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5 years ago  ::  Aug 30, 2009 - 10:13PM #21
dblad
Posts: 1,703

What absolutely kills me is how people TRUST government to be all and end all.


There are three core questions, that need an answer.


1. Cost. Any extension of benefits will be enormously expensive. Hopes for savings, where government is concerned, are spinners' daydreams. (Check recent history, any program.) In all universal health coverage schemes, governments subsidize, taxpayers pay the freight. Who is to pay this added cost? Do we jiggle the books as with Medicare, borrow more, adding to the deficit, or tax the guy behind the tree who's too slow or stupid to dodge? I see few people eager to pay for somebody else's coverage... call it what name you will.


2. Benefits. Who reaps, who sweats it out? Every country with cradle-to-grave coverage dilutes or rations care. All restrict many kinds of coverage, especially for the aged; they don't kill grandma' but she won't get the transplant.


3. Management. Who runs the program, doctors, patients, or bureaucrats? Government can't manage now... why trust it with greater responsibility?


Answers these questions in cement... and we might have a pleasant discourse.


 

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5 years ago  ::  Aug 30, 2009 - 11:11PM #22
Summer813
Posts: 325

Aug 30, 2009 -- 10:13PM, dblad wrote:


What absolutely kills me is how people TRUST government to be all and end all.



This isn't about trusting government vs not trusting government. But again, government is a tool. Do you normally distrust your tools?


There are three core questions, that need an answer.


1. Cost. Any extension of benefits will be enormously expensive.



You're going to have to define what you mean by "extension of benefits" before we can really discuss this part. In whatever scenario you are envisioning, who or what is doing the extending? What are the benefits? To whom are they extended?


Hopes for savings, where government is concerned, are spinners' daydreams. (Check recent history, any program.)



Again, BS. The government has more bargaining power than insurance companies - IF it uses this power properly, it WILL save money over what insurance companies pay, for the same treatment. Medicare pays less for the same procedure than any insurance company does, for example. And Medicare doesn't have to turn a profit for shareholders or CEO compensation.


In all universal health coverage schemes, governments subsidize, taxpayers pay the freight.



So what? Taxes are the price of admission for living in a civilized, orderly, safe and functional  society. Government subsidizes education as well - think public schools, or Pell grants for college attendance both public and private - would you prefer to live in a society where no one is guaranteed an education, where 45 million people receive NO education, and where millions of families go bankrupt every year attempting to obtain an education for their children?


Who is to pay this added cost?



Thus far, we have not even seen that there will BE an added cost, and the evidence points to there actually being a LOWER cost.


I see few people eager to pay for somebody else's coverage... call it what name you will.



1. I'm willing to pay for universal health coverage for my fellow Americans, because I know that it will benefit me as well as others. Not having my friends and neighbors - or even complete strangers - die or live horribly constrained lives due to treatable conditions is something that I cannot even put a price ON. I'm sorry to hear that you feel differently.


2. We are - all of us - already paying the price of other people's health care. Don't believe me? If you have health insurance, and the amount you pay in premiums over the course of, say, a year, is less than the amount you get back in health care, then you are paying a part of the cost of treatment of those other people insured by your insurer who  DO wind up using more dollars worth of care than the cost of their own premiums. Likewise, the reason medical procedures and hospital stays are costing more and more is because the cost of treating those who have neither insurance coverage nor wealth gets passed on in the form of higher price tags. Somebody winds up paying the bill, after all, and that somebody is EVERYONE who actually does pay their medical bills. Now, the alternative would be providing care only to those who can afford to pay up-front, requiring even the guy who shows up unconscious and in cardiac arrest to present cash or a credit card before the ER staff saves his life (and if he doesn't have the means to pay, they just let him die). Would you find that preferable?


Benefits. Who reaps, who sweats it out? Every country with cradle-to-grave coverage dilutes or rations care.



