Government Provided Breast Cancer

This story broke a couple days ago............. (0.00 / 0)

and the very first thing I thought was "here we go" - once your health care is in the hands of the federal government they will start changing all the rules about what medical exams you need and don't need.  In order to cut costs they will say that cancer screening is not necessary until you are older - not younger.

This is the death squad that people were talking about.  No coverage for < 50 cancer exams.  So folks that are poor will not get the exams and when they finally get to be 50 and are allowed to get the test - it may be too late.

You watch - once national healthscare is in place the feds will determine what we can eat and when we get to see a doctor.  

It's health scare - not health care.....

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by: Vote3rdpartynow @ Wed Nov 18, 2009 at 10:02:29 AM CST

So I get it. You don't like the idea of having government-run health care. (4.00 / 1)

Why don't you sit back and relax, let congress pass their public option bill, and than just decided to DECLINE the public OPTION and keep the health care you already have, since it sounds like it's working out pretty well for you?

Key word here, as you can probably tell from my Caps Lock, is option. NO ONE has to switch to government health care. It's entirely possible (though absurdly unlikely) that NOT A SINGLE PERSON could decide to take up the government's offer for public health insurance. Because wether or not you sign up for it is up to you!

So here's an idea. Why don't you take it easy, enjoy the wonderful healthcare that you've earned as a fringe benefit of whatever you do for work, and stop fussing at the government for trying to make the health care YOU ALREADY HAVE available to those, like many of my friends who have had to leave college for financial reasons in this recession, who currently have NONE.

It's a win-win! You get to keep the awesome, free-market healthcare that already works for you and your family, and my friends who currently can't even see a doctor of they get sick get some limited access to the healthcare they need.

sound fair to you?

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by: davesoko @ Wed Nov 18, 2009 at 14:39:36 PM CST

[ Parent ]

Here is where I challenge you................ (0.00 / 0)

Private companies offer all kinds of health insurance options.  There are basic plans, buy up plans and Cadillac plans.  Each an option for people of different income levels.  Under the new national program I am allowed to keep my existing plan, BUT my existing plan must be made to conform to the new federal mandates.  Guess what?  That means my health insurance just got a lot more expensive because the federal government requires all kinds of higher thresholds - including coverage for pre-existing conditions.  And more companies will be required to offer health insurance to employees than before, which means those smaller companies must now chose between health benefits and employees.

If you think that the federal government can pass legislation affecting one sixth of the entire US economy without it affecting me then you need to spend more time on RMG.  Everything the federal government does affects me, and you as well.  I think its rather silly that you assume the federal government can implement a 1 to 2 trillion dollar program (possibly higher) and it won't affect me.

The net result of this national health insurance program will be higher taxes (affects me), more expensive health insurance (affects me), less access to Doctors (affects me) and increased national debt (affects me).

I assume (perhaps incorrectly) that you are a college student as you mentioned your college student friends.  I hope you realize the spending that Barack Obama is doing right now will prevent anyone college age or less from ever owning a home.  The cost of the national debt will be realized through higher interest rates and a weaker dollar, both of which shall push the realization of home ownership out of the hands of huge numbers of graduating college students.  The average American owes $39,000 each for the national debt.  That means my family of 5 owes almost $200,000 toward the national debt. That is paid for by higher interest rates and a weaker dollar.  That means fewer jobs, higher taxes, and a far greater likelihood of poverty for millions of Americans.

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by: Vote3rdpartynow @ Wed Nov 18, 2009 at 15:04:43 PM CST

[ Parent ]

A Response. (0.00 / 0)

I'll organize this in bullet points, if that's okay.

-The Economy.

I happen to agree with you- at least in part. Out of control Federal Deficits, a ballooning national debt and a growing trade deficit all threaten our economic future. Why? Because the burden of the debt will make us less competitive with the rest of the world. You know what else makes us less competitive? An employer-based health care system.

Our employer-based health care system has turned General Motors and Crysler from auto companies who provide health insurance to their workers and retirees into health insurers who struggle, and fail, to sell autos fast enough to pay for the care their insured parties need.

When an automobile is manufactured in Canada, or France, or the UK, or Japan, how much of the revenue from it's sale goes to paying for health care for the line workers who actually made the car? Not much- just a portion of the firm's corporate taxes.

-Healthcare.

I personally believe that the very existence of for-profit health care in this country is an abomination. Health care is an emergency service, like Police protection or Fire protection. Can you imagine if your home was on fire, you called 911 and they asked for your credit card information before sending you help?

