's their responsibility as citizens to school politicians in proper, ethical, civilized behavior), we would have a drastically different political situation in this nation.

Negotiating leverage -- and dereliction of public duty
 

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There is one thing that I simply don’t understand -- and that is the predilection to attack government as "the bad buys", rather than actually trying to govern in a competent and compassionate manner.

Heck, the point has been made that the United States government could have made USD 1,000,000,000,000 (that’s one trillion dollars!) on behalf of taxpayers, by being just a bit more savvy.

As far as I understand it, there wasn’t any attempt by the former or present administration to exploit the situation to the advantage of taxpayers.

The same thing goes with regard to health insurance and health services. When you’re in a position of purchasing quantity (as the government is), then you have negotiating leverage with regard to price. To not use that leverage is dereliction of public duty, and idiocy.

After all: show me the insurance company that doesn’t exploit their own negotiating leverage for all it’s worth! But somehow Uncle Sam is not supposed to be allowed to do so?!?

Give me a break!
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Read the article, already knew most of it. All politics is business and all business is politics in the USA. It has always been this way. I actually had a very smart person tell me they don't want the health care bill to pass and I was hoping for a response that went along the lines of how inept our government was at giving individuals more rights over corporations, but instead I got the whole we are going to become a socialist country bull crap.

Not only are the politicians in this country running around making a mockery of this, our citizens don't even know what is going on.

I think I need to just start my own country. Too bad they don't make land anymore.

Who was that guy from the 80's (I think) who took over an abandoned oil rig in the North Sea and declared it an independent nation? as far as I know, he's still holed up out there. :)

It's called Sealand, owned by a guy named Bates. It was for sale for a mere $975M a couple of years ago. Don't know what happened after that..

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The USA is not even close, and never will be. But I suppose to avoid the risk of "socialism" the logical choice is to abolish MediCare and MediCaid, and privatize Social Security (oops, they’ve been there and tried that).

The way it is now, you would think that the insurance companies’ "death panels" were on the Endangered Species List, and worthy of protective measures.
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If we don't fix this, the U.S. will go bankrupt as healthcare will begin to chew up more and more of our GDP every year and the deficit will continue to grow as a result of this mess.

Once the country is bankrupt, then we'll all be happy:) No more medicare, medicaid, pensions, government healthcare, fixing roads, etc... And we think that this recession is bad. This is the perfect storm for the making of WWIII.

I noticed this in Arctic's post, and I have to vent about how much this argument irritates me. Really... it's just a level of ignorance I can't tolerate. if anyone ever tries it on you again, just remember that they have no idea what socialism is, almost as a fact. They will not be able to define socialism, and they will not be able to say why a particular thing is or isn't socialist. they won't even come close. At best, they have some vague notion about Soviet-style state socialism (which wasn't a socialist state any more than the Republic of Iraq under Hussein was a republic), or maybe something about Roosevelt and the New Deal (which is possibly closer to the truth, but a bit ironic since the New Deal saved our collective butts from a collapse caused by unbridled capitalism), but for most of them 'socialism' is a synonym for 'the Boogie Man', and has no actual intellectual merits beyond the there's-a-scary-thing-hiding-in-the-closet idea.

I've found it's effective (or at least satisfying) to start with a really patronizing line like "Ooo... poor baby is all scared that the baaad socialists are gonna come and take his toys away". That usually infuriates them enough that they actually try to explain themselves (rather than sitting on their unspoken assumptions like smug toads), and once they start trying to explain themselves... well that road just leads to deep embarrassment, because there's just no explanation for the belief.

eh. enough ranting...

Many in the US are seriously afraid of government taking over health care. Before one can support a single payer system or any other government managed program, one must first trust the government to have their best interest at heart.

For starters, what we would likely get in the way of services from a single payer system would be budget sensitive rationing. Revenues down, services down. If you think this isn't real, look at your own state's Medicaid program. My state limits prescription drugs to 3 a month. Hospital stays are limited to 7 days per year. Physician visits 12 a year. When there is a budget shortfall, services get cut.... by state constitution, the state must balance the budget every year... no deficit spending, etc.

That's the state. Now look at what the feds did to Medicare prescription drug coverage.... doughnut holes, etc., etc.

Health care rationing in the US? You betcha. My father was retired Army, served in WWII, Korea, etc. He was NOT eligible for VA health care because, due to a short fall in congressional budgeting, VA health services were means tested..... not just income, but assets, too. He wasn't poor enough.

Would you trust these elected officials to do what's right? If you do, just sit back and watch what they do to health care reform.... and then post back that they have Joe six pack's best interest at heart if you still believe that.

If one is sitting comfortably with what they have, why would they want to risk government messing it up for them?

Asking people to trust govt with health care in a nation where we constantly hear Social Security is bankrupt (Ponzi scheme, money not really in the trust fund), Medicare will fail in the next 5 years, etc., is a big leap. Remember there are more Americans who believe in flying saucers than there are who believe they will ever see a Social Security check.

