View Full Version : Health Insurance is REALLY ouy of control!
Health care is of course a very hot issue right now. It's a hot issue for me personally, as my own health insurance - which I purchase privately as a self employed person - just went 28%. That's not a typo. It's always gone up 4-6% per year, this year, 28%, not to mention an increase in the deductible and other costs, and now exceeds my car payment...
I'm in the state of MA, which passed a universal health care law that everyone had to have health insurance (they will literally fine you $900 per year if you don't BTW), with the state offering plans at lower premiums for those who qualified, etc.
This was supposed to lower insurance costs by making the market more competitive, etc. The result for MA, a huge increase in insurance premiums, and an increased state deficit to boot...
I don't know the details of the proposed national health care plan yet, but I do recall a speech by Pres Obama making reference to MA as some sort of success story...
If the national system has any relation to the MA system, we are going to be in big trouble real fast...
I'm not at all against universal health care as a concept, but without major cost containment taking place, such as tort reforms, and other measures, in particular, drug costs, it's a pipe dream.
Doctors are also being squeezed hard these days on many levels (for example, insurance costs for doctors is also off the charts these days...), and this only makes it more difficult for them to help their patients.
To that end, many are not aware just how much big pharma costs this country, how much power they have, and what a great job they have done of preventing true competition in the market while driving their profits up.
Marcia Angell, M.D. - former editor of the New England Journal of Medicine (NEJM) - one of the most respected med journal on the planet, in line with JAMA, Nature, etc - wrote one of many good books on the topic. Below, is a summery of some of the major issues by which drug companies fail American citizens, keep our costs up, and add greatly to insurance premiums.
From THE TRUTH ABOUT THE DRUG COMPANIES:
How They Deceive Us, and What to About It
by Marcia Angell, M.D.
(Random House; August 31, 2004)
1. The pharmaceutical industry claims to be a high-risk business, but year after year drug companies have higher profits than any other industry - by a long shot. In 2002, the top ten American drug companies had a profit of 17 percent, compared with 3.1 percent for the other Fortune 500 industries. The biggest drug company, Pfizer, had a profit of 26 percent.
2. The industry claims to be innovative, but only a small fraction of its drugs are truly innovative. Of the 78 drugs approved by the Food and Drug Administration (FDA) in 2002, only 17 contained new active ingredients, and only 7 were classified by the FDA as likely to be improvements over drugs already on the market. Most of the others were just minor variations of old drugs.
3. The most profitable drugs are variations of top-selling drugs already on the market - "me-too" drugs. There are whole families of me-too drugs, and no good reason to believe one is better than another at equivalent doses. They cash in on already-established, huge markets. The top-selling drug in the world, Pfizer's Lipitor, is the fourth of six cholesterol-lowering drugs of the same type.
4. The industry's most innovative drugs usually stem from research done at government or university labs. An internal National Institutes of Health (NIH) document showed that only 1 of the 17 key research papers that led to the five top-selling drugs in 1995 came from the company that sold the drug. Big drug companies license or otherwise acquire about a third of all their drugs from' universities, the NIH, or smaller companies.
5. Contrary to popular belief, big drug companies spend less on research and development (R&D) than they keep in profits and far less than they spend on marketing. By their own figures, in 2002 (when profits were 17 percent of revenues), the top ten American drug companies spent only 14 percent of revenues on R&D and 31 percent on marketing and administration (of which the lion's share was probably marketing). The industry claims to spend $802 million to bring each new drug to market, but independent analysis shows that the true figure is a small fraction of that amount.
6. The U. S. is the only advanced country that does not regulate drug costs in some way, and other countries spend only about half as much for the same drugs as Americans. Methods vary, but essentially governments in other countries take advantage of their bargaining power to negotiate prices. Still, drug companies do not sell at a loss in these countries.
7. The pharmaceutical industry has an iron grip on Congress and the White House. It has the largest lobby in Washington, with more lobbyists than elected representatives, and it contributes heavily to political campaigns. Over the past two decades, Congress has enacted a series of laws that practically ensure windfall profits to the pharmaceutical industry, at public expense. For example, the Medicare prescription drug benefit enacted in 2003 specifically prohibits Medicare from negotiating for lower drug prices.
8. Drug companies promote diseases to fit drugs. To expand sales, they persuade people in affluent countries that they are suffering from conditions that need long-term treatment. Thus, millions of normal Americans come to believe that they have dubious or exaggerated ailments like "generalized anxiety disorder," "erectile dysfunction," "PMDD," and "GERD."
9. The part of the FDA that approves new drugs receives half its support from drug companies. The FDA reviews drugs for safety and effectiveness before they are allowed on the market, but drug companies pay large "user fees" in return for quick reviews. That means the agency is beholden to the industry it is supposed to regulate. .
10. New drugs are not required to be any better than old ones, and there is usually no way to know whether they are. Drugs have to be tested before the FDA will approve them, but they do not have to be compared with older drugs for the same condition, only with placebos. That means we don't know whether new drugs are better or worse than old ones. They just have to be reasonably safe and better than nothing -- *a low standard indeed.
11. Drug companies have enormous influence over what doctor are taught about drugs and what they prescribe. The companies support most continuing medical education (CME) courses, medical conferences, and meetings of professional societies. They have armies of sales representatives to visit doctors and teaching hospitals to tout their wares, hand out free samples, and provide meals and other gifts. There is ample evidence that this huge investment in medical "education" pays off in terms of the prescriptions doctors write.
12. Drug companies have a lot of control over clinical trials of their drugs, which makes drugs look better than they are. They support much of the drug research done in academic medical centers by faculty researchers. In return, they insist on designing studies that increase the likelihood of a favorable result. There is good reason to believe that much of the company-supported research on prescription drugs is biased as a result.
13. The pharmaceutical industry portrays itself as a model of American free enterprise, but it is anything but. Of the top ten companies in 2002, half are European. And while the industry is free to decide what drugs to develop and to price them as high as the traffic will bear, it is utterly dependent on government-funded research and government-granted monopolies in the form of patents and FDA*conferred exclusive marketing rights.
14. Even while the pharmaceutical industry turns out whole families of me-too drugs for relatively mild conditions in affluent people, it pays almost no attention to major scourges in poor people -- like malaria. It also gives short shrift to less profitable drugs. There are shortages of some vaccines and life-saving drugs, such as antivenins for poisonous snakebites; because few companies want to make them.
Health care is of course a very hot issue right now. It's a hot issue for me personally, as my own health insurance - which I purchase privately as a self employed person - just went 28%. That's not a typo. It's always gone up 4-6% per year, this year, 28%, not to mention an increase in the deductible and other costs, and now exceeds my car payment...
I'm in the state of MA, which passed a universal health care law that everyone had to have health insurance (they will literally fine you $900 per year if you don't BTW), with the state offering plans at lower premiums for those who qualified, etc.
So, why did your premium go up so much? Have you asked your insurer? Have you shopped for other coverage? Did it occur to you that the "reforms" in MA might have something to do with your premium going up because you are basically subsidizing the "lemons" in the market that insurers are now forced to cover?
The MA situation is evidence of what a terrible idea this national bill will be.
Doctors are also being squeezed hard these days on many levels (for example, insurance costs for doctors is also off the charts these days...), and this only makes it more difficult for them to help their patients.
No, they're really not. They bitch about that and certain political factions claim that it's an issue, but it isn't for most doctors. Some docs (like OB/GYB) have, and always have had, high malpractice insurance costs. Most don't and it's a small portion of their budgets.
To that end, many are not aware just how much big pharma costs this country, how much power they have, and what a great job they have done of preventing true competition in the market while driving their profits up.
Could you elaborate on that? They develop drugs and then market drugs. This requires very large investments at many levels, from research and investigation, development, clinical trials and approval, sometimes manufacturing that is very costly, etc. They get patents on their intellectual property, as they should. You do not have a right to their products, or a right to them at what you consider to be fair, just because you are alive and think you need them.
Marcia Angell, M.D. - former editor of the New England Journal of Medicine (NEJM) - one of the most respected med journal on the planet, in line with JAMA, Nature, etc - wrote one of many good books on the topic.
NEJM and most medical journals have an incredibly liberal slant. These are the same journals that think guns are an epidemic disease and that publish flawed studies on the dangers of guns. They do very poorly when they venture outside their lanes, which is what happens when they comment on economic policies.
1. The pharmaceutical industry claims to be a high-risk business, but year after year drug companies have higher profits than any other industry - by a long shot. In 2002, the top ten American drug companies had a profit of 17 percent, compared with 3.1 percent for the other Fortune 500 industries. The biggest drug company, Pfizer, had a profit of 26 percent.
So what? Buy stock in them. Looks like they're doing well.
2. The industry claims to be innovative, but only a small fraction of its drugs are truly innovative. Of the 78 drugs approved by the Food and Drug Administration (FDA) in 2002, only 17 contained new active ingredients, and only 7 were classified by the FDA as likely to be improvements over drugs already on the market. Most of the others were just minor variations of old drugs.
Then presumably they don't have patent exclusivity and will have competitors.
3. The most profitable drugs are variations of top-selling drugs already on the market - "me-too" drugs. There are whole families of me-too drugs, and no good reason to believe one is better than another at equivalent doses. They cash in on already-established, huge markets. The top-selling drug in the world, Pfizer's Lipitor, is the fourth of six cholesterol-lowering drugs of the same type.
If they're competitors in a glutted market then there isn't an issue with unfair competition or monopoly power.
4. The industry's most innovative drugs usually stem from research done at government or university labs. An internal National Institutes of Health (NIH) document showed that only 1 of the 17 key research papers that led to the five top-selling drugs in 1995 came from the company that sold the drug. Big drug companies license or otherwise acquire about a third of all their drugs from' universities, the NIH, or smaller companies.
And they pay for those licenses. The patents are still held by whoever invented it. This isn't a dirty secret, it's business as usual in every industry that uses intellectual property.
5. Contrary to popular belief, big drug companies spend less on research and development (R&D) than they keep in profits and far less than they spend on marketing.
So what? They're businesses that sell a product to an enormous market - the entire world. Of course they spend a lot on marketing. How much of a bottle of Coke do you think is marketing cost?
6. The U. S. is the only advanced country that does not regulate drug costs in some way, and other countries spend only about half as much for the same drugs as Americans. Methods vary, but essentially governments in other countries take advantage of their bargaining power to negotiate prices. Still, drug companies do not sell at a loss in these countries.
Yeah, those other countries are socialist. In exchange for paying less for drugs, everyone pays higher taxes and gets to wait 9 months for a doctor's appointment. Great, where do I sign up.
I can't even stomach anymore of this. This lady needs to go back to being a doctor and stop trying to be an economist.
Belmont31R
01-01-10, 10:55
Im not against a government plan as long as the costs are COMPLETELY contained within such a plan, and general tax dollars are not used to fund it.
I dont believe in subsidized or mandatory health care.
I dont believe the gov can tell a company what specific products or services they have to offer, how much they can charge for it, and how much profit they can make.
I dont believe hospitals should be forced to treat people who cannot pay. Emergency care? Sure...but only if the doctor agrees it really is an TRUE emergency, and not just someone choking up the ER because they know they are going to get treated for their cold.
Frivilous medical lawsuits should be a felony just the same as filing a false police report, and a medical lawsuit should have the approval of two doctors signing off on it.
I should be able to buy insurance from any company legally operating in the US.
Gov should get out of the business of regulating importation/reimportation of drugs. Somehow we pay way more than everyone else for the same medicine.
Doing the above would most assuredly result in far lower medical costs both in billing, and insurance costs. Yet ObamaCare does the exact opposite. Drugs are going to be more expensive, insurance companies are now a hair away from being government run and operated, does NOTHING for drug costs, subsidizes health care, lowers reimbursement costs for doctors accepting current gov plans which means us with insurance are going to get charged more, does nothing about bogus lawsuits, does nothing about people going to the ER for bogus shit, raises taxes tremendously in a very bad time economically, and the list goes on.
I fully believe this is designed for nothing more than appealing to the leeches of society, throws another wrench in private insurance making costs go up, and lowers the quality of care....in 10-20 years or whatever when everyones health care is almost entirely unaffordable, care sucks, and there are way too few doctors the "fix" will be another huge government take over. Single payer is their objective, and they have been doing everything possible to ruin the concept of individual private insurance. The start was socialized healthcare like Medicare and Medicaid. You know why hospitals are forced to treat people who don't pay them? because if they accept gov insurance as payment they have to abide by the Patients Bill of Rights which means they have to treat everyone who walks through their door. Now 50 some years later the excuse for more government health care is because of people who walk into an ER and dont pay.
If hospitals got the same pay from people on gov insurance as they do private insurance gov insurance would have gone bankrupt a long time ago. The only reason its gone on this long is because they dictate what they pay doctors, and keep lowering the rates. For every dollar they lower rates doctors raise the charges to private insurance a dollar just to keep the same cash flow coming in.
You'd be surprised just how cheap medical care would cost if doctors went to a cash only system, and didnt have to worry about a bogus malpractice lawsuit every patient they treat.
You'd be surprised just how cheap medical care would cost if doctors went to a cash only system, and didnt have to worry about a bogus malpractice lawsuit every patient they treat.
Got anything to back that up?
If you're suggesting that malpractice insurance costs, or lawsuit costs (litigating them and paying claims) is any significant cost, you're just wrong. The numbers just don't bear that out, no matter how many times various pundits talk about it.
If you're suggesting that doctors practice differently because they can get sued if they screw up, you're right and that's a good thing. Every other industry and profession (lawyers, engineers, manufacturers, etc.) can and do get sued for screwing up, and carry insurance for that. It also means that they try a lot harder to not screw up and to get it right - which is the whole point of a tort system.
If doctors woke up tomorrow and all of a sudden it was impossible, or much harder, to sue them for screwing up, what do you think would happen to the overall quality of care? People blabber on and on about "defensive" medicine as though that's bad thing. It's not - it's making sure you get it right. It's also why the U.S. has, for example, a much higher cancer survival rate than countries with socialized medicine who "contain costs."
I do agree that we need to make the consumer feel the cost of the care they consume much moreso than we do now. People should be allowed to decide if they pay for the extra tests after the cost/benefit is explained by the provider.
If you want to see how disastrous govt. run health care can be, check the history of TennCare here in TN. It is/was highly abused and almost bankrupted the state. If anyone thinks national healthcare is going to be a positive, tell E.T. "hi" for me.
Belmont31R
01-01-10, 11:16
Got anything to back that up?
If you're suggesting that malpractice insurance costs, or lawsuit costs (litigating them and paying claims) is any significant cost, you're just wrong. The numbers just don't bear that out, no matter how many times various pundits talk about it.
If you're suggesting that doctors practice differently because they can get sued if they screw up, you're right and that's a good thing. Every other industry and profession (lawyers, engineers, manufacturers, etc.) can and do get sued for screwing up, and carry insurance for that. It also means that they try a lot harder to not screw up and to get it right - which is the whole point of a tort system.
If doctors woke up tomorrow and all of a sudden it was impossible, or much harder, to sue them for screwing up, what do you think would happen to the overall quality of care? People blabber on and on about "defensive" medicine as though that's bad thing. It's not - it's making sure you get it right. It's also why the U.S. has, for example, a much higher cancer survival rate than countries with socialized medicine who "contain costs."
I do agree that we need to make the consumer feel the cost of the care they consume much moreso than we do now. People should be allowed to decide if they pay for the extra tests after the cost/benefit is explained by the provider.
Im not doing your research for you...but look at the states who have reformed medical lawsuits.
I never said a doctor should not be sued if he ****s up. However the process to getting there should be a lot harder than just signing up with some scumbag attorney, and dragging the doctor to court costing him thousands in legal fees. There should be doctors signing off on the complaint saying...yes this sounds like a valid case, and then let it go to court. If the doctor is not found to have done anything wrong then the plaintiff should pay their legal costs.
Look at LEO's...they have legal protection in doing their job. A doctor on the other hand in most states have little to no protection from bogus lawsuits.
Type in google: Texas Tort Reform results
Im not doing your research for you...but look at the states who have reformed medical lawsuits.
I live in and practice law in a state that has a med mal cap (Virginia) - it has practically zero effect on the number of lawsuits, the costs, or the insurance premiums paid by docs here.
I never said a doctor should not be sued if he ****s up. However the process to getting there should be a lot harder than just signing up with some scumbag attorney, and dragging the doctor to court costing him thousands in legal fees. There should be doctors signing off on the complaint saying...yes this sounds like a valid case, and then let it go to court. If the doctor is not found to have done anything wrong then the plaintiff should pay their legal costs.
You clearly have little of idea how any of this works if you think that this needs to happen. In my state and others, you have to file a certificate of merit already that's signed by a doctor (or other specialist health care provider) with every med mal case.
You also don't seem to understand that, for these "scumbag" lawyers, it's a huge risk to pursue a med mal case and they'd go bankrupt quickly if they pursued frivlolous ones. In addition to the fact their fees are contingent on recovery, the litigation costs for the plaintiff in a med mal case (which are typically fronted by the attorney) are enormous compared to other types of cases, due to the experts that have to be hired and paid to evaluate and testify. A typical med mal case will have $50K-$80K in costs, which means no lawyer is going to front that unless it has merit AND has signficant, provable damages.
Med mal is not the realm of cheesy strip mall lawyers. It is serious, expensive plaintiff's work that requires a lot of bankroll and skill.
Look at LEO's...they have legal protection in doing their job. A doctor on the other hand in most states have little to no protection from bogus lawsuits.
Not picking on LEOs specifically here, but government employees have sovereign immunity which means they can't be sued for negligently performing government functions - and oddly enough, many of them have a reputation for being lazy, incompetent, ineffecient, and not caring if they screw up. Imagine that.
