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Author Topic: Are you a 1-Percenter?  (Read 4389 times)
jonzr
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« on: Jul 26, 2009 at 11:57 »

Didn't think so.  Write your congressman and tell him you want your universal health care, now.

http://informationclearinghouse.info/article23134.htm

You do deserve health care, don't ya?  I mean, all the health care we're already paying for w/out the morass of insurance company bureaucracy, etc. as the gate keeper?

This shouldn't be a bipartisan issue.  We're Americans, we should have the best, right?  Well, we don't.  We pay the most, yes?  But we're lagging well behind most of the developed world in health care.  That should not stand.

Write your senator.
Write your representative.
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vinman3
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« Reply #1 on: Jul 26, 2009 at 14:40 »

Yeah, cause the government does such a good job of administering other programs. And it is not just the top 1%, Obama has said himself, that the increase would be those making $250K or more (not me). That is NOT rich, sorry. Reform, yes. Government mandated and controlled health care. Absolutely not. Sorry Jonzr, have to disagree with your position here. I am sure I am the minority though Smiley
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jonzr
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« Reply #2 on: Jul 26, 2009 at 15:08 »

The status quo ain't cutting it though.  We need something different.  I know "government mandate" sounds bad, but if the government insists that you have health care, are you gonna argue?  My point is, we're paying for it already.  May as well have the money go towards the care than the pockets of the insurance fat cats and lobbyists and dirty politicians and pill-pushing-kickback-taking doctors, etc.

And what's wrong with asking the top 1% to carry their share of the load?  They've had their taxes slashed in recent years anyways. 

I can understand though vinman if you're one of those people hauling in a household income of $280K.  I'm sure you're already quite comfortable!  And those hauling in $280M probably don't worry about health care either. 

But for everyone else, the system stinks.  I've always had insurance either through my wife's job or mine.  Last year I spent 3 days in the hospital with an IV in my arm.  The bill was $15K and I had to pay my $1.5K portion of that.  WTF is that?  Yeah, 10% ain't bad.  But $15K for 3 days in the hospital?  Are you kidding me?  There were no expensive test with the machine that goes "ping" or anything, just an IV for the first 48 hrs + the antibiotics that were dripping.  Sorry, that's not 5 grand a day's worth of health care.  The system stinks.

Status quo ain't cutting it.  Write your congressman for your neighbor's sake if not yours.
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« Reply #3 on: Jul 27, 2009 at 08:35 »

"The nine most terrifying words in the English language are, 'I'm from the government and I'm here to help."
Ronald Reagan


Reform Yes, control no.
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jonzr
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« Reply #4 on: Jul 27, 2009 at 08:45 »

"Be thankful we're not getting all the government we're paying for."

- Will Rogers

I hear ya.  Still, the health care problem won't fix itself.  People have to let their senators and reps know that they'll be out of office if they don't bow to the will of The People rather than the will of The Dollar.

Of course, that would require us to actually vote them out of office.

And, of course, that'll never happen if we keep letting ourselves get distracted and divided by such silliness as partisan politicking.
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« Reply #5 on: Jul 27, 2009 at 14:35 »

I'm gonna have to disagree with you across the board on this one jonzr.  Any government involvement will only make it worse.  Medicare for everyone isn't going to work - we simply can't pay for it, no matter how much we squeeze the top 1% (by the way, they earn 18% of the income and currently pay 27% of the taxes while using fewer resources, so they're already pulling their weight).  And all countries with goverment funded care have major issues, no matter how the media portray how great it is.  Long waits for basic care, for example.

You want to limit drug company profits - two major issues with that.  First, they're a private business.  Is it fair to tell them what they can charge?  Not really a monopoly, since there are usually several competing products.  (BTW, government reguations make it a real problem for companies to reduce prices of drugs once they're set.  Basically, they'd have to pay back the difference to Medicare for previous prescriptions sold).

Second, if you limit profits, you also limit research on new drugs.  Those antibiotics you got in the hospital?  Without research it would have been pennicillin.  And probably the bacteria would have said "don't bring that weak s(tuff) in here!"

Pill-pushing-kickback-taking doctors?  Not even going to go there - wait, yeah I am. There are professions that make more money with less hassle and less on the line.  YOu want the best and brightest going into medicine?  Or do you want the guy working the night shift at Seven Eleven standing at your bedside with you or your family member's life hanging on his decision?  You want the smartest people willing to deal with all that goes into the job, don't begrudge them making a good living.

One big help would be tort reform.  Significantly reduce liability, eliminate frivolous lawsuits, and two big cost savings occur.  Small one is that malpractice insurance goes down, decreasing cost of doing business.  Major cost savings is a significant reduction in extra tests being ordered/procedures performed because physicians won't feel like they have to protect themselves as much.

