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Thread: It's time for national healthcare - Page 87







Post#2151 at 03-22-2011 12:38 PM by playwrite [at NYC joined Jul 2005 #posts 10,443]
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Quote Originally Posted by Galen View Post
A free market is not utopia but it is better than everything else.
Depends on what "free market" you are talking about. Every "free market" in existence is bounded and controlled to some significant degree by government policies and regulations. Those who espouse a particular "free market" are those that believe they currently benefit most from the particular government policies and regulations of that "free market" and don't want any changes. They want to believe, or more importantly want other people to believe, that any change to the current government policies and regulations controlling their "free market" is a threat to the idea of a free market when, in fact, it is only a different "free market" that may be less beneficial to them personally.

Judging from what you have espouse, I can only include that you like the current government policies and regulations of our current particular "free market" - which is in the process of dismantling our middle class. If you're in the top 5% of incomes (around $500K per year) in this country, I can understand your support - I find it disgusting but I can understand it. If you're not in the top 5%, well, I'll be "nice" and just suggest you need to attempt to think about it a little more.
"The Devil enters the prompter's box and the play is ready to start" - R. Service

“It’s not tax money. The banks have accounts with the Fed … so, to lend to a bank, we simply use the computer to mark up the size of the account that they have with the Fed. It’s much more akin to printing money.” - B.Bernanke


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Post#2152 at 03-22-2011 12:54 PM by playwrite [at NYC joined Jul 2005 #posts 10,443]
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Without the lies and hysteria

On the 1-year anniversary of the health care reform law, Ezra Klein provides a calm, measured description of what it is -

Column: Explaining health-care reform
By Ezra Klein


Wednesday is the first birthday of the Patient Protection and Affordable Care Act, the law better known as health-care reform. Cake, I imagine, will not be served. As much as Democrats are trying to leverage the milestone to sell the public on the legislation’s many virtues, the reality is that it has been a tough year.

At best, public support for the law is mixed and contradictory. A Kaiser Family Foundation survey released last week was typical: A slight plurality had an unfavorable impression of it, but a slight majority opposed efforts to repeal it or replace it with a Republican-backed alternative. It brings to mind an old Woody Allen joke about a restaurant where the food is terrible and the portions are too small. Americans don’t think they like the Affordable Care Act, but they don’t want to be without it or left with whatever Republicans want to put in its place.

For most Americans, the dominant emotion is confusion. According to the Kaiser poll, “confused” outranks “angry,” “anxious” and “enthusiastic” as a descriptor. At 53 percent, it commands an easy majority — and I’d guess that’s a low estimate.

So this is my birthday present to the legislation, and those who are befuddled by it: some clarity on what it does, and how it does it.

The health-care reform law is, without a doubt, among the most consequential pieces of social policy passed since the Great Society. But it’s also a lot more incremental than many people realize. More modest, by far, than the health-care overhauls proposed by Presidents Clinton, Nixon, Johnson and Truman.

In 2019, once the law has been fully implemented for five years, it is expected to cover about two-thirds of the uninsured, to cost about 4 percent of what the health-care system spends in any given year and to cut the federal deficit by less than 1 percent. If you obtain insurance from your employer, Medicare, Medicaid or the veterans system — and that describes most Americans — you probably won’t notice the legislation at all.

Nevertheless, the Affordable Care Act, once it kicks in fully in 2014, is expected to do four things: provide coverage; remake a small slice of the private insurance market; pay for itself; and try to control costs. Let’s take them in order.

The law has two main mechanisms for covering people: Medicaid — which is a government insurance program that focuses on the poor — and subsidies to help people afford private insurance. The split is expected to be almost even: Of the 32 million people the law is expected to cover by 2019, 16 million will be on Medicaid and the rest covered by private insurance.

The problem with subsidizing insurance is that the sick rush to sign up and the insurers refuse to cover them. The law escapes this conundrum by telling people who can afford insurance that they have to buy it or face a small fine (the dreaded individual mandate) and by telling insurers that they can’t discriminate based on preexisting conditions. That is to say, healthy people can no longer say no until they get sick and insurers can no longer say yes only when applicants are healthy.

These transactions will happen on the new “exchanges” — a place that will, in effect, be a Web site where people can compare plans and choose the one that will serve them best. But behind the pleasing exterior (you can see it at HealthCare.gov), the exchanges offer another layer of consumer protection: Just as Amazon.com would stop carrying a toaster that routinely exploded when customers plugged it in, if an insurer repeatedly misbehaves, regulators can kick it out of the exchange.