Personally, I could support a single payer system. But, what they are cooking up now doesn't seem to make any sense at all to me.

well, that last line is the kicker, isn't it. right now I'm out of a job, and having a tough time getting a new one (even in academia things are tough). that means I have no health care, because I lost the coverage from my last post. while I can make ends meet doing this and that for the moment, if I do happen to get seriously ill I am (frankly) going to die. It doesn't matter if it's curable, because I won't be able to afford the cure. the reason I can't afford it, of course, is that the 'free market' medicine rubric we've been using has driven up the costs of medicine and insurance ridiculously - drug and medicinal supply companies pad their prices because they know hospitals will pay for it, hospitals pad their rates because they know insurance companies will pay it, insurance companies raise the costs of their policies because they know that businesses and individuals don't have much of a choice except to pay it, and the wheel goes on. there isn't a damned thing the government could mess up that would make my situation worse.

Now I don't think anyone (except maybe &*#%$@s like Glenn Beck and Sarah Palin) is suggesting that government is going to take your nice comfy health package away from you, and I wouldn't be for any policy that tried to do that anyway. and for the moment I'm in good health, so that's not too much of a worry. But in the event I do get sick and die, I don't really want that to happen because the paranoid delusions of a bunch of brainless right-wing pundits made it impossible for me to get any reasonable health care whatsoever. do you follow me?

TW, I certainly agree the current system is totally broken. It is dysfunctional to an extreme and hugely expensive. I would be happy to support a Canadian, French or English type health care system. I wouldn't oppose basic health insurance reform.... do away with pre-existing conditions, etc. I would do this despite being completely happy with my health insurance situation and with full knowledge a govt program would increase my taxes.

My post was simply to point out a lot of people are not afraid of socialism or socialized medicine.... they're simply afraid govt is going to mess up what they have and leave them in a bind. Glenn Beck and the other talking heads really are irrelevant to 95% of Americans.... most of whom have never heard of Glenn Beck.

My only advice in this difficult time is to make sure you receive your
unemployment first before dipping into your savings. If you get sick, it doesn't have to be a death sentence since the hospital's emergency room by law can't turn anyone away and must treat everyone.

I was unemployed once and we bought insurance on the open market and I swear that it was one of the most difficult things for me to understand. I wasn't trapped by the housing bubble, but I sure was snared by the health insurance bubble and it was when we were most vulnerable.

Good Luck with your search.

@ aehurst:
understood, and apologies for venting a bit. it's been a stressful week. But still, I'm not sure that you can discount the talking heads quite that easily. even people who've never heard of Beck have heard the arguments, and a lot of this distrust of government arises because people like that have spent years spouting a lot of nonsense for purely partisan purposes. I don't think the Fox News crowd really gives a rats a$$ about health care one way or the other, except to the extent that it's been prioritized by the new administration. there's a line between creating a counter-position based on reasoned principles and just being a plain old-fashioned biatch that FN crosses on a daily basis. the whole 'socialist' thing is just the latest slap-in-the-face tactic on an age-old pattern of aggressive idiocy. grumble grumble grumble....

well, that's not exactly an option. I wasn't fired or laid off, per se; I was working on a term-by-term contract which didn't get renewed, so technically speaking I don't meet the requirements for unemployment benefits. think of me as a migrant university worker... :rolleyes: if worst comes to worst, I'll take the CBest and temp at some high school for a bit - god knows between my math skills, my computer skills, and my own discipline I ought to be in demand. but high schoolers... yeeEEEeee...

thanks for the good thoughts, though.

Term-by-term contracts are becoming increasingly common in all walks of life -- not a good trend. About a decade ago, my youngest worked term-by-term for the government of British Columbia; no unemployment coverage, no pension plan, no other benefits. Currently, my eldest works the same way for a major drug company. In a perverse way, it's one of the downsides of legislation that makes it increasingly difficult to fire anyone for cause; companies and governments (particularly governments) hire increasing numbers of their employees as consultants/advisors/temporary workers, etc. There are fewer and fewer permanent career path jobs out there. Unfortunately, when times get tough, all those folks like tw get laid off without any severance or UI coverage.

I want to add to your statement. I know of someone who has worked under contract for years in the IT field doing client side Java j2EE and he seems to be able to stay employed contract after contract. I once stated, "It must be tough working under a contract all the time and switching jobs?" His reply was that, "It no tougher than working for an employer since you are under contract too." He further stated, "that we are all under contract."

After thinking about it, I have to agree with him. I've always sign a contract that states that this is a right to work state meaning that I can be let go anytime and I can choose to leave anytime I want. The difference is that my contract comes with benefits while his contract doesn't.

@tw

Not sure I can agree with this one. The rich (Fox News crowd) oppose health care reform, universal coverage, etc., because they know full well that a big part of the cost is going to fall on their shoulders by way of higher taxes on the wealthy. The bill passed by congress is paid for, in part, by a surtax on high earners. It is always about money, with the other crap being just fodder for the public to lock on to. Any and all govt programs are bad ju-ju to this crowd..... they call social programs "feeding the beast" and view it as a bottomless pit for govt to throw their money into..... and the need will always be endless.

Don't worry about no health insurance causing your death.... as Ron pointed out the emergency room will always treat you. Walmart & Walgreens will both fill any generic prescription for $5 or less.