None of them "dilute" it, and the USA already rations it. That is to say, we allow it to be rationed on the basis of profitability, by insurance companies. We also ration it on the basis of the patient's - or their family's - ability to pay. Do you honestly think that is good, or moral, or desirable?


All restrict many kinds of coverage, especially for the aged; they don't kill grandma' but she won't get the transplant.



False, and false. In the USA, your 90 year old granny won't get a transplant either, because transplant organs are in limited supply and they are given to those most likely to both survive the surgery AND benefit from the transplant. On the other hand, in Canada or the UK (just to use two examples) the 45 year old recently laid-off father of three who needs a heart transplant won't be denied one because he can't afford to pay hundreds of thousands of dollars to get one. Guess what would happen to him in the USA under our current system?


Management. Who runs the program, doctors, patients, or bureaucrats? Government can't manage now... why trust it with greater responsibility?



I have to break this one into two separate issues. First off, the plan currently being considered does NOTHING to change who manages actual medical care: your friendly insurance company claims department manager, following the guidelines handed down by the company's board of directors, which usually boils down to a directive to minimize cost while maximizing profit. (The actual results for the patient are often only a secondary consideration.) The bill currently before Congress would simply place restrictions upon the ability of insurance companies to deny coverage, resulting in the return of more control over care to the actual doctor and patient.


Now, if we switched to a single-payer system like what Canada has (and note that the aforementioned bill does NOT include this), then DOCTORS and PATIENTS would be in charge of actual care, and the government system (in Canada's case, each province runs their own system) merely pays the bills (like insurance more or less used to do in the USA).


Seems we in the USA already have enough "bureaucrats" meddling with people's medical care. Ours aren't government employees, though. Instead, they work for the likes of Blue Cross, etc.


Note: I have worked in the healthcare industry, including in a claims department. I know how the system [mal]functions.


 

Shared pain is lessened, shared joy increased. Thus do we refute entropy. - Mike Callahan, Callahan's Crosstime Saloon
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5 years ago  ::  Aug 30, 2009 - 11:25PM #23
Summer813
Posts: 325

Also of note: the current bill also aims to prevent health insurance premiums from continuing their current meteoric rise, which if left unchecked will likely price health insurance out of reach of the majority of Americans within the next decade. Any increase in your taxes (and you won't see an increase at all if you are in the middle class - the increase is supposed to be a very small percentage and applies only to the top income brackets) will be offset by the increase you WON'T have occurring in your health insurance premiums.


So at the end of the day, you will have no less money in your pocket overall, and quite possibly you will have more, while at the same time knowing that the people around you have better access to medical care and therefore are healthier and more likely to be able to be productive... which is good for the economy.

Shared pain is lessened, shared joy increased. Thus do we refute entropy. - Mike Callahan, Callahan's Crosstime Saloon
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5 years ago  ::  Aug 31, 2009 - 8:09AM #24
dblad
Posts: 1,703

Elements of HR 3200


According to a July 24 Free Republic.com posting, the bill:


-- rations health care;


-- lets a government committee and Health Choices Commissioner decide what treatments and benefits are allowed;


-- provides a National ID Healthcard to all US residents;


-- gives the government access "all individual bank accounts for electronic funds transfer;" also to all financial and personal records;


-- lets the government set physician wages;


-- taxes individuals with inadequate coverage 2.5% of income;


-- cuts Medicaid payments;


-- has doctors of all specialties get comparable compensation; and


-- lets the government decide end-of-life treatments.


 

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5 years ago  ::  Aug 31, 2009 - 10:48AM #25
TPaine
Posts: 9,380

Aug 31, 2009 -- 8:09AM, dblad wrote:


Elements of HR 3200


According to a July 24 Free Republic.com posting, the bill:


-- rations health care;


-- lets a government committee and Health Choices Commissioner decide what treatments and benefits are allowed;


-- provides a National ID Healthcard to all US residents;


-- gives the government access "all individual bank accounts for electronic funds transfer;" also to all financial and personal records;


-- lets the government set physician wages;


-- taxes individuals with inadequate coverage 2.5% of income;


-- cuts Medicaid payments;


-- has doctors of all specialties get comparable compensation; and


-- lets the government decide end-of-life treatments.