All this will cost money — and in a system that’s already overpriced. Which brings us to offsets and cost controls. It’s important to know the difference: Offsets are the policies that cover the law’s costs. They’re concrete, simple reforms — cutting this much, taxing that much — and as long as we are willing to implement them, they are likely to work. Controls are the policies that try to rein in health-care spending. They’re ambitious attempts to change the way doctors are paid, insurance is bought and Medicare is reformed. If they work, they will, in the long run, save an enormous amount of money — much more than the offsets.

The big offsets in the health-care law slow payment increases to certain classes of providers (which means, ultimately, doctors) who participate in Medicare ($240 billion), cut payments to private insurers that participate in Medicare but cost more than the basic Medicare program does ($140 billion), an increase in the Medicare tax paid by high-income folks ($210 billion) and a new tax on very expensive health-care plans ($20 billion, although much more than that between 2020 and 2029), and so on. All in all, the legislation is expected to save or raise about $100 billion more than it spends in the first 10 years. You can see all the offsets and expenses in a simple table here.

The cost controls will occur over a longer period and are more speculative. Medicare, for instance, is going to experiment with paying hospitals a flat sum for all successful care associated with a particular condition. This will mean that doctors make more money when they do less and are successful at it, rather than making more for doing more, as is the case now. The tax on expensive health insurance plans is meant to drive people — and employers — to seek plans that better control costs.

The Independent Payment Advisory Board is a group of stakeholders and experts charged with helping Medicare control costs and empowered to make changes to the system even if Congress is too paralyzed or distracted to act. It will be fed ideas by the new Center for Medicare and Medicaid Innovation, which will test ways to improve care and cut expenses. The exchanges will make it easier to comparison-shop, and the subsidies are linked to the lowest-priced plans in the exchanges to reward cost-efficient insurers. New information about what drugs and treatments work best and for whom will come from trials, and if combined with electronic-medical records, could help doctors make more cost-effective decisions.

Is it a perfect piece of legislation? Not even close. Will everything work as expected? Almost certainly not. But for all its flaws, it’s a good law, which is why Republicans have had so much trouble coming up with state plans that could cover more people at a lower cost. And it’s worth trying.

So happy birthday, Affordable Care Act. Here’s to many more.
Okay, now back to the hysteria.
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Post#2153 at 03-22-2011 03:50 PM by Galen [at joined Aug 2010 #posts 1,017]
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Quote Originally Posted by playwrite View Post
Judging from what you have espouse, I can only include that you like the current government policies and regulations of our current particular "free market" - which is in the process of dismantling our middle class. If you're in the top 5% of incomes (around $500K per year) in this country, I can understand your support - I find it disgusting but I can understand it. If you're not in the top 5%, well, I'll be "nice" and just suggest you need to attempt to think about it a little more.
What we currently have for health care can not be remotely considered a free market. It could be considered a poster child for the concept of regulatory capture. If you think that I support the current regulatory structure then you are sadly mistaken because it is an object lesson in how government always seems to achieve the opposite of its stated goal.
Last edited by Galen; 03-24-2011 at 04:42 AM.
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Post#2154 at 03-22-2011 04:08 PM by Child of Socrates [at Cybrarian from America's Dairyland, 1961 cohort joined Sep 2001 #posts 14,092]
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Quote Originally Posted by playwrite View Post
On the 1-year anniversary of the health care reform law, Ezra Klein provides a calm, measured description of what it is -



Okay, now back to the hysteria.
Kudos to Ezra for writing this and to you for thinking to link to it. Thanks.







Post#2155 at 03-23-2011 01:49 AM by playwrite [at NYC joined Jul 2005 #posts 10,443]
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Quote Originally Posted by Galen View Post
What we currently have for health care can not be remotely considered a free market. It could be considered a poster child for the concept of regulatory capture. If you think that I support the current regulatory structure then you are sadly mistaken because it is an object lesson in how government always seems to achieve the opposite of its stated goal.
There's nothing new,let alone earthshaking, about Dalmia pointing out the 'myth' of the US system as a pure free market system - as I said, such a thing doesn't exist in the world. One might point to Somalia, but one would have to have a very broad definition of "system" and even then I'm not so sure how free it is.