Having been down the road you are worrying about now, I took it upon myself to learn all that I could about how this system works. So, in the unlikely event you end up facing one of those catastrophic health care situations let me suggest some ideas to you:

1. Check out catastrophic coverage. It is a whole lot cheaper than the generic employer based plan you are used to, and it will effectively protect you from losing everything to the hospitals. Coverage is usually limited to a dollar amount, say $500k to a $1 mil. and you'll pay the first $3-5k out of pocket. Who cares about the cap, you're just filling a short term need and you'll be paying that first $3-5k or more out of pocket anyway.

2. Medicaid in many states will pay medical bills for a class of eligibles called "medically needy." This would cover expenses for those who, for example, have $100k in medical bills and only $20k in assets. They will require you to spend your assets first, but they don't count your home or your first car. Point being..... it is better to be broke with your bills paid and your house and car safe than broke, owing $100k and about to be forced into a bankruptcy hearing. (Of course, "medically needy" is about getting hospitals paid and is usually initiated by the teaching hospitals as a way of subsidizing their operation by the state covering costs for their uninsured patients.) Don't go borrow big bucks for hospital bills without first checking this out in your state.

3. I successfully negotiated with a hospital to reduce their bill by 50%.... they weren't too tough about it because basically I ended up paying more than they would have received if I had full insurance coverage. And, if they turned the account over to a collection agency to collect, the collection agency would get 50 percent, too. So best for them to just say okay and accept the 50 % now and avoid all the hassle to get the same 50%... maybe.

It is a crying shame Americans have to put up with this crap while the rest of the developed world has free or near free health care (free as in pre-paid with your taxes).

Apologies for the long post.

Very good points and definitely something for all of us to think about that may encounter a layoff prior to a healthcare bill being signed.

I had the same experience as you with negotiated a 50% reduction in pay during my layoff sometime ago. I was completely surprised when they happily stated that they would take half the fee. I didn't quite understand why they would so happily accept 50% without a fuss. My conclusion was that at 50%, they are still making a substantial profit on the service. Your argument makes it clear that they still made more money during the negotiations than they would have made if I were fully insured. But it still shows how these hospitals inflate their prices to cover for losses in other areas of their operation.

A while back, I knew a guy who worked as a radiation lab tech (yeah, the people that make you lie on the table and zap you with high energy particles are not doctors - you don't even need a master's degree for that, just a junior college certificate). the radiologist (the actual doctor, who came in on thursdays) asked him to order some cardiac needles for the lab. so, the guy calls down to the supply area and asks for cardiac needles - turns out they're a box of 6 for $24. but the supply people tell him that he can't order from them, he has to order through central dispatch. so he calls over to central dispatch and discovers that cardiac needles are now $26 dollars apiece. so, why there was a 600% markup for carrying the box of needles down the hall and unpacking them?

It boggles the mind...

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To my great shame, the hospital at my alma mater has done precisely that. UC Davis Hospital made national headlines after sending the family of a student a bill for more than $ 29,000 for five minutes in the emergency room. To top it off, that was after the patient died. :(

But you don’t!

All that is required is Election Finance Reform. In most countries, the American model of financing elections is called corruption.
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What those people don't realize is that even if they're happy with what they have now, they're very likely NOT insured. They only think they are because they see health insurance mentioned on their pay stubs.

As for Glenn Beck and other Fox News talking heads, the problem is that too many Americans have not only heard of them, but they listen to them!

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It seems to me that one of the best ways to ensure meaningful Health Care Reform, is to require all senators and congressmen to be covered by the measures of the new bill. :cool:
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I keep coming back to this, and it strikes me that the big problem is that most Americans aren't smart enough to see that it isn't a matter of trusting the government or not. It's a matter of who do you trust more? Do you trust for profit corporation in a very mature market, where the best way to increase profits is to reduce benefits to the insured and eliminate those who get sick, or a government bureaucrat who has no financial incentive? Sure the government may not be as efficient, but when business efficiency is aimed at destroying your wealth, and with it your health, is that what we want?

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As far as I understand it, MediCare is one of the most efficient operations out there – public or private. Am I wrong?

And lo and behold, the bureaucrats are using their negotiating power – just like private insurance companies are.
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No, you're not wrong. I was just ceding the often expressed idea that business is more efficient than government. The point being that even if it is, that doesn't mean that it's good for society. Personally, I see just as much waste in business as in government. Maybe more.

Actually, I think Medicaid may be more efficient.... well less costly any way. My state pays 75% of the Medicare reimbursement rate on most items. All Medicaid claims are submitted electronically and automatically approved/disapproved with a check/auto-deposit or denial all untouched by human hands (course, they also do audits from time to time). And, they charge providers $5 per claim for the honor of being able to bill them electronically.