A for-profit hospital has every motivation to increase the price of care and decrease the quality of care (and thereby their cost of delivering it) to help the bottom line. A for-profit enterprise is ultimately responsible, at the end of the day, to it's share holders. They are higher than the CEO, the CFO, and the Board.

The idea of meaningful competition in the healthcare field is also laughable. With almost every other industry, if the price is too high, the consumer has every chance to walk away and simply say, "no deal". If I need heart surgery ASAP, and the hospitals in my area are all intent on gouging me for all that I am worth, I don't really have the option to say "no deal", because I'll be dead. In fact, I will probably sell my house, take out loans, borrow money from family or whoever will give it to me, just to pay for the care to save my life. I'll do this even if it literally bankrupts me. And least I'll still be vertical.

This is as opposed to, if my car dies tomorrow, and every dealership in New England tries to gouge me for everything I'm worth on a new car, I can just say "no deal" and bike or take the bus. My life continues, if with a little bit less convenience.

I'm sorry, but the only people in the medical field who should be able to be in the business for profit are plastic and cosmetic surgeons. It's simply wrong to make a killing by pricing health care out of reach for 1/5 of all Americans.  

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by: davesoko @ Wed Nov 18, 2009 at 15:49:01 PM CST

[ Parent ]

It takes skill (0.00 / 0)

to operate on a brain. You want somebody making 40K doing that? I don't.  It takes years and years of privately funded research to develop a drug to treat a rare disease. Do you want that to dry up? I don't.

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by: Rob "EaBo Clipper" Eno @ Wed Nov 18, 2009 at 15:54:08 PM CST

[ Parent ]

BS scare tactic... (0.00 / 0)

...operate on a brain. You want somebody making 40K doing that?

Complete BS and would be laughable if people didn't already think health care reform is like Nazi genocide.  

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by: Festus Garvey @ Wed Nov 18, 2009 at 16:08:47 PM CST

[ Parent ]

agreed. (0.00 / 0)

I sure don't want the brain surgeon who opens me up making $40K/yr.

BUT, where does it say that everyone who works in the nonprofit world can only get paid a pittance? Charlie Baker used to run a non-for profit. He sure seems to be doing okay. Ditto for Alan Khazie. And Paul Levy, from my hometown, who runs the BI Medical Center in Boston- an outstanding nonprofit leader if there ever was one. If I remember right, I think good ol' Charlie was bringing home in the ballpark of 500K, and Mr. Big Citizenship around 300. Doesn't look like any of these guys are pinching pennies.

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by: davesoko @ Wed Nov 18, 2009 at 16:12:18 PM CST

[ Parent ]

Do you really think (0.00 / 0)

I'm sorry, but the only people in the medical field who should be able to be in the business for profit are plastic and cosmetic surgeons. It's simply wrong to make a killing by pricing health care out of reach for 1/5 of all Americans.  

That providers are doing that just to get rich?  Do you really think the entire industry is so profit driven they'd price themselves out of business.....it's a lose model.  Why would anyone do that....make their prices so intentionally high that it reduces their future profits because it was no longer affordable?  Non-sense

Providers, doctors, hospitals, raise their prices because their expenses have increased dramatically.  Everything from insurance to x-ray machines has increased, and they get less and less money from the growing numbers of people on the existing government programs, so they have to stick it to the other people.  Doctors practice defensive medicine, because why risk it?  The system is overutilized in part because people are disconnected from the payment system.

I'm sure there is some component of any field motivated by profit, but just because some appear to be getting rich does mean they are.  How many hospitals do you know that have more than enough money?....must be why I keep getting those letters begging me for money every month.  Don't think the insurance companies are getting rich either....they spending 88 cents of every dollars for treatment, procedures and meds.  They pay their people and keep the lights on with the other 12 cents.

This is the general view that astounds me from many on the left....that because something is unaffordable for some, that others are intentionally depriving them of it out of greed and profit motives.....please.  Everyone loves to find the few fat cats and attribute the system's woes to them, but they never see the other 90% of the workers under them making garbage money.  

Follow me on twitter @garyrlake

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by: garyrlake @ Wed Nov 18, 2009 at 16:44:44 PM CST

[ Parent ]

You know, (0.00 / 0)

Right here in the great ol' US of A, spend more than twice what our neighbors to the North, the Canadians, spend on health care per person covered.

Do you honestly believe that here in America, our medicine is so advanced that it genuinely costs TWICE what Canadian care costs to administer?

No, my friend, someone(s) is making a killing off of this- pun intended.

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by: davesoko @ Wed Nov 18, 2009 at 20:23:14 PM CST

[ Parent ]

Poor rationale (0.00 / 0)

It's a much larger system with many more moving parts, and yes everyone takes their cut along the way. So someone evil must be in there huh?  

