Health Care Reform - almost a done deal? DONE

[zomgwtf]

Just wondering... why exactly does the American healthcare system work the way it does (or did I guess)?

Is it just so that the doctors and insurance companies can be free to make as much money as they want and so the government doesn't have to step on anyones money making toes?

 

[Topher925]

So, now that 30 million more people have insurance, does this mean there will be more patients or just that their medical bills will be paid by everyone else?

If both, aren't we going to need another 500,000-1,000,000 more doctors and supporting staff?

No, the amount of patients will remain the same. And we already pay all those 32 million people's bills.

There will always be a shortage of medical professionals so long as the AMA caps the amount of doctors that can graduate per year.

 

[Ivan Seeking]

This is a big f*cking deal

- Vice President Joe Biden
http://www.wgme.com/template/inews_wire/wires.national/3e9d2d30-www.wgme.com.shtml

Too funny!

 

[edward]

If the health care reform works Limbaugh says he will leave the country. That alone is a good enough reason to hope that it is successful.

 

[MotoH]

I've re-read your information and it is correct. Jumbled, but correct.

Why don't I have benefits now? Why can't I go to the doctors office and get some free care for this soar throat I have?

Oh wait we have to pay taxes until the government has enough money to provide everyone with care.

 

[WhoWee]

Interesting bit of information about the popularity of this bill. While 59% of those surveyed last weekend opposed the bill, 13% said it is because the bill isn't liberal enough. Those people will mostly fall in line, which means that over 50% of the country supports the bill in principle, with 13% saying it should have gone farther.
http://i2.cdn.turner.com/cnn/2010/images/03/22/rel5a.pdf

In fact, if we assume that all liberals who wanted more will ultimately support the progress made, that puts the approval of the bill at 52%, which is about the same number that Obama saw in the 2008 election - 53%. 5% are undecided. It is likely that they will also support this with time as the truth begins to sink in.

The popularity of this will continue to rise for many months as the gloom and doom predictions prove to be nonsense. Obama should also take a good bump in the polls. Former President Clinton predicts that he will see a 10 point rise in his approval rating.

If you ask the same people if they would like the Govt to pay their utilities - what do you think they would say?

 

[Gokul43201]

If anyone pays less, it will be because YOUR taxes subsidized them. Premiums will increae otherwise due to mandated coverage of (high risk) pre-existing conditions and removal of maximum lifetime payouts. The costs to the insurance companies WILL INCREASE - SO WILL PREMIUMS.

Gokul, where do you think this money will come from? Us middle class citizens will get raped through the nose in the coming years.

4-6 years of taxes before we see any benefits? Just another way for the government to try and make money under the guise of health care.

So neither of you knows of a reputable study that calculates the extent of the middle class raping that is to ensue?

 

[MotoH]

I've posted an article earlier in the thread.

Read.

 

[Nebula815]

Hope you all are right who say the bill will greatly improve healthcare, it will be wonderful if in the future it really has made things better, but with the history of government programs and in particular government healthcare programs, I will believe it when I see it.

 

[Ivan Seeking]

So, in fact, most Americans support health care reform, while 13% think this should have gone father. What do our conservative news sources have to report?

Dobbs

...but this "victory for the American people" is anything but. If that was the case, why would poll after poll show an overwhelming majority of Americans against the legislation?...

http://loudobbs.com/

CS Monitor

In a sign of President Obama’s failed attempt at convincing Americans his healthcare reform bill will help them, a new Gallup poll shows the majority of the US believes the bill in Congress will benefit just the poor and uninsured.

http://www.csmonitor.com/USA/Politics/2010/0319/Why-Americans-oppose-the-healthcare-reform-bill

Rasmussen

Yet while in Congress there has been months of posturing and shifting of political tactics, voter attitudes have remained constant: A majority oppose the plan being considered by the legislators...

http://www.rasmussenreports.com/pub.../healthcare/september_2009/health_care_reform

LifeNews

Polls Find Majority Oppose Barack Obama, Pro-Abortion Health Care Bill

http://www.lifenews.com/nat6179.html

Fox

Fox News Poll: 55% Oppose Health Care Reform

http://www.foxnews.com/politics/2010/03/18/fox-news-poll-oppose-health-care-reform/

 

[Topher925]

Hope you all are right who say the bill will greatly improve healthcare, it will be wonderful if in the future it really has made things better, but with the history of government programs and in particular government healthcare programs, I will believe it when I see it.