Clearly, though, government does it better and cheaper than private business. Unfortunately, Medicare and Medicaid also reimburse less than the private insurance companies resulting in providers sometimes declining to serve a Medicaid/Medicare client.

if you ask me, the real problem in both cases is the organization's attitude towards people in general. Private corporations regard people pretty much the same way that farmers regard cows (i.e. as things that have value as individuals precisely to the extent that they can be milked), while government bureaucracies tend to peg your average citizens as somewhere between helpless idiots and a mindless irritants (e.g., as things that get in the way of the smooth functioning of the bureaucracy, which is all a bureaucrat really cares about). you might get better service with a private corp for the general run of small inexpensive stuff, but at least you can be sure that the gov bureaucrat isn't wondering whether you'd satisfy the bottom line better as hamburger patties.

If you're trying to say nobody gives a rat's a$$ about you and me, I think you nailed it.

He's saying more than that, and so am I. The government employee doesn't give a rats a$$ about you, meaning that there's no skin off his/her nose if you're covered or not. They just want their little fiefdom to function properly so they can get their next raise. The corporate employee on the other hand, can't get his/her next raise or bonus unless they find a way to deny your coverage for any expensive illnesses. That's what makes the whole "death panel" objection to a public option so absurd: it's private insurance that has death panels!

Ditto to that! As the saying goes, "unless I can feel your pain, I don't feel ya"

This makes sense!
 

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Like most posters here, I have not read either the Senate or House Health Care Bill – and I’m not sure I could decipher it if I did.

On the other hand, Ronald Brownstein has written an excellent and optimistic analysis of what is actually on the drawing board. And I do take that as good news!

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I haven't read it either, but my method of judging how good it will be is to pay attention to insurance industry lobbying against it. The more they scream and lie, the better it will be. They're doing a fair amount of both right now, so I'm feeling a little optimistic.

Americans bleeding and dying for an unviable system
 

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Two things are for sure:

• American health care costs as a percentage of the GDP must come down. There is no viable reason why the USA should use 16% of its GDP (and increasing!), compared to the UK’s 8.4%.
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• No "civilized" country can continue to accept a situation where 18,000 people die every year (recently revised to 44,000 in a Yale University study), because

a) patients lack funds/insurance to pay for life-saving medical procedures or
b) the "death panel" at their insurance company refuses/delays coverage.

That’s a "health care" system more lethal that the Irag and Afghanistan wars together!

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One more thing that is for sure:

• Somebody's making a lot of money off of that 16%, and they're spending some of that money to keep it going.

As for a "civilized" country allowing people to die, corporations (and they do run the country) routinely allow people to die if it means profits for them. We only occasionally hear about some companies getting caught doing it.

My daughter was in an auto accident her senior year of high school and sustained a brain injury. She is quadriplegic, non-verbal, legally blind, tube fed, etc., etc..... globally disabled. She can move her right thumb and eyes and pretty much nothing else. Her accident was 25 years ago. She lives at home with us. She left for school that morning a talented and gifted student. An hour later she was mentally retarded.

I can tell several thousand stories (literally) about just how really, really screwed up our system is. Of all the criteria used by insurance companies and the medical professionals, doing the right thing is just not one of them. Cost effective is the only criteria for treatment..... that translates to when the insurance runs out, you are out of treatment. I learned two things early on that I will pass along for others who might someday find themselves in a similar situation.

1. If you don't have a family willing to fight for you, you are dead.

2. Lawyers are cheaper than doctors.

My major complaint about the proposed health care reforms is they retain too much of what is wrong with the current one!

Here's another one I just don't understand. Why in the world would we want to add a tax on people just because they have an expensive health insurance policy? If we can't have great insurance, you shouldn't either. Huh?

http://news.yahoo.com/s/ap/20091210/..._care_overhaul

Anybody know what a Cadillac plan is ? What do they get the rest of us don't? Surgeons who wash their hands first? Cute nurses or something?

The reason you want a tax on a Cadillac plan is that as the rich get richer and the middle class gets poorer, you end up with cheap plans that don't cover very much or very well for most people and more expensive plans that offer good coverage for the wealthy. There are only two possible solutions for this:

• Heavily regulate the industry.
  
• Tax the Cadillac plan to make it more expensive and less profitable to divide the market this way while subsidizing government expenses incurred from underinsured and uninsured middle class people who end up in emergency rooms for basic care.

Well, the Democrats are getting closer to passing a bill and I for one am happy they are getting close. Some coverage is better than no coverage at all. But on the other hand, what isn't covered is what will be exploited by the industry. They will turn this into something that should be desired. This is why there should be some other source for getting what you need outside of private health insurance.

I think the conservatives have a lot to fear from this kind of thinking. Obama promised up front that if you like what you have you can keep it.... but of course we're going to tax the daylights out of it until your employer cancels that great policy and, maybe, dumps you into a public plan that is far inferior (because it will be underfunded).

If you like your Medicare, you can keep it, but we're going to suck $400 BILLION out of this already underfunded, projected bankrupt, program to pay for reforms elsewhere.

I'm all for reforming the system, but gosh I wish MY party would have a little more integrity in the matter. Of course taxes are going to go up and so will the deficit unless we find a way to raise more in taxes than we spend on health care. Of course many are going to lose coverage if a public plan is included.... employers will indeed dump their more expensive coverage when a taxpayer funded option is out there.... they did with Medicare, right? Of course cutting Medicare by $400B will have a detrimental effect on that program.