You think maybe that a doc doesn't have to pay a couple hundred thousand a year in malpractice insurance might skew those numbers?  What's the last medical breakthrough you heard from Montreal?  How about the last American who hopped a bus to seek superior treatment in Canada?  Last life saving medication? When the goalie needs his jaw rebuilt, guess where he goes?

Canada?  That discussion was done to death months ago....your side lost BTW.

No offense....but inexperience or perhaps youth is clearly showing.  You're going to have to do better than that.  Better try a different pitch...your fastball just ended up on Landsdown street from the number 8 hitter..And Ebo is on deck....and he's Canadian :)


Follow me on twitter @garyrlake

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by: garyrlake @ Thu Nov 19, 2009 at 00:11:42 AM CST

[ Parent ]

Ok, answer me this: (0.00 / 0)

If Canada's health care system is soooo much worse than ours, why can Canadians expect a longer life?

http://geography.about.com/lib...

USA: 77.1 yrs

Canada: 79.4 yrs

Are we seeing a pattern? Look at all those nations with government-run healthcare systems beating us!

UK: 77.7 yrs

Sweden: 79.6 yrs

Switzerland: 79.6 yrs

Japan: 80.7 yrs

Germany: 77.4 yrs

France: 78.8 yrs

I could go on... and on... and on... but you get the point

I happen to know several Americans who have hopped a bus to Canada to get live-saving prescription drugs that they could not afford here in MA.

For what it's worth, I think you're right on about the problem with affordable malpractice insurance. The frivolous lawsuits are out of control. My doctor just has me sign a form waving my right to sue if something goes wrong during a procedure... that seems like a pretty reasonable solution to me.

But seriously though, you seem like you haven't travelled much in the developed world, or been close with anyone whose lived overseas. Most of the industrial democracies that I've visited are not the backwards, third-world hellholes you seem to think they are.

Believe it or not, America is not the only place you can live a good life. Do we have he most opportunity of anywhere in the world? Hell yeah. But that doesn't mean that all across Europe, Canada and Japan, everyone is unemployed and has to wait six months to see a doctor whey get strep throat.

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by: davesoko @ Fri Nov 20, 2009 at 12:07:07 PM CST

[ Parent ]

Because you are not comparing apples to apples (0.00 / 0)

I love it when people pull a single stat out and say "Well this must be better".  The simple fact is Canada is a different world.  It's population is pretty much homogeneous and generally have healthier lifestyles (yes, we're hendonists).  We have a unique situation here.   And a whole different set of variables.

Show me a country that has as diverse population as we do, does the same levels of R&D in terms of cancer (disease in general) and meds and has the same level of red tape in terms of getting procedures and meds approved, and commits the same resources to things like miltary, diplomatic, relief and all of the other BIG things we do and then maybe you can do a one to one comparison of a single stat.

How about you compare cancer survival rates....or even more specific prostate cancer survival rates....we win on that, so we must be better.

Your friends were able to get their meds in Canada cheap because we are the world's test beaker.  We fund the R&D for meds for the rest of the world, and big gov't systems like Canada, Medicare, and many European countries say you can only charge X number of dollars for this med....or don't do business here.  Pharma would rather take the slim profit than none at all....so yeah they screw us....I've been saying that for years.  But I'd really be against the gov't telling a private business what they can charge for a product (unless they are buying it themselves).   It is not the US way....for as much as people complain about it....price controls are a very slippery slope (tempting as it is to me)

I don't think other countries are that backward, and yes, I have done a fair amount of travel.  But to hold up Canada as a model to emulate?  Start with some place good like Germany......but tell me how we going to convince the public that gov't should be subsidizing the education of docs (which many of the European countries do).

The simple fact is many of these countries that do large gov't systems usually have a couple things in common.

1) They do some form a rationing....which make sense in some cases....some do it alot...some barely do it.

2) They don't have anywhere near the expenses we do as a portion of GDP on things like military, diplomatic, intelligence, and direct relief.  If you want to make the case to gut the military and state department to pay for healthcare, have at it.

3) They have excessive taxation at every turn.  Sin taxes, VAT's on everything...voters won't stand for that for long.

4) They usually have pretty homogeneous populations  (you know...nation of immigrants).  I bet if you look at the lifespans of Tibetian monks how long they live with almost no healthcare.  This is a bigger issue than people acknowledge.

Yeah, we have some really big issues in terms of chronic disease management....obesity, diabetes, asthma, autism and now for some reason deadly allergies.  And some of it is lifestyles.  But I'd don't want to live a society where people are not permitted to make their own stupid choices.  I'd rather be encourage people to do the wiser thing....you know the old honey/vinegar adage.