The rest of us in the real, non-government world can get sued and behave accordingly.
Belmont31R
01-01-10, 11:34
I live in and practice law in a state that has a med mal cap (Virginia) - it has practically zero effect on the number of lawsuits, the costs, or the insurance premiums paid by docs here.
You clearly have little of idea how any of this works if you think that this needs to happen. In my state and others, you have to file a certificate of merit already that's signed by a doctor (or other specialist health care provider) with every med mal case.
You also don't seem to understand that, for these "scumbag" lawyers, it's a huge risk to pursue a med mal case and they'd go bankrupt quickly if they pursued frivlolous ones. In addition to the fact their fees are contingent on recovery, the litigation costs for the plaintiff in a med mal case (which are typically fronted by the attorney) are enormous compared to other types of cases, due to the experts that have to be hired and paid to evaluate and testify. A typical med mal case will have $50K-$80K in costs, which means no lawyer is going to front that unless it has merit AND has signficant, provable damages.
Med mal is not the realm of cheesy strip mall lawyers. It is serious, expensive plaintiff's work that requires a lot of bankroll and skill.
Not picking on LEOs specifically here, but government employees have sovereign immunity which means they can't be sued for negligently performing government functions - and oddly enough, many of them have a reputation for being lazy, incompetent, ineffecient, and not caring if they screw up. Imagine that.
The rest of us in the real, non-government world can get sued and behave accordingly.
In my state since tort reform went into effect the costs for doctors have gone down quite a bit. There are several studies that show this. We've also had an influx of doctors from out of state wanting to practice here. The results speak for themselves, and at the very least results in lower costs for doctors. That means more people will want to become a doctor, and improve competition which lowers costs just by itself.
Good on Virginia to require a doctor to sign off on a lawsuit. It should be that way nationwide.
It may not have a large effect on costs but it does help, and we need every little bit that helps. Is there a reason not to have national tort reform?
Edit- Many gov workers are incompetant and lazy because they have excellent job security, diversity, and a lack of will on part of the population to do anything about it. We get the government we deserve, and if that means its full of lazy incompetent people then so be it. Just like I have no sympathy for California, and their state government. The people elected those in charge of spending, and now their prisons are letting people out early because they cant afford to house them. Will anything change there? Not likely.
And when Obamacare takes affect, and our health care system goes even into worse shape than it is now we have no one to blame but ourselves. I dont blame the politicians. I blame the idiots that put them into office. I don't blame the lazy government worker. I blame the people that voted a politician into office who created the laws and regulations that put that lazy gov worker into the job in the first place.
If you're suggesting that doctors practice differently because they can get sued if they screw up, you're right and that's a good thing. Every other industry and profession (lawyers, engineers, manufacturers, etc.) can and do get sued for screwing up, and carry insurance for that. It also means that they try a lot harder to not screw up and to get it right - which is the whole point of a tort system.
If doctors woke up tomorrow and all of a sudden it was impossible, or much harder, to sue them for screwing up, what do you think would happen to the overall quality of care? People blabber on and on about "defensive" medicine as though that's bad thing. It's not - it's making sure you get it right. It's also why the U.S. has, for example, a much higher cancer survival rate than countries with socialized medicine who "contain costs."
Balance of things is a key. Physician's accountability is important, but, in my professional experience, the pendulum has over-swang. Every week I see patients in consultations that shouldn't be referred to me, but they are referred nonetheless. I superwise and interpret hundreds of tests annually that have little or no indications, at a price of $800 to $2000 apiece, often times leading to more expensive testing just to say that everything is fine. I've just finished seeing a patient who is in ICU with renal failure due to IV dye load given during CT scan which provided no meaningfull info, except for reassurance that there was nothing terribly wrong. Her care is costing thousands of dollars daily. Despite the fact that patient is gravely ill, doc who ordered the test is bulletproof from lawsuit because he ordered it to "make sure you get it right".
So, yes, defensive medicine is costing a ton of money, in my opinion, wasted money. Now, my opinion doesn't matter; what matters is your, consumer's, opinion and attitude. And current attitude is a desire for 100% certainty and near zero tolerance for adverse outcomes, and that, folks, is going to cost you, one way or another.
Re cancer survival rates, it is a separate discussion. US population enjoys some of the highest survival rates from cancer, heart attacks and major trauma, US spends more money on health care than anybody else, yet longevity and quality of health are far from being on top. Food for thought, eh?
dbrowne1- Never thought I would agree with you on much(if my memory is working properly) but I agree with your first post. Guess how many people own pharma stocks in their 401k's, 403(b)'s, pension funds, etc.
As far as malpractice being a significant portion of overhead, it usually is. My wife is an OB/GYN(yes, I know they are specifically sued often b/c of the way laws are written-can get sued in most states by someone they delivered UNTIL THE INDIVIDUAL IS 21!) but for her her malpractice is about 60K/yr. and this is with her having never had a lawsuit. We are moving soon and her tail coverage will be 84K. Most of our friends that are MD's avg. probably 20-40K/yr in malpractice overhead.
Tort reform states usually have lower premiums. When we lived on St. Maarten(Dutch side), 52% of my paycheck was gone right off the top. I had SVB(gov. ins.). My wife found a lump in her breast while we lived there. The best MD's were on the French side so we went to a French MD. He said he could get her to an imagery center on the French side, through the so-called great French socialized medicine in about 3-4 months. Or, she could go to a private imagery center on the Dutch side in about 3hrs. Just my little experience with socialized medicine and just my .02.
ForTehNguyen
01-01-10, 12:57
best idea for tort reform is to have medical disputes certified and settled in medical courts with independent experts, not bon bon eating uneducated juries. However I am not a fan of caps on damages by some arbitrary number.
Also health insurance company profit margins are very slim like 3-4% profit margin, so dont buy the BS that they are evil profiteers.
If you want to see how disastrous govt. run health care can be, check the history of TennCare here in TN. It is/was highly abused and almost bankrupted the state. If anyone thinks national healthcare is going to be a positive, tell E.T. "hi" for me.
BINGO!
Additionally why would anyone think that they are somehow entitled to medical treatment that they can not afford or that others should be forced to pay for treatment for their illnesses. Which are many times was caused directly by the person suffering from it.
I have read the US Constitution and the Bill of Rights(as well as all the other amendments)more than a few times and have never once found anything that even slightly could be used to argue for free subsidized or all inclusive health care. Hell I can't even find where they even mentioned health care one way or another.
I will also ask that someone please show me just one government run or regulated agency/program that is highly trusted highly rated highly efficient and cutting edge in regards to better products and or services.
Demand TORT reform now and start penalizing those instituting frivolous lawsuits, that will go a long ways in starting to make the changes needed.
BTW through the generosity of millions of Americans millions of others receive medical care they could never afford and the US government and lawyers are not involved.
Medical insurance isn't a complicated business model. The money coming in has to be greater than the money going out, enough to cover administrative and operating expenses, and make a bit of profit.
Rates keep going up because we as a society keep demanding greater and greater amounts of more expensive care. A lot of that is new and ever more expensive drugs. Insurance companies try to keep doctor's charges down, but get vilified for it. Doctors need to stop prescribing the latest and greatest drugs and stick with proven ones that are available as generics. Sometimes this isn't possible, but the marketing practices employed by pharmceutical reps do sway doctors into prescribing the most profitable alternatives. For example, there is no reason to prescribe Lipitor when other generic statins are available, unless there is a drug interaction or other reason why Lipitor is the only option. But the patients need to stop asking for the new drugs - and that means a ban on direct-to-consumer pharma advertising.
I just had an dental hygienist more or less admit to me the other day that the local dentists engage in unofficial price fixing. That's illegal collusion under the anti-trust laws. They charge what the other guys charge. Same goes for most doctors. They don't compete on price, and many won't even discuss prices up front.
Every business has to continuously become more efficient to stay profitable and stay in business because of competition. If doctors can't make as much money as they'd like (and most make a very comfortable living) then maybe they need to make their practices more efficient instead of colluding to raise rates all the time.
Outlander Systems
01-01-10, 13:22
...but government employees have sovereign immunity which means they can't be sued for negligently performing government functions - and oddly enough, many of them have a reputation for being lazy, incompetent, ineffecient, and not caring if they screw up. Imagine that.
The rest of us in the real, non-government world can get sued and behave accordingly.
This.
Got anything to back that up?
If you're suggesting that doctors practice differently because they can get sued if they screw up, you're right and that's a good thing. Every other industry and profession (lawyers, engineers, manufacturers, etc.) can and do get sued for screwing up, and carry insurance for that. It also means that they try a lot harder to not screw up and to get it right - which is the whole point of a tort system.
And this.
FromMyColdDeadHand
01-01-10, 13:46
1. The pharmaceutical industry claims to be a high-risk business, but year after year drug companies have higher profits than any other industry - by a long shot. In 2002, the top ten American drug companies had a profit of 17 percent, compared with 3.1 percent for the other Fortune 500 industries. The biggest drug company, Pfizer, had a profit of 26 percent.
5. Contrary to popular belief, big drug companies spend less on research and development (R&D) than they keep in profits and far less than they spend on marketing. By their own figures, in 2002 (when profits were 17 percent of revenues), the top ten American drug companies spent only 14 percent of revenues on R&D and 31 percent on marketing and administration (of which the lion's share was probably marketing). The industry claims to spend $802 million to bring each new drug to market, but independent analysis shows that the true figure is a small fraction of that amount.
6. The U. S. is the only advanced country that does not regulate drug costs in some way, and other countries spend only about half as much for the same drugs as Americans. Methods vary, but essentially governments in other countries take advantage of their bargaining power to negotiate prices. Still, drug companies do not sell at a loss in these countries.
8. Drug companies promote diseases to fit drugs. To expand sales, they persuade people in affluent countries that they are suffering from conditions that need long-term treatment. Thus, millions of normal Americans come to believe that they have dubious or exaggerated ailments like "generalized anxiety disorder," "erectile dysfunction," "PMDD," and "GERD."
11. Drug companies have enormous influence over what doctor are taught about drugs and what they prescribe. The companies support most continuing medical education (CME) courses, medical conferences, and meetings of professional societies. They have armies of sales representatives to visit doctors and teaching hospitals to tout their wares, hand out free samples, and provide meals and other gifts. There is ample evidence that this huge investment in medical "education" pays off in terms of the prescriptions doctors write.
13. The pharmaceutical industry portrays itself as a model of American free enterprise, but it is anything but. Of the top ten companies in 2002, half are European. And while the industry is free to decide what drugs to develop and to price them as high as the traffic will bear, it is utterly dependent on government-funded research and government-granted monopolies in the form of patents and FDA*conferred exclusive marketing rights.
14. Even while the pharmaceutical industry turns out whole families of me-too drugs for relatively mild conditions in affluent people, it pays almost no attention to major scourges in poor people -- like malaria. It also gives short shrift to less profitable drugs. There are shortages of some vaccines and life-saving drugs, such as antivenins for poisonous snakebites; because few companies want to make them.
Dude, sucks that your premiums went up. Probably does make sense to look around now. Lot's of issues with your points though.
1. The high profit margin of the drug companies proves that the business that they are in is high risk. Over the long run, if something has higher returns, that is the markets way of pricing in risk. Utilities have low returns, risky business have higher returns.
5. "top ten American drug companies spent only 14 percent of revenues on R&D and 31 percent on marketing and administration (of which the lion's share was probably marketing). " Probably mostly marketing? Running billion dollar organizations is pretty cheap :rolleyes: . The anti-drug people also love to dump education into 'marketing'.
6. First pill is $100,000,000.00 , the second pill is $0.10. "Don't sell at a loss" according to what accounting?
8. Hands of my Viagra! GERD a boutique disease? What about its links to esophagial cancer?
11. Drug companies sending out drones of sales people is so 1980s. In the past 15 years my wife has gotten twenty bucks in game tokens and buffet dinner from drug companies. Someone needs to stop watching Harrison Ford in "The Fugative".
14. Drug shortages and vaccine issues are more because these functions get so messed with by govts that companies don't want to get into the business. Why spend all the time and money when govts will just take your tech? The H1n1 flu vaccine is a great example. Govt run program and it was late and had a lot of recalls. Great model for more govt intervention in the drug business.
Don't get me wrong, I'm not a fan of the "Doctor-in-a-pill" way that medicine is going, and the fact that most healthcare money is spent because of bad life-style decisions by people.
I almost wonder if when the govt has more say in our healthcare, and the service goes down, and the treatment options dwindle, will we become more healthy? Sometimes I think that is why people in Europe are healthier, getting sick has a lot worse outcome- maybe not just in life-death stuff, but waiting in lines and having to que up in lines for services.
Mike G- Agree with your points on fixes for healthcare. Especially #1 & #2. I am torn on the disqualifying factors. I do not have an answer for that one. If someone is a drug addict that caught AIDS through IV drug use, why should the Ins. Co. be forced to accept them and then the company's other customers are forced to defray the costs through increased premiums. It is an extreme example but there are other examples as well. I am not knocking the suggestion, but like I said earlier, just wrestling with the issue.
(I Hope I get the attribution right)
6. The U. S. is the only advanced country that does not regulate drug costs in some way, and other countries spend only about half as much for the same drugs as Americans. Methods vary, but essentially governments in other countries take advantage of their bargaining power to negotiate prices. Still, drug companies do not sell at a loss in these countries.
Yeah, those other countries are socialist. In exchange for paying less for drugs, everyone pays higher taxes and gets to wait 9 months for a doctor's appointment. Great, where do I sign up.
I can't even stomach anymore of this. This lady needs to go back to being a doctor and stop trying to be an economist.
One major reason that medicine (drugs) are more here than in other countries is that the market does not function due to govt interference in those other countries. Because those countries artificially cap the price they will pay for drugs, someone else has to take up the slack, and that is the US. I'd rather see the US, if the govt is the solution, step in and prohibit the sale of drugs for less than real market prices to other countries. That would drop our costs for drugs.
Other countries do not pay less because drug firms are greedy. They pay less because their govt interferes and shifts costs to the US as a side effect. They actually do sell the drugs at a loss to those countries when you take into account the total cost of the drug, not just manufacture. The companies sell still to these countries because if they didn't the countries would most likely seize their IP and make clones of the drugs claiming national security and national welfare reasons that trump international economic agreements on IP. It has happened before. So to avoid losing that revenue (and it does cover current manufacturing costs etc) they submit to the extortion.
Also, for those who claim that each drug is brought to market for much less than the drug companies claim, did these "independent" analyses actually look at the total costs? The costs of all the failed drugs, the liability costs (billions in law suits for someones heart attack), etc? I don't think so. Many many drugs are researched to some degree and fail. Those costs get spread across the successful drugs.
The real solution to the cost of health care is to get govt OUT of the equation:
* Allow insurance to be sold across state lines
* get rid of mandates
* get rid of community rating
* emphasize real insurance and not maintenance plans. Car insurance is a real insurance that spreads the risk around. Health insurance is a maintenance plan that people expect to pay all their costs for routine care. If your car insurance paid for oil changes your car insurance would go WAY up in cost. Make the consumer the payer of the first dollar and emphasize catastrophic care (with HSAs). Costs will go down and people would probably be healthier.
My wife is an RN and has worked in both Japan and the US. She currently works in a cardiac ICU and previously worked on a normal medical/surgical floor. (She also did a stint in elder care at a nursing home). She is not an economist by any means. She has come to the conclusion, based on her own observations in the hospital (and the repeat frequent flyers that are not drug seekers) that a lot of expense goes to people who don't pay for their own care and don't make any efforts to be healthy -- they know someone else will pay for their next trip to the hospital. So they don't worry about their weight, diet, exercise, or anything. It is their right to have other people pay for them and they feel no responsibility to minimize their health problems.
Put the primary responsibility back on the patient consumer and get rid of or deemphasize maintenance plan health plans and get back to real insurance. Get rid of govt interference that drives up costs.
While I agree we need tort reform etc in order to weed out the most egregious abuse of the system, all those sorts of things will have minimal impact on costs, not be a driving factor. They are important pieces but they are not the solution. Get back to basic market oriented services and personal responsibility.
Physicians do perform unnecessary tests and procedures due to the fear of malpractice suits. How many different tests do you think are appropriate as pertinent negatives? i.e. test comes back negative to rule something out. You have to pay for tests that come back negative just like the ones that come back positive.
I understand that. Running a test if it's indicated is not necessarily wasteful or "unnecessary" just because it comes back negative. If it's clinically indicated, if the standard of care says you do it, then you do it. If not, you don't. A negative result is still useful information.
Malpractice insurance is a significant component of overhead for physicians, particularly if you are part of a smaller group where you are personally responsible for the payments. I personally know of at least one OB/GYN that went straight GYN due to not being able to afford the costs of malpractice insurance as a component of overhead. Her buyout to cover the last birth she did until that child turned 21 was $100,000.
OB/GYN is an outlier, as I already mentioned in my previous post. As a proportion of the revenues of most practices, it's just not a huge issue. More to the point, I still see no evidence that "tort reform" has any significant effect on these premiums. I also see no reason, philosophically, why doctors should get a "pass" or special treatment for their screwups while the rest of the world (professional and otherwise) has unlimited exposure.