Biggest problem is the huge number of people, legal or not, that don't contribute yet utilize resources.  That doesn't change with government funding, since they don't pay taxes.

One issue to resolve, though one that may be unappetizing - everyone should have access to care, but should everyone get the same level of care?  Free clinics, hospitals with no bells and whistles, good medicines but not top of the line - is that reasonable for people without other options? 
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jonzr
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« Reply #6 on: Jul 27, 2009 at 15:47 »

I'm gonna have to disagree with you across the board on this one jonzr.  Any government involvement will only make it worse.  Medicare for everyone isn't going to work - we simply can't pay for it, no matter how much we squeeze the top 1% (by the way, they earn 18% of the income and currently pay 27% of the taxes while using fewer resources, so they're already pulling their weight).  And all countries with goverment funded care have major issues, no matter how the media portray how great it is.  Long waits for basic care, for example.
I just don't buy those numbers.  But if the 1% line is bothersome, make it .1%, whatever.  The rich have other sources of income that are taxed differently whether from investments or whatever.  So, a CEO who draws a $1 salary but pockets $250M in bonuses is paying the same proportion of taxes as me with my little sub $100K salary?  I highly doubt that.  If his accountant is worth his salt, he ain't paying anywhere near the my %.

I'm sure we already pour enough money into the system that it could be repaired to function properly w/out collecting more taxes.  But I'd still want to collect a fair share from those that aren't paying theirs.


You want to limit drug company profits - two major issues with that.  First, they're a private business.  Is it fair to tell them what they can charge?  Not really a monopoly, since there are usually several competing products.  (BTW, government reguations make it a real problem for companies to reduce prices of drugs once they're set.  Basically, they'd have to pay back the difference to Medicare for previous prescriptions sold).


Second, if you limit profits, you also limit research on new drugs.  Those antibiotics you got in the hospital?  Without research it would have been pennicillin.  And probably the bacteria would have said "don't bring that weak s(tuff) in here!"
I didn't say anything about limiting drug company profits.  I'm talking about reform of our health care system.  Drug companies are part of that, sure. 

Pill-pushing-kickback-taking doctors?  Not even going to go there - wait, yeah I am. There are professions that make more money with less hassle and less on the line.  YOu want the best and brightest going into medicine?  Or do you want the guy working the night shift at Seven Eleven standing at your bedside with you or your family member's life hanging on his decision?  You want the smartest people willing to deal with all that goes into the job, don't begrudge them making a good living.

If you weren't one of those then don't take offense.  But it's a simple fact that some medical doctors do accept kickbacks to push certain drugs on their patients.  This is part of the problem.

One big help would be tort reform.  Significantly reduce liability, eliminate frivolous lawsuits, and two big cost savings occur.  Small one is that malpractice insurance goes down, decreasing cost of doing business.  Major cost savings is a significant reduction in extra tests being ordered/procedures performed because physicians won't feel like they have to protect themselves as much.
True, but that will only be part of the solution.  The entire system needs to be torched and rebuilt from the ground up.

Biggest problem is the huge number of people, legal or not, that don't contribute yet utilize resources.  That doesn't change with government funding, since they don't pay taxes.

One issue to resolve, though one that may be unappetizing - everyone should have access to care, but should everyone get the same level of care?  Free clinics, hospitals with no bells and whistles, good medicines but not top of the line - is that reasonable for people without other options? 
I don't know, certainly don't have all the answers.  There will always be another level of care that people can purchase if they have the money.

Don't get me wrong here though.  I'm not all for "let's turn it over to the government" but at some point we need them to represent us and help establish a system that works for everyone, that provides care and in the case of a serious condition, doesn't bankrupt a family. 

Think of the troops and the children and our great nation. </palinism>
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« Reply #7 on: Jul 27, 2009 at 16:40 »

Quote
If you weren't one of those then don't take offense.  But it's a simple fact that some medical doctors do accept kickbacks to push certain drugs on their patients.  This is part of the problem.

I don't take any offense, but I think that problem is an exceedingly small percentage that doesn't significantly impact the bottom line.

Quote
I didn't say anything about limiting drug company profits.

My mistake, misread it.  Insurance is a big issue I admit.  However, more control governmnet has, more money for fat-cat politicians to "reappropriate."

Even many Democrats say reform won't happen without more money/increasing deficit.  If more revenue is needed, I tend to favor what I call "optional" taxes.  Two examples:  raise cigarette tax - let those who smoke pay more for increased costs due to smoking related illnesses.  Don't want to pay - quit smoking and your health care costs will likely go down also.  Second, if you want more taxes from wealthiest group, is a luxury tax.  Add 5% to cost of vehicles over 50K, boats, high end TVs, etc.  If you don't want to pay, don't buy the item.