The simple reality is there is a widespread HEALTHY mistrust of government.  It's a good thing....it's how we made it this far....by leaders in history telling us to have a healthy skepitsicm when gov't tells us "TRUST ME".

There is something to be learned from other systems, but there are certain cultural phenomenon that are just never going to change....at least not by an act of government.

Follow me on twitter @garyrlake

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by: garyrlake @ Fri Nov 20, 2009 at 16:52:04 PM CST

[ Parent ]

do you really think that when (0.00 / 0)

Canada is spending about 1/2 per person insured that we are, and getting a (slightly) better outcome for their money, that there is still NOTHING that we can learn from them?

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by: davesoko @ Fri Nov 20, 2009 at 19:53:17 PM CST

[ Parent ]

There is something (0.00 / 0)

We can learn from any large system.  I see a big part of the problem being private insurance that is tied primarily to employers. ...coupled with the whole model of paying for everything as discussed below.  

There's lots of big stuff to address, and I may not have all or even most of the answers, but I know beyond doubt is that what congress is doing is not the answer (or even an answer).  Oh it may solve the lack of insurance for alot of people but it will not solve the accelerating costs.  

Think about it, we have had universal healthcare here for what 3-4 years with a mandate.  Has the cost of any medical procedure, treatment, test, or medication actually gone down?  have costs even leveled off ? Are the emergency rooms less crowded and chaotic?  We have some of the most expensive (we may be #1) costs in the country and the longest wait times, and our costs are rising faster than other areas....but everyone has insurance.  Ours doctors are leaving (my PCP moved because of the rules and is now practicing in TX).  And the expanded medicaid costs to the states will be killer.  This does not benefit MA at all....it can only make matters worse.

What I have seen that Canada does employ is more clinics that treat non emergency cases.  Other countries make much better use of electronic record keeping...but they don't have to deal with as many privacy and security concerns....my previous job was working with electronic medical record systems....it's a nightmare because of the rules that are in place around privacy and info sharing....and the security is a nightmare.

If you could devise a plan that had insurance for the expensive stuff, people paid most or all of the costs of routine stuff, and the government covered the little stuff for people who could not afford it, with very strict rules on malpractice suits, and private insurance could be purchased outside the employer based system and across state lines.....you'd be onto to something.  Make all out of pocket expenses deductible (even on the 1040EZ), and do something to reign in big pharma's ability to strangle hold on the markets through more competition, and make use of electronic records and e-prescribing I'm in.

True story....know the only reason doctors still write out paper scripts....because it is illegal to prescribe any controlled substance without a written prescription....that's about 40% of all meds that can't be e-prescribed.  That is one simple rule change that congress could easily do, but I bet it probably not in the bill.

I would have no problem paying a modest national sales tax, or even a VAT if a decent system could be devised.  The problem I have with most of it is gov't will be setting treatment guidelines because they will have so much money in the game, and it will be in their interests to reduce costs....and that is how rationing starts.  The system has very few "market" mechanisms in place because people aren't spending their money directly.  There are no incentives to stay healthy.  From where I sit, the more gov't gets involved the worse it gets...they are not the sole cause but they are part of the problem(s).

Just think about how many more people are living to an age that makes them eligible to use medicare, and many more are on medicaid.  Those gov't systems control costs by only paying a small portion of the actual bills....know where providers get the rest?  From us.  The providers will cover their costs and make their living...if they have to take more from Peter because Paul paid less, they will.

Follow me on twitter @garyrlake

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by: garyrlake @ Fri Nov 20, 2009 at 22:37:57 PM CST

[ Parent ]

If we want to (0.00 / 0)

compare a specific statistic that is near and dear to my heart.  Let's take my lifespan.

In 2003 I was diagnosed with a rare condition called cushings disease caused by a tumor that grew to the size of a golfball on my pituitary.  It took almost a month to diagnose and would not have been possible without quick access to an MRI.  Not only is cushings rare, the symptoms I presented with were a-typical, so it made it that much more difficult.  I waited exactly 4 days once the MRI was ordered and was diagnosed the day after, had surgery and was cured (not completely, but close to normal) because a skilled surgeon at one of only a handful of hospitals in the country that does the type of surgery I required.
If I had to wait an extra month, two or five for that MRI, which would have been the case in Canada because I did not have cancer, I WOULD BE DEAD TODAY.

So lifespan of garyrlake in US healthcare system is yet to be determined.  In the Canadian Healthcare system 40.2 years.

So we can quote all the general stats about why other systems are so much better, but they mean little to my would have been widow and 2 small children.