I see that you live in VA and claim that lawsuits are not out of control. Do you watch TV much? In my area (VT) the number one TYPE of commercial is medical wrongdoing/personal injury. "Hey, you want free money because your feelings got hurt and you didnt listen to your doctor's advice" or "Hey, I am a coke head too, and when I didnt tell my doctor and he performed a treatment that was complicated by me being a coke head, I got money through Hedidit & Whodoneit law offices"
I don't know - I don't get my view of the legal system from watching TV ads - I do it every day, professionally. You can put whatever ads you want on TV - it doesn't mean that you can throw whatever crap you want up and just see if it sticks, or that you won't have to face the reality of a jury with at least some jurors who think just like you. Some lawyers run ads like that to cast a wide net, but every one of them has a screening process and I can tell you with certainty that the vast majority of people who call them get rejected. My firm doesn't advertise at all and I reject a lot more cases than I take. I'm not wasting my time on a case with questionable liability and/or small damages.
Perhaps you're engaging in hyperbole, but you seem to have an incredibly flawed view of what is an actual malpractice case that might actually result in payment, and what is just bullshit that no lawyer is going to waste time and money pursuing. I already addressed the economics of why a lawyer who pursues a frivolous med mal case will earn a 33% contingent fee of zero and lose his ass to the tune of $50K+ in costs, but I guess in whatever world you live in, that's not enough of a deterrent.
You might also want to examine the defense side, in med mal and in tort law in general. They churn up enormous costs for the insurers because that's how they make money, fighting over minutiae and dragging out meritorious claims rather than settling them as they should. They are as much a problem as the plaintiffs' lawyers, and I have worked both sides (about equal time, in fact).
There is a lot wrong with the health care system and I do disagree with numerous points in Will's post but bottom line is that tort reform would help on a number of levels.
Who would it help (other than doctors)? And wouldn't it hurt people with legitimate, significant claims who would be hindered and capped? This isn't an easy, one way street. Some people would gain and some would lose.
Before you tell me how off base I am please give us a run down of how many different environments you have worked in because I have worked in US hospitals, EMS, interfacility transport, OCONUS/NON-US donated healthcare missions, OCONUS/NON-US hospitals, OCONUS clinics serving both US Citizens and NON-US Citizens with 24 hour emergent and non-emergent FREE access. I feel safe to say that I have probably functioned in more health care delivery types than most and I have had patients from all walks of life (middle class American, lower class American, impoverished American, urban Central and South American, rural/no previous access Central and South American, Bosnians, Iraqis, Africans ranging from well educated with BA/BS and up to the 'I sized them for their first pair of shoes', and the list goes on). Each of these groups represents a number of components: Current health, value of offered health care, history of access to health care.
OK ... I'm sure you're well qualified to deliver care across such a broad spectrum. I don't see what that has to do with the problems we're discussing, which are complex ones of law and economics. I have degrees in both fields and experience on both the plaintiff and insurance/defense side.
The majority of people who get free or subsidized health care have poor overall health due to compliance AND the level of care that is provided due to care being spread out so thin. They also do not value health care as a whole which ties back into compliance. On the other hand, people that have to pay for health care and work for it (in trade or simply have to work hard to reach a clinic) value the services offered.
I agree on that - which is why we need to make health insurance into REAL insurance. Not something that pays for every little checkup or $100 x-ray that should be paid out of pocket, but to insure against more significant but less frequent events. I don't ask my car insurer to pay for oil changes or every time the computer scans for codes in it.
You want to be a fat pig that smokes all day only stopping to crush up some oxycontin then you will either have really expensive health insurance OR you will have none and it will be a self limiting problem, bye bye.
I agree. Neither I nor anyone else should be forced to subsidize those people, and insurers should be allowed to decline coverage for them or charge a (high) premium that reflects the risk.
Some months ago, the people who led the effort to socialize Massachusetts' healthcare system admitted in a news article that costs were spiraling upward out of control, like the conservatives (maybe Repubs, maybe not) stated they would, but it HAD to be because of profiteering or some other illegal business practices, and in effort to reduce costs they were going to create a whole new branch of government to oversee this new system. :rolleyes:
The article also claimed that Massachusetts had the most expensive medical coverage in the whole world. It was not refuted by the MA officials.
So socializing medicine leads to the highest costs in the world? Yeah, good plan. :rolleyes:
Let's get back to the OP's topic:
Why are medical costs continually going up faster then everything else? Everyone says it's not them:
- Doctors say they are squeezed by insurance company reimbursement rates and it's not their fault.
- Insurers make 3% profit and the executive salaries don't amount to much in the big picture despite the Dems constant complaints about compensation.
- Lawyers say it's not malpractice cases, because those don't amount to much in the big picture.
- Pharmaceutical companies say it's not them, it's the huge investment cost in developing new drugs and the fact that other countries won't pay the full cost of the drugs, so the US picks up the tab.
Everyone says it's not them, but the money is going somewhere. As I said earlier, either one or more of the above is lying or we as a nation must be demanding a lot more care at a much higher cost so we must be the problem. Or at least we are accepting a higher level of care as recommended to us by our doctors as long as we don't have to pay the bill.
Every hospital around where I live building additions and new wings and opening up their own cardiac care centers. This is not something that should be happening if medical providers are really getting squeezed by the insurance companies. In order to justify all this investment cost, they have to generate the patient revenue. That means they have to get people on the treadmills, run the stress tests, and find problems to treat with stents, angioplasty, or what have you. Maybe it's all in the patients' best interests, but maybe there's some unnecessary revenue generation going on as well. Or maybe coronary artery disease is just a fact of life for most people and it will eventually get you if cancer doesn't get you first. That means every single human is a potential patient.
One younger doctor told me the older doctors admit it used to be a free-for-all. They made tons of money from "good" insurance plans paying claims without much question and from medicare. They also admit that it got out of hand, and it's going to be a lot different for younger doctors.
The cost of care keeps going up instead of coming down as technology advances. For non-covered procedures like Lasik, normal market forces are bringing costs down. Not so with procedures covered by insurance.
The inescapable conclusion is that there is a perverse relationship between insurance providers and doctors such that patients are complicit in the cost run up.
As stated by many people here, the only solution is to reintroduce market forces into the system by eliminating full-service health plans and turn health insurance into a real insurance plan for major issues. Then doctors should be forced to publish prices, provide binding quotes, and get patient approval for every addition to the treatment plan after it is approved. Hell, even a car repair shop has to do that!
Allowing insurance to be sold across state lines gets into a domain that is state regulatory issue. Doctors already say the administrative overhead of dealing with so many different insurance companies and plans is crippling. What will happen if they have hundreds more plans with different rules, different approval procedures, claims procedures, etc. to deal with?
On preventive care:
While preventive care may increase patient health and provide better outcomes, it has not been proven to actually reduce cost. The cost of screening 100 people to find one or two that are ill and don't know it yet isn't exactly low. And when those couple of people are found, they may still be put through expensive care programs. The cost of their care may be cheaper than waiting for the symptoms to show up and doing more expensive treatment, but it doesn't necessarily offset the cost of screening all the people that come up negative.
So Obama's and others' claims that preventive care will reduce costs are not based in fact. It may very well improve patient outcomes, and extend lives, so it's not like we shouldn't do these things - we just shouldn't expect them to reduce overall medical costs by any appreciable amount. Remember, someone who doesn't know they have coronary artery disease who drops dead costs a lot less in medical costs than someone who finds out they have a problem and get bypass surgery, a pacemaker, some stents, and some angioplasties. Not to mention all the checkups and treadmill tests.
And even if people live longer, they still die eventually of something, and they still will rack up hundreds of thousands of dollars in "death taxes" as medical providers try to extend their lives a little more at ever greater cost. Even if you live a healthy life, eat right, exercise, don't smoke, don't abuse alcohol or drugs, you will STILL die of something. And we know that most of your lifetime medical costs are racked up in the last year or two of life.
This is the fundamental problem that no one has a way to fix, and no one wants to talk about. No one wants Medicare or an insurance company to tell them when they can no longer have the care they (or their families) want because it's not cost effective. The Republicans are railing against "death panels" and Medicare cuts but supplying infinite amounts of care to the elderly will bankrupt the country. In effect they are arguing against more socialized medicine so they can preserve the status quo in the socialized medicine we already have! Of course, everyone knows the elderly vote in a greater proportion than any other age group, so their voices are heard.
Alaskapopo
01-01-10, 16:38
Health care is of course a very hot issue right now. It's a hot issue for me personally, as my own health insurance - which I purchase privately as a self employed person - just went 28%. That's not a typo. It's always gone up 4-6% per year, this year, 28%, not to mention an increase in the deductible and other costs, and now exceeds my car payment...
I'm in the state of MA, which passed a universal health care law that everyone had to have health insurance (they will literally fine you $900 per year if you don't BTW), with the state offering plans at lower premiums for those who qualified, etc.
This was supposed to lower insurance costs by making the market more competitive, etc. The result for MA, a huge increase in insurance premiums, and an increased state deficit to boot...
I don't know the details of the proposed national health care plan yet, but I do recall a speech by Pres Obama making reference to MA as some sort of success story...
If the national system has any relation to the MA system, we are going to be in big trouble real fast...
I'm not at all against universal health care as a concept, but without major cost containment taking place, such as tort reforms, and other measures, in particular, drug costs, it's a pipe dream.
Doctors are also being squeezed hard these days on many levels (for example, insurance costs for doctors is also off the charts these days...), and this only makes it more difficult for them to help their patients.
To that end, many are not aware just how much big pharma costs this country, how much power they have, and what a great job they have done of preventing true competition in the market while driving their profits up.
Marcia Angell, M.D. - former editor of the New England Journal of Medicine (NEJM) - one of the most respected med journal on the planet, in line with JAMA, Nature, etc - wrote one of many good books on the topic. Below, is a summery of some of the major issues by which drug companies fail American citizens, keep our costs up, and add greatly to insurance premiums.
From THE TRUTH ABOUT THE DRUG COMPANIES:
How They Deceive Us, and What to About It
by Marcia Angell, M.D.
(Random House; August 31, 2004)
1. The pharmaceutical industry claims to be a high-risk business, but year after year drug companies have higher profits than any other industry - by a long shot. In 2002, the top ten American drug companies had a profit of 17 percent, compared with 3.1 percent for the other Fortune 500 industries. The biggest drug company, Pfizer, had a profit of 26 percent.
2. The industry claims to be innovative, but only a small fraction of its drugs are truly innovative. Of the 78 drugs approved by the Food and Drug Administration (FDA) in 2002, only 17 contained new active ingredients, and only 7 were classified by the FDA as likely to be improvements over drugs already on the market. Most of the others were just minor variations of old drugs.
3. The most profitable drugs are variations of top-selling drugs already on the market - "me-too" drugs. There are whole families of me-too drugs, and no good reason to believe one is better than another at equivalent doses. They cash in on already-established, huge markets. The top-selling drug in the world, Pfizer's Lipitor, is the fourth of six cholesterol-lowering drugs of the same type.
4. The industry's most innovative drugs usually stem from research done at government or university labs. An internal National Institutes of Health (NIH) document showed that only 1 of the 17 key research papers that led to the five top-selling drugs in 1995 came from the company that sold the drug. Big drug companies license or otherwise acquire about a third of all their drugs from' universities, the NIH, or smaller companies.
5. Contrary to popular belief, big drug companies spend less on research and development (R&D) than they keep in profits and far less than they spend on marketing. By their own figures, in 2002 (when profits were 17 percent of revenues), the top ten American drug companies spent only 14 percent of revenues on R&D and 31 percent on marketing and administration (of which the lion's share was probably marketing). The industry claims to spend $802 million to bring each new drug to market, but independent analysis shows that the true figure is a small fraction of that amount.
6. The U. S. is the only advanced country that does not regulate drug costs in some way, and other countries spend only about half as much for the same drugs as Americans. Methods vary, but essentially governments in other countries take advantage of their bargaining power to negotiate prices. Still, drug companies do not sell at a loss in these countries.
7. The pharmaceutical industry has an iron grip on Congress and the White House. It has the largest lobby in Washington, with more lobbyists than elected representatives, and it contributes heavily to political campaigns. Over the past two decades, Congress has enacted a series of laws that practically ensure windfall profits to the pharmaceutical industry, at public expense. For example, the Medicare prescription drug benefit enacted in 2003 specifically prohibits Medicare from negotiating for lower drug prices.
8. Drug companies promote diseases to fit drugs. To expand sales, they persuade people in affluent countries that they are suffering from conditions that need long-term treatment. Thus, millions of normal Americans come to believe that they have dubious or exaggerated ailments like "generalized anxiety disorder," "erectile dysfunction," "PMDD," and "GERD."
9. The part of the FDA that approves new drugs receives half its support from drug companies. The FDA reviews drugs for safety and effectiveness before they are allowed on the market, but drug companies pay large "user fees" in return for quick reviews. That means the agency is beholden to the industry it is supposed to regulate. .
10. New drugs are not required to be any better than old ones, and there is usually no way to know whether they are. Drugs have to be tested before the FDA will approve them, but they do not have to be compared with older drugs for the same condition, only with placebos. That means we don't know whether new drugs are better or worse than old ones. They just have to be reasonably safe and better than nothing -- *a low standard indeed.
11. Drug companies have enormous influence over what doctor are taught about drugs and what they prescribe. The companies support most continuing medical education (CME) courses, medical conferences, and meetings of professional societies. They have armies of sales representatives to visit doctors and teaching hospitals to tout their wares, hand out free samples, and provide meals and other gifts. There is ample evidence that this huge investment in medical "education" pays off in terms of the prescriptions doctors write.
12. Drug companies have a lot of control over clinical trials of their drugs, which makes drugs look better than they are. They support much of the drug research done in academic medical centers by faculty researchers. In return, they insist on designing studies that increase the likelihood of a favorable result. There is good reason to believe that much of the company-supported research on prescription drugs is biased as a result.
13. The pharmaceutical industry portrays itself as a model of American free enterprise, but it is anything but. Of the top ten companies in 2002, half are European. And while the industry is free to decide what drugs to develop and to price them as high as the traffic will bear, it is utterly dependent on government-funded research and government-granted monopolies in the form of patents and FDA*conferred exclusive marketing rights.
14. Even while the pharmaceutical industry turns out whole families of me-too drugs for relatively mild conditions in affluent people, it pays almost no attention to major scourges in poor people -- like malaria. It also gives short shrift to less profitable drugs. There are shortages of some vaccines and life-saving drugs, such as antivenins for poisonous snakebites; because few companies want to make them.
Excellent post.
I don't know the perfect answer about what to do about health care cost but something needs to be done. Health insurance companies are almost criminal in how they do business. Practices such as refusing all claims the first time and making people appeal just so they pay is ludicrous and don't tell me it does not happen because I have had it happen to me. I am for wide scale overhauls of the entire health care system. One thing I would like to see is no more for profit insurance companies. Only allow non profit health trusts.
Pat
Mike G,
So does it follow that if the non-payers are provided coverage of some sort then the hospital charges will come down in price for those of us that do have the ability to pay? If there are fewer non-payers then we won't be carrying them anymore, right?
Do you think the hospitals would really reduce the charges, or the insurance companies would make them do it?
A health insurance company employee told me a couple years ago that we already have socialized medicine because the non-payers still get treatment, and the payers cover the cost.
The one thing that keeps flashing through the hard drive in my pumpkin, is just how did the "Greatest Generation" ever survive. They survived the Great Depression, prosecuted WW2 on every part of the globe, and they managed all that without anything remotely close to what we accept as "adequate healthcare" today. And they left their offspring with a quality of life found almost nowhere else on the planet. Somewhere in the answer to that question lies the solution to today's contentious debates regarding "affordable healthcare". Personally, I see it as purely a service industry. Therefore, you buy the service at whatever the market is, or you do not avail yourself of the service. It's a business and if my memory serves me correctly, while I was majoring in Business Administration in college, they taught that businesses are all about the "bottom line". Would certainly be nice if businesses had some moral obligation to the greater cause of humanity, but that is simply not the reality. Even for the lawyers that prosecute the malpractice suits, it is a business based on monetary gain, as was so aptly pointed out in a previous post. How did this nation's citizens arrive at the conclusion that they all deserve quality healthcare regardless of ability to pay? Where is that written? Me thinks we have become grotesquely attached to the "nanny state" in all it's welfare iterations and beholding to all those who profit from it's socialist machinations. Sort of glad I'm at the point where I won't be around to see this once great nation of ours become a land of snivilers and pantywaistes.
The one thing that keeps flashing through the hard drive in my pumpkin, is just how did the "Greatest Generation" ever survive. They survived the Great Depression, prosecuted WW2 on every part of the globe, and they managed all that without anything remotely close to what we accept as "adequate healthcare" today. ... Personally, I see it as purely a service industry. Therefore, you buy the service at whatever the market is, or you do not avail yourself of the service. ... How did this nation's citizens arrive at the conclusion that they all deserve quality healthcare regardless of ability to pay? Where is that written? Me thinks we have become grotesquely attached to the "nanny state" in all it's welfare iterations and beholding to all those who profit from it's socialist machinations. Sort of glad I'm at the point where I won't be around to see this once great nation of ours become a land of snivilers and pantywaistes.
AMEN
I couldn't agree more. Just because health care has advanced and the technology exists to do things - at a cost - that we could not do before, does not mean that everyone is entitled to it.
Medicine is, in my view, no different than the other learned professions. You pay for the service. If you can't pay, you don't get it and you're not entitled to rob your neighbors to pay for it.
Alaskapopo
01-01-10, 20:57
AMEN
Medicine is, in my view, no different than the other learned professions. You pay for the service. If you can't pay, you don't get it and you're not entitled to rob your neighbors to pay for it.
I totally disagree with that sentiment. Everyone should pay into health care at the same rate and then take out when they need it. Ie socialized medicine. Under your system only the rich will be able to afford health care. Which is the way its starting to get in the country fortunately congress is working hard to change that.