A little common sense from the Democrats, PLEASE.

The Senate bill seems the most likely one to pass. Guess what... that bill allows for annual and lifetime caps on medical care if the insurer wants to do that, and I think some of them just might because they already do.

http://www.comcast.net/articles/news...nate.Loophole/

No annual or lifetime caps in the House bill, but no support in the Senate for passage, either.

Pardon me for a momentary rant, but I really get sick of this kind of reasoning. If I were to put this argument in full context, what it says it something like:

"It is acceptable to commit the American people to practically any level of expenditure so long as that expenditure focuses on the welfare of large corporations or the destruction of foreign nationals, but not where that expenditure might aide a less wealthy US citizen."

It is a selfish, short-sighted and pugnacious attitude, one that screams "this is what's mine, and I'm going to f@ck up anyone that tries to scr%w with it". The damned conservatives have spent so long pushing the fear button (something like 20 years now that they've been doing it in earnest) that a large section of the US population has no response to political issues except panicked, clingy possessiveness or paranoid belligerence. It's disgusting.

So let's be clear: if we had not committed ourselves to taxing citizens for trillions of dollars to wage two more-or-less pointless wars against relatively impoverished middle eastern nations, and had not committed ourselves to taxing citizens for a trillion or two more to bail out corporations whose greedy, overly-aggressive business practices caused a world-wide economic collapse, then we might (might!) have the moral high ground to say we cannot justify taxing citizens a few hundred billions to ensure everyone has basic health care. But we did do the first and we did do the second, and so all I can say to the latter argument is: Suck it up! If y'all want to get petty, get petty over hurting people, not over helping them.

Frankly, it might be a good thing if people did lose their nice, cushy health care plans. The fear of losing it blinds people; the shock of losing it might open their eyes.

And yeah, I know someone's going to complain that this is a thread about health care not about the wars or the economic collapse, but frankly that's bull. This is a thread about money - what we should and shouldn't tax, and how we should or shouldn't distribute the taxes - and put in that context the whole issue stinks of bourgeois self-righteousness (e.g. someone who'll regularly drop a hundred bucks to buy his friends liquor but won't give twenty to a bum because the bum might spend it badly). I don't think that the poorest segment of the population should be asked to make sacrifices (with their health) because of the drunken excesses of hawk politicians and greedy CEOs, and I question the moral standards of anyone who makes that argument.

Ugh. Excuse me while I wander off to mutter some more...

Nice rant, TW. I just wish you'd go ahead and say what you really think.

I'm calling for a little honesty from the liberals because that is my party. That's all. Both the House and Senate versions of health care leave gaping holes in the system and run up the costs by leaving the insurance companies in charge of health care. Are we too stupid to see what we're doing?

As I've posted before, I would fully support a Canadian, British, French type system or any other single payer system, but that is not on the table. Of course the rich are going to have to pay more than the poor for such a system.

(For the record, I am on Medicare. I have no Cadillac policy. I am not rich, but I don't hate those who are.)

yeah, it sucks being inhibited...

I'm sorry, but I'm tired of watching the 'fiscal conservative' arguments get used solely and exclusively on social welfare policy. I have no problem with fiscal conservatism, but being a fiscal conservative doesn't mean you cut back on fresh vegetables so you can buy gas for your Hummer. Reign in the war expenditures, cut back on corporate entitlements, and worry about health care provider problems when the amount of money involved is no longer comparatively trivial. I say make the most expansive, pro-social health care package possible, pass it, and get back to worrying about serious economic issues. all of this hooforah over health care is just a petty distraction.

Sometimes it sucks being a capitalist on this forum, too. (Capitalist = anyone who doesn't blame all the world's ills on corporations.:))

Far too many people are thinking if we can get something passed, we can make it better over time. Wrong. The insurance companies (like AARP) and other special interests will just slowly shove us back into our place.

The solutions to our health care problems really are extremely simple if just fixing the problems is what we want to achieve. Simply let anybody who wants to buy into a Medicare policy at the average patient cost to Medicare. Let anybody who wants to buy into their state Medicaid program with a premium based on family income. No life time caps, no pre-existing conditions, no cancellations for illness, etc., in either of those programs.

With the Medicaid buy in you instantly get access to health care coverage for anybody who wants it through a system that is HUGELY more efficient than the private insurance programs. Sure, taxpayers would have to chip in for the Medicaid option; I'm willing to do that. Not exactly single payer or socialized medicine, but everybody would have an option they could afford.... and the unions can keep what they have, too.

What's being proposed, however, is to continue the existing system where you pay through the nose for health insurance only to find yourself bankrupt if you ever have a health crisis. We've got an open artery and they are throwing us band aids.

We're jumping through all these hoops on health care reform just to make sure insurance companies stay in business and stay profitable. That's what my party is proposing, and I don't understand why they (we) want to protect insurance companies because we all know they don't provide any health care, right?