Follow me on twitter @garyrlake

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by: garyrlake @ Fri Nov 20, 2009 at 18:30:44 PM CST

[ Parent ]

Davesoko, very good point.............. (0.00 / 0)

and one that I had not thought of.... Health care is much like police and fire protection and should be available as equally as the other two.  I am going to think for a while on that.  Very interesting point and one that I have not heard.  

I guess I might go for that with the exception that the police department and fire departments aren't costing us trillion of dollars.  Obamacare will cost us that much and more......But as I said I am going to let that sink in for a while......

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by: Vote3rdpartynow @ Wed Nov 18, 2009 at 17:47:01 PM CST

[ Parent ]

Fire protection (0.00 / 0)

doesn't include adding additions on to your house or buying new furniture every year.  It is just to put the fire out, whether it's a big mansion or a tenement building.  It also doesn't include yearly visits by the fire inspectors to inspect all the wiring and smoke detectors.

In other words, it's basic.  We could make fire protection cost us trillions of dollars if we wanted to, by demanding free yearly inspections, fresh new furniture every year, new paint every year, new roof, etc.

To lower cost of health care, we have to chuck some expectations of what's covered by health insurance.  The abortion debate is a good place to start.  People should pay for them out of their own pocket, and if they can't afford it, then Planned Parenthood or some other private charity should provide them for free.  Same with organ transplants, hip replacements, fertility treatments, IVF, cosmetic surgery, and other "non-basic" treatments.  And we have to stop paying trillions of dollars to biotech researchers, and pay only the actual cost of drugs that have been developed.  As long as we are supporting a huge fat parasitic industry and giving them whatever they ask for, the cost is going to be as much as we got.  

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by: John Howard @ Wed Nov 18, 2009 at 18:06:36 PM CST

[ Parent ]

An example of a failure to communicate... (0.00 / 0)

...wow, we've corresponded for all these years and I just thought that taking care of people's health was as basic as police and fire services and here you had no concept of that.  We are jsut from different worlds.

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by: Festus Garvey @ Wed Nov 18, 2009 at 19:51:07 PM CST

[ Parent ]

I am willing to listen............... (0.00 / 0)

Ya know, I used to complain that a murderer got government paid legal representation, but the guy he shot wouldn't get government paid medical care.  I always thought that to be an injustice.  But no one on the left side has been saying that until Davesoko said it just now. (Light dawns on Marblehead)  Until now the left has been saying gimme, gimme, gimme.  They called me a hater and a racist and that is part of why I opposed their efforts.

Taking care of people's health is important - as important as fire and police protection.  After all, what good is sending the fire department to my house if the Doctors are going to let me die.

I could be convinced that a national health care system could be good, but it would have to be with a lot of pre-established understandings.  No abortion on demand, no face lifts, no liposuction, no boob jobs, no telling me what I can and cannot eat and that kind of thing.

You gave me a new way of thinking about things tonight Daveosko, so thank you.

Festus, make a note that tonight I learned something......

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by: Vote3rdpartynow @ Wed Nov 18, 2009 at 20:21:10 PM CST

[ Parent ]

V3PN, thank YOU for a lively and enlightening discussion! (0.00 / 0)

I've really enjoyed it, and you've given me much to think about as well.

BTW, I think we are on the same page in the 'no taxpayer $$$ for aborting viable fetuses, face lifts, lipo, new boobs etc'! (with the possible exception of reconstructive plastic surgery to help burn victims and the like).

If somebody wants lipo or new boobs, they should get a second job! :)

-DS

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by: davesoko @ Wed Nov 18, 2009 at 20:30:38 PM CST

[ Parent ]

As Promised I thought about things some more.... (5.00 / 1)

And the difference between the fire/police protection and health insurance is that fire/police are emergency only.  I don't call the fire department to start my barbecue and I don't call the police to lock my doors at night.  But today's generation DOES call the doctor for every little thing that they think is wrong.  That is why it is so expensive!

Its a demand issue - people demand to much health care.  People want pills and medical programs to solve everything from weight gain to hair loss and everything in between.  That falls under the umbrella of health care.  Our system simply can't sustain the amount of health care demanded.  

I would actually vote for an emergency or catastrophic health care system in which the federal government took the liability of catastrophic illness off the plates of health insurance coverage.  Imagine how low our premiums would be if they didn't have to cover cancer, heart surgery or any of the majorly expensive surgery?  If health insurance covered only routine maintenance and ordinary surgery it would be quite affordable.  But when it needs to cover everything it becomes ridiculously expensive.

