Health Care Reform Debate 2009

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[LyricFox]

Since this topic is going to be with us awhile, I decided it needed its own thread. You can post links to blogs, articles, opinions and have discussions in here.

[LyricFox]

Doctors and the Cost of Care

As the debate over health care reform unfolds, policy makers and the public need to focus more attention on doctors and the huge role they play in determining the cost of medical care — costs that are rising relentlessly.

http://www.nytimes.com/2009/06/14/opinion/14sun1.html?em

[Starglade]

The more I read about this (and I'm reading a lot, thanks to my BA in progress) the more I'm seeing that this situation has been bad from somewhere around WWI, and has only gotten worse over time. There's no single point at which we can level a finger and say "THERE! THAT is where it went wrong." The three major concerns--cost, quality, and access--have always been the three major concerns, and there has yet to be found a way to control all three at once. Any control gained over one or two only makes the other one or two worse.

The conflict of interest that has come about in the last ten or so years, as physicians order more and more tests through facilities in which they have a personal stake, must clearly be a major point in any overhaul. Trouble is, ANY point is a major point, at present. 

The public health sector, which is where I'm being drawn, is in more trouble than any other in the areas of quality and cost, from what I'm seeing and reading. Sultz and Young (2009) point out that the objectives from Healthy People 2000, set in 1990, have been largely unmet, with 85% of them being swept under the carpet as the new set, called Healthy People 2010, were created. (This, by a group twice the size of that which created the first set.)(p. 61) It seems that people in general--and by that, I mean the public as well as the professionals and the government--think that as long as they pay lip service, and claim to have a concern for doing the right thing, that's good enough. "Well of course we need to do XYZ things. If we don't, who will?" And of course, no one does--because everyone has his or her own interests at stake, and refuses to put anyone else first.

I don't see "reform" as being very practical, to be honest. I see a "slash and burn" as a requirement. Tear the whole thing down, and start from the dirt up. Ugly, to be sure. Painful, without a doubt. But as it stands? I don't see any real way to correct the problems. They're systemic, and have been present from the very beginnings.

Sultz, H.A., & Young, K.M. (2009). Health care U.S.A.: Understanding its organization and delivery. Sudbury MA: Jones and Bartlett.

[LyricFox]

Baucus, Grassley Seek to Salvage Health-Care Bill

http://news.yahoo.com/s/bloomberg/20090612/pl_bloomberg/aopmm5sy6vw

[LyricFox]

I wondered when someone was going to come up with something like this.

State Lawmakers Considering Move to Opt Out of Federal Health Care
Lawmakers in six states are considering legislation to "protect" citizens from a federal health care plan by creating statewide initiatives to vote on whether to opt out of the national program -- even before Congress has created the program

http://www.foxnews.com/politics/2009/06/25/state-lawmakers-considering-opt-federal-healthcare/

[Owl]

I wondered when someone was going to come up with something like this.

State Lawmakers Considering Move to Opt Out of Federal Health Care
Lawmakers in six states are considering legislation to "protect" citizens from a federal health care plan by creating statewide initiatives to vote on whether to opt out of the national program -- even before Congress has created the program

http://www.foxnews.com/politics/2009/06/25/state-lawmakers-considering-opt-federal-healthcare/

There's a moron in every bunch.....

[LyricFox]

Obama gets ally for health care plan: Wal-Mart
In a letter, retailer says it embraces employer coverage mandate proposal

WASHINGTON - Wal-Mart is the latest in a line of traditionally Republican-leaning businesses to embrace key portions of President Barack Obama’s bid to overhaul health care, a trend that could complicate opponents’ efforts to build a united front when Congress ramps up its work on the issue this summer.

http://www.msnbc.msn.com/id/31667110/ns/business-consumer_news/

[mandrina]

Obama gets ally for health care plan: Wal-Mart
In a letter, retailer says it embraces employer coverage mandate proposal

WASHINGTON - Wal-Mart is the latest in a line of traditionally Republican-leaning businesses to embrace key portions of President Barack Obama’s bid to overhaul health care, a trend that could complicate opponents’ efforts to build a united front when Congress ramps up its work on the issue this summer.

http://www.msnbc.msn.com/id/31667110/ns/business-consumer_news/

I'm going to say something nicely.  My employer provides health insurance.  Most of the staff can't afford it, and for the those who can, it maxes out after 50,000 life time.  That's right, 5 digits.  Oh, yeay, and doesn't hit hospital until the second day, after all the expensive stuff is done for say,a heart attack..  One of our nurses had a lump in her breast., It maxed out after the lumpectomy.