The problem is that factcheck.org has investigated that information, and out of the 48 assertions made in that "report" 26 are false, 18 are misleading (only partially or half true) and only 4 are true. That's not a great record.


www.factcheck.org/2009/08/twenty-six-lie...


 



"The genius of the Constitution rests not in any static meaning it might have had in a world that is dead and gone, but in the adaptability of its great principles to cope with current problems and current needs." -- Justice William Brennan: Speech to the Text and Teaching Symposium at Georgetown University (October 12, 1985)
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5 years ago  ::  Aug 31, 2009 - 11:35AM #26
dblad
Posts: 1,703

Not everyone agrees with factcheck or snops or truthorfiction or etc.  


WILL THE PLAN RATION MEDICAL CARE?


This is what the bill says, pages 284-288, SEC. 1151. REDUCING POTENTIALLY PREVENTABLE HOSPITAL READMISSIONS:


'(ii) EXCLUSION OF CERTAIN READMISSIONS.-For purposes of clause (i), with respect to a hospital, excess readmissions shall not include readmissions for an applicable condition for which there are fewer than a minimum number (as determined by the Secretary) of discharges for such applicable condition for the applicable period and such hospital.


The government has the power to determine what constitutes an "applicable [medical] condition."
The government has the power to determine who is allowed readmission into a hospital.
This determination will be made by statistics: when enough people have been discharged for the same condition, an individual may be readmitted.
This is government rationing, pure, simple, and straight up.
There can be no judicial review of decisions made here. The Secretary is above the courts.
The plan also allows the government to prohibit hospitals from expanding without federal permission: page 317-318.


Will the plan punish Americans who try to opt out?


What the bill says, pages 167-168, section 401, TAX ON INDIVIDUALS WITHOUT ACCEPTABLE HEALTH CARE COVERAGE:


''(a) TAX IMPOSED.-In the case of any individual who does not meet the requirements of subsection (d) at any time during the taxable year, there is hereby imposed a tax equal to 2.5 percent of the excess of-


(1) the taxpayer's modified adjusted gross income for the taxable year, over
(2) the amount of gross income specified in section 6012(a)(1) with respect to the taxpayer. . . ."


This section amends the Internal Revenue Code.
Anyone caught without acceptable coverage and not in the government plan will pay a special tax.
The IRS will be a major enforcement mechanism for the plan


What constitutes "acceptable" coverage?


Here is what the bill says, pages 26-30, SEC. 122, ESSENTIAL BENEFITS PACKAGE DEFINED:


(a) IN GENERAL.-In this division, the term ''essential benefits package'' means health benefits coverage, consistent with standards adopted under section 124 to ensure the provision of quality health care and financial security . . .


(b) MINIMUM SERVICES TO BE COVERED.-The items and services described in this subsection are the following:


(1) Hospitalization.
(2) Outpatient hospital and outpatient clinic services . . .
(3) Professional services of physicians and other health professionals.
(4) Such services, equipment, and supplies incident to the services of a physician's or a health professional's delivery of care . . .
(5) Prescription drugs.
(6) Rehabilitative and habilitative services.
(7) Mental health and substance use disorder services.
(8) Preventive services . . .
(9) Maternity care.
(10) Well baby and well child care . . .


Have you tried to read the bill? It is almost impossible to get through all the leaglese.


 

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5 years ago  ::  Aug 31, 2009 - 11:51AM #27
amcolph
Posts: 17,697

Aug 31, 2009 -- 11:35AM, dblad wrote:


WILL THE PLAN RATION MEDICAL CARE?



Medical care is already rationed--it's just a question of who gets to do it.