You misunderstand me. I'm not anti-capitalist, and I think your suggestion has merits (though I wonder a bit what would happen to those people who can't 'buy into' anything, for one reason or another), and I don't blame all of the world's ills on corporations. My point is that I'm sick to death of people 'nickel-n-dime'-ing prosocial efforts while they support shoveling gobs of money down the gullet of the military and industries. if you want to say things like:
well then you'd better damned well point out that we sucked 700+ billion out of the system as a gift to stupidly run corporations (that's just out of pocket at one shot, and to no real economic effect by most measures), and we sucked several trillions out of the system to pay for wars that did absolutely nothing to increase our domestic and international security.

I'm tired of dealing with this health care issue as though it lived in its own little fishbowl. maybe if we can expand the discussion to its proper perspective some of our representatives would be embarrassed enough to do the right thing (doubtful, though - they're not too prone to embarrassment).

Conservatives, or those who call themselves conservative, fear anything that brings about meaningful change. It's why they're not to be trusted.
Don't you mean chicken-hawk politicians?
Hah!
Why should anyone blame the people who run things when things go wrong?

I'm kind of puzzled about the phrase, "that if you like your health care you can keep it." Well, I like my health care which is provided through the company I work for but will it be possible for the company to usurp my benefits with something I would rather not have? If so, then this phrase has little meaning, particularly if companies get to decide whether you keep it or not.

On another note, I may not be able to afford it in the long run since the premiums have increased about 7-10% a year ever since I been at the company. Sounds like what people are saying here is that health care reform will do nothing to keep my premiums from rising faster than my salary.

Well, as TW used to say.... so much to say, so little internet.

I'd be happy to shut down every corporation in the world first thing Monday morning if somebody could tell me what we would replace them with that would provide the same function. Only one entity out there big enough to take that on and that is the government. Anyone for turning Apple, Inc. over to Uncle Sam? Thought so.

Of course, TW, you are right about it being about money and how it is distributed. There is one reason only that reform will not involve a Medicare or Medicaid buy-in as the solution. Both programs reimburse at rates below the private insurance companies.... you'd lose the support of the American Medical Association, all health care providers, insurance companies, and on and on. It's the right thing to do, but it can't, politically, be done. Too many people fear they would lose their cash cow.

@TW
Point taken. Of course we can afford national health care as well the band aids that are being offered. We lack the will to make the change even though absolutely nobody, including the evil forked tongue conservatives, will say what we have now is the best we can do.

Clinton tried and failed. My gut says Obama will fail, too, to pass anything that comes close to what we need. It is going to take a voter revolt to move this off dead center.

I am neither a Murrican nor a lawyer (but I repeat myself....); would someone who is both like to comment on the chances of getting the insurance companies indicted under RICO?

I'm not a lawyer, but I believe RICO implies a conspiracy to commit a criminal act (it's used, for instance, to convict mob bosses who order criminal activities but don't directly participate in them). What we really have here is not conspiracy to commit a criminal act of that nature, but rather something closer to anti-trust violations (laws against efforts by organizations to dominate and artificially shape commercial markets). unfortunately, anti-trust laws are geared towards industrial organizations, where trust violations involve the control and manipulation of easily trackable material resources. financial markets are too much smoke-and-mirrors for anti trust laws to find any purchase.

Insurance companies are exempted from antitrust laws. Better to try RICO. The criminal act here is that they are committing fraud by pretending to sell insurance and instead merely collecting premiums.

I'm wondering if the same will be true if the the health care reform bill is passed. Maybe, it won't be the insurance companies but the employers themselves that will usurp your benefits.

It will be true for the insurance companies if there is no public option because they'll have no competition. They clearly don't compete amongst themselves, except to get the healthiest clients and drop the most sick ones.

As for employers, that's another matter altogether. Corporations shipping $50,000/year US jobs to the Chinese at $5,000/year aren't going to be concerned over health costs until they can't continue to ship those jobs.

It's not just the insurance companies, you need to look at the providers, too.

Consider the way insurance companies set their reimbursement rates. They take a survey by asking various providers what they charge for different services and then take an average. From there, they negotiate with the providers to provide the service at a discount and that is what they pay for the service. (different methodology for things like durable medical equipment, supplies, etc.)

And that is why an office call is $100, but the insurance companies only pay $50 for a visit. Providers are smart people and they know how to play this game. When the next survey comes around, of course the standard fee is going to be outrageous because they know they are only going to collect half that fee. It's a shell game where everybody makes out fine except the poor sap who doesn't have insurance.... he gets to pay double.

Sure it's a shell game, but look at who's running it: The insurance company runs the survey, then tries to force fees to below the average! They can do that by getting some of those just above average to drop to the average rate, thus lowering the average for the next year, putting pressure on everyone. If the providers don't play the game then that hundred dollar fee drops to 90, then 80, 70, 60,... at some point it drops below cost and the provider is out of business.

I'm not saying there isn't waste on the provider end, just that the biggest source of problems by far is from the insurers. You only have to look at who's making the most money to see that. Hospitals are struggling, doctors are getting out, and insurance companies are making huge profits while patients are going bankrupt.

It seems I am not the only one who thinks we're getting sold a bill of goods....

http://news.yahoo.com/s/ap/20091216/..._overhaul_dean

Howard Dean agrees.