Regulatory capture IS just another particular form of "free market" (e.g., consumers can still take it or leave it). The fact that HCR poses the potential for the loss of some degree of the current level of regulatory capture is exactly the reason for the big-money opposition to the reform and maintaining the current "free market" situation that is so profitable to them.

Throwing out the concern for the 'loss' of 'free market' just provides the excuse to not specifically identify (and possible trade-off) the bene's of one 'free-market' version versus another.
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Post#2156 at 03-23-2011 08:50 AM by radind [at Alabama joined Sep 2009 #posts 1,595]
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Quote Originally Posted by Marx & Lennon View Post
...

Well, we are either going to have a healthcare system or we're not. If we are, then it will have to be funded. I suggest that we provide that funding in the least costly way: single payer. We can argue about the ownership of hospitals and other healthcare institutions, but the checkbook needs to be in a single hand.
I agree that we need to reduce the administrative costs to a minimum. Single payer is one solution. The current USA federal employee health care system is my choice for a model . However, health care insurance is not the primary cost driver. The major costs in health care stem from the health care providers. What can be done to control the rising health care costs?







Post#2157 at 03-23-2011 04:36 PM by Marx & Lennon [at '47 cohort still lost in Falwelland joined Sep 2001 #posts 16,709]
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Quote Originally Posted by Galen View Post
... Economic stimulus always ends in a depression of some sort. Consider how long it took the US to get where it is after 1913 when the Federal Reserve system was created.
If your complaint is stimulus, then start with the massive Keynesian stimulus of WW-II. The Keynesian system was stable and free of major recessions, to say nothing of depressions, until the oil shocks of the 70s. Even then, it was a different animal: stagflation. Ronald Reagan is the one who returned the country to a pre-Keynesian model of low taxes and deregulation. We've returned to the old business cycle recessions since then. Are you arguing that this is an anomaly?

Quote Originally Posted by Galen ...
Given that the government has done such a wonderful job of managing its finances it is pretty clear that any system they manage would be manged badly as usual. It has long been known in economics that the least efficient way to spend money is to have a third party do it. Single payer will have the same problems we are experiencing now for that reason. The checkbook needs to be in the patients hand where they can decide the most cost effective form of treatment.
For 30 years, we've had one major political party that espoused the goal of drowning the Federal government in a bathtub. They held power through the majority of that period, and the results are a disintegrating Federal government. I can't blame that on the Fed or any economic theory. This is the result of deliberate political policy.
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Post#2158 at 03-23-2011 04:40 PM by Marx & Lennon [at '47 cohort still lost in Falwelland joined Sep 2001 #posts 16,709]
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Quote Originally Posted by radind View Post
I agree that we need to reduce the administrative costs to a minimum. Single payer is one solution. The current USA federal employee health care system is my choice for a model . However, health care insurance is not the primary cost driver. The major costs in health care stem from the health care providers. What can be done to control the rising health care costs?
Administrative and compliance costs due to the multiplicity of health plans provided by all the healthcare providers is a huge factor. Current estimates are 30+% of all healthcare dollars. That's not to diminish to responsibility of the providers, but insurance is the prime offender.
Marx: Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies.
Lennon: You either get tired fighting for peace, or you die.







Post#2159 at 03-23-2011 10:43 PM by Deb C [at joined Aug 2004 #posts 6,099]
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On the Anniversary of ObamaCare Tell Congress We Need Real Reform


Mar 23, 2011 — KZeese

Today is the anniversary of the Obama Health Law, the Patient Protection and Affordable Care Act, a fact-based review of its impact should make this a very unhappy birthday. What has happened in the first year of ObamaCare?

- Premiums have continued to rise at rapid rates.

- Insurance coverage has shrunk for those who have insurance.

- More than 1,000 waivers by the Obama administration allow mini-med plans, which provide limited and inadequate insurance, to continue.

- The U.S. is moving toward a new norm: “unaffordable underinsurance.”

- Areas of expansion of coverage are failing to increase insurance coverage of the uninsured.

- Medicaid, half of the expansion of coverage, is shrinking with hundreds of thousands being taken off Medicaid and states are cutting back on its already inadequate coverage.

- The insurance mandate, the other major coverage expansion (which Prosperity Agenda believes is unconstitutional) is under attack and headed to a very close Supreme Court decision.