One important thing to note, is that lot of this "government run healthcare" will actually be managed at the state level. So if your state screws it up, just move to another one.

 

[MotoH]

That's weird, I didn't know 39% was more than 59%

 

[Nebula815]

Note also that the Dow went up yesterday. No doom and gloom.

Not surprising since the bill mandates 300M customers for health insurance with 30M new members and Big Pharma is promised exclusive distribution in the US with a ban on imported pharmaceuticals. The health insurance companies, big pharmaceutical companies, hospitals, etc...all are guaranteed big profits thanks to this bill.

 

[cristo]

Also, your random 10% unemployment stat is ridiculous: it's not true for many European nations with universal healthcare (UK, Norway, Finland, Sweden, Denmark, Switzerland, just to name a few from browsing that website)

What you mean by random? It's unemployment is always close to 10% which is worse than US. It has many regulations and unions.

Do you guys across the pond actually look at statistics, or do you just prefer to conjure things up yourselves? If you would, you'd see this:

Unemployment rates (from wiki, but see sources)

UK 7.8%; Switzerland 3.6%; Denmark 4.2%; Norway 3.3%; Sweden 8%; Finland 8.5%

USA 9.7%.

 

[CRGreathouse]

Do you guys across the pond actually look at statistics, or do you just prefer to conjure things up yourselves?

The original quote to which RootX referred was about the unemployment rate in France, and included a link showing its unemployment rate over the last 10 years or so. So your ad hominem attack is baseless.

Now there's an argument for cherry-picking: maybe France is a bad example, or maybe the Scandinavian countries are. You could compare other European countries (Spain, Germany, Portugal, Italy, Poland, Greece, etc.), or perhaps just the overall EU rate. At least this way you'd be discussing the facts rather than attacking each other.

 

[cristo]

The original quote to which RootX referred was about the unemployment rate in France, and included a link showing its unemployment rate over the last 10 years or so.

Even if that was the comment he was replying to, had he looked at statistics comparing the two countries, he would see that a claim such as "It's unemployment is always close to 10% which is worse than US" was incorrect. For example, from table 1 http://www.bls.gov/fls/intl_unemployment_rates_monthly.htm one can see that the unemployment rate in the USA for much of 2009 was worse than that in France.

 

[CRGreathouse]

Even if that was the comment he was replying to

I did trace the quotes backward (that's what the 'right arrow' buttons do*). That was the quote responded to.

* Not to be condescending -- actually I only noticed this myself a few months ago.

he would see that a claim such as "It's unemployment is always close to 10% which is worse than US" was incorrect. For example, from table 1 http://www.bls.gov/fls/intl_unemployment_rates_monthly.htm one can see that the unemployment rate in the USA for much of 2009 was worse than that in France.

That claim was about long-term rates for both countries (as I mentioned in my post, the source was a long-range plot). That the US rate was at some point worse doesn't seem to weaken the point at all. (That France may not be a good example *does* weaken the point.)

Now if the claim had been "Its unemployment is close to 10% which is always worse than US", the criticism would be valid. But it wasn't.

 

[Nebula815]

Europe, on average, has a higher unemployment rate than the U.S. The UK isn't really Europe and Switzerland is more free-market than the U.S., so I wouldn't use them as an example.

Stand by for a VAT tax when it becomes clear how large a hole in the budget this healthcare legislation blows.

 

[Office_Shredder]

Europe, on average, has a higher unemployment rate than the U.S. The UK isn't really Europe and Switzerland is more free-market than the U.S., so I wouldn't use them as an example.

Stand by for a VAT tax when it becomes clear how large a hole in the budget this healthcare legislation blows.

Switzerland requires everyone to get health insurance, and the UK has universal health care, and a fairly high VAT. Considering that we're supposed to be talking about how the march to socialism brought on by the health care bill will sink us like Europe, I think they're very relevant examples.

 

[Nebula815]

Switzerland requires everyone to get health insurance, and the UK has universal health care, and a fairly high VAT. Considering that we're supposed to be talking about how the march to socialism brought on by the health care bill will sink us like Europe, I think they're very relevant examples.

