Universal Health Care Reform in the United States

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Originally Posted by Jag_Warrior

Yeah, here we are. What I mean is the national debate though. I don't know about you, but I don't feel like any progress is really being made.

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At least someone out there is thinking about an actual plan. I just wish one of our leaders would.

http://blogs.reuters.com/great-debat...espethokoukis/

"Call it the Purple Plan, one that brings red and blue together. Make health insurance mandatory and subsidize those who can't afford it. (That's the blue part.) But at the same time dismantle employer-based health plans, which prevent consumers from understanding the true costs of their healthcare decisions. In any case, employer plans are just an accident of history. (That's the red part.)"

It's not quite perfect, but it's a start and maybe at least politically possible.

It's very Orwellian when the Dems are accusing the townhall protesters of being paid plants, when the one's actually profiting from all this are members of the Obama administration. Transparent and honest, my @ss.

http://news.yahoo.com/s/ap/20090819/...re_consultants

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Originally Posted by chuck34

Again, what would stop the government from doing these type of things? They also want to control costs. Looking at a cost/bennifit chart rationally as you suggested the government would do, leads down some pretty nasty roads. Especially if/when the government is your only option.

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Insurance companies do exactly the same thing, look at how they can limit healthcare for particular levels of coverage and see how much bang they (and you) can get for each buck. How do you think they select how much to charge and ensure they make a profit?

Also I've noticed a few people claim the reforms will result in a 100% government funded healthcare system but as far as I can see this isn't on the cards at all, it looks to me like Obama is mainly concerned with reforming insurance cover, introducing a cap and subsidies for the poor whilst starting up a state funded alternative insurer. Have I got the fundamentals correct?

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Originally Posted by Jag_Warrior

Let's rationally discuss the issue at hand. We, as a people, need to stop allowing ourselves to be played like puppets and sheep by the powers-that-be. What is the truth? What do we want? What is it going to take to get us there? I blame Obama for not being at all clear about his (non) proposal. I blame the Dems for not putting forth a rational plan. I blame the Republicans for not putting forth a rational counter plan. I don't feel like we're getting anywhere! Hell, I'm as confused as anybody else. It is clearly something that (IMO) needs to be addressed. But the interested parties really know the game and they're playing it extremely well. I doubt we end up with anything truly worth a damn.

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Thats the thing with modern politics though isn't it. Everything is so complicated I doubt the guys drawing the reforms up truly understand it all. I doubt a President who has to look at healthcare as one other thing amidst all the other things on his plate truly understands it, even though its his pet project. So what chance do the rest of us, and I include common or garden Democrat and Republican politicians, have in understanding the nuances?

Thats why the debate can easily be hijacked by nonsensical propaganda, because the reforms confuse the hell out of everyone.

Still, if I were you I'd feel lucky that the debate is being held in the public eye at all. In the UK the NHS has been 'reformed' many many times at huge expense with no public debate whatsoever. Most people are unaware about the huge changes made or exactly how much money has been wasted, nor about the frankly bizarre way in which private companies have been allowed to buy up NHS services or had ludicrously favourable contracts accepted.

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Originally Posted by Jag_Warrior

Anthony, a man was just on Bloomberg and he was denied an operation unless he could come up with a $3000 downpayment for an eye operation. He couldn't get the money and so he couldn't get the operation. Because of his pre-existing diabetes, his premiums made insurance unaffordable. Pay the mortgage and buy food or carry insurance. I guess he liked to eat and live indoors. He's now partially blind. What's cruelly ironic about that situation: now that he's disabled, he is now covered by Medicare.

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Unfortunately that kind of case boosts the cost of healthcare further. Instead of a one off op that could have saved his sight the state now has to pay for his ongoing care as he is registered as disabled as a result, and its one of the big weaknesses of the system as it stands. His healthcare costs over the course of his life would likely have been cheaper had he had the op.

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Originally Posted by Dylan H

Insurance companies do exactly the same thing, look at how they can limit healthcare for particular levels of coverage and see how much bang they (and you) can get for each buck. How do you think they select how much to charge and ensure they make a profit?

Also I've noticed a few people claim the reforms will result in a 100% government funded healthcare system but as far as I can see this isn't on the cards at all, it looks to me like Obama is mainly concerned with reforming insurance cover, introducing a cap and subsidies for the poor whilst starting up a state funded alternative insurer. Have I got the fundamentals correct?