- Programs providing insurance to people with prior conditions are not being used because they are too expensive. Millions have no insurance due to pre-existing conditions but only 12,000 have signed up for the insurance available to them.

- The insurance industry is expanding its tentacles into other aspects of health care including providing health care. This creates a rigged game where insurance approves providers and then owns the providers.

For details on all of these facts with links to sources read, One Year Anniversary: The Incredible Shrinking Obama Health Care Law.

The implosion of ObamaCare is presenting an opportunity for the single payer movement. More and more public officials are seeing improved Medicare for All as the only solution. Terry Dougherty, director of MassHealth, from the state which is the model for the Obama law is reaching the obvious conclusion: “I like the market, but the more and more I stay in it, the more and more I think that maybe a single payer would be better.” He notes that unlike the insurance industry government costs less, with much lower administrative costs and “We don’t build big buildings. We don’t have high salaries. We don’t have a lot of marketing.”

Vermont is moving toward a single payer system. A state showing single payer works would be a tremendous advancement. Also, the "Expanded and Improved Medicare for All Act," H.R. 676, a bill that sets up a single payer system has been introduced in the U.S. Congress.
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Post#2160 at 03-23-2011 11:53 PM by radind [at Alabama joined Sep 2009 #posts 1,595]
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Quote Originally Posted by Marx & Lennon View Post
Administrative and compliance costs due to the multiplicity of health plans provided by all the healthcare providers is a huge factor. Current estimates are 30+% of all healthcare dollars. That's not to diminish to responsibility of the providers, but insurance is the prime offender.
Insurance is a big offender, just not the prime offender. I do agree that we do not need 100's or 1000's of providers. A limited set of ~ 10 would be sufficient. The federal system has a combination of companies , unions, and employee organizations as providers that compete annually for business. The government provides oversight , but not day to day administration.







Post#2161 at 03-24-2011 09:15 AM by Deb C [at joined Aug 2004 #posts 6,099]
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Quote Originally Posted by radind View Post
Insurance is a big offender, just not the prime offender. I do agree that we do not need 100's or 1000's of providers. A limited set of ~ 10 would be sufficient. The federal system has a combination of companies , unions, and employee organizations as providers that compete annually for business. The government provides oversight , but not day to day administration.
A few of the problems with the insurance industry managing health care, is the enormous salaries of their top management, their high administrative costs, their beholding to their stockholders, and basically their bottom line mentality of profit before people. This industry, calling itself health care insurance, is a scam. Their profits are based on people not getting sick and needing their services. Somewhat like a gambling casino who makes money from people spending but not winning. This is why they all carry a pre-existing condition clause, it stacks the odds of them coming out on top. A government system would provide health care for all. IMHO, that's a pretty significant difference.
"The only Good America is a Just America." .... pbrower2a







Post#2162 at 03-24-2011 09:40 AM by radind [at Alabama joined Sep 2009 #posts 1,595]
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Quote Originally Posted by Deb C View Post
A few of the problems with the insurance industry managing health care, is the enormous salaries of their top management, their high administrative costs, their beholding to their stockholders, and basically their bottom line mentality of profit before people. This industry, calling itself health care insurance, is a scam. Their profits are based on people not getting sick and needing their services. Somewhat like a gambling casino who makes money from people spending but not winning. This is why they all carry a pre-existing condition clause, it stacks the odds of them coming out on top. A government system would provide health care for all. IMHO, that's a pretty significant difference.
I agree that we need health care for all. Put all citizens in the same insurance pool and require all providers to offer comprehensive health care insurance for all ( no cherry picking, no exclusions). The savings in administrative costs( 20 to 30%) would go a long way to paying for the currently uninsured. The federal model( expanded to include all) does provide for competetion and any provider that did not keep overhead costs down would not attract customers. Please note that the current federal employee national health care plans include a few companies and several Unions and employee associations.

If we solve the administrative cost issue( a big factor to be sure), there still remains the long term continuing cost increases from the health care providers.

I also like the idea of states trying the single payer approach to see how this works out.







Post#2163 at 03-24-2011 02:35 PM by radind [at Alabama joined Sep 2009 #posts 1,595]
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FEHBP plans have wide range of flexibility and cost (11/5/10) -- GovExec.com
http://www.govexec.com/dailyfed/1110/110510l1.htm
Participants in the Federal Employees Health Benefits Program have myriad options in selecting a plan this open season. When deciding which type of coverage fits best, they should consider their preferences, such as whether they intend to see a particular physician or want the flexibility to seek care from a wide range of providers.
Walton Francis, author of the Consumers' Checkbook 2011 Guide to Health Plans for Federal Employees, said there is no right choice, as most FEHBP participants favor some plan features or cost structures over others.