Can't the federal government cover only the catastrophic illnesses?  Why hasn't the debate about national/single payer/public option health care been at all along the lines of catastrophic health care?  I think that is something the American people could get their arms around.

What say you?

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by: Vote3rdpartynow @ Thu Nov 19, 2009 at 17:28:49 PM CST

[ Parent ]

Again, I think you are right... (0.00 / 0)

(I'm begining to see a pattern here!)

I believe the concern of many of the left (myself included) is the cruel injustice of a family brought to bankruptcy by a catastrophic medical event- a heart attack with bypass surgery to save the life, a car accident with massive injuries and a long hospital stay).

If the feds provided universal insurance for catastrophic medical events (say, something costing over $10,000), premiums would go way down, since these super-expensive medical catastrophes are such a big part of the money they have to pay out to their insured members.

This leaves the issue, though, of chronic healthcare problems. I.e, I take a pill every day, twice a day for acid reflux. It's a condition I was born with, and will almost certainly have until I die. It's a genetic thing, and everyone in my family has it- some worse than others. My Mom's had two surgeries to try to fix the problem (both unsuccessful), so she wouldn't have to keep taking pills for the rest of her life.

Right now, my private insurance covers almost all of the cost of my reflux medication- I only pay about $20 a month for it. But I'm sure that as a result, everyone else's premiums are going up, even if they are healthy, because of my chronic condition. That's not really fair, but I also know that I'd struggle mightily to pay for the pills on my own every month, year after year.

So what's the right solution? The answer is, I'm not sure.

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by: davesoko @ Fri Nov 20, 2009 at 12:48:55 PM CST

[ Parent ]

Becase as usual (0.00 / 0)

The debate is viewed through two different set of specs based on your political view of the world

The Left views it as a crisis because not everyone can afford healthcare insurance, and it's an injustice that some cannot afford something so important as health insurance, so lets find a way to get everyone health insurance (at least most of them).

The right views this a problem of coverage, but from a cost perspective.  The crisis is costs that are spiraling out of control, and that if we find a way to control costs without affecting quality, more would be able to afford insurance and more businesses would provide it.

And as typical the two ideologies have differing views on their solutions.  The left wants to provide a big government program to cover everyone and remove rules that hinder access, but is not addressing costs.

The right wants to remove expensive parts (like lawsuits) and lower the cost through increased competition.  And the small section of uninsured left over (because it will be so affordable) can be absorbed into existing programs.

But neither is a complete solution.  I like the GOP's better, but the basic problem is the consumer has been insulated from the cost, and the system has become overused.  Can you imagine if you had to buy car insurance through your employer? or pay 5-10 ten times it on the open market?  The difference is car insurance is not (as you point out) for the little things.  You maintain your car, put gas in it, change the oil, fix the muffler, and call your insurance company when there is something major wrong.  Can you imagine if car insurance was only allowed to charge the same general price no matter your driving record?  Or if they had to cover fire and theft and were only allowed to charge the same rates whether you lived in NYC or a small village in upstate NY?  Healthcare is about treatment and prevention, insurance is about managing risk and lower exposure to loss.

Follow me on twitter @garyrlake

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by: garyrlake @ Fri Nov 20, 2009 at 19:09:05 PM CST

[ Parent ]

Pre-exisitng conditions and being in your late 40's (0.00 / 0)

V3PN. you and I are of a similar age and we both have had varied work experiences.  And no one can predict their health and both of us could develop a "pre-existing condition" tomorrow...whether it's diabetes, or have a mild heart attack or skin cancer or most anything else.  If we get a new job, or try and start our own gig; we're suddenly stamped with a "pre-existing condition" and no one would insure us.  Imagine that, I've paid for health insurance since I was out of college, and now when I need it, I'm told tough luck.  Is that really a reality you want to face in your 50s?  Do you really want to be taking the chance of being uninsurable if two reasonably possible events occur...1) you develop one of hundreds of pre-existing conditions and you switch jobs/health insurance.

It is complete madness to think that it's "ok" to have a system in which someone pays thousands of dollars each year for 35 years for health insurance, and then at 55 develops high blood pressure and they then can not get insurance for a pre-existing condition?  Is that the America you want to live in?

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by: Festus Garvey @ Wed Nov 18, 2009 at 16:06:15 PM CST

[ Parent ]

No one is disagreeing (0.00 / 0)

And the message is clear and has been.  Yes everyone agrees the system has more than a few inequities in it, and some things that are just plain wrong.  But to think that anything that has been proposed by congress by either the house or the senate is actually going to help the rising costs is just fantasy.  Do we really think because everyone has insurance that prices will go down?  Did that happen in MA now that everyone has it?  Has quality improved?  Outcomes?  Wait Times?  Been to an ER lately?....worse than ever.