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Well, given that the selling of influence is truly a bipartisan practice, and that lobbyists exert massive power on both sides of the aisle, it is difficult to imagine how substantive Health Reform can be achieved.

There is no way Medicare or Medicaid would be implemented today!

In more advanced democracies the election financing system practiced in the USA would probably well result in corruption charges... ;)
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It certainly would in Canada.

Yes, but it is not election finance, you see, contributions are a form of free speech. Makes absolutely no sense to me either.

Also, it was Obama who raised so much money he opted to not use public election financing and all the rules that go along with that. No public involvement, no rules.

But all is not lost. If the Senate can pass anything, then we are in a situation where the House has already passed a bill and the two bills go to a committee to resolve the differences. House bill is much stronger, so I would assume the resulting bill coming out of joint committee might possibly be better than the Senate version.

Still think we are going to get taken to the cleaners. BTW... the taxes to support this starts next year despite the fact that nobody can actually access any of the health care provisions for another 3-4 years (should something actually get passed).

Now the insurance companies seem happy with what is coming. You should be afraid. Be very afraid. You'll probably be required to buy health insurance or pay a fine and they'll be able to charge whatever they like, with no competition to drive down prices.

Yup. I'm a little confused, though, why the insurance companies oppose a public plan. If we had a public plan, they would have a place to dump all the people with a health problem and continue to cherry pick the rest. Guess they decided competition was the greater long term risk or something?

Maybe a mandatory requirement to buy from them will be more profitable in the long run since they will be free to pass the costs of serving everybody on to, well, everybody. A "no lose, guaranteed profit" proposition will make them more money than the cherry picking did I guess.

Pardon a Canadian's viewpoint.
 

I'm thinking that Howard Dean (an MD) has got it right; kill the Senate Bill -- it doesn't represent a change at all. Think about it: Big Pharma gets its way; no Canadian drug imports to compete, no negotiating lower prices. Big Insurance gets its way too; no public single-payer option, no expansion of Medicare to younger uninsured, mandatory purchasing from the big players.

Health is going along with the the financial industries in my view: no real action on derivatives, loopholes for foreign currency swaps so that most derivative trading won't even be reported. Taxing obscene bonuses: ain't gonna happen. Regulating credit default swaps: no way. Lots of help for the big guys, none for the poor slob whose mortgage is underwater or for the worker without a job.

How about climate change? Ridiculously weak house bill and upcoming senate version will amount to nothing when they're consolidated. The big polluters win.

How about indefinite detentions and unconstitutional invasions of privacy initiated by the past administration? I don't see any changes there, either.

The current administration talks a great talk, but doesn't seem to be walking the walk at all.

For many years, I just voted against the incumbent regardless of party.... if they hadn't fixed anything, why give them another term to not fix anything again.

We need a voter revolt. Throw them all out and bring in some people willing to solve some problems..... and EVERYBODY knows US health care is a problem. Not fixing it or making progress toward fixing it is just unacceptable to me.

Yep, I'm in agreement with Howard Dean on this one. They allowed Joe Lieberman to basically gut any real competition the public would have against the insurance companies. It odd, because the new proposal seems to be more of what the republics wants but they still want support it.

We have to find a way to get these lobbyist out of politics otherwise they are going to seriously and irreversibly wreck this country.

It's not just that they cherry pick the healthy. They make huge profits by dumping the sick, and if people continue to see them finding ways to drop clients and deny claims from those who get sick then very few will choose them over a public plan. Don't think that just because a health "reform" bill might pass they intend to stop abandoning sick people.

I don't see why your conspiracy to commit criminal acts should not apply to mail fraud, which is what it is when you sell insurance and then deny indemnity. CWT gets it, though he missed that RICO was my original suggestion. Why are you guys discussing things with these mobsters? Make with the SWAT teams and have the top executives shot while resisting arrest. Then you sit down and create a public plan. :D

The lobbyists are paying the legislators, and the legislators are paying each other to get the Senate bill though. It would seem it is now common practice for politicians to vote for something only if they get a pay off.... as in something special for their state, which of course will help with reelection.

Now days I guess they just call that "compromise." Personally, I call it theft.

http://news.yahoo.com/s/cq/20091221/...olitics3271696

Yep, but this sort of things has been going on in congress for a long time. The compromise part of this is standard procedure in the Senate. Senators, after all, are there to represent their states. They are essentially making these agreements to the detriment of the federal government. I believe that the federal government and state government can enter agreements with one another as spelled out in the constitution.

Really? I thought I agreed with you in post #63!

It looked to me as if you were replying to #62 alone and hadn't read my prior, but apologies if I'm wrong.

I'd read it. Personally, I don't care what they get these guys on: RICO, mail fraud, truth in advertising, etc. The Feds got the notorious murderer/gangster/bootlegger Al Capone on tax evasion charges, and that's fine with me. The important thing is that they locked him up for the rest of his life, just as they should most bank and insurance company CEOs and their board of directors.