Federal Employees Health Benefits Program
http://en.wikipedia.org/wiki/Federal...nefits_Program

..."The underlying legislation for the FEHB program is minimal and remarkably stable, particularly in comparison to Medicare. The FEHB statute is only a few dozen pages long, and only a few paragraphs are devoted to the structure and functioning of the program. Regulations are minimal; only another few dozen pages. In contrast, the Medicare statute found in title 18 of the Social Security Act is about 400 pages long and the accompanying regulations consume thousands of pages in the U.S. Code of Federal Regulations.

The FEHB program has often been proposed as a model for national health insurance and sometimes as a program that could directly enroll the uninsured. These proposals began within its first decade [11] and have continued ever since.[12] Notable economist Alain Enthoven explicitly built a proposal for a system of "managed competition" as a national health reform decades ago, and has continued promoting the idea ever since.[13] A version of this proposal was recently adopted by the Netherlands. In the 2004 presidential campaign, Senator John Kerry proposed opening enrollment in this plan to all Americans. In enacting the Medicare Modernization Act in 2003, the Congress explicitly modeled the reformed Medicare Advantage program and the new Medicare Part D Prescription Drug program after the FEHB program.[14] One of the prominent proposals for health reform in the United States, the proposed bipartisan Wyden-Bennett Act is largely modeled after the FEHB program, as have recent "Republican Alternative" proposals by Representative Paul Ryan."







Post#2164 at 03-25-2011 12:46 AM by Brian Rush [at California joined Jul 2001 #posts 12,392]
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Here's a nice bit of news:

http://www.boston.com/news/local/ver...lth_care_bill/

Quote Originally Posted by Boston Globe
MONTPELIER, Vt.—Every Vermonter could sign up for state-financed health insurance under a bill passed by the House on Thursday that would put the state on a path to a single-payer health care system by the middle of this decade.

"This bill takes our state one step closer to a system that ensures that all Vermonters have access to the care they deserve and contains costs," House Speaker Shap Smith said shortly after the House passed the bill 92-49.

The measure now goes to the Senate, where it is expected to pass, but with some possible changes.

Gov. Peter Shumlin, who made single-payer health care a centerpiece of his gubernatorial campaign last year, also praised the legislation. He said it would make Vermont "the first state in the country to make the first substantive step to deliver a health care system where health care will be a right and not a privilege, where health care will follow the individual, not be a requirement of the employer, and where we'll have an affordable system that contains costs."


Costs are an open question. The bill sets up a five-member state board to design a benefit package to be called Green Mountain Care, but doesn't require the governor to propose a way to pay for it until 2013. That drew fire from minority Republicans in the House . . .


Despite the Republicans' complaints, majority Democrats largely held together with their leadership to pass the bill. A similar outcome is expected in the Senate, though that chamber's president pro tem, Sen. John Campbell, said members would do their "due diligence" on the bill and might seek some changes.

The bill outlines a four-year timeline leading to establishment of the statewide, publicly funded system. It begins by setting up the Green Mountain Care Board on July 1 with a budget of $1.2 million to begin planning the new system. It then creates a health insurance marketplace -- or "exchange," of the sort required by last year's federal health care legislation. And it then calls for converting the exchange to the Green Mountain Care system.

On reflection, this might be the way that we end up with a single-payer system: with progressive states showing the way. That's the way things often work in our federal system of governance, as opposed to something all-at-once at the federal level. Eventually a federal system will make more sense, but if it must begin this way, then so be it.
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Post#2165 at 03-25-2011 12:53 AM by Child of Socrates [at Cybrarian from America's Dairyland, 1961 cohort joined Sep 2001 #posts 14,092]
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I'll be very interested to see how the Vermont plan works, should it be implemented.







Post#2166 at 03-25-2011 09:07 AM by radind [at Alabama joined Sep 2009 #posts 1,595]
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Quote Originally Posted by Brian Rush View Post
Here's a nice bit of news:

http://www.boston.com/news/local/ver...lth_care_bill/




On reflection, this might be the way that we end up with a single-payer system: with progressive states showing the way. That's the way things often work in our federal system of governance, as opposed to something all-at-once at the federal level. Eventually a federal system will make more sense, but if it must begin this way, then so be it.
If this is the best way, then I really like the idea of testing this by several states first.