You're a conservative, so naturally you think that rich Christian white guys would do it best job of it.


Will the plan punish Americans who try to opt out?



Yes, just like automobile insurance--and for the same reasons.


Have you tried to read the bill? It is almost impossible to get through all the leaglese.


 




It has to be weasel-worded to get anything useful past those lobbyists the health care industry is paying a million three a day to to keep anything useful from happening

This post contains no advertisements or solicitations.
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5 years ago  ::  Aug 31, 2009 - 12:11PM #28
TPaine
Posts: 9,380

You're right. Not everyone agrees with factcheck. In fact, here are some groups that agree with you on this issue.


Christian Coalition
www.cc.org/actionalert/stop_health_care_...

The Family Research Council
www.frc.org/

The World Net Daily
www.wnd.com/

The American Family Association
www.wnd.com/

Liberty Council
www.lc.org/index.cfm?PID=19516


I've found that when I disagree with the Christian Reich fascists it turns out to be the correct way to go. I have read HR3200. There are things in it I like as well as things I dislike. I also realize that any bill that makes it through both houses of Congress and the Conference Committee and reaches the President's desk will not have whole lot in common with HR3200.


Something has to be done to curb the greed and power of the health insurance companies:


    Company                           2007 Profits in $millions    
1    UnitedHealth Group        $4,159.00     
2    Wellpoint                        $3,095.00                   
3    Aetna                              $1,702.00     
4    Humana                             $487.00     
5    Cigna                              $1,155.00         
6    Health Net                         $329.00     
7    Coventry Health Care        $560.00     
8    WellCare Health Plans       $139.00     
9    Amerigroup                        $107.00     
10    Centene                           ($44.00)    
11    Medical Mutual of Ohio     $100.00     
12    Molina Healthcare              $46.00     
13    Sierra Health Services      $140.00     
    Average Profit                       921.15

Forbes April 30, 2007 issue
money.cnn.com/magazines/fortune/fortune5...

"The genius of the Constitution rests not in any static meaning it might have had in a world that is dead and gone, but in the adaptability of its great principles to cope with current problems and current needs." -- Justice William Brennan: Speech to the Text and Teaching Symposium at Georgetown University (October 12, 1985)
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5 years ago  ::  Aug 31, 2009 - 12:46PM #29
dblad
Posts: 1,703

I'm a middle-of-the-roader... and I do value my FREEDOM. I will continue to try and wade through the hype concerning this issue.


Thank you for your input. The RR may agree with me on this issue, doesn't mean I agree with them on other issues... What they seem to object to mostly in this bill is the preceived/real abortion thing.


What I disagree with mostly is the loss of freedom.


 


 


 

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5 years ago  ::  Aug 31, 2009 - 4:46PM #30
Summer813
Posts: 325

dblad:

Your first mistake is using a partisan source like Freerepublic, which has a known record of falsifying and deliberately misreading things in order to promote disinformation and a partisan agenda. If you want an honest discussion, you will need to go to honest sources. Factcheck and Snopes ARE honest, nonpartisan, agenda-free sources. The fact that they do not tell you what the Freepers want you to believe does nothing to change this.

FACT: Right now, your insurance company rations your medical care, excluding hospital admissions for certain conditions, and certain treatments for various conditions. HR3200 does nothing worse in that regard than what your insurance provider already does. Therefore, HR3200 contains nothing that will restrict or remove any freedom you already have, except possibly the "freedom" to starve in the street with your family after losing everything you own because you had no health insurance and you or a dependent received treatment for a life-threatening illness or injury that you could not afford to pay for out of pocket. Hmmm... doesn't look like much of an infringement of rights to me. But the folks at Freerepublic would like you to think it is, because they view virtually anything other than sheer primordial dog-eat-dog barbarism as inimical to their concept of "freedom"... and their concept of freedom has very little in common with what most of the modern, civilized First World regards as freedom.