Yes, there is a lot to be fixed, but this latest monstrosity from Pelosi and company takes a bad situation is makes it worse, and puts us further in debt in the process.  10 years of revenue for 6 yrs of expenses.  Still did not address medicare payments (that's another $250Bln) and anyone who thinks they can squeeze more than a few pennies out of medicare is being way too optimistic.

Follow me on twitter @garyrlake

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by: garyrlake @ Wed Nov 18, 2009 at 16:21:09 PM CST

[ Parent ]

Sure, the Democratic Health Bill will be... (5.00 / 1)

...mush and it will kinda address that problems, but I'm not optimistic about coming close to the savings and cost reductions we need.  But two things: A) With the Republicans basically being a total obstruction, you can't be patting yourself on the back about this.  Secondly, our problems are big and we need big, radical solutions--like taxing the foods that make us unhealthy and make healthy eating cheaper; or some kind of incentive for exercising--to truly reform "health care".  That will never happen and we're doomed to a downward cycle of unhealthy people being treated, or more like being propped up, for many preventable illnesses like heart disease, diabetes and obesity.  

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by: Festus Garvey @ Wed Nov 18, 2009 at 17:40:39 PM CST

[ Parent ]

Not opposed (0.00 / 0)

The things you propose, but as we have discussed, it's only a small part of the problem.  And I am not patting myself on the back...i just think it makes more sense to do nothing than do the wrong thing and rethink the process on the things that can be agreed on.  I'm not suggesting doing nothing as a solution, but just not supporting 'mush' as a solution either.  Government is generally not good at correcting it's mistakes after the fact, so tread carefully.  we could spend alot of fruitless years trying to put the toothpaste back in tube if this mess passes.

I'd be open to some of the more liberal positions if the liberals were open to some of the more conservative options.  I might go for a public option in exchange for tort reform (not necessarily caps, but something like "loser pays" with stricter evidence rules).  I would advocate for allowing a fat tax if private insurance could charge higher rates for obese people (and the government did too).  You know, give a little, get a little.  You give me allowing those of means being able to purchase high deductible plans with HSA's, and I'll give you the individual mandate with basic healthcare.  Right now it's all one-sided with visions of doctors just working for less and being told to be happy with it.  Even the dean of the Harvard Medical school came out in opposition today.

If the senate gets cloture on their "chicken salad" bill it's a done deal, and it will all be decided behind closed doors, and the big things the President PROMISED would not happen will (public funding for abortions, adding to the deficit, and coverage for illegals).  And the only ones who'll benefit are groups like AARP, pharma, and the big insurance providers.  You and I will have exactly what we have now, and we'll just being paying more for it.  There are no mechanisms to "bend the cost curve" being employed other than wishful thinking.

Follow me on twitter @garyrlake

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by: garyrlake @ Wed Nov 18, 2009 at 18:44:19 PM CST

[ Parent ]

maybe more thoughts later... (0.00 / 0)

...but let me be clear, mush is much better than the status quo...just no where near enough.  In general, ya, I think you and I could bang out a plan that would be much closer to "fixing" things, but we would piss off a lot of people and we'd run into a buzz saw of "NO".

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by: Festus Garvey @ Wed Nov 18, 2009 at 19:46:38 PM CST

[ Parent ]

Yeah I get that (0.00 / 0)

I just tend think mushy solutions make for a more a of mushy mess that's harder to deal with long term.  And yes the status quo is unacceptable.

I've spent literally years in my professional life holding together grand mushy plans implemented by predecessors who did not have a clear understanding of the scope of the problem or how business might change in the future. All they knew was something had to be done right NOW...so they did something.

Mush begets more mush in my experience.  I'd prefer to reset, bite the bullet, get a clear scope of the problem and figure out what are workable solutions now instead hoping a grand mushy plan (or doing nothing) will just work out after I move on to another employer.  

Some poor sap is going to have to live with the results of my work later, or worse attempt to fix a problem I may have overlooked.  I prefer he didn't have to wade through the mush to find the root cause.  I'm not going to let perfection be the enemy of good, but I'm not going to pretend a steaming pile of crap is good either.  I might need a reference some day :)

Follow me on twitter @garyrlake

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by: garyrlake @ Wed Nov 18, 2009 at 22:59:09 PM CST

[ Parent ]

Mush (0.00 / 0)

...but let me be clear, mush is much better than the status quo...just no where near enough.

Had to destroy the village to save it.