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« Reply #8 on: Jul 27, 2009 at 16:52 »

Kinda surprised as I thought jonzr was a libertarian.  Though I'm not sure how they view this.

I manage two medical practices and a department of medicine at a local hospital.  I probably won't wade in deep to this discussion, as I realize the pain caused by high prices and seemingly scarce care.

You mentioned the $15K bill.  Was the $15K the charge or payment?  My experience with patients and my own family healthcare bills is that the hospital charges a certain amount, the insurance company pays about 36% of the bill and the patient is responsible for any applicable co-pay or deductible (also in v. out-network).  

Not projecting this to jonzr's comments but M'care is a terrible model for a national plan.  M'care denies so much coverage that private companies don't.  M'care is usually a year+ behind covering medications and procedures that the private insurers pay for.  My guess is that to make a national plan work, and to really save $$$, the plan would drastically reduce what is covered while increasing denials (which mean the payment falls on the patient, if the medical office has the patient sign an Advanced Beneficiary Notice per M'care guidelines).  

To msdmnr's comments about the best and brightest, I actually read an article recently that there is a push to dumb down the requirements to get into med. school.  The idea is to bring in students from rural areas that have difficulties attracting and retaining PCPs.  I guess it's better than no doc but it certainly creates two health care systems.  

And that lends itself to msdmnr's point of various levels of care.  I guess kind of like car insurance plans.  Whatever the state minimum is and then tiers above that (ie, silver, gold and platinum package).  Patients w/ low tiered care still go into debt or are placed on a long waiting list for treatment in free clinics.  

I don't know if msdmnr faces this already but insurances, M'care, M'caid and private, are moving to a quality-based payor system.  PQRI is already available from M'care and Carefirst has some similar program out.  Ideally, for example, wrong-site surgeries and infectious disease #s go down on the inpt. units.  Very great end benefits.  What likely will occur as well is denied days in the hospital increase as the ins. companies use quality indices to minimize the days they have to pay.  Hospitals will push to get these non-paying patients out of the hospital ASAP.

Healthcare is an uncomfortable topic, as we expect everyone who gets sick to have the opportunity to get better.  

I put a lot of responsibilities on the patient for preventative care.  Many of the patients seen in my practices do not use insurance-covered or free education programs re: their conditions. So many patients are non-compliant with medications and life-style changes.  They don't enjoy eating differently, exercising, etc., but come back every few months with abnormal lab values and general unhappiness with their condition.  

More than I wanted to say.  I live in the DC corridor, which is thick with pro-national healthcare talk.  Some valid reasons on that side of the aisle to move things in a different direction.  Problem is, the way to reduce cost is to cut the # of available physicians, NPs, PAs, etc., reduce medications and procedures covered, and run the country further in to debt or having an already burdened middle class take on more and more taxes to pay for the new system.

Okay, I dove in instead of wading in.  Not a very academic or thougthful discussion on my part.  Just a view from the other side.
« Last Edit: Jul 27, 2009 at 16:55 by SCacalaki » Logged

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« Reply #9 on: Jul 27, 2009 at 17:07 »

I like the idea of single payer: take out the conflict of interest between profiteering and health decisions.  Public financing, private delivery.  We talk about how inefficient Medicare is, but over 30% of our healthcare dollar goes to paperwork, admin costs, bottom line profits and CEO wallets.  I just don't buy that we can't streamline the paperwork and bureaucracy -- Obama's ideas on getting us into the 20th century of information exchange ring true here -- and do better than 70% efficiency.  

In fact, we're spending two, three times what other Western nations are for healthcare.  For every person who says Canadian, French, Brit, etc. healthcare involves long waits and substandard care, there are plenty of others who say that's nonsense.  IMO, it's moot: we already HAVE the healthcare providers in place AND we're spending the money.  What we're not getting is ROI in terms of life expectancy (and other metrics) for health dollar spent.  We should be able to maintain (or improve) care, not increase per capita spend, and expand coverage for what we pay right now.  

My big disappointment is that Obama has removed SP from the discussion entirely.  We wouldn't want to disrupt the for-profit healthcare providers, after all: that's our bottom line, isn't it?  

All the arguments against government ANYTHING fall flat for me, too.  Believe me, I've seen government inefficiency firsthand, but there are successes as well.  I'll take the US Army over Blackwater any day, and we do just fine with socialized notions as firefighters and police forces.  There are certainly arguments against using Medicare as the model for a SP system, and I agree that we can reduce costs looking at tort reform, and getting provider input for a SP model.  But I don't think SP is coming any time soon.

http://www.pnhp.org/

I think I'm in over my head with posters here who know more about this subject than I do, but this is one area where I think free market absolutely fails the needs of consumers.
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