Post#2167 at 03-25-2011 11:58 AM by Marx & Lennon [at '47 cohort still lost in Falwelland joined Sep 2001 #posts 16,709]
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Quote Originally Posted by radind View Post
Quote Originally Posted by Deb C View Post
A few of the problems with the insurance industry managing health care, is the enormous salaries of their top management, their high administrative costs, their beholding to their stockholders, and basically their bottom line mentality of profit before people. This industry, calling itself health care insurance, is a scam. Their profits are based on people not getting sick and needing their services. Somewhat like a gambling casino who makes money from people spending but not winning. This is why they all carry a pre-existing condition clause, it stacks the odds of them coming out on top. A government system would provide health care for all. IMHO, that's a pretty significant difference.
I agree that we need health care for all. Put all citizens in the same insurance pool and require all providers to offer comprehensive health care insurance for all ( no cherry picking, no exclusions). The savings in administrative costs( 20 to 30%) would go a long way to paying for the currently uninsured. The federal model( expanded to include all) does provide for competetion and any provider that did not keep overhead costs down would not attract customers. Please note that the current federal employee national health care plans include a few companies and several Unions and employee associations.

If we solve the administrative cost issue( a big factor to be sure), there still remains the long term continuing cost increases from the health care providers.

I also like the idea of states trying the single payer approach to see how this works out.
Everything you say is more or less accurate but it avoids the question: why have any private insurers in the mix at all? Unless you are only going to allow non-profits to participate, private insurance mandates profits for shareholders. Why provide profits to private entities they haven't earned? They will be plying a closed and mandated market. For them, this is like shooting fish in a barrel. For us, it provides no value I can see ... none!

We don't need to provide profits just to maintain the appearance of a private enterprise system. In fact, it's contrary to the private-enterprise model. Let them find their own profits elsewhere.
Last edited by Marx & Lennon; 03-25-2011 at 12:01 PM.
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Post#2168 at 03-25-2011 01:18 PM by Justin '77 [at Meh. joined Sep 2001 #posts 12,182]
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Quote Originally Posted by radind View Post
I agree that we need health care for all. Put all citizens in the same insurance pool and require all providers to offer comprehensive health care insurance for all ( no cherry picking, no exclusions).
Arg.

Health insurance /= Health care.

It's a major victory in perpetuating the broken American system to have people equating the two. They've got only a very passing acquaintance. If you want to get health care available for all, then just have health care providers who provide to all. Bang. Done. That kind of thing can and does peacefully and comfortably coexist with health care for pay and even insurance for those who are inclined to it. Insurance-for-all just elevates one of the more broken aspects of the model we have to the a key position. That's no way to fix things.
"Qu'est-ce que c'est que cela, la loi ? On peut donc être dehors. Je ne comprends pas. Quant à moi, suis-je dans la loi ? suis-je hors la loi ? Je n'en sais rien. Mourir de faim, est-ce être dans la loi ?" -- Tellmarch

"Человек не может снять с себя ответственности за свои поступки." - L. Tolstoy

"[it]
is no doubt obvious, the cult of the experts is both self-serving, for those who propound it, and fraudulent." - Noam Chomsky







Post#2169 at 03-25-2011 02:31 PM by radind [at Alabama joined Sep 2009 #posts 1,595]
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03-25-2011, 02:31 PM #2169
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Quote Originally Posted by Marx & Lennon View Post
Everything you say is more or less accurate but it avoids the question: why have any private insurers in the mix at all? Unless you are only going to allow non-profits to participate, private insurance mandates profits for shareholders. Why provide profits to private entities they haven't earned? They will be plying a closed and mandated market. For them, this is like shooting fish in a barrel. For us, it provides no value I can see ... none!

We don't need to provide profits just to maintain the appearance of a private enterprise system. In fact, it's contrary to the private-enterprise model. Let them find their own profits elsewhere.
I still believe in competition. If the non-profits provide a better product or the same product for a lower cost, then the customers( citizens) will go with the non-profits and abandon the compamies. So far, that has not been the experience in the federal system(FEHB). Before I retired , I was enrolled for a few years in one of the Union plans( as non-member). The assessment of which plan to join changed as the plans changed and personal circumstances changed.
No plan is guaranteed any customers , so I don't see the problem with a managed competition(annual open season). The companies can earn no profits unless they first attract customers.