So don't let the Freepers fool you. They really don't have your best interests at heart.

Also, you don't appear to have done a very careful reading of the clause you stated. Let's look at it again, shall we? For those following along at home, here is the full text of HR3200. Let's work with what the bill ACTUALLy says, instead of what the Freepers would like us to believe it says, shall we?


‘(C) EXCESS READMISSION RATIO

      ‘(i) IN GENERAL- Subject to clauses (ii) and (iii), the term ‘excess readmissions ratio’ means, with respect to an applicable condition for a hospital for an applicable period, the ratio (but not less than 1.0) of--

            ‘(I) the risk adjusted readmissions based on actual readmissions, as determined consistent with a readmission measure methodology that has been endorsed under paragraph (5)(A)(ii)(I), for an applicable hospital for such condition with respect to the applicable period; to

            ‘(II) the risk adjusted expected readmissions (as determined consistent with such a methodology) for such hospital for such condition with respect to such applicable period.


      ‘(ii) EXCLUSION OF CERTAIN READMISSIONS- For purposes of clause (i), with respect to a hospital, excess readmissions shall not include readmissions for an applicable condition for which there are fewer than a minimum number (as determined by the Secretary) of discharges for such applicable condition for the applicable period and such hospital.

(Bold emphasis is mine, added to denote the portion originally quoted by dblad in Post #26. - Summer813)



Clause (ii) is nothing more than a clarification of material contained in Clause (i), which I note you did NOT quote. Taking something out of context is a well-known tactic when one is attempting to spin something so that it appears to say something that it really does not say at all. Now let's look at what Clause (ii) REALLY means: it is fairly clear from the header of this portion of the text ("REDUCING POTENTIALLY PREVENTABLE HOSPITAL READMISSIONS") that this section concerns itself with keeping people from being readmitted to the hospital over and over again if not medically appropriate, or if the condition that results in hospitalization can be either prevented or treated in a manner that does not require hospitalization. This is nothing different from what goes on under our current system - try reading the fine print of your health insurance summary of benefits sometime, if you don't believe me. However, note that the sole purpose of Clause (ii) is to clarify what does or does not constitute an "excess readmission". Under Clause (ii), if you go into the hospital to be treated for Condition X, are discharged following treatment, then later relapse and are admitted again (this is what a "readmission" is) for further treatment for the same condition, it is not counted against the hospital unless you exceed a particular number of readmissions - OF THE SAME INDIVIDUAL - for that condition... and a "normally expected" number of readmissions for any particular condition is something that can be calculated by analyzing how that condition is treated. Again, this is something that ALREADY OCCURS in our current system. Your health insurance, if you bother to read the documents given to you by the insurer, retains the right to deny a claim for payment if certain conditions are not met or are exceeded, including how many times you are hospitalized for the treatment of any given condition.

Now, here is what the above text from HR3200 does not say, or mean, or imply:

Aug 31, 2009 -- 11:35AM, dblad wrote:

The government has the power to determine what constitutes an "applicable [medical] condition."
The government has the power to determine who is allowed readmission into a hospital.
This determination will be made by statistics: when enough people have been discharged for the same condition, an individual may be readmitted.



HR3200 says NONE of these things, and that third one is especially silly. Thank you for giving a classic example of reading entirely too much into a piece of text and fleshing it out with wild fantasies. This is what Freepers are famous for.

Now, let me know when you want to discuss the reality of our current health care system and what HR3200 actually means in terms of reforming it. In the meantime, we now return you to the original topic of this thread; namely, whether or not it is right to bring religious precepts into debates over legislation when such precepts would require action to benefit even those who are not adherents of the religion in question, or whether it is okay to do so only when such precepts would require non-adherents to abide by the mores of a religion they do not share - or whether religious argument has any place in such debates at all.

Shared pain is lessened, shared joy increased. Thus do we refute entropy. - Mike Callahan, Callahan's Crosstime Saloon
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