Pat
Alpha Sierra
01-01-10, 21:04
I totally disagree with that sentiment. Everyone should pay into health care at the same rate and then take out when they need it. Ie socialized medicine. Under your system only the rich will be able to afford health care. Which is the way its starting to get in the country fortunately congress is working hard to change that.
Pat
You have absolutely no understanding of the issues at hand. Some posters here have an excellent grasp of the problem and it went right over your head or you chose to ignore them.
You also seem to be willing to ignore the train wreck that is socialized health insurance in Massachusetts.
Why should anyone listen to what you have to say on this subject?
What else of my earnings would you like to help yourself to?
I totally disagree with that sentiment. Everyone should pay into health care at the same rate and then take out when they need it. Ie socialized medicine. Under your system only the rich will be able to afford health care. Which is the way its starting to get in the country fortunately congress is working hard to change that.
Pat
Well we will simply have to agree to disagree. I would caution you about your penchant for pure socialism, as wherever it has been instituted, it has failed miserably. How about everyone pays into a common food fund and draws out as they need it? I'll leave it at that since I think you have enough sense to appreciate where this discussion was going from there.
I totally disagree with that sentiment. Everyone should pay into health care at the same rate and then take out when they need it. Ie socialized medicine. Under your system only the rich will be able to afford health care. Which is the way its starting to get in the country fortunately congress is working hard to change that.
Pat
No, health care providers will have to think about how to reduce costs and become more efficient if they want to have any customers - LIKE EVERY OTHER BUSINESS. They cannot survive as a profession with only a few rich clients.
The greatest generation, including my grandparents survived the Depression and WWII despite the fact that they paid CASH for medical services for the first few decades of their lives. Doctors made house calls back then, and didn't seem to expect the kind of compensation they believe they are entitled to today. If someone needed an operation the family chipped in to pay for it. Costs didn't start to spiral out of control until Medicare was implemented and health insurance become more common as they got older. Also remember that a lot of hospitals were run as non-profits by religious organizations who viewed treating non-payers as a form of public service. They had the charitable donations back then to help finance the hospitals, but I would think they are less capable of such subsidies today.
FromMyColdDeadHand
01-01-10, 21:46
I totally disagree with that sentiment. Everyone should pay into health care at the same rate and then take out when they need it. Ie socialized medicine. Under your system only the rich will be able to afford health care. Which is the way its starting to get in the country fortunately congress is working hard to change that.
Pat
Pat, when did you become a communist??? Or at least a socialist, bigtime. Lack of sunlight getting you down up there, brother?
Everyone paying in and getting what they need is not really socialized medicine, that is what we have right now, mainly insurance- except there are people that refuse to or can't pay. The problem is when you have a lot of people who don't want to pay, and even more that very few actually put money on the barrel head for health services.
If my wife had dollar for everytime she had someone with a $100 nail job, who won't get off the cell phone, and Nautica'd up asking for a script for Tylenol so that Medicaid will pay for it, she could have paid off her med school loans.
Why should my wife's services be dictated and controlled by the gov't when, to be perfectly frank, her less intelligent classmates who went into law get to charge whatever they want, drum up spurious business during day time TV, and scam the states out of all the tobacco money.
Since govt run health care is now in the bag, can we move on to socializing lawyers? Want to file a lawsuit? You get the next lawyer in line (actually a legal secretary who will refer you to the line for the specialist). The gov't will set the amount the lawyer can charge for each type of service, and doctors get to second guess all of your legal procedings, even though they don't know anything about the law.
Great piece from the IBDE about the immorality of people's needs leading to their right to take from others.
http://www.investors.com/NewsAndAnalysis/Article.aspx?id=516405&Ntt=needs
I totally disagree with that sentiment. Everyone should pay into health care at the same rate and then take out when they need it. Ie socialized medicine. Under your system only the rich will be able to afford health care. Which is the way its starting to get in the country fortunately congress is working hard to change that.
Pat
Pat, you should hop across the Bering to Russia. It sounds like it would be much more to your liking.
Outlander Systems
01-01-10, 21:57
I'm seeing more proof that the entitlement mentality is alive and well.
If you've got a cell phone, cable TV, and a late-model car, but no health insurance, you've got no room to bitch.
I totally disagree with that sentiment. Everyone should pay into health care at the same rate and then take out when they need it. Ie socialized medicine. Under your system only the rich will be able to afford health care. Which is the way its starting to get in the country fortunately congress is working hard to change that.
Pat
And this does what for us? Congress CAUSED The problems of only the rich being able to afford health care. The more Congress has gotten involved the more expensive healthcare is.
Alaskapopo
01-02-10, 00:17
You have absolutely no understanding of the issues at hand. Some posters here have an excellent grasp of the problem and it went right over your head or you chose to ignore them.
You also seem to be willing to ignore the train wreck that is socialized health insurance in Massachusetts.
Why should anyone listen to what you have to say on this subject?
What else of my earnings would you like to help yourself to?
You have every right to your opinion but why don't you try to convey them in a polite manner. I am not going to respond further to you as I know what you will resort to next and I don't want to be subjected to another four letter word name calling fest.
Pat
Alaskapopo
01-02-10, 00:22
Well we will simply have to agree to disagree. I would caution you about your penchant for pure socialism, as wherever it has been instituted, it has failed miserably. How about everyone pays into a common food fund and draws out as they need it? I'll leave it at that since I think you have enough sense to appreciate where this discussion was going from there.
There is nothing wrong with some socialist type programs in a free society. Society has an obligation to care for its young, old and sick. I think everyone should have to pay no free lunch but everyone should get what they need. Like it or not the current health care system is not working. Hard working blue collar americans can not afford health care. If you don't have a government job or if you don't work for a large private company chances are you are not going to have health insurance. The USA is the last major industrial country not to have socilaized healthcare.
When I first started at my current employer we had 90 10 coverage and a co pay of $80 a month. Now due to increasing costs we pay 160 a month and have 80 20 coverage. Plus our deductables are much higher. We are now paying more for less coverage and the trend is continuing. I don't even care if they don't go with a public option so long as they regulate the crap out of the health insurance and medical industry to bring costs back down to a reasonable level so that the average american can afford it. The middle class in this country is rapidly shrinking.
Pat
Alaskapopo
01-02-10, 00:24
Pat, you should hop across the Bering to Russia. It sounds like it would be much more to your liking.
Your post was childish and added nothing to the conversation. I love this country and I won't have my patriotism challenged because my political views on health care differ from yours.
Pat
Alaskapopo
01-02-10, 00:26
And this does what for us? Congress CAUSED The problems of only the rich being able to afford health care. The more Congress has gotten involved the more expensive healthcare is.
That is highly debatable. Obviously the hands off approach has not worked. That approach has gotten us what we have now a broke health care system.
Pat
Alaskapopo
01-02-10, 00:29
Pat, when did you become a communist??? Or at least a socialist, bigtime. Lack of sunlight getting you down up there, brother?
http://www.investors.com/NewsAndAnalysis/Article.aspx?id=516405&Ntt=needs
There is nothing wrong with some socialist programs. Rather you support nationalized health care or are against it does not make you more or less evil or good. I hate it when the extreem right throws out labels like Liberal, Socialist etc as name calling put downs. We obviously disagree on the approach. I may be wrong on what the solution is to our countries health care problems. But there is no denying there is a problem. I will say I respect most of the posters on this forum despite some political differences of opinion. We all need to remember that its best to treat each other with respect when voicing those disagreements rather than letting our emotions get the best of us. With that I am going to go back to the other sections of this forum and talk about guns. Politics always brings out the worst in people.
Pat
Alaskapopo
01-02-10, 01:14
Alaskapopo,
The problem isnt the blue collar worker OR the rich, its the people who would rather have a flat screen TV than health insurance, its the people that would rather "get by" on food stamps rather than get a job, it is the people that would rather listen to collectors than actually pay a bill. They are a drain on the system and they wont pay if you make it the public option, they wont pay if you make it government run, and they wont pay until you make it free, even when you make it free they will wait until the absolute last minute to take care of things and seek out reactive care instead of getting things under hand early, during business hours, when you are not paying a premium for the service. Giving a handout doesnt make people work harder. On top of that, when you setup a system that "everyone pays into, and everyone takes what they need" you will end up with rationing. Do a little research on all the other great countries that have socialized medicine. Do you want to have access to a health care system that rations time on a ventilator? Some countries do that, 90 days lifetime max on a vent, day 91 and they pull the plug and roll it down the hall to someone else or to maintenance for servicing. How about we set it up like the UK where you have to wait 12+ months for knee surgery (ligament repair), you can wait or you can roll over to Poland and get it done for cash on the spot (this is a case from a student that I taught, and she is a med student in the UK). Her case is much worse than just the wait, the wait was for her second surgery which was not effectively repaired the first time and her orthopedist told her she was fine and didnt need a follow up MRI. Being a med student she felt that she did and went to Poland for the MRI, paid out of pocket and had the results read revealing a repeat tear of her ACL.
Sorry you have to pay $160/month for 80/20 coverage. Try paying Cobra for 18 months at $1200, I have done it. I pay a little over $600/month for my wife and I to have good solid coverage, I am happy to pay it and I dont go to the doc for frivalous stuff. In fact I try to take care of most ailments and injuries on my own at home. I have never had a day in my life that I wasnt insured and you dont see me jumping up and down about creating a socialist system. I am very happy for the services available to me.
I agree with many of your points. I also understand Cobra sucks. I was out of work for a few months and there was no way I could afford Cobra. That is my point the average smuck can afford health care, even the hard working ones. I also agree people should not be dead beats and live off of the government. However when it comes to health care I think as a society we have a responsibility to care for our sick. As for rationing health care we do that now with money. If you don't have insurance or money you can afford the surgery's you need. A friend of mine does not have dental insurance at his work. He is looking at a 5500 bill to get some dental work done. The poor guy is hardly making it and this comes up. I am sorry but our system is broke. I don't work in the health care field. I do know people however who are suffering under our current system.
Pat
FromMyColdDeadHand
01-02-10, 01:54
I agree with many of your points. I also understand Cobra sucks. I was out of work for a few months and there was no way I could afford Cobra. That is my point the average smuck can't afford health care, even the hard working ones. I also agree people should not be dead beats and live off of the government. However when it comes to health care I think as a society we have a responsibility to care for our sick. As for rationing health care we do that now with money. If you don't have insurance or money you can't afford the surgery's you need. A friend of mine does not have dental insurance at his work. He is looking at a 5500 bill to get some dental work done. The poor guy is hardly making it and this comes up. I am sorry but our system is broke. I don't work in the health care field. I do know people however who are suffering under our current system.
Pat
It's late, so I think you missed some " 't " s?
No body is saying that the current system is perfect, but many see the current path as swerving to miss the Elk in the road and instead going over a cliff. From the complaints that you have of the current system, I don't see how the 'reforms' are going to really address them. Do you think it is just going to be free? Government free programs are expensive, and it always seems like you make $10k more than the program helps.
Don't take the commie stuff to seriously, it's just to easy to pass up since you can see Russia from your house.
I think the real issue is that we have large swaths of people in America that can't pay their share of the tab. While personal decisions and lack of ability have something to do with it, the larger issue is that we have erroded our national competitiveness and set our economy so that we have a third world country interwoven into our country. The goods we couldn't import or the jobs we couldn't outsource are done by a lower class that has its earning power erroded by illegal immigrants.
Health care is just a symptom of the issue that we need to start kicking-ass again. Stop this get-rich quick, skim a bit off the transaction, arbitrage and commoditize financial/service economy and start making things again.
Alaskapopo
01-02-10, 02:59
Sucks for your buddy, sorry to hear that. Has he considered approaching a dentist with a trade for services (not sure what his background is) or a payment plan? I am serious when I say this, not a joke. There is a medical clinic near me that does a lot of business on the barter system, chickens and pies, no lie.
When it comes to major surgeries that are the difference between life and death vs. comfort a lot of times they will get done, insurance or not. Need a knee or hip and that is a different story. Need a stint, you are probably going to get it if it is emergent.
Unfortunately in all cases of socialized medicine or universal health care (whichever you prefer) in order to provide care for the masses you will increase delays, decrease quality/standard of care, and increase cost. So what you will end up with is higher premiums than you have now that are not "optional", a lower quality of care, and a longer wait to see your doc or dentist.
Thanks I will tell him to try bartering. He is an electrician so maybe he can do some work on the dentist house or what not.
I agree socialized medicine has some draw backs like delayed service times and poor service. I am not sure it is the right answer. But I do feel we need to over haul the US health care system.
Pat
variablebinary
01-02-10, 04:03
I support healthcare reform and do believe it needs to be made accessible to all American citizens. In this horrid economy, lots of people have been laid off and have no healthcare for there famalies.
If we can afford to bail out AIG, and ensure GM executives get hundred million bonuses, we can ensure families still have access to medical care while they are down on their luck.
I do not however support Obama care. I don't think it will achieve what I regard as acceptable healthcare reform. For example there is no protection for physicians from scumbag John Edwards types.
Von Rheydt
01-02-10, 06:45
Interesting. I am moving from the UK to the USA. In the UK I benefit from a State controlled healthcare system. In the USA I know will have to pay for even a basic minimum.
Just to give you an idea of how it works in the UK, seeing as it was held up as an example against the healthcare reform bill that the President is pushing thru.
In the UK the good bits:
1. It is a state provided system of health and dental care.
2. If you are employed you have a +/- 12% deduction that is supposed to pay for your health, dental, unemployment and retirement.
3. If you are unemployed you still receive all the same health benefits with no discrimination.
In the UK the bad bits:
1. People who make a career out of being unemployed get the same benefits.
2. Because it is all state controlled they can decide what drugs and procedures are available to patients. That is to say, if the powers that be decide a particular drug or treatment would be too expensive for the population then they will not place it on the list of approved treatments or drugs.
3. Because of the fiscal controls mentioned in 2, above, Dr's are also not exposed to the use of leading edge treatments and procedures.
4. There is a civil service mentality in the heath service here and waiting lists are long in some areas.
I pay extra for private healthcare here in the UK. This gives me quicker access to treatments and it also gives me access to treatments not ordinarily available thru the national health service.
I have been told I will be paying £450 a month in the USA, thats around $750, mainly 'cos I am now 50 and I have 2 diagnosed slipped discs ........ my own fault, too many rucksacks and too much jumping from planes.
However, in the USA the range of treatments available to patients is far greater than the range of treatments available here ........ so I am happy with that. I also heard an interview discussing the health reform bill where some politico was going on about 'Death Committee's'. That is to say, once you reach a certain age treatment will be scaled back. In the UK experience that is not true. I personally worked as a student nurse on an Osteo ward where the patients were in the main between 60 - 80 and had all had either knee or hip surgery.
But I do agree with you all, healthcare ain't cheap.
ForTehNguyen
01-02-10, 08:18
I support healthcare reform and do believe it needs to be made accessible to all American citizens. In this horrid economy, lots of people have been laid off and have no healthcare for there famalies.
If we can afford to bail out AIG, and ensure GM executives get hundred million bonuses, we can ensure families still have access to medical care while they are down on their luck.
I do not however support Obama care. I don't think it will achieve what I regard as acceptable healthcare reform. For example there is no protection for physicians from scumbag John Edwards types.
I dont think there is an accessibility problem, only an expense problem. Anyone who wants care in the US gets it whether they can pay for it or not. The average uninsured patient receives 50-70% of care that an insured person does.
tort reform should remain a state power like it is now.
Congress needs to exercise its interstate commerce clause power to make insurance compete across state lines. That is the original intent of the commerce clause to regulate (to make regular which is what the word regulate meant back then) interstate commerce. This power was needed because back then states would enact tariffs and other protectionisms against each other. Car insurance is sold across state lines why not health insurance.
As for rationing health care we do that now with money.
Pat, we do that with EVERYTHING. Money is how we figure out who gets what and how much of it. There is a finite amount of goods and services. Russia had a different system for distributing things. It didn't work so well for them, though.
If you don't have insurance or money you can afford the surgery's you need. A friend of mine does not have dental insurance at his work. He is looking at a 5500 bill to get some dental work done. The poor guy is hardly making it and this comes up.
So the mere fact that somebody you know has a huge dental bill means the system is broken? What is your proposal - tax me and everyone else, who have been wise enough to pay for dental insurance, to pay for him? That doesn't sound too "fair" either. You're making the typical bleeding heart one-sided argument where you only argue anecdotes about the people who are suffering and you don't acknowledge the monetary, moral, and behavioral damage you will inflict on everyone else if you socialize these things.
I am sorry but our system is broke. I don't work in the health care field. I do know people however who are suffering under our current system.
Have you ever examined WHY they are suffering? Are there choices they could make, or could have made in life, that would make them (or would have made them) better off? I am not paying for the health care of somebody who could have paid for it himself if he'd not spent money on other things or had made better decisions earlier in life.
If you want somebody else to pay for your health care, you better be living in a cardboard box, without two nickels to rub together, and you better have a compelling story on how you ended up there. The vast majority of people I see leeching off even the current programs are nowhere near there.
The costs keep going up for everybody beacuse we are all subsidizing Medicaid, Medicare, Chip and S Chip. When the doctors and facilities costs go up, the insurance costs go up, then your employers goes up, then your costs go up. Mine went up 100%, I'm happy with mine.
If you think it's expensive now, just wait until:
1. the insurance companies have to pay a bunch of lawyers to figure out what's in the health care bill so they can abide by it.
2. they have to insure your obese neighbor that eats Mcdonalds every day and can't charge them extra b/c they have diabetes, sleep apnea, etc. so everybodys costs go up.