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by: gary @ Thu Nov 19, 2009 at 12:49:29 PM CST

[ Parent ]

In Canada (0.00 / 0)

People had to go to court to win the right to purchase private health services.  In other countries it is illegal for doctors to practice outside of the government plan.

I fear that we are headed there as well.

Also.  You obviously don't live in Massachusetts, or your friends are illegal in Massachusetts, because we have universal coverage laws.

And if it wasn't for Mayor Menino those friends could get quality medical care at CVS minute clinics. A very well thought out FREE MARKET solution.  

I don't want to pay for your or your friends purchase of health care.

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by: Rob "EaBo Clipper" Eno @ Wed Nov 18, 2009 at 15:39:19 PM CST

[ Parent ]

Actually, I do live in Massachusetts. (5.00 / 1)

The friends I mentioned, alas, do not. Perhaps they should- as you say, we have universal coverage here!

My long-term girlfriend grew up in Australia. In that country, they have a system of universal, government-run health care that is accessible to everyone, but most in the monied and middle class also buy their own, supplemental insurance as well. I believe that this is a good compromise solution.

We have police protection available to everyone, paid for courtesy of your taxes. If you want even more police protection, fine- hire Wackenhut, or a similar private security firm. For the right price, you can get as much police protection as your heart desires! But not matter how poor you are, you still get to call the PUBLIC police department for help if you need it.

I think it's very, very sad that you don't want your tax dollars to pay for other people to have medical care- mostly because they already do! I'm sure your familier with the litany of government-run health care programs from SCHIP to Medicare to Medicaid, etc etc etc. And if a Republican administration ever decided that they wanted to try to privatize any of these, they'd probably have just about as much luck as W had privatizing Social Security.

As for Menino and the Minute Clinics, you're probably right. Looks like he screwed that one up good. Don't blame me, I voted for Flatts!

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by: davesoko @ Wed Nov 18, 2009 at 15:57:42 PM CST

[ Parent ]

Also- (0.00 / 0)

on the subject of my (and your) taxes paying for other people's health care, I couldn't be prouder that my tax dollars pay for medical care for our American veterans and their nuclear families for as long as they live. It is the very least we can do to thank our living breathing American heros.

Happy late Veteran's day everyone!

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by: davesoko @ Wed Nov 18, 2009 at 20:34:22 PM CST

[ Parent ]

Ya know, if you keep talking like this......... (0.00 / 0)

people on this blog will think that there is a rationale group on the left.  

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by: Vote3rdpartynow @ Thu Nov 19, 2009 at 17:19:13 PM CST

[ Parent ]

haha, well, good! I've never understood why some folks feel that one political side has a monopoly on patriotism. (5.00 / 1)

My boss until about a year ago was a man named Pat. Pat is one of the finest men I have ever had the pleasure to have known. Pat grew up in Somerville in a family on wellfare and food stamps, with parents (a trucker and a bartender) who had immigrated from Ireland to escape desperate poverty.

Pat excelled in High School, and was admitted early-acceptance to West Point, where he graduated first in his class and joined the US Army Airborne Rangers. As a Major, he lead the Rangers on hair-raising missions deep inside Serbia to free American POWs and civilians who were in the Milosovic regime's jails. During the course of the Kosovo war, Pat transferred to the 101ist Airborne Division, and led an Infantry Battalion in battle against the Serbian militia in Kosovo, who at the time were trying to commit genocide against the Albanians.

For his service is Kosovo, Pat received a medal for courage (I forget just which one).

And you know what the first job Pat took was once he left the US Army?

Executive Director of an SEIU Union Local! The guy is even further to the left that I am.

I think most Americans know that patriotism, love for country and a desire to serve know non political bounds. For those who don't, I hope someday they meet my former boss Pat. : )

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by: davesoko @ Fri Nov 20, 2009 at 12:16:04 PM CST

[ Parent ]

Sounds like you are now (5.00 / 1)

"I don't want to pay for your or your friends purchase of health care."

But isn't the point of this post to complain that mammograms would only be covered once every two years instead of every year?  As it stands now, women get them every year, and you are paying for them, since they are also on your plan (or on any plan from your insurance company, since surely some plans are more profitable for the company and subsidize other plans.)

I don't want to pay for unnecessary tests that do not improve health (I wouldn't want excess done on me if we were talking men's health, either).

And, if I was paranoid about prostate cancer, or a woman was paranoid about breast cancer, nothing would stop us from paying for extra tests ourselves, out of pocket.  Some people could get them once a week if they wanted, but wouldn't you agree they were being wasteful with their money and, by increasing demand, driving up the price for everyone?

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by: John Howard @ Wed Nov 18, 2009 at 17:12:41 PM CST

[ Parent ]