Post#2170 at 03-26-2011 01:59 PM by TnT [at joined Feb 2005 #posts 2,005]
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03-26-2011, 01:59 PM #2170
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Quote Originally Posted by radind View Post
I still believe in competition.
We'd be a lot better off if the competition was between healthcare PROVIDERS. If there was a single PAYOR, then the good healthcare systems would have to compete for customers. If I had my choice of Provider, why wouldn't I go to Sloan Kettering for my cancer treatment, instead of East Jesus Memorial Cancer Money Tree in Yellowstream, Montana?

But, nope. My "insurance" mandates that I go to East Jesus for everything. The only thing that is "insured" is that I get less than optimal treatment for whatever I have. Choice? Freedom? The "Insurance" industry has pretty much taken all that away from me.
" ... a man of notoriously vicious and intemperate disposition."







Post#2171 at 03-26-2011 03:51 PM by radind [at Alabama joined Sep 2009 #posts 1,595]
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03-26-2011, 03:51 PM #2171
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Quote Originally Posted by TnT View Post
We'd be a lot better off if the competition was between healthcare PROVIDERS. If there was a single PAYOR, then the good healthcare systems would have to compete for customers. If I had my choice of Provider, why wouldn't I go to Sloan Kettering for my cancer treatment, instead of East Jesus Memorial Cancer Money Tree in Yellowstream, Montana?

But, nope. My "insurance" mandates that I go to East Jesus for everything. The only thing that is "insured" is that I get less than optimal treatment for whatever I have. Choice? Freedom? The "Insurance" industry has pretty much taken all that away from me.
But, in the federal model, you get to select your insurance provider during each annual open season. You are not captive to a single provider. I also would like to see competition aamong the health care providers.







Post#2172 at 03-26-2011 03:56 PM by radind [at Alabama joined Sep 2009 #posts 1,595]
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03-26-2011, 03:56 PM #2172
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Quote Originally Posted by radind View Post
But, in the federal model, you get to select your insurance provider during each annual open season. You are not captive to a single provider. I also would like to see competition aamong the health care providers.
In the current Medicare system which is proposed by some as a model, I don't see competition between the health care providers( costs continue to rise). I do see some doctors refusing to accept Medicare patients. This is another issue that must be addressed in any national health care system.







Post#2173 at 03-29-2011 09:38 PM by TnT [at joined Feb 2005 #posts 2,005]
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03-29-2011, 09:38 PM #2173
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Quote Originally Posted by radind View Post
But, in the federal model, you get to select your insurance provider during each annual open season. You are not captive to a single provider. I also would like to see competition aamong the health care providers.
What difference does it make? No matter the insurance I "choose" I don't get to go to Mayo, or Cleveland Clinic, or Sloan-Kettering. If I change insurance companies, then instead of having to go to East Jesus for treatment, I have to go to West Jesus. The only thing I can hope for is that my insurance happens to contract with the healthcare providers that happen to be good at what I happen to get sick with. If I get something that my providers aren't good at ... tough s**t, I still get to go to them for its treatment.

Competition between payors merely causes dysfunction in the financing of healthcare provision.

Competition between providers will cause folks to get interested in those providers that make people well.
" ... a man of notoriously vicious and intemperate disposition."







Post#2174 at 03-29-2011 09:52 PM by herbal tee [at joined Dec 2005 #posts 7,116]
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03-29-2011, 09:52 PM #2174
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Quote Originally Posted by TnT View Post
If I change insurance companies, then instead of having to go to East Jesus for treatment, I have to go to West Jesus.
I. Love. That. Sentence. :


Quote Originally Posted by TnT
The only thing I can hope for is that my insurance happens to contract with the healthcare providers that happen to be good at what I happen to get sick with. If I get something that my providers aren't good at ... tough s**t, I still get to go to them for its treatment.

Competition between payors merely causes dysfunction in the financing of healthcare provision.

Competition between providers will cause folks to get interested in those providers that make people well.
Thank you. I couldn't agree more.







Post#2175 at 03-29-2011 09:55 PM by TnT [at joined Feb 2005 #posts 2,005]
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03-29-2011, 09:55 PM #2175
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Herbal ... you are too kind.
" ... a man of notoriously vicious and intemperate disposition."
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