The costs keep going up for everybody beacuse we are all subsidizing Medicaid, Medicare, Chip and S Chip. When the doctors and facilities costs go up, the insurance costs go up, then your employers goes up, then your costs go up. Mine went up 100%, I'm happy with mine.
What's really happening is a constant, multi-way battle between providers and insurance companies (including public programs). Providers are constantly having to raise the "sticker price" on services and supplies (which is why you see $200 bags of saline solution) in order to keep the reimbursement - the amount they're actually paid - from the insurers high enough to make any real money. They also have to balance their load and jack prices and coding of services up where they can in the face of people who can't/don't pay and in the face of sub-market reimbursement rates from Medicare.
It's a huge, complicated shell game at this point. It is not ideal, but socialized medicine, or the de facto socialized medicine being proposed now, would be much worse for everyone (including providers and their bottom lines).
Any time politicians start talking about "cost containment," what they are really saying is that people with good insurance that covers many things now, and who can get a broad variety of services, will have to give that up in order to "save money" (who's money?) in exchange for covering more people at a mediocre level. Great, everybody gets the same level of mediocre care instead of the world class care that most of us get now and that anyone can get if they choose to pay for it. No thanks, I'll stick with what I have now - and no matter how many times Obama LIES in a speech about being able to keep current plans, the text of the bills say otherwise.
The thing I keep asking myself is why the Democrats are pushing this POS bill through.
Do they really think it will achieve the goal of expanding coverage and reducing cost? Everyone who has done any real analysis of the issues is saying it won't reduce costs, won't expand coverage to those that need it, and will drive up insurance premiums.
So why are they still pushing it if they KNOW it won't work? Just to say they did SOMETHING? Maybe some of them are self-delusional and clueless about basic business, economics, and finance so they think it really will help. But most probably know it won't. So what happens when they pass it and it goes into effect and it backfires on them? Don't they fear the repercussions?
The only possible conclusion is they want control. And once this is in place the political patronage they can generate from it will be greater than what they currently can get. That means they plan to buy future elections to stay in power.
Throw in the "path to citizenship" legislation and all those new Democratic votes and they very well might just find a permanent majority of dependent sheep.
The thing I keep asking myself is why the Democrats are pushing this POS bill through.
Because they have been talking about it and promising it forever, they have started and gone through much of a closely watched process at this point, and if they don't enact something to wave during speeches, they will have "failed."
They do not care what they pass at this point. They could paint sanskrit characters using monkey shit on a piece of parchment, enact that, and claim victory as long as it says "Health Care Reform" at the top.
Do they really think it will achieve the goal of expanding coverage and reducing cost? Everyone who has done any real analysis of the issues is saying it won't reduce costs, won't expand coverage to those that need it, and will drive up insurance premiums.
See above. They don't care and are deaf to the facts and to the fundamental economic premise that you can't suddenly insure 40 million "lemons," and yet save money, to say nothing of the strain this is going to put on health care providers.
The only possible conclusion is they want control.
Yup. Nothing new here, been going on since FDR.
ForTehNguyen
01-02-10, 10:37
Do they really think it will achieve the goal of expanding coverage and reducing cost? Everyone who has done any real analysis of the issues is saying it won't reduce costs, won't expand coverage to those that need it, and will drive up insurance premiums.
All you have to look at is Massachusetts, after they implemented their socialized healthcare it is a huge failure. Their insurance premiums are the highest in the nation and rise twice as fast as other states. Their state is running deficits trying to finance it, it still hasn't eliminated the "uninsured" patients, wait times have increased, and their governor is threatening price controls which will make shortages even worse.
What a joke
We talked about this issue at the Christmas dinner table with my family of mixed political views.
Some of the Democrat, pro-Obama, Pro- Union faction of the family feel that health care is an obligation and that each person needs provided health care by the state/national system.
Some of the anti-Obama and/or anti democrat side felt that a man should work hard and find better employment as he gains age and experiance and be able to provide for the needs of himself and his family. Some even said that if a man is mentally limited or otherwise skill bound or education bound to a "starter job" that could not properly provide for a family or not provide for a large family.... this individual should consider not getting himself into a situation with a family or not have a large family. In other words, don't have 3, 5 or 10 kids if your a career Wall-Mart greeter.
My personal question and statement was this:
If you lined a uninsured folks up with broken arms and marched them into the Emergency room.... 100 arms will be set and casted.
My aunt then replied that what if you lined up 100 uninsured folks with high blood pressure and cholesteral that is off the charts. She says that they would be stabilized and sent home with a prescription that they likely would not be able to afford. She went on to say that her friend is in this situation, a prescription for meds that there is no cash to buy.
So, my question is this.... is it true? Lets say I made $35,000 a year gross. I have 4 children, my wife makes $7.50 an hour 25 hours a week as well. We have no ins. If we had chronic conditions such as mentioned above and could not get on CHIP or any other federal welfare health system, would be doomed to live with the issue until it reared up it's head and sent us to the Emergency room again, or is there some way for this extremly money limited family to get the maintenance meds needed?
I don't know the answer.
I quit working for others and had a small business for a few years. I have a wife and 3 children. I paid $450 a month for health ins. At first I thought it was going to be insanely high, but I had hired Ameriprise Financial as my financial Advisors after I left Westinghouse and cashed out my 401K. They helped me reinvest the 401K and also helped me set up health care and life ins. I thought $450 was very reasonable. We paid $45 co-pay per doctor visit and had $35 co-pay on drugs, but this was very acceptable. The out of pocket was $7500 per year and then the ins covered 100% up to $250K. In other words, should I have a big problem, the ins would swing in and take care of me... but for most small things me and the ins were splitting it. The odds of me at 35 years old hitting the $7500 was slim, but I knew that if my kidney ruptured or I got ass-cancer.... the ins would be there.
Now I work for a large electric power company, and I feel 100% sure, no wait, 110% sure that should a public health care system be set into motion, our company will drop its current health care options IMMEDIATELY and force all employees into the Obama-care system.
There is a whole other side of this that I mentioned to the family that night. Interesting how I got the answeres I expected from the national health care supporters!
I asked that if we should supply health care to ever person in our country because it is a requirement, it is something that as a human you deserve and are entitled to.... what do we do about the homeless? Yep, most felt that we owe it to the homeless to have govt shelters where they can go to.
I asked about folks with no food. The reply was that it was the children that have no food in the house that we need to feed. We need to find a way to be sure that every child has food to eat and a bed to sleep in.
So there you have it. The father/mother made the child, but we should make shure it is fed and has a place to live? We should keep it alive why? I have my wife and 3 kids, if you (not you... anyone) can not provide for your own.... then the buffalow theory should play out. I did not tell the idiots who drank beer and smoked pot instead of going to college to stay uneducated. The kids from high school (graduated in 1990) that are still working the gas station pump or are the cook at the local bar.... you are where you placed yourself dude! You are NOT my issue. Should you be found frozen solid and dead in the morning, it is honestly of NO CONCERN TO ME. Should your children be beside you, I will thank the Lord that I made better choices than you... and thank the lord for my ambition in life.
We all make choices. And I bet MANY of full grown men that fight with the frustrations of adult life would rather point fingers at me and say that I should be paying into a national system that helps everyone. F-You! Think back to your days in Jr. High and High School.... where were your priorities? What did you do after high school? I went on and got a degree. I never worked a day of life in a field related to my degree, but that degree opened the doors for me to be able to work every day of my adult life that I wished to and at a wage that is much higher than a Wall-Mart greeter. It is not my resposability to care for you or your offspring. I would never ask you to care for mine. I will do whatever it takes to survive for me and my family, I will live without if needed.
I am anti national health care. But I also have some limited amount of sadness for those stuck in the middle like my Aunt had mentioned. A family that may bring in $45K a year or so with 3-4 kids and know that there is a chronic issue but not be able find the money to pay for the maintenance drugs.
What do we do?
My aunt then replied that what if you lined up 100 uninsured folks with high blood pressure and cholesteral that is off the charts. She says that they would be stabilized and sent home with a prescription that they likely would not be able to afford. She went on to say that her friend is in this situation, a prescription for meds that there is no cash to buy.
So, my question is this.... is it true?
My responses would be:
1. It's still not my problem and she has no right to steal my money to buy her medicine.
2. How did she get to the doctor? In a car she spends money to fuel, maintain and insure? Where did she go after that - back to a home she spends money to furnish, provide with cable TV, internet, etc.?
Most of these people could afford their meds if they cut back in other areas. They just won't, and they think the rest of us should pay for them merely because they have a pulse. It's disgustingly selfish.
Somebody needs to sit America down and politely explain that you are not "entitled" to jack shit, let alone "free" health care.
The out of pocket was $7500 per year and then the ins covered 100% up to $250K. In other words, should I have a big problem, the ins would swing in and take care of me... but for most small things me and the ins were splitting it.
That's the way it should be. Insurance by definition is supposed to pay for low probability, high cost/loss events. Such as your car getting totalled, your house burning, etc. I don't call my homeowner's carrier to file a claim for fixing my furnace, I don't call my auto insurer if I get a flat tire.
Now I work for a large electric power company, and I feel 100% sure, no wait, 110% sure that should a public health care system be set into motion, our company will drop its current health care options IMMEDIATELY and force all employees into the Obama-care system.
Of course they will, so will every other employer. Which is why the "public option" is nothing but a back door to nationalized socialist medicine.
I agree with the rest of your post 100%. The general attitude in this country is steaming in a frighteningly collectivist direction. If you are not immediate family or a close friend who I choose to help, you aren't my problem and should not be made my financial problem by government fiat. Deal with your own shit, everyone has setbacks at some point in life.
I am anti national health care. But I also have some limited amount of sadness for those stuck in the middle like my Aunt had mentioned. A family that may bring in $45K a year or so with 3-4 kids and know that there is a chronic issue but not be able find the money to pay for the maintenance drugs.
They aren't stuck in any middle, they are the same people you describe earlier in your post who did not have the ambition or work ethic to get into higher-earning work but still feel entitled to have 3-4 kids, and then whine that they have no money for medicine. Why did they have all those kids? Why are they and their kids my problem?
It seems like this thread is getting more and more personal, and closer and closer to being unsatisfactory on personally directed "attacks". Please try and discuss this without the direct attacks.
Thanks.
It seems like this thread is getting more and more personal, and closer and closer to being unsatisfactory on personally directed "attacks". Please try and discuss this without the direct attacks.
Thanks.
Sorry Shivan, I was trying to speak only about my direct family and our direct conversation that does relate very much to the OP's topic. I had no intention of personal or attacking. Please forgive me if I accidentally appear to be attacking any of you folks, that is not the intent of my words.
God Bless you all.
Happy New Year!
There is nothing wrong with some socialist type programs in a free society. Society has an obligation to care for its young, old and sick. I think everyone should have to pay no free lunch but everyone should get what they need. Like it or not the current health care system is not working. Hard working blue collar americans can not afford health care. If you don't have a government job or if you don't work for a large private company chances are you are not going to have health insurance. The USA is the last major industrial country not to have socilaized healthcare.
When I first started at my current employer we had 90 10 coverage and a co pay of $80 a month. Now due to increasing costs we pay 160 a month and have 80 20 coverage. Plus our deductables are much higher. We are now paying more for less coverage and the trend is continuing. I don't even care if they don't go with a public option so long as they regulate the crap out of the health insurance and medical industry to bring costs back down to a reasonable level so that the average american can afford it. The middle class in this country is rapidly shrinking.
Pat
Unfortunately it is that type of mentality that has helped bring us to this point . The proposal that "it takes a village" is pie in the sky and is literally tantamount to pure socialism if not communism. This nation was not founded on ANY principle that is even remotely similar to what you espouse. In fact it was founded on minimal, limited government and the responsibility of the individual to apply themselves and take advantage of all the opportunities that come with living in a free society. You make your choices and live with the results. You are allowed to succeed, and you are allowed to fail also.
I spent my 30 year career as a firefighter/EMT in SoCal and I got to witness all socio/economic aspects of our society. There is a growing and insidious trend that is destroying the fabric of individual responsibility that helped make this nation great. Most folks in the upper or middle class seldom called on us for field medical care. Usually they simply took responsibility for whatever needed done and got on with it. What is literally bankrupting the system is the growing number of people with an untold number of years of bad choices and decisions written all over their faces, demanding that someone else pick up the tab for their individual lack of personal responsibility. You see that also whenever "the system" diverts blame from the individual and places it on "social circumstances", ie. "it's not their fault!" If I am reading you right, you want responsible people to pick up the tab for those that made poor or bad choices, and you imply that it is our responsibility as a society to do that. Sorry. With all the information out there about the hazards of smoking, drug abuse, and alcoholism, in light of it all, someone still makes the personal choice to partake, I have zero, nada, none, compassion for the results of that self inflicted behavior. Same applies to personal health issues such as diet, exercise, weight control, etc.
Certainly there are instances when someone is born with an affliction or is struck down by one during their life. That circumstance has been with mankind from the beginning and there are options available to address those on a case by case basis.
Health care is a business, not an inalienable right. Part of the problem with prices today is that the government overstepped their Constitutionally mandated limitations and waded into that field. The "laws of supply and demand" were disolved at that point. No industry, as you will soon see in the automobile sector, can compete with a government that has unlimited taxing authority to support their poor, uncompetitive market decisions. Think FannieMae and Freddie Mac. The "government" became the Healthcare Industry's cash cow through MediCare and Medicaid and traditional market forces became moot. Remember the old admonition about fearing the "Military/Industrial Complex"? It's that complex that gave us $500 toilet seats on military aircraft and $300 screwdrivers. Wait until you witness the effects of the "Medical/Government Complex". You think you've seen bad? You haven't seen anything yet.
Pat. I do appreciate that you have a different view on this subject. Both our personal experiences are probably vastly different, although I'm sure we have many similarities also. There is a solution to this current healthcare cost issue. I for one simply cannot, after being witness to their managing the USPS, Social Security, Veteran's Adminstration, MediCare & MedicAid, trust the Federal bureaucracy to properly and fairly administer it's citizens personal healthcare issues. If and when they try to force compliance through a "mandate" they had better start building a lot more incarceration facilities, because I and millions like me are simply not going down that road peacefully and obligingly.
Unfortunately it is that type of mentality that has helped bring us to this point . The proposal that "it takes a village" is pie in the sky and is literally tantamount to pure socialism if not communism. This nation was not founded on ANY principle that is even remotely similar to what you espouse. In fact it was founded on minimal, limited government and the responsibility of the individual to apply themselves and take advantage of all the opportunities that come with living in a free society. You make your choices and live with the results. You are allowed to succeed, and you are allowed to fail also.
THIS is patriotism, THIS is standing up for American values and what we believe in, or used to believe in as the case may be. Calling oneself an American patriot and defending socialism is a pure contradiction.
The socialists have been trying to turn America into something it was never meant to be, and they simply will not give up until they succeed. They will eventually, be shear apathy on the part of the citizenry unless something major happens to wake them up.
Something else not directed at anyone here:
I get really tired of hearing how "better" it is in Europe with their health care systems and other socialist constructs. America isn't ****ing Europe! It was created as the antithesis of Europe. My ancestors left Europe to find better opportunity here. If you want to live in Europe go right ahead and move there and tell us how you like it!
I get really tired of hearing how "better" it is in Europe with their health care systems and other socialist constructs. America isn't ****ing Europe! It was created as the antithesis of Europe. My ancestors left Europe to find better opportunity here. If you want to live in Europe go right ahead and move there and tell us how you like it!
Yup. Europe has interesting history and quaint, pretty buildings. It's a nice place to visit but otherwise there is nothing better about it.
I might have some of the best "experience" with all the different health care programs out there.
1. Used the Military health care system (which is as close to socialized medicine as you can get without being socialized). VA hospitals are some of the worst with some of the worst Doc's available (not all are bad of course). My wife had a botched surgery leaving her classified as 30% disabled for the rest of her life.
If people believe that a socialized program (where we all pay in and the Govt controls everything) is the "best option" ask a veteran that has suffered through the "system" what they think.
2. As a small business owner, I purchase a medical plan via Aultcare for my family. We have a $5k deductible and our monthly payments for a family of 4 are in the $400 + range a month.
We have a wide range of Doc's in the program and have been happy with this care (so far). The cost goes up every year though.
3. Step-Father got cancer and almost died from it. The insurance company covered almost everything. Because of not being able to work any more, he basically retired. No one will give him medical or if they do, it is a small fortune. So he is basically screwed at this point.
So what is the answer to the problem? Should poor people that cannot get health care through their employer be SOL? How bout their kids? Should we the tax payers cover people that cannot afford medical insurance? Should illegal aliens be able to get into a socialized medical program (that is funded by tax payers money)?
I don't know what all the answers are or even what the best option is. I do know that I want something to change. I know I don't want to pay for none US citizens to get medical. I know that I want people that have a serious illness to be able to get coverage at a reasonable rate (don't know what that rate would be, but something under $500 a month). I know that I don't want to see a 24% price hike every single year. I also know that I don't want the Govt to run ANYTHING as they can screw up a bowl of soup (look at the postal service and VA hospitals if you have any questions).
So am I willing to pay a higher premium to avoid a .Gov system? Yes I am. Will I always have the money to be able to do that? Don't know. Do I want the Govt telling me that I cannot see a Doc because I am too old and should just die? Nope! Do I want to wait 6 months to see a specialist? Nope!
Those of you with friends in Canada, ask them how they like their system. I do have some northern friends and they all tell me that their health care system is great, as long as you don't have to use it!
The health care bill being voted on right now is one of the worst things I have seen in quite some time. Does the Govt need to do something? Sure does. Could they take smaller steps (like allow insurance companies to compete across State lines)? Yes they could and things like this would make a LARGE differences in what people are paying.