Switzerland is a very tiny country and is not an entitlement utopia though. The central government there has very little power. They have a large private sector health insurance system combined with a public aspect.

As for the UK, they are in dire straits economically and fiscally right now and headed towards going over a cliff again. They almost did in the late 1970s, the only thing that saved them was Margaret Thatcher and the Conservative party. After the Conservate party started becoming too corrupt (and also raising some taxes), they lost to Labour party, which had re-branded itself as "New Labour," and thus has gone on to spend money like crazy and raise taxes. I would not hold them as an example for us to copy.

They're universal healthcare system has been a contentious issue ever since it was created, and they have various problems with rationing in it to this day. There were actually fewer hospitals in the UK by the 1970s then there had been in the early twentieth century due to the NHS.

They also have heavy regulations over junk lawsuits, which would mean the equivalent of heavy tort reform in the U.S. I am sure that to pay for health reform here, the Democrats will push for a VAT tax, but mention tort reform and they will never do that.

Also, as I said in an earlier post, even if we decide to copy the Euro systems, assuming they work well, we have a very poor record of creating such systems within our own nation. Again, it may sound like a broken record, but it's the truth:

Medicare - trillions in deficit
Medicaid - trillions in deficit

(these two programs alone are both causes of the increasing costs of American healthcare and also are responsible for a large portion of the future deficit projections our nation faces)

Massachusettes healthcare program - premiums among highest and costs very high (http://www.boston.com/news/health/a...health_insurance_premiums_highest_in_country/)

Tennessee - tried an expansion of Medicaid which ballooned out of control in costs (http://online.wsj.com/article/SB125046457087135327.html)

So IMO we should work to make sure this stuff works on the small level before trying it on the national level.

 

[Galteeth]

If you ask the same people if they would like the Govt to pay their utilities - what do you think they would say?

I, for one, would like for the government to give me a pizza.

 

[turbo]

I, for one, would like for the government to give me a pizza.

I'd prefer and oil and filter change.

 

[WhoWee]

So neither of you knows of a reputable study that calculates the extent of the middle class raping that is to ensue?

I commented:

"If anyone pays less, it will be because YOUR taxes subsidized them. Premiums will increae otherwise due to mandated coverage of (high risk) pre-existing conditions and removal of maximum lifetime payouts. The costs to the insurance companies WILL INCREASE - SO WILL PREMIUMS."

As for a reputable study on the subject - I have to laugh (or maybe cry). That is the problem - they didn't do an honest study of the consequences of this legislation.

I posted with regards o how the insurance industry operates. Risk is measured and a premium is quoted ->>> more risk = greater premium.

 

[Galteeth]

I commented:

"If anyone pays less, it will be because YOUR taxes subsidized them. Premiums will increae otherwise due to mandated coverage of (high risk) pre-existing conditions and removal of maximum lifetime payouts. The costs to the insurance companies WILL INCREASE - SO WILL PREMIUMS."

As for a reputable study on the subject - I have to laugh (or maybe cry). That is the problem - they didn't do an honest study of the consequences of this legislation.

I posted with regards o how the insurance industry operates. Risk is measured and a premium is quoted ->>> more risk = greater premium.

Theoretically, this might be offset by the massive influx of new customers. Of course, it sort of stifles competition, and this "increased competition" aspect of the bill doesn't take effect till 2014, and by my understanding still does not allow for competition over state lines.

 

[cristo]

Europe, on average, has a higher unemployment rate than the U.S.

Really? Because the link I gave above, averaged over the last year or so, says otherwise.

The UK isn't really Europe and Switzerland is more free-market than the U.S., so I wouldn't use them as an example.

You can't just redefine "Europe" to suit your argument.

 

[Nebula815]

Really? Because the link I gave above, averaged over the last year or so, says otherwise.

Europe, on average, as a continent, has a chronically high unemployment rate and more stagnant economic growth rates during good times. They also have higher levels of national debt to GDP on average. The United States, on average, maintains full employment, with unemployment only going higher during recessions. This current recession was the equivalent of a torpedo (real-estate bust) hitting the ship (economy), which has thus driven unemployment to its highest in approximately three decades (the last time being the Volcker Recession of 1981-1982).