[sailor_tech]

I'm going to say something nicely.  My employer provides health insurance.  Most of the staff can't afford it, and for the those who can, it maxes out after 50,000 life time.  That's right, 5 digits.  Oh, yeay, and doesn't hit hospital until the second day, after all the expensive stuff is done for say,a heart attack..  One of our nurses had a lump in her breast., It maxed out after the lumpectomy.

This is probably what Wal-Mart is looking for. Federal mandate on minimum coverage that pre-empts state efforts; and it puts all companies that might compete with Wal-Mart on the level as Wal-Mart.

[mandrina]

This is probably what Wal-Mart is looking for. Federal mandate on minimum coverage that pre-empts state efforts; and it puts all companies that might compete with Wal-Mart on the level as Wal-Mart.

Truthfully, our health insurance is not that much of a strain on the company.  We're a mostly medicaid nursing home.  We don't spend much on bennies outside of vacation.  Seriously.  Not much at all.  It's expensive, but only on the family plan version. 

[LyricFox]

Obama Open to Partisan Vote on Health-Care Overhaul, Aides Say

July 14 (Bloomberg) -- President Barack Obama may rely only on Democrats to push health-care legislation through the U.S. Congress if Republican opposition doesn’t yield soon, two of the president’s top advisers said.

http://www.bloomberg.com/apps/news?pid=20601087&sid=a4.kYDWV9erc

[RandallS]

Obama Open to Partisan Vote on Health-Care Overhaul, Aides Say

I always figured this would be what it came down to, but he really did need to try. Unfortunately, the only bill that could get much republican support would be next to useless at actually solving the problem.

[NTL, 32]

I know that this is a hotly debated topic and there are so many different ways of looking at the situation.  I understand that health care is very important and it is not something that can wait much longer.  However, I believe that if this situation is not looked at very carefully there will be a serious problem.  We are talking about covering 300 million people.  I do not believe that any country has done this yet.  I believe it can be done but there is something that is troubling me. 

Why hasn't any congress basically said... "in order to cut the cost of health care to make a general national plan more affordable we need to look at the places where the money is being spent." 
Find the areas that money is being wasted on or projects that are receiving government/tax payer money and if they have not made significant progress in a specific amount of time cut  the program.  Most of the health care costs come from research.  It is no surprise then that with the major technology that has been coming out over that last two decades that the price of health care has increased.  It is not cheap to research most of the experimental and radical new procedures, medical equipment, and medical drugs.

Furthermore, we know that there is a problem with the cost of malpractice insurance.  If the government is paying for health care costs then are the doctors going to have to purchase malpractice insurance subsidized by the government?  If that is so, then are malpractice suits going to have to filed with the government and thus a malpractice suit that gets paid out by the government? 

I believe that health care is possible but many questions need to be answered first.  I can't imagine that our government cannot come up with a way to cut costs. 

[HeartShadow - Cutethulhu]

I believe that health care is possible but many questions need to be answered first.  I can't imagine that our government cannot come up with a way to cut costs.

The problem is, one of the biggest costs is overhead.  It's paperwork and middlemen and profits going to every level of the system.

The government won't be in it for the profit, which will MASSIVELY cut that cost right out.

It's one of the reasons the argument of "you don't want some dude in Washington between you and your doctor" has always struck me as a bull argument.  Why should I care WHICH insurance dude is between me and my care - if there's one there anyway?  I'd prefer it isn't someone specifically PAID to say "no" ....

[NTL, 32]

The problem is, one of the biggest costs is overhead.  It's paperwork and middlemen and profits going to every level of the system.

That's what my concern is.  I also think that the biggest cost is research and the lawsuits.  If the government is paying for healthcare premiums (which if it works that is fine with me), then who are we going to be suing when a malpractice suit comes up.  I mean that may be the least of some people's worries, but one of the biggest talks in my law school right now is the overwhelming need to reform our Tort system.  I would like to see that implemented in the health care debate. 

The other thing that I do not want (and I doubt that the government may actually do this) is I do not want to be forced to have insurance.  I pay cash for everything and I do not want to be forced to take any health care that I don't want.  Like I said before, I doubt that the government would actually do this to anyone. 

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