Forcing people to pay for health care (when they might not even want it) is un-constitutional and believe that we will see a lot of lawsuits make it to the Supreme Court. I think we will also see some States talk about succession.
Should be interesting!
C4
There is nothing wrong with some socialist type programs in a free society. Society has an obligation to care for its young, old and sick. I think everyone should have to pay no free lunch but everyone should get what they need. Like it or not the current health care system is not working. Hard working blue collar americans can not afford health care. If you don't have a government job or if you don't work for a large private company chances are you are not going to have health insurance. The USA is the last major industrial country not to have socilaized healthcare.
When I first started at my current employer we had 90 10 coverage and a co pay of $80 a month. Now due to increasing costs we pay 160 a month and have 80 20 coverage. Plus our deductables are much higher. We are now paying more for less coverage and the trend is continuing. I don't even care if they don't go with a public option so long as they regulate the crap out of the health insurance and medical industry to bring costs back down to a reasonable level so that the average american can afford it. The middle class in this country is rapidly shrinking.
Pat
I think we want a lot of the same things. So let's focus on them for a moment. We want to slow down the rising cost of health care. We want people that have a pre-existing condition to be able to get medical coverage for that issue (at a fair rate). We want people that don't make a lot of money to be able to get medical coverage (of some sort).
So how do we get there? We have socialized medical now (Medicare & Medicaid). This system is FULL of fraud and is draining the tax payers money (http://www.cbsnews.com/stories/2009/12/15/health/main5981436.shtml).
States like MA and TN have also attempted State run medical programs and they have either failed or are failing. Wealthy citizens from Europe and Canada come to the US to BUY better medical care (when they could just get it for free in their country). http://www.cbsnews.com/stories/2005/03/20/health/main681801.shtml
States such as Ohio have FREE medical coverage for adults and children that are under a certain income level. We have a friend that has a baby born with rare condition and she has got fantastic care from the Clelevand clinic (that she could never afford).
So truly "poor" people do often times qualify for medical coverage at the tax payer expense now (so they are being covered). A single man in his 30's can get buy medical coverage for $180-$230 (depending on the deductible) a month. He can also choose to NOT buy it if he so chooses too.
Under the US Govt, people will NOT be able to opt out of the plan (under penalty). Where is the freedom in that? The Govt fining you for not wanting to buy one of their products? Really? Does that sound like something you would want to support?
I know you want to see fixes and options (like the rest of us), but having big brother control, mandate and run something is NEVER our best option.
C4
So, why did your premium go up so much? Have you asked your insurer? Have you shopped for other coverage? Did it occur to you that the "reforms" in MA might have something to do with your premium going up because you are basically subsidizing the "lemons" in the market that insurers are now forced to cover?
Short answer: Yes.
Longer answer: The Wall St. Journal had this to say about the MA "experiment" which no doubt, has to have some bearing on the national front:
"They're trying to manage the huge costs of the subsidized middle-class insurance program that is gradually swallowing the state budget. The program provides low- or no-cost coverage to about 165,000 residents, or three-fifths of the newly insured, and is budgeted at $880 million for 2010, a 7.3% single-year increase that is likely to be optimistic. The state's overall costs on health programs have increased by 42% (!) since 2006.
Like gamblers doubling down on their losses, Democrats have already hiked the fines for people who don't obtain insurance under the "individual mandate," already increased business penalties, taxed insurers and hospitals, raised premiums, and pumped up the state tobacco levy. That's still not enough money.
So earlier this year, Mr. Patrick appointed a state commission to figure out how to control costs and preserve "this grand experiment." One objective is to change the incentives for preventative care and treatments for chronic disease, but everyone says that. It sometimes results in better health but always more spending. So-called "pay for performance" financing models, on the other hand, would do away with fee for service -- but they also tend to reward process, not the better results implied.
What are the alternatives? If health planners won't accept the prices set by the marketplace -- thus putting themselves out of work -- the only other choice is limiting care via politics, much as Canada and most of Europe do today. The Patrick panel is considering one option to "exclude coverage of services of low priority/low value." Another would "limit coverage to services that produce the highest value when considering both clinical effectiveness and cost." (Guess who would determine what is high or low value? Not patients or doctors.) Yet another is "a limitation on the total amount of money available for health care services," i.e., an overall spending cap.
The Institute for America's Future -- which is providing the intellectual horsepower (we use the term loosely) for reforms like those in Massachusetts -- argues that the cost overruns prove the state must cap how much insurers are allowed to charge consumers and regulate their profits. If Mr. Patrick doesn't get there first, that is. He reportedly told insurers and hospitals at a closed meeting this month that if they didn't take steps to hold down the rate of medical inflation, he would."
Cont:
http://online.wsj.com/article/SB123811121310853037.html
NEJM and most medical journals have an incredibly liberal slant. These are the same journals that think guns are an epidemic disease and that publish flawed studies on the dangers of guns. They do very poorly when they venture outside their lanes, which is what happens when they comment on economic policies.
I agree, but that topic is not outside their lane, or the person who wrote it. She's also not remotely alone in the findings regarding how pharma fails American citizens. The rest is solely your opinion vs hers, which jibes well with what I already know of the industry. I respect your opinion, but we will have to agree to disagree here.
Thax for the input.
Im not against a government plan as long as the costs are COMPLETELY contained within such a plan, and general tax dollars are not used to fund it.
I dont believe in subsidized or mandatory health care.
.
It's been an f-ing disaster in MA. :confused:
To all, a great thread that considering the topic, stayed respectful and on topic. I learned some stuff, got some new perspectives, and agreed with some, not with others, but everyone - unlike other forums that will remain un named - didn't just crash and burn into ignorant rambling. For that, I say thank you. Says a lot about the members here.
We talked about this issue at the Christmas dinner table with my family of mixed political views.
Some of the Democrat, pro-Obama, Pro- Union faction of the family feel that health care is an obligation and that each person needs provided health care by the state/national system.
Some of the anti-Obama and/or anti democrat side felt that a man should work hard and find better employment as he gains age and experiance and be able to provide for the needs of himself and his family. Some even said that if a man is mentally limited or otherwise skill bound or education bound to a "starter job" that could not properly provide for a family or not provide for a large family.... this individual should consider not getting himself into a situation with a family or not have a large family. In other words, don't have 3, 5 or 10 kids if your a career Wall-Mart greeter.
My personal question and statement was this:
If you lined a uninsured folks up with broken arms and marched them into the Emergency room.... 100 arms will be set and casted.
My aunt then replied that what if you lined up 100 uninsured folks with high blood pressure and cholesteral that is off the charts. She says that they would be stabilized and sent home with a prescription that they likely would not be able to afford. She went on to say that her friend is in this situation, a prescription for meds that there is no cash to buy.
So, my question is this.... is it true? Lets say I made $35,000 a year gross. I have 4 children, my wife makes $7.50 an hour 25 hours a week as well. We have no ins. If we had chronic conditions such as mentioned above and could not get on CHIP or any other federal welfare health system, would be doomed to live with the issue until it reared up it's head and sent us to the Emergency room again, or is there some way for this extremly money limited family to get the maintenance meds needed?
I don't know the answer.
I quit working for others and had a small business for a few years. I have a wife and 3 children. I paid $450 a month for health ins. At first I thought it was going to be insanely high, but I had hired Ameriprise Financial as my financial Advisors after I left Westinghouse and cashed out my 401K. They helped me reinvest the 401K and also helped me set up health care and life ins. I thought $450 was very reasonable. We paid $45 co-pay per doctor visit and had $35 co-pay on drugs, but this was very acceptable. The out of pocket was $7500 per year and then the ins covered 100% up to $250K. In other words, should I have a big problem, the ins would swing in and take care of me... but for most small things me and the ins were splitting it. The odds of me at 35 years old hitting the $7500 was slim, but I knew that if my kidney ruptured or I got ass-cancer.... the ins would be there.
Now I work for a large electric power company, and I feel 100% sure, no wait, 110% sure that should a public health care system be set into motion, our company will drop its current health care options IMMEDIATELY and force all employees into the Obama-care system.
There is a whole other side of this that I mentioned to the family that night. Interesting how I got the answeres I expected from the national health care supporters!
I asked that if we should supply health care to ever person in our country because it is a requirement, it is something that as a human you deserve and are entitled to.... what do we do about the homeless? Yep, most felt that we owe it to the homeless to have govt shelters where they can go to.
I asked about folks with no food. The reply was that it was the children that have no food in the house that we need to feed. We need to find a way to be sure that every child has food to eat and a bed to sleep in.
So there you have it. The father/mother made the child, but we should make shure it is fed and has a place to live? We should keep it alive why? I have my wife and 3 kids, if you (not you... anyone) can not provide for your own.... then the buffalow theory should play out. I did not tell the idiots who drank beer and smoked pot instead of going to college to stay uneducated. The kids from high school (graduated in 1990) that are still working the gas station pump or are the cook at the local bar.... you are where you placed yourself dude! You are NOT my issue. Should you be found frozen solid and dead in the morning, it is honestly of NO CONCERN TO ME. Should your children be beside you, I will thank the Lord that I made better choices than you... and thank the lord for my ambition in life.
We all make choices. And I bet MANY of full grown men that fight with the frustrations of adult life would rather point fingers at me and say that I should be paying into a national system that helps everyone. F-You! Think back to your days in Jr. High and High School.... where were your priorities? What did you do after high school? I went on and got a degree. I never worked a day of life in a field related to my degree, but that degree opened the doors for me to be able to work every day of my adult life that I wished to and at a wage that is much higher than a Wall-Mart greeter. It is not my resposability to care for you or your offspring. I would never ask you to care for mine. I will do whatever it takes to survive for me and my family, I will live without if needed.
I am anti national health care. But I also have some limited amount of sadness for those stuck in the middle like my Aunt had mentioned. A family that may bring in $45K a year or so with 3-4 kids and know that there is a chronic issue but not be able find the money to pay for the maintenance drugs.
What do we do?
I could not agree more with the points you made. I have a personal story to relate. My daughter just had 3K of dental work done 1 month ago. She's only 5 years old and we didn't have dental insurance. I took the gamble and lost. It tore me apart having her go through that, and for me having to pay that. But you know what? Its my fault that as her dad I didn't help her brush her teeth or get regular dental visits. No one else should bear that responsibility.
I suspect most will remember the supposed "Peace Dividend" that was supposed to take place due to the collapse of the Soviet Union. Suddenly, since we did not have to support a huge military due to us literally winning the Cold War, our illustrious politicians simply could not control their drooling over the prospect of using tax funds that were supporting a Cold war military capability, for their individual pet social programs. Ever see any of that "Peace Dividend"? Me either. But those of us in Public Safety at the time were challeged to define how we might use such a monetary windfall to upgrade and improve our services to the public we served. We went through the process, but none of the funds ever materialized, only Federally mandated, unfunded program increases.
What the heck does this all have to do with the topic of this thread? Imagine for a moment, if the Federal Government created another branch, something equivalent to our current military services, only designed it to provide healthcare to the masses. One would enlist and be trained in a certain specialty after agreeing to a period of service that would compensate for the costs of said training. If one chose they could actually make a career out of it. Medical facilities would be as prevalent as military bases, the procedures and logistics would be standardized, etc. Necessary equipment and hardware would be purchased in large quantities which should keep the per unit costs down. The same oversight and management of such a system would be as with the military, managed from within with Congressional oversight. Ponder on it for awhile. It's a pipe dream, but it could have taken place utilizing the supposed "Peace Dividend" and the burden to the taxpayer would have remained much as it was had their taxes gone to a much larger military instead.
Socialism you say! It would simply be as bad as what the current House and Senate bills will shove up our butts you say! Perhaps. But if there is anything this Federal government has ever had their crooked hands on that has been the envy of every other country on this orb, it is our military. In spite of it answering to the civilian political leadership as our founders designed, our military is first class and simply using a similar model to provide "Quality Healthcare" to the masses could be just as successful. I know anyone who has ever been "served" by the Veteran's Administration is simply shuddering at the thought of expanding such an abysmal interprise. But the very problems indemic within the Veteran's Administration is exactly what we will see with government mandated healthcare. That Adminstration needs to be gradually disolved, and those under it's care be moved into the newer "military managed branch" We have all witnessed how bad the Feds are at running the Veteran's Administration so by and large keep them out of it. Sleep on it and dream about what could have been had we only had representatives in Washington that had some foresight and wisdom as opposed to self interest and greed.
John_Wayne777
01-02-10, 20:39
In spite of it answering to the civilian political leadership as our founders designed, our military is first class and simply using a similar model to provide "Quality Healthcare" to the masses could be just as successful.
I must strongly disagree. We already have scores of programs where the federal government manages healthcare...including provision of healthcare in the military. They are all hardly what I would call shining success stories. If your argument is that government efforts simply haven't been grand enough to truly fulfill the vision...well...that's just scary.
I must strongly disagree. We already have scores of programs where the federal government manages healthcare...including provision of healthcare in the military. They are all hardly what I would call shining success stories. If your argument is that government efforts simply haven't been grand enough to truly fulfill the vision...well...that's just scary.
I know that little treatise might have been a little convoluted, but my whole point was that if the Federal government believes it has the Constitutional authority to mandate national healthcare, they had their opportunity a couple of decades ago. They don't, and they didn't. Remember I said it's pipe dream:D. Thinking outside the box. However this whole healthcare debate/controversy plays out, it does not bode well for anyone, even those who are actually in favor of it.
Belmont31R
01-02-10, 21:09
I must strongly disagree. We already have scores of programs where the federal government manages healthcare...including provision of healthcare in the military. They are all hardly what I would call shining success stories. If your argument is that government efforts simply haven't been grand enough to truly fulfill the vision...well...that's just scary.
I thought the military health care system sucked based on my experiences. I injured my back and neck on my 2nd deployment, and was told the wait for an MRI was 6 months...this at a post with a full service hospital just down the street. It took over 10 clinic visits just to be told that, and the most anyone wanted to do was shove another bottle of motrin at me. Based on everything I saw they wanted to do as little as possible unless you went in there with an obvious injury like a broken leg with a bone popping out.
Belmont31R
01-02-10, 21:19
I suspect most will remember the supposed "Peace Dividend" that was supposed to take place due to the collapse of the Soviet Union. Suddenly, since we did not have to support a huge military due to us literally winning the Cold War, our illustrious politicians simply could not control their drooling over the prospect of using tax funds that were supporting a Cold war military capability, for their individual pet social programs. Ever see any of that "Peace Dividend"? Me either. But those of us in Public Safety at the time were challeged to define how we might use such a monetary windfall to upgrade and improve our services to the public we served. We went through the process, but none of the funds ever materialized, only Federally mandated, unfunded program increases.
What the heck does this all have to do with the topic of this thread? Imagine for a moment, if the Federal Government created another branch, something equivalent to our current military services, only designed it to provide healthcare to the masses. One would enlist and be trained in a certain specialty after agreeing to a period of service that would compensate for the costs of said training. If one chose they could actually make a career out of it. Medical facilities would be as prevalent as military bases, the procedures and logistics would be standardized, etc. Necessary equipment and hardware would be purchased in large quantities which should keep the per unit costs down. The same oversight and management of such a system would be as with the military, managed from within with Congressional oversight. Ponder on it for awhile. It's a pipe dream, but it could have taken place utilizing the supposed "Peace Dividend" and the burden to the taxpayer would have remained much as it was had their taxes gone to a much larger military instead.
Socialism you say! It would simply be as bad as what the current House and Senate bills will shove up our butts you say! Perhaps. But if there is anything this Federal government has ever had their crooked hands on that has been the envy of every other country on this orb, it is our military. In spite of it answering to the civilian political leadership as our founders designed, our military is first class and simply using a similar model to provide "Quality Healthcare" to the masses could be just as successful. I know anyone who has ever been "served" by the Veteran's Administration is simply shuddering at the thought of expanding such an abysmal interprise. But the very problems indemic within the Veteran's Administration is exactly what we will see with government mandated healthcare. That Adminstration needs to be gradually disolved, and those under it's care be moved into the newer "military managed branch" We have all witnessed how bad the Feds are at running the Veteran's Administration so by and large keep them out of it. Sleep on it and dream about what could have been had we only had representatives in Washington that had some foresight and wisdom as opposed to self interest and greed.
The federal government simply has no authority to provide health care to anyone.
Think about the way the government used to be ran. It took a amendment to outlaw alcohol, and another to legalize it. Yet today they just ban and do whatever they want when they want, and let the courts decide what is constitutional and what isnt.
Much of this crap stems from the FDR period, and the 2nd bill of rights he proposed. You often hear democrats talk about what a great president FDR was. He was just short of being a tyrant, and a socialist ****stick to boot. He went to war against the supreme court, and when that didnt work he had the number of justices increased, and then packed the court with justices that would not oppose his will. Our country has gone down the shitter since then because of the liberal mentality he imposed during his 4 terms in office. SS was started under him, and the the entitlement/ gov provider crap started flowing with medicare and medicaid.
All these programs are bankrupting the US. We spend more on SS in one year than Iraq has cost us since 2003. Yet you hear people like Obama pointing the finger at Iraq being the cause of the governments fiscal problems. If these entitlement programs were done away with taxes could be lowered to well under half what they are today, and our economy would be booming. But ever so more with each passing year the number of leeches living off the tax payer increases, and now we are at the point (especially with this congress and president) where just to pay for everything we are borrowing trillions of dollars. We have one of the highest tax corporate tax rates in the world in the worlds largest economy, and we are still deficit spending like crazy.