The U.S. also has fairly decent growth during good times and a lower debt-GDP ratio (although it's getting up there).

You can't just redefine "Europe" to suit your argument.

"Technically" the UK may be considered part of Europe but from my understanding, they have never regarded themselves as "European" in the conventional sense. But regardless, the UK does not have the same degree of mixed economy as other nations in the EU. The UK is able to still put the same amount of money proportionally into its national defense as the United States.

Switzerland is not part of the European Union. Switzerland does not follow the same policies as most EU countries (high taxes, massive social welfare systems), although they have aligned certain policies to match the EU recently. They have a modern market economy with low taxes, low unemployment, decent GDP growth, and one of the highest GDP per capitas in the world.

One thing to also think about is the national defense. A big danger for the United States of becoming a European-style social democracy is the cut required in the defense. In addition to more of the budget going to social expenditures, the probable higher level of debt will increase the interest that must be paid, gutting the defense more.

Remember, if the European nations had had to fend for themselves after WWII, there is no way they would have been able to pour the amount of money into social systems that they do. They were able to do this because the U.S. to a great degree has subsidized their security for many years.

But if the U.S. goes the same route, who will replace us?

The paranoid fear about a New World Order forming, but I think in the future we risk just the opposite, a world with truly no order.

 

[mheslep]

Source? Given the potential damage to other buildings from an uncontrolled fire, I'm having a hard time believing this. (I could be mistaken though)

Some high-end estates and large business may contract for private fire-protection, but the large businesses that I have worked with have mutual-aid agreements with public fire departments, as well. I haven't yet lived anywhere where your property taxes didn't pay for public fire departments.

Surely you guys have heard of http://en.wikipedia.org/wiki/Volunteer_fire_department" ? Often the VFD's mix in with the regular pro's, but in some small towns it is all VFD, at least there are in my state. Edit: The first VFD in the US was Franklin's idea, set up in Philadelphia in 1736. They followed with private fire insurance in 1751 which led to rapidly improvement in Philly's fire prevention measures. Maybe that's why Philly never had one of those total city-destroying fires ala Chicago, SF, NYC.
http://www.ushistory.org/tour/tour_contrib.htm

 

[Ivan Seeking]

I commented:

"If anyone pays less, it will be because YOUR taxes subsidized them. Premiums will increae otherwise due to mandated coverage of (high risk) pre-existing conditions and removal of maximum lifetime payouts. The costs to the insurance companies WILL INCREASE - SO WILL PREMIUMS."

As for a reputable study on the subject - I have to laugh (or maybe cry). That is the problem - they didn't do an honest study of the consequences of this legislation.

I posted with regards o how the insurance industry operates. Risk is measured and a premium is quoted ->>> more risk = greater premium.

So you keep insisting on your point but have nothing to back it up but personal opinion. Got it.

 

[mheslep]

I wish some Republicans had been willing to cross the aisle, along with Olympia Snowe.

Snowe as you may know voted to forward the Senate bill out of here Finance Committee with some reservations. After that the bill went behind closed doors it came out completely differently; she and every other R. voted against that. Today she went on the floor and attacked the final bill in detail, describing how it went completely off the rails after committee. Meanwhile, here's the written statement she released couple days ago, as I can't find today's floor speech yet.

http://snowe.senate.gov/public/index.cfm?FuseAction=PressRoom.PressReleases&ContentRecord_id=881403bd-802a-23ad-4641-266a1f517857

“As one who has been intimately involved in the multiple facets of health care reform for well over a year and the only Republican to vote for the Finance Committee's reform bill, and at this time when Americans are facing the enormous challenges of access to affordable coverage, it is disappointing to consider what might have been if the process had focused on addressing fundamental problems with the bill to develop a more balanced, effective, and credible approach that would be embraced broadly by the American people. Instead, energy and ingenuity that could have been applied to making key adjustments on the critical issues of the affordability of plans and the negative effect of the bill on small businesses and job growth was directed toward executing an arcane process that ultimately denied Congress the opportunity to pass the best possible package. Today was regrettably the manifestation of legislative and political expediency trumping responsible policy.