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I understand that insurance companies do that now. But what stops government from doing the exact same thing? I have heard too many stories out of the UK and Canada that say they are no better. Even if you are "not-for-profit" as the gov is, you still have to control costs.

Obama isn't proposing to do a 100% government funded deal right away. But he has said in the past that that is exactly what he wants. Add to that the fact that my company has already told us that if a "Public Option" is offered, we'll be dropped. I'm sure my company is not the only one thinking that. So you can see how fairly quickly a "Public Option" can become the de-facto only option. And that is precicely what Obama said he wanted to do.

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Originally Posted by chuck34

I have yet to see anyone explain to me how you add millions of people to the "system" without raising taxes or rationing services.

Anyone?

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Getting lost in details again.

Anyone have any thoughts about this? Anyone? Bueler, Bueler?

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Originally Posted by chuck34

I understand that insurance companies do that now. But what stops government from doing the exact same thing? I have heard too many stories out of the UK and Canada that say they are no better. Even if you are "not-for-profit" as the gov is, you still have to control costs.

Obama isn't proposing to do a 100% government funded deal right away. But he has said in the past that that is exactly what he wants. Add to that the fact that my company has already told us that if a "Public Option" is offered, we'll be dropped. I'm sure my company is not the only one thinking that. So you can see how fairly quickly a "Public Option" can become the de-facto only option. And that is precicely what Obama said he wanted to do.

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Of course the NHS and every other system rations healthcare. There isn't a single system out there that doesn't including the US. The way it works in the UK though is that everything is treated but that the treatments that give the lowest bang for the buck are not available to the NHS. All of the ones that are not available are almost exclusively the most expensive drugs around that offer a marginal benefit over existing cheaper alternatives or where there isn't evidence to suggest they'd be a benefit. The vast majority of people who are unwell are unaffected by this as it tends to affect terminal cancer care the most.

Still, in those cases if you want to pay cash for that treatment then there's nothing stopping you.

I don't see how the current American system can get anything close to being 100% state provided regardless of the current reforms, there are far too many powerful lobby groups around to let that happen, and it would require a total destruction of the current system and rebuilding for it to occur. Obama's proposing major changes to the system, but he isn't starting from scratch by any means.

BTW I've often wondered how the US health system hobbles its own industry. How hard would the UAW fought to have the best/most expensive healthcare options for its members if there had been decent free or cheap state funded healthcare available? At least most European makers aren't hobbled by the same expenses and the Japanese ones have to pay far less in contributions for their workers (in Japan at least).

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Originally Posted by chuck34 http://www.motorsportforums.com/foru...s/viewpost.gif
I have yet to see anyone explain to me how you add millions of people to the "system" without raising taxes or rationing services.

Anyone?

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Originally Posted by chuck34

Getting lost in details again.

Anyone have any thoughts about this? Anyone? Bueler, Bueler?

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Yes, the devil is (truly) in the details on this issue, Chuck.

Looking down from rom 1000 ft, all I can say is whether it's 10 million or 40 million people who are uninsured, these people are in the health care system, they just aren't in an insurance system. When they get sick, they tend to use the most expensive (and inefficient) means of care: the emergency room. If they need follow up care, they may wait until it's serious enough that they have to go back to an emergency room.

I don't have the figures and I don't know enough about this massive system of care and insurance to really answer your question. But I feel pretty confident that there is more than enough waste and inefficiency that could be attacked, that there should be significant cost savings if that approach was taken. Would the cost savings from getting them out of the ER cycle of care be enough to offset the increased cost of insuring these people? That, I don't know. But the fact is, they're being paid for by those who can pay already.

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Originally Posted by Jag_Warrior

But I feel pretty confident that there is more than enough waste and inefficiency that could be attacked, that there should be significant cost savings if that approach was taken.

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The rational for all this has always been to save costs, and cover the uncovered. Well the "uncovered" are actually already covered, in one way or the other. It may not be the best, but people are taken care of. And everyone seems to "know" where all these inefficiencies are.

So that being said, why don't we fix Medicare/Medicaid to improve the responsiveness, quality, and costs, and then address the waste and ineffieiency? If there is so much money out there just being wasted away, why not fix that right now, without totally over-hauling the entire system?

I guess what I am saying is that we should be FIXING the root problems, not putting a feel good band-aid on them.