Giving a government this kind of control, power, and training the masses to look to the government for care and nourishment is VERY DANGEROUS, and has never worked out to good in the past. We cannot be considered a free people when the government will put us in jail for not purchasing some product just for being a living breathing human being. What else will we be forced to buy in the future?
Alaskapopo
01-02-10, 21:26
Unfortunately it is that type of mentality that has helped bring us to this point . The proposal that "it takes a village" is pie in the sky and is literally tantamount to pure socialism if not communism. This nation was not founded on ANY principle that is even remotely similar to what you espouse. In fact it was founded on minimal, limited government and the responsibility of the individual to apply themselves and take advantage of all the opportunities that come with living in a free society. You make your choices and live with the results. You are allowed to succeed, and you are allowed to fail also.
.
When this country was founded only white male land owners could vote. Not everything we were founded on is good. There are a lot of capitalistic ideals I believe in and there are some socialistic ideals I believe in. Capitalist vs. Socialist is not a fight of good and evil. Both are just different political ideals nothing more. The current capitalist way of running our health care system is failing miserable and it needs to be changed. I am all for everyone paying their fair share and no free loaders. But I also believe in society as a whole is responsible to deal with certain issues like the health of its people.
Pat
Alaskapopo
01-02-10, 21:28
The federal government simply has no authority to provide health care to anyone.
Think about the way the government used to be ran. It took a amendment to outlaw alcohol, and another to legalize it. Yet today they just ban and do whatever they want when they want, and let the courts decide what is constitutional and what isnt.
Much of this crap stems from the FDR period, and the 2nd bill of rights he proposed. You often hear democrats talk about what a great president FDR was. He was just short of being a tyrant, and a socialist ****stick to boot. He went to war against the supreme court, and when that didnt work he had the number of justices increased, and then packed the court with justices that would not oppose his will. Our country has gone down the shitter since then because of the liberal mentality he imposed during his 4 terms in office. SS was started under him, and the the entitlement/ gov provider crap started flowing with medicare and medicaid.
All these programs are bankrupting the US. We spend more on SS in one year than Iraq has cost us since 2003. Yet you hear people like Obama pointing the finger at Iraq being the cause of the governments fiscal problems. If these entitlement programs were done away with taxes could be lowered to well under half what they are today, and our economy would be booming. But ever so more with each passing year the number of leeches living off the tax payer increases, and now we are at the point (especially with this congress and president) where just to pay for everything we are borrowing trillions of dollars. We have one of the highest tax corporate tax rates in the world in the worlds largest economy, and we are still deficit spending like crazy.
Giving a government this kind of control, power, and training the masses to look to the government for care and nourishment is VERY DANGEROUS, and has never worked out to good in the past. We cannot be considered a free people when the government will put us in jail for not purchasing some product just for being a living breathing human being. What else will we be forced to buy in the future?
You have a very interesting view on one of the greatest american presidents to ever live. FDR. He was a great man that lead this nation out of the last depression. He was also very popular with the people winning 4 terms in office. The US spends far more in forign aid and on the war than they do on social programs to help our own people.
Pat
John_Wayne777
01-02-10, 23:46
You have a very interesting view on one of the greatest american presidents to ever live. FDR.
If George W. Bush tried even 1/4 of what FDR pulled he would have been impeached.
FDR is the closest thing we've had to a dictator in American history.
As for "spending more", you should recheck your figures. Entitlements and social programs consume the majority of the federal budget.
Alaskapopo
01-02-10, 23:54
If George W. Bush tried even 1/4 of what FDR pulled he would have been impeached.
FDR is the closest thing we've had to a dictator in American history.
As for "spending more", you should recheck your figures. Entitlements and social programs consume the majority of the federal budget.
As for FDR if that man was that bad he would not have won 4 terms and been loved by the people. We will have to agree to disagree.
Here is an article about the budget.
http://www.cbpp.org/cms/index.cfm?fa=view&id=125
I would much rather spend 30 billion to help our poor than the same money put into one Jet fighter.
variablebinary
01-03-10, 00:05
But I also believe in society as a whole is responsible to deal with certain issues like the health of its people.
Pat
Agreed. I believe it is outright evil that we don't provide a method for all citizens to receive basic healthcare.
If someone is sick they should have the ability to go to doctor, period. Preventive care so people dont reach deaths door and need to go to the emergency room.
Our current healthcare system is not good enough. We can do better and should strive for something better.
Edit: Let me clarify, that my primary concern is displaced workers and their families , not those that have never worked or paid into the system for whatever reason, children excluded.
When this country was founded only white male land owners could vote. Not everything we were founded on is good. There are a lot of capitalistic ideals I believe in and there are some socialistic ideals I believe in. Capitalist vs. Socialist is not a fight of good and evil. Both are just different political ideals nothing more. The current capitalist way of running our health care system is failing miserable and it needs to be changed. I am all for everyone paying their fair share and no free loaders. But I also believe in society as a whole is responsible to deal with certain issues like the health of its people.
Pat
We are not running the current health care system in a capitalistic way. That is actually the problem. The more govt gets involved the more screwed up it gets. Mandates, community rating, employer provided healthcare (especially the way it is regulated that discourages anything else) (yes, employer provided healthcare is a response to govt meddling in the economy and dates back to wage controls in WW2)
Society is the sum of the people. It is not the govt or the state or anything else. The people themselves is what society is made up of. And society has no more power than an individual member of that society has. I cannot give up rights and privileges to society, or the state, that I do not own or have myself. So stealing from your neighbor to fund your healthcare is not something that society has the power to do. Since I cannot myself steal from my neighbor legally I cannot empower society (or the state for that matter) to steal from my neighbor.
Society is not responsible for the health of its people. PERIOD. The people themselves are responsible for their own health. And everything else that has to do with their well being (housing, food, etc).
There is no authority and it is EVIL with a capital E to propose socialistic responses to society's "problems." Anything that takes away personal freedom and makes one dependent on the state is EVIL. Again, with a capital E.
If George W. Bush tried even 1/4 of what FDR pulled he would have been impeached.
FDR is the closest thing we've had to a dictator in American history.
As for "spending more", you should recheck your figures. Entitlements and social programs consume the majority of the federal budget.
+100000e6
John_Wayne777
01-03-10, 00:08
We spend more than all the other countries in the world combined on our military. I doubt we put more into social programs than that.
http://www.heritage.org/research/features/BudgetChartBook/Images/federal-spending_12-850.jpg
http://www.heritage.org/research/features/BudgetChartBook/Images/federal-spending_06-580.jpg
In 2008 we spent a little over 600 billion dollars on defense. We spent over 615 billion on Social Security, 396 billion on medicare, and 203 billion on medicaid. That doesn't even factor in federal welfare programs.
There's nothing to doubt...it's just the truth when you look at federal spending. Mandatory spending makes up the majority of federal spending. The biggest chunk of that are the entitlement programs, SS, medicare, medicaid. A smaller portion is debt service. (Interest on the national debt) Mandatory spending makes up over HALF of the total federal outlays. Defense spending is discretionary spending, and only a chunk of the discretionary spending.
In the united states we spend more on social welfare programs than we spend on anything else in the federal budget...and that doesn't even factor in state and local spending on those programs....and that's in just one year. Totaled we've spent tens of trillions of dollars on welfare programs since their introduction...and yet the hue and cry is for more.
As for FDR if that man was that bad he would not have won 4 terms and been loved by the people.
He tried to turn the last independent branch of the US government into a rubber stamp for his policies...and succeeded. After he was out of office the constitution was amended to prevent anyone else from serving as many terms as he did. Those would be "clues". ;)
As for popularity...well...Chavez is popular too.
To catch up with the edit:
I would much rather spend 30 billion to help our poor than the same money put into one Jet fighter.
...so it's preferable to hand another 30 billion to "our poor" (to follow the trillions we've already spent) than to spend that money on a jet fighter which provides the US with a capable weapon useful for defending the nation, and which also provides gainful employment for XXX people and technological advances that are useful to society?
Agreed. I believe it is outright evil that we don't provide a method for all citizens to receive basic healthcare.
If someone is sick they should have the ability to go to doctor, period. Preventive care so people dont reach deaths door and need to go to the emergency room.
Our current healthcare system is not good enough. We can do better and should strive for something better.
What is evil is the govt/state intruding in and screwing up healthcare so to make it broken and unaffordable.
You have a very interesting view on one of the greatest american presidents to ever live. FDR. He was a great man that lead this nation out of the last depression. He was also very popular with the people winning 4 terms in office. The US spends far more in forign aid and on the war than they do on social programs to help our own people.
Pat
FDR did not lead this nation out of the depression. Many economists think he prolonged it. In the US it is called the "Great Depression" but elsewhere in the world it was just an economic depression and did not last nearly as long in most of the rest of the world as it did in the US. FDRs programs and spending did nothing to get the US out of the the depression of the 30s and only screwed things up. Including leaving the country a lasting legacy of ever increasing social spending that will bankrupt us.
John_Wayne777
01-03-10, 00:14
Agreed. I believe it is outright evil that we don't provide a method for all citizens to receive basic healthcare.
...evil? It's evil?
What I consider "evil" is the idea that I have a right to stick a gun in your face and take what you have because I think part of it should be given to Bob over here who I determine to be in "need".
If you aren't handing a bunch of money to Bob, you're "evil"....thus I, the benevolent and enlightened one, have the right to take whatever you have to meet what I determine to be Bob's need.
Alaskapopo
01-03-10, 00:20
FDR did not lead this nation out of the depression. Many economists think he prolonged it. In the US it is called the "Great Depression" but elsewhere in the world it was just an economic depression and did not last nearly as long in most of the rest of the world as it did in the US. FDRs programs and spending did nothing to get the US out of the the depression of the 30s and only screwed things up. Including leaving the country a lasting legacy of ever increasing social spending that will bankrupt us.
Again highly debatable. Some right wing ecomomist may think he prolonged it. WWII definately got us out. But his programs were helping if you look at netral views on the subect rather than politically biased ones.
pat
Alaskapopo
01-03-10, 00:21
http://i25.photobucket.com/albums/c80/Thirdworldmedic/Fy2008spendingbycategory.png
http://en.wikipedia.org/wiki/File:Fy2008spendingbycategory.png
By my calculations we are looking at a little over 50% for social programs (social security, medicare/medicaid, HUD, unemployment)
I can live with 50% on social programs to help americans. We should be spending more on social programs than the military.
Pat
John_Wayne777
01-03-10, 00:24
I can live with 50% on social programs to help americans. We should be spending more on social programs than the military.
Pat
We do...and we have for years.
...and guess what? It never seems to solve the problem. I happen to believe that spending should accomplish something.
...well, something besides giving people a warm fuzzy because we spend trillions of dollars to "help" the "poor" who, oddly enough, don't seem to be all that helped by our efforts.
variablebinary
01-03-10, 00:25
...evil? It's evil?
What I consider "evil" is the idea that I have a right to stick a gun in your face and take what you have because I think part of it should be given to Bob over here who I determine to be in "need".
If you aren't handing a bunch of money to Bob, you're "evil"....thus I, the benevolent and enlightened one, have the right to take whatever you have to meet what I determine to be Bob's need.
Allowing people to be devoured by cancer and illness with an emergency room solution is nothing short of red cape, horns and tail demonic evil.
How many people are out of work currently? A lot. People that have done nothing wrong other than get caught up in a down economy. They no longer have health insurance.
I dont think sitting back, and saying "F U, good luck. Hope your kids dont get a toothache" is a viable solution.
Alaskapopo
01-03-10, 00:27
We are not running the current health care system in a capitalistic way. That is actually the problem. The more govt gets involved the more screwed up it gets. Mandates, community rating, employer provided healthcare (especially the way it is regulated that discourages anything else) (yes, employer provided healthcare is a response to govt meddling in the economy and dates back to wage controls in WW2)
Society is the sum of the people. It is not the govt or the state or anything else. The people themselves is what society is made up of. And society has no more power than an individual member of that society has. I cannot give up rights and privileges to society, or the state, that I do not own or have myself. So stealing from your neighbor to fund your healthcare is not something that society has the power to do. Since I cannot myself steal from my neighbor legally I cannot empower society (or the state for that matter) to steal from my neighbor.
Society is not responsible for the health of its people. PERIOD. The people themselves are responsible for their own health. And everything else that has to do with their well being (housing, food, etc).
There is no authority and it is EVIL with a capital E to propose socialistic responses to society's "problems." Anything that takes away personal freedom and makes one dependent on the state is EVIL. Again, with a capital E.
You have a right to your opinion. I have a right to mine. However when you start labeling another political view as evil that shows great intolerance on your part. Politics is politics and morality is morality. There are good capitalists and evil ones same with socialists.
The simple truth right now is due to our captitalist society the middle class is shrinking, the rich are getting richer and the poor are getting more poor. What is evil is to allow this to continue. People do have a responsibility to work and be productive however an issue like health care is best handled by the State. Just like emergency medical services and the military. Imagine if we did not have government run police forces and everything was private security. Sorry but some things are better ran by private enterprise and some things are better ran by the government.
Pat
Alaskapopo
01-03-10, 00:29
Allowing people to be devoured by cancer and illness with an emergency room solution is nothing short of red cape, horns and tail demonic evil.
How many people are out of work currently? A lot. People that have done nothing wrong other than get caught up in a down economy. They no longer have health insurance.
I dont think sitting back, and saying "F U, good luck. Hope your kids dont get a toothache" is a viable solution.
+1
It saddens me to see such a lack of compassion in my fellow americans. What happened to the compassionate conservatives. They seem to be few in number these days.
Pat
John_Wayne777
01-03-10, 00:38
Allowing people to be devoured by cancer and illness with an emergency room solution is nothing short of red cape, horns and tail demonic evil.
...so when you perceive a need, it entitles you to use force to take whatever is necessary from whomever has it to meet that need.
That would mean I have the right to show up at your house and take your car to help pay for my grandmother's medical bills. She broke her neck and the care she has needed the last several months has been expensive. She has a need so I can just go take whatever is necessary to meet it.
How many people are out of work currently? A lot. People that have done nothing wrong other than get caught up in a down economy. They no longer have health insurance.
The failure of your logic is not in recognizing that there are people who are in unpleasant and undesirable situations...it's in believing that somehow redistributionist programs will solve the problem. We've had such programs since the 30's...and they aren't solving the problems. That's because they aren't free...with the decision to redistribute wealth as Congress sees fit there are costs. There is waste. There is fraud. There is abuse. There is moral hazard. There are free riders.
...etc. If government playing Robin Hood solved problems we wouldn't have any. Neither would most of the countries in Europe...and yet, the problems are there and no matter how much money is thrown at the problems they never seem to go away and the bill continually gets larger. Isn't the definition of insanity doing the same thing over and over and over again and expecting a different result?
John_Wayne777
01-03-10, 00:39
+1
It saddens me to see such a lack of compassion in my fellow americans. What happened to the compassionate conservatives. They seem to be few in number these days.
Pat
I don't believe compassion is defined by how far I'm willing to reach into somebody else's checkbook.
John_Wayne777
01-03-10, 00:59
Not all EMS is handled by the state. A lot of EMS is handled by private/contract services and at least in the area I am they commonly have higher standards of training, better pay, and better providers.
The reason the middle class is shrinking is because the government makes it harder and harder to run a small business.
You know, I've heard that "shrinking middle class" thing a bunch and it always raises a question for me:
Exactly what government policies or actions are supposed to remedy the "shrinking" middle class?
I ask because the United States has spent the last 70 or so years spending trillions of dollars on a wide range of social programs and yet the gap between rich and poor never closes. On the contrary, many argue that it's gotten wider. Taxes comprise a larger chunk of the average family's income today than at any time in the history of our nation, and yet the gap between rich and poor is vast and the middle class is "shrinking".
...so I find it difficult to believe that yet more taxes and yet more government spending is actually going to stop the shrinkage of the middle class or close the gap between rich and poor. Every year we tax and spend more than the previous year, and every year we seem to hear more about the gap and the disappearing middle class.
Correlation does not necessarily prove causation...but I think maybe we ought to take a hard look at that.
You have a right to your opinion. I have a right to mine. However when you start labeling another political view as evil that shows great intolerance on your part. Politics is politics and morality is morality. There are good capitalists and evil ones same with socialists.
When your political view treads on moral issues than it is perfectly right to call something evil. Socialism is not just a political view. It leads to action that is immoral. Stealing is immoral and socialism relies on stealing money to pay for itself.
The simple truth right now is due to our captitalist society the middle class is shrinking, the rich are getting richer and the poor are getting more poor. What is evil is to allow this to continue. People do have a responsibility to work and be productive however an issue like health care is best handled by the State. Just like emergency medical services and the military. Imagine if we did not have government run police forces and everything was private security. Sorry but some things are better ran by private enterprise and some things are better ran by the government.
Pat
The middle class is not shrinking due to our capitalist society. The rich are not getting richer and the poor are not getting poorer due to our capitalist society. If these things are happening, it is due to govt intrusion and meddling that screws things up and distorts the incentives to act. You talk about facts and then spout dogma. Your "simple truth" is dogma and not truth at all.
+1
It saddens me to see such a lack of compassion in my fellow americans. What happened to the compassionate conservatives. They seem to be few in number these days.
Pat
It is compassionate to steal from me so I cannot afford to take care of my own family?
Have you ever looked at charitable giving statistics in this country? People who would probably be in the "conservative" category tend to give a lot more to charity than those who would not be in the "conservative" category. True compassion is helping the poor and needy out of ones free will and heart. Not stealing from your neighbor to give to the poor and needy out of your neighbors pocket.
There is NOTHING compassionate about socialism, progressive policy, and state sponsored health care.
Allowing people to be devoured by cancer and illness with an emergency room solution is nothing short of red cape, horns and tail demonic evil.