"None of the above"
 

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I once heard a wonderful proposal for election reform, and it’s simple:

Below any list of candidates there shall be a box labelled "none of the above". If "none of the above" wins a majority, then new elections shall be held -- with a proviso that none of the rejected candidates be allowed to participate. :cool:

I think this proposal was voiced by that delightful old grouch on Sixty Minutes. :D
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Ahh, CWT; the real problem is that the bank and insurance company CEOs have not broken any laws to get us in this trouble. We need new laws in that regard, but we aren't going to get them from this congress (or from President Obama, for that matter). They're all in bed with those folks.

Last I knew, fraud was against the law.

Well.... it is almost done. Senate bill passed and the House has previously passed a bill. Given a comfortable majority in the House and Senate, this may be a done deal with only the details to follow. Senate passed with 60 votes which, if they can hold them, makes the final vote filibuster proof. Now for a joint committee to hash out the details.


http://news.yahoo.com/s/ap/us_health_care_overhaul

I am surprised, frankly. Not the health care reform we wanted, but at least a tiny step in the right direction. Something to build on, maybe?

I think that exactly how we should look at it. It's a first step and something to build on. With something this complicated, it's amazing that the bill even got this far. Recall, the 7 other presidents have tried before in the past and all have miserably failed.

So it's a small victory in the sense that it sets the tone for more regulations to follows.

While the puzzle palace in DC ponders govt health insurance for all, main street is taking hits. Some 3 million lose health care in California due to budget shortfalls and cuts to Medicaid.

http://www.sfgate.com/cgi-bin/articl...BAGS1BF2R5.DTL

Nothing in the Senate or House bill will prevent this from happening again in the future... or continuing to happen in the present. Yet another example of the huge holes in the so called reform.

Now that the Democrats have lost their filibuster proof majority in the Senate, all bets are off on health care reform. Given the Democratic candidate in a "safe" traditionally Democratic state got whipped badly because of an angry electorate, I suspect a lot of Democrats coming up for re-election are going to reconsider their positions on a lot of issues.... like health care, the national debt, and stimulus spending.

Some insiders are saying the House Democrats might just simply approve the Senate health care bill so it won't have to go back to the Senate for another vote.... others are saying that would be political suicide.

Best guess is health care reform gets watered down even more and even that will have trouble passing with the opposition screaming "we can't afford it."

That isn't the really bad news. The Supreme court just ruled that a Corporation (which isn't even a US citizen) can spend whatever it likes to influence the government.

I kind of think that was the intent all along. the traditional role of the senate is to drag their heels to prevent 'noxious populist factions' from getting laws passed through momentary popular movements. that was supposed to be a check that defended the rights of the population from frenetic minorities, but it seems to have been co-opted by industry for their own benefit. I'll be willing to bet that the only thing the final health care bill mandates is that all Americans will be required to purchase health insurance (another sinecure for the insurance industry); there won't be anything that mandates improvements of control over the medical or insurance industries themselves.

Watching from a distance, it seems that the current administration has pandered to industry on every front. I haven't been able to decide whether that's because Congress and the Senate are entirely in the thrall of business interests all around, or because that's what the administration wants. Massachusetts made it clear that it isn't what ordinary folks want.

Kinda tough to figure out exactly what the voters of Massachusetts were trying to say. For sure, they are angry like the rest of us. But, is it health care or the deficit, or still being at war? Some are saying, with a little credibility I think, it is the entire liberal agenda that is being slam dunked. Time to move back to the center a little?

Since there was not an incumbent in this race, you gotta think this was a strong message to the Democrats.

Probably just the economy....no job makes people a little testy.

What the Republicans call the "center right" is still extremely far to the right.

I think this is more a message on the failure's of the educational system. People are once again voting against their self interests because they easily buy Big Lies like death panels.

I think too that (as Newsweek put it), the Democrats, finally in power with a Senate majority instead operated as a "circular firing squad". They've been shooting themselves in the foot with their own internecine bickering while the Republicans (no matter what you think of their position on these things) have at least been monolithic.

That was a biggie and will be a huge boost to Republican fund raising efforts as well as attach ads..... all in time for the November elections.

I think that the Democrats should have forced things through when they had the power. The Republicans certainly would, and did. As for the Republicans being monolithic, that's not a good thing either. They seem to be willing to do or say anything as long as they win, without caring if it harms the country. Health care is a good example. They've been more concerned with handing the President a loss than with doing anything that might benefit the country.

Rome was once Democracy, then it became an Empire. The next empire will be run by the greediest of CEOs.

I'm ordinary folks, and the election didn't turn out the way I hoped. (Not that the health care bill is quite what I hoped for, either.) And 51.9 v 47.1 is hardly the "trouncing" it has been called. I know that in our town the high turnout was partly a result of by a ballot initiative to reverse a (very) slight local meals tax, a response to decreased state aid, meant to raise money especially during tourist season. It was a hot button issue before Ted Kennedy died.

I mostly kept my mouth shut, but I did find myself saying things like, "No, Martha Coakley did not say anything about Brown's daughters, what actually happened was..." and, in a more snarky mood, "If tax cuts are the only way to control government spending, maybe a pay cut help will help you gain control of your personal debt."

The fickle electorate wants a miracle worker, and will quickly turn on anybody who isn't, never learning that there is no such thing.

Too true.

One can hope...