“Representing the State of Maine which has been bludgeoned by premium costs representing a 349 percent increase over the last decade alone, it is inherently clear that the status quo is unacceptable. At the same time, I believe that process dictates substance, and the bill that the Senate voted on last December was the result of a defective process that could not produce the kind of legislation that would garner widespread support and credibility.

“Now, here we are today – with the majority leadership doing an ‘end run’ around the regular order of legislative procedures with a ‘reconciliation’ process that severely curtails the scope of potential amendments that could improve the underlying bill, which I find profoundly troubling as one who has said throughout this debate that I would work to improve the legislation regardless of whether I could ultimately support it. The fact is, reconciliation was designed to address budget deficits, not to enact the reordering of more than $33 trillion on health care expenditures over the next ten years and one-sixth of our economy. Given this legislation would essentially not take effect until 2014, Congress could have taken the opportunity to address the underlying concerns with the bill rather than resort to legislative machinations.

“Indeed, at this precarious time when we must reestablish our economy, this is precisely the wrong moment to be increasing penalties in the bill from $750 to $2,000 for employers, with more than 50 workers, who do not offer health insurance. Moreover, retaining the Medicare tax increases from the Senate version of the bill will disproportionally affect our nation’s small businesses which will hinder, rather than help, small business job growth. The House also failed to remove the Class Act, a new entitlement which has been criticized by the non-partisan Medicare Actuary, who pointed out that it has serious problems with adverse risk selection that would make it ‘unsustainable.’ And I am troubled that the House also cut more deeply into Medicare, which moves us further in the wrong direction.

“While the House reconciliation bill would increase subsidies for low-income and middle-class individuals, I remain concerned the bill does not ensure affordable premium options for all Americans. That is why I wrote to the Congressional Budget Office on December 3 to request a state-specific analysis of the impact on premiums, however I did not receive an answer to that question before the Senate vote in December and as of today we still don’t have that critical information.

“This was not Congress’s finest hour -- we could have produced bipartisan legislation supported by a strong majority of Americans but the process by which we considered this enormous task failed to allow for that outcome, to the detriment of the American people."

The floor speech today has much more detail.

 

[mheslep]

David Frum has a very thoughtful blog that is ostensibly about the health care bill, but ends up diagnosing a big problem the Republicans have:

http://www.frumforum.com/waterloo"

I agree with Frum here:

So today’s defeat for free-market economics and Republican values is a huge win for the conservative entertainment industry.

For me its an empiric point: if I look objectively at the current public policy and conclude its going very wrongly, I conclude that the mouths doing most of the talking center stage are not effective, even destructive. They need to shut up and get off the stage. Limbaugh from what little I can tell is not much of a http://74.125.93.132/search?q=cache..._Burke+edmund+burke&cd=1&hl=en&ct=clnk&gl=us" conservative in the political sense. He is a 'leave everything as it is' conservative in the first dictionary sense, and the two are often completely different.

 

[mheslep]

Do you have a reliable independent study supporting that assertion (and how many "middle class Americans" are you talking about: 100 or 100 million)? The last CBO analysis on premiums, from Nov 30, says that most people will see a decrease in costs. I don't believe they've redone that analysis more recently.

http://www.politifact.com/truth-o-m...-care-reform-does-not-increase-premiums-and-/

www.cbo.gov/ftpdocs/107xx/doc10781/11-30-Premiums.pdf

I'm inclined to look to the 2006 Massachusetts reforms as the best guides for what is to come, as they're similar. Mass has by far the highest premiums in the country and the longest wait times to see a GP. They had high premiums before reform too, but they've continued to increase since 2006, the WSJ op ed says 30%/year for individuals.
http://online.wsj.com/article/SB10001424052748703444804575071294139286892.html?mg=com-wsj
Boston.com says, about 10%/year for the overall market.
http://www.boston.com/business/healthcare/articles/2009/09/16/health_insurers_plan_10_rise_in_rates/
Meanwhile the state's spending on health has increased dramatically, with Gov Patrick recently threatening price controls.

http://www.boston.com/bostonglobe/e...9/03/02/mass_healthcare_reform_is_failing_us/

 

[Gokul43201]

Yeah, it's possible this may end up similarly, but I'm not sufficiently aware of the details to comment. Nevertheless, I find it odd that a plan that is supposedly so similar to the one implemented by the Republican front-runner for the next Presidential election is being heckled so savagely by the Republican Party.

On a somewhat related note, I'd never heard of the position and role of Senate Parliamentarian until today.

http://en.wikipedia.org/wiki/Parliamentarian_of_the_United_States_Senate

 

[Gokul43201]

Snowe as you may know voted to forward the Senate bill out of here Finance Committee with some reservations. After that the bill went behind closed doors it came out completely differently; she and every other R. voted against that. Today she went on the floor and attacked the final bill in detail, describing how it went completely off the rails after committee.

There was an op-ed in the Times a couple weeks ago, written by Snowe's Health Policy adviser.

Here it is: http://www.nytimes.com/2010/03/16/opinion/16pewen.html

Some interesting snippets:

...Republicans rightly note that their role was minimized in four of the five Congressional committees charged with drafting the legislation. Yet many Republicans had decided even before Inauguration Day to block reform, including policies that their party had previously supported. In 2003, for example, Republicans enacted legislation that financed end-of-life counseling — yet in town halls last August they claimed a similar measure would create “death panels.”

Republican cries for fiscal responsibility also ring hollow when you consider the party’s record of establishing higher-cost private Medicare plans and enacting a drug benefit that wasn’t paid for. The fact is that under the Republicans’ watch, critical problems of escalating health costs and access to affordable coverage were largely ignored.

Yet Democratic leadership worsened the erosion of bipartisanship.
...
Democrats later merged legislation from the two Senate committees into a single bill.

In that merging, the focus shifted to a one-sided political calculus, and away from critical questions like just how much it would cost Americans to carry the minimum amount of insurance coverage required under the emerging bill. Rather than address such concerns, the Democratic leadership, in the interest of political expediency, expanded the scope of the legislation, adding more regulation, spending and taxes. Soon health care reform, which had been achievable, became endangered.
...
No less embarrassing was the way the majority leadership killed a bipartisan amendment to establish an F.D.A.-regulated system for importing prescription drugs. Safe importation would have produced nearly $100 billion in savings, $19.4 billion of which would have been realized by the federal government. But the amendment conflicted with the deal Democrats had made with the pharmaceutical industry.
...

 

[mheslep]

Yeah, it's possible this may end up similarly, but I'm not sufficiently aware of the details to comment. Nevertheless, I find it odd that a plan that is supposedly so similar to the one implemented by the Republican front-runner for the next Presidential election is being heckled so savagely by the Republican Party.

Two reasons, as Romney and others have often responded when asked that question:
1. Mass/Romney care admittedly didn't attempt to address cost head on. The main idea was simply to get people covered. Romney now admits the beast doesn't work for costs. Then, the Mass legislature, in an all too predictable hand-out-the-bacon move for politicians, piled on a heap of benefits and requirements into the state plans that Romney didn't want.
2. Mass/Romney care is a _state_ based solution. At the state level, the plan is customized for Mass needs, the politicians have a higher degree of accountability for the problems, as do the local bureaucratic implementers, and fixes are far easier to make than it ever will be for a federal plan.

On a somewhat related note, I'd never heard of the position and role of Senate Parliamentarian until today.

http://en.wikipedia.org/wiki/Parliamentarian_of_the_United_States_Senate

Neither had I.

 

[Nebula815]

Yeah, it's possible this may end up similarly, but I'm not sufficiently aware of the details to comment. Nevertheless, I find it odd that a plan that is supposedly so similar to the one implemented by the Republican front-runner for the next Presidential election is being heckled so savagely by the Republican Party.

Well just because Mitt Romney enacted the program doesn't mean that conservatives were in agreement with it.

One thing to keep in mind on Romney as well is most conservatives have always been suspicious of him, but are willing to go along with his current policy choices, not vote for him based on his past, in which he was first a Democrat, then became a pro-choice Republican who created Romneycare in Massachusettes, then changed to being pro-life and against government-mandated healthcare.

On a somewhat related note, I'd never heard of the position and role of Senate Parliamentarian until today.

http://en.wikipedia.org/wiki/Parliamentarian_of_the_United_States_Senate

A lot of people hadn't heard of reconciliation until this bill either. Or deem-and-pass.