How many people are out of work currently? A lot. People that have done nothing wrong other than get caught up in a down economy. They no longer have health insurance.
I dont think sitting back, and saying "F U, good luck. Hope your kids dont get a toothache" is a viable solution.
Ultimately it is their own responsibility.
However, the current system is screwed up. I don't think anyone would disagree with that. The solution is not however more govt intrusion, more govt programs, etc. That is HOW we got here in the first place. We need to fix the system so that people can afford real insurance, are responsible for their own care and that of their families first, and one that encourages charity for others by those who can.
Again, we need to get away from company sponsored healthcare, put real insurance back into healthcare, and get away from govt mandates, community rating, and other intrusions that drive up costs. Allowing insurance to be sold across state lines would help with the mandates and community rating. Also allowing people to form groups to buy insurance in a much more open and freely accessible way. Put the consumer back at the center of responsibility and get the state out of the way. First dollar payment by the consumer. This would go a long way to fixing the system.
Again highly debatable. Some right wing ecomomist may think he prolonged it. WWII definately got us out. But his programs were helping if you look at netral views on the subect rather than politically biased ones.
pat
Review of the facts is what is showing that his programs made things worse and were not helping. Not political biases.
variablebinary
01-03-10, 01:59
Tough titties my man. You need to find whoever it is that convinced you "fair"applies to life and kick them square in the nuts.
Unfortunately, the end result of this type of thinking is Obamacare.
Doing nothing will never be a palatable or acceptable solution, the people will see to that with their vote.
The do-nothing, fiscal hawks and so-called conservatives would be smart to get it through their noggin that throwing people to the wolves is a losing strategy.
You have to get ahead of the issue and deal with it intelligently, or liberals will eat your lunch for you with sweeping draconian measures like Obamacare
I personally believe there is a way to provide healthcare without bankrupting the nation, and if the so called converatives got on board, and found solutions instead of just putting their fingers in their ears and saying "LA LA LA, CANT HEAR YOU, AND I DONT CARE" we would be better off.
As it is, this attitude is why the Dems do what they do (enact f-ed up legislation.)
There is a reason Herbert Hoover is considered one of the worst presidents in history, and FDR is revered and borderline saint. Expecting Hoovervilles to self correct will never be seen as better than the New Deal. If you loved the New Deal, then keep telling people "FU, life isnt fair. Enjoy your rotting breasts and lack of Chemo"
Personally, I dont like the New Deal, and I dont like Obamacare, so I know not supporting healthcare reform is not an option because you know where that gets you.
Personally, I dont like the New Deal, and I dont like Obamacare, so I know not supporting healthcare reform is not an option because you know where that gets you.
I don't think most conservatives want to do nothing. They just want to do nothing that is a statist approach. Lots of "conservative" reforms have been suggested. Ones that would actually help fix the system. But with the progressives in power they are non-starters.
variablebinary
01-03-10, 02:19
I don't think most conservatives want to do nothing. They just want to do nothing that is a statist approach. Lots of "conservative" reforms have been suggested. Ones that would actually help fix the system. But with the progressives in power they are non-starters.
We had 8 years of GOP total rule. What did they do? Nothing. TARP was rushed through in days. Healthcare wasnt even a blip on the GOP's radar.
And now we have Obamacare. Day late, dollar short.
We had 8 years of GOP total rule. What did they do? Nothing. And now we have Obamacare. Day late, dollar short.
We did? I must have missed it.
The GOP never had 60 votes in the Senate and in fact 2 years the Senate was controlled by the jack asses and 2 years it was evenly split thanks to a dumb-whit from Vermont.
And the President was not particularly "conservative."
Healthcare wasnt even a blip on the GOP's radar.
Not actually true. They did pass that misguided drug benefit. That was healthcare oriented
And got HSAs and some small steps toward consumer oriented healthcare through.
variablebinary
01-03-10, 02:26
We did? I must have missed it.
The GOP never had 60 votes in the Senate and in fact 2 years the Senate was controlled by the jack asses and 2 years it was evenly split thanks to a dumb-whit from Vermont.
And the President was not particularly "conservative."
Point made. However, the fact remains, being the majority, even without a super majority, did afford the GOP plenty of latitude to at least get Healthcare reform on the table.
Point made. However, the fact remains, being the majority, even without a super majority, did afford the GOP plenty of latitude to at least get Healthcare reform on the table.
Not all of the GOP is conservative and as I said, there were efforts made at healthcare. It was tough enough to get HSAs passed and other similar consumer oriented reforms. Lots of small things were done in healthcare. Without the supermajority you cannot pick a fight on healthcare and make more than token progress. And there were other distractions where the President thought he needed to expend his "political capital."
And remember, the GOP was not run by "conservatives" during this period. Bush was not a conservative.
And that is all in the past. The majority of Americans do not support Obamacare and it is being rammed down our throats.
John_Wayne777
01-03-10, 08:39
The do-nothing, fiscal hawks and so-called conservatives would be smart to get it through their noggin that throwing people to the wolves is a losing strategy.
...who said anything about throwing people to the wolves?
A very simple fix that could be easily done would be to allow people to purchase medical insurance across state lines. The democrats resisted this because, in the words of Howard Dean, they don't want the insurance commissioner in Texas to have a say in what is covered in the health insurance of Vermont. In other words, people like Dean have been telling insurance companies what they will and will not cover for YEARS and at the same time forbidding people from buying other insurance products.
See, in any other market you have a range of products you can purchase that provide different types of coverage at different price points...but in a number of states where "progressives" have had free reign, they've used government mandate to force coverage of all sorts of things that raise the cost of insurance and price people out of the market...all in the name of "compassion" and fighting for the "little guy."
There's a reason why past results should be figured in when we're deciding on a course of action for the future.
You have to get ahead of the issue and deal with it intelligently,
The beginning of dealing with the issue intelligently is dealing with the reality of the situation. The current political landscape is one gigantic unreality.
I personally believe there is a way to provide healthcare without bankrupting the nation, and if the so called converatives got on board, and found solutions instead of just putting their fingers in their ears and saying "LA LA LA, CANT HEAR YOU, AND I DONT CARE" we would be better off.
Conservatives have put forth a number of solutions...but their measures don't get so much as a hearing in the current media and legislative environments.
Stop getting your news from MSNBC and perhaps you'd realize that a number of alternatives have been put forward that address the irrational parts of our current healthcare situation....including an acknowledgment of the fact that expecting health insurance to pay for EVERYTHING is probably a bad idea since we're worried about people not being able to afford insurance plans to insure against serious illness.
As it is, this attitude is why the Dems do what they do (enact f-ed up legislation.)
No, they enact messed up legislation because they are seeking to promote their own personal power and the power of a meddlesome state (united, with liberty to do what we're permitted, under them) that regulates every aspect of our lives. They are put into those positions by people who vote based on emotional appeals and the idea that government should "Do Something!!!" to "fix" a problem despite the fact that none of the previous "Do Something!!!" measures these chowderheads have enacted have actually solved a problem.
They're great at consuming resources, but don't really excel at much else.
There is a reason Herbert Hoover is considered one of the worst presidents in history,
...because as the world recession hit he supported tarriffs and other protectionist measures which basically started a trade war in the middle of a major world recession.
and FDR is revered and borderline saint.
...because the victors often write history. "He won WWII!!" No, the grunt storming the beaches of Normandy won WWII. The person working double shifts at factories to furnish the war effort won WWII. FDR was just in the big chair when all that happened. FDR's policies were not ending the recession known colloquially as the Great Depression. In fact, there's plenty of evidence that they significantly hindered it.
Presidents often receive entirely too much credit and entirely too much blame.
Expecting Hoovervilles to self correct will never be seen as better than the New Deal. If you loved the New Deal, then keep telling people "FU, life isnt fair. Enjoy your rotting breasts and lack of Chemo"
Personally, I dont like the New Deal, and I dont like Obamacare, so I know not supporting healthcare reform is not an option because you know where that gets you.
You speak as if there are no other options. You speak as if the liberals are the only ones with ideas and proposals that will help.
That's exactly what MSNBC wants you to think.
We had 8 years of GOP total rule. What did they do? Nothing.
We did not have 8 years of total GOP rule. When the GOP was in the majority they were continually hindered by the more "moderate" individuals in the house and senate who have made Obamacare possible. They were also hindered by rules they adopted that gave the minority greater input on legislation and greater opportunity to derail legislation, making compromise with the minority an absolute requirement to realistically get anything done. They adopted those rules as a part of the Contract With America...rules that the dems torpedoed the minute that they had the opportunity. Suddenly all their lectures about the majority dealing in "good faith" and allowing the input of the minority didn't seem as appealing as the raw power to just get whatever you want passed once they had the power.
Funny how that works, isn't it?
The Republicans did plenty...like inexplicably expanding medicare coverage to prescription drugs...as a means to try and aid the healthcare situation...and yet you seem unaware of it. The Republicans tried to save the social security system and reform medicare...but were shot down at every turn by democrats who screamed about destroying the programs. Now Democrats are proposing a cut of 500 billion dollars to Medicare to deal with "waste fraud and abuse"...and if you believe that, I've got a bridge to sell you in Brooklyn. See, when the Republicans talked about waste fraud and abuse in Medicare they were trying to deny old people medical care...but now that the dems need the numbers to look good 500 billion in "waste, fraud, and abuse" (which FAR exceeds any price tag the Republicans ever put on it) is somehow in the program and able to be easily cut out.
Did I mention that the bridge is only 19.99 if you act in the next 10 minutes?
The Republicans did a lot over the last 8 years...including massive interference with our educational system with a bill written largely by Ted Kennedy, which happened because Bush tried to set a "new tone" in Washington with compromise on a number of domestic policy issues...just as his father did before him.
It turned out about as well as his father's attempts to find consensus and compromise.
variablebinary
01-03-10, 08:52
Stop getting your news from MSNBC .
:rolleyes: And here we go...
Capitalist vs. Socialist is not a fight of good and evil. Both are just different political ideals nothing more. The current capitalist way of running our health care system is failing miserable and it needs to be changed. I am all for everyone paying their fair share and no free loaders. But I also believe in society as a whole is responsible to deal with certain issues like the health of its people.
Pat
In principle, I don't disagree with above. It's the specifics of how we (attempt) to achieve it, that worries me. There are MANY people in poor health/using the health care system, improperly, and due to their own stupidity, lazyness, and entitlement.
Those people suck, are a major cost driver to the system, but have also been literally bred for it to be perfect (read ignorant) consumers, and that includes consumers of medical care they either don't need, or need due to por choices on their end
However, there are also those that due to no fault of their own, are unable to afford health care/get adequate medical care. It's easy to tell others it's all part of the free market 'dog eat dog' system if they fall through the cracks, but if you have never walked a mile in those shoes (and I have...), you are in no place to comment on that.
Turning our backs on such people is as Un American as it gets in my view. American's don't turn their backs on other American's in need.
The issue is being tough choices on the first group over the latter.
Allowing people to be devoured by cancer and illness with an emergency room solution is nothing short of red cape, horns and tail demonic evil.
How many people are out of work currently? A lot. People that have done nothing wrong other than get caught up in a down economy. They no longer have health insurance.
I dont think sitting back, and saying "F U, good luck. Hope your kids dont get a toothache" is a viable solution.
I would agree. 'Till you walked int those shoes...
Specific to my original thread regarding drug companies less then free market behavior and one major cost driver to health insurance, one of the mods on my site is a rehab MD. To my post he responded:
This is very true, Will. But physicians have the power to prescribe or not prescribe.
What I have seen, as a physician observing other physicians, is that not everyone does things in a cost-conscious nor evidence-based manner.
What I have also seen, is that patients want new and expensive treatments, even if they aren't better. Case in point: Knee Scopes For No Particular Reason.
Generic drugs contribute much less to overall pharmaceutical impact on health care costs, and 95% of effective medications are available as generics.
Here's the problem. The patent runs out 14 years after development. If a drug company comes out with Novel Drug A, they are doing well for that 14 years. And physicians can justifiably prescribe the drug, when indicated. Fine. BUT...
But what happens when that 14 years are up? The drug is still just as effective. Only now, the drug company cannot exclusively offer it. But they still want THEIR drug prescribed. So what do they do? One of three things, generally:
1) Come out with a nearly identical drug, for the same indication, that, because of its structure, can be patented. Complete with shiny new advertising campaign.
2) Combine an existing drug FOR WHICH THE PATENT RAN OUT with another one and make a combo pill. Brand that combo pill and patent it. This is no different than taking the two drugs separately for considerably cheaper. A very popular drug that juxtaposes pictures of apple pie with grandma in its ads fits this bill.
3) Come out with a novel drug for the same indication, and claim that it's "better" than the old drug for which the patent ran out. The idea that it's better is not supported by good science, but instead by a shiny advertising campaign.
Here's the thing, though. If docs don't prescribe Shiny New Drug, they don't make money. If patients don't think they need Shiny New Drug, likewise...to an extent.
I can't tell you how many docs, particularly in private practice, don't keep up with the literature and almost literally get their info from drug reps and advertisements. This is inexcusable. We get educated for a long time (I'm in my 14th year of post-secondary education/training). We are supposed to be intelligent and critical thinkers. We are not supposed to fall prey to shiny ads.
Two things need to happen:
1) Docs need to take responsibility and prescribe responsibly. If a cheap drug for which the patent has run out works better, don't prescribe the shiny new one. A good analogy for gym rats is creatine. We all know (at least on this forum) that essentially, plain ol' creatine monohydrate powder works just as well as UberXtreme CreaBlast 9000 that just came out last month with a bunch of junk ingredients. This is equivalent to the old generic drug working just as well as the shiny, sexy new one with the ad campaign. Doctors should be intelligent enough to figure this out.
2) Patients in America need to be educated. It is NOT THEIR FAULT that they think they need the most expensive treatments. People are not all complete idiots. They want the best care.
When I've taken time to explain to Average Joes and Average Janes, in plain terms, the reasons why, just because they have non-mechanical knee pain, they don't need an MRI or arthroscopic surgery, 95% of them get it, regardless of educational level.
So regardless of what pharmaceutical companies do, it is up to docs to do things the right way. If your only CME is from a drug company-sponsored dinner, you are not being responsible as a physician and a life-long learner.
John_Wayne777
01-03-10, 09:44
:rolleyes: And here we go...
So if you don't get your news from msnbc...why aren't you aware of numerous proposals put forward by those who aren't attempting to destroy the free market?
I agree that some changes to the healthcare industry need to be made I don't believe either the House or the Senate bill address those issues and only create a bigger, far more bloated, system that in the long run is going to decrease the quality of care while increasing cost.
If this is such and important issue why the rush? Why is it necessary to get it pushed through so quickly? Why was it so important to write huge bills and bring them to vote so fast that most in Congress admitted that had not read it? Why has the insurance companies been so quiet?
Something is seriously wrong; payoffs, bribes, promises made that have nothing to do with healthcare. And for those of you that want to blame the Dems or say the GOP is doing nothing, wake the $#*& up. Both sides are just as bad and neither care about the America public or your healthcare. They are selling us down the river for their own agenda.
Turning our backs on such people is as Un American as it gets in my view. American's don't turn their backs on other American's in need.
The issue is being tough choices on the first group over the latter.
There is a major difference between Americans and the govt. Americans are the people. The govt is not "Americans." The govt stealing from people to help other people is not American. Americans do stand up to help. Especially the non progressive Americans who donate a lot to charity. No one is arguing that sometimes people need help. We are arguing that destroying the healthcare system and stealing from people in Robin Hood style are in appropriate responses to that problem. Obamacare and any other progressive "solution" is not about Americans. It is about political power and forcing things by govt power.
You have a very interesting view on one of the greatest american presidents to ever live.
A view that I, and many other Americans who have looked at history objectively and not through the rosy lens of public school history books, share about FDR.
He was a tyrant and a socialist. He could have just as easily led America through the depression and WWII without creating all of the permanent government dependency that he did - but he didn't. He deliberately and knowingly created programs that he intended to be permanent in order to fix temporary problems. He flat out said it himself.
I agree, but that topic is not outside their lane, or the person who wrote it. She's also not remotely alone in the findings regarding how pharma fails American citizens. The rest is solely your opinion vs hers, which jibes well with what I already know of the industry. I respect your opinion, but we will have to agree to disagree here.
The doctor's article is systematically flawed for at least two reasons, just from a cursory glance:
1. She cites pharma profits very spottily, using only single (probably cherry-picked) years and companies. Absolutely amateur "research" if you're trying to prove a point as broad as the one she's making. I could make Hitler look like a saint if I only picked one year of his reign or one part of his government.
2. The conclusions and solutions she proposes would have enormous economic effects, bad ones, that she just seems to ignore. She fail to engage in any sort of meaningful cost/benefit analysis or even acknowledge the downsides to screwing with the current model, which is the mark of somebody with an agenda.
Agreed. I believe it is outright evil that we don't provide a method for all citizens to receive basic healthcare.
We do provide that. Anybody can walk into a facility and get treatment. Your problem, and the problem that the bleeding hearts seem to have, isn't a health care problem, it's a money problem. Some people just can't or won't pay for it, so we come up with absurdly convoluted schemes to just steal money from people who have more of it and give it to those who have less. No matter how many layers of bureaucracy and how many labels you put on it, it's socialism.
If someone is sick they should have the ability to go to doctor, period.
They can. See above.
Our current healthcare system is not good enough. We can do better and should strive for something better.
We have the best health care system in the world. Of course, that's also why it costs more.
There is a major difference between Americans and the govt. Americans are the people. The govt is not "Americans." The govt stealing from people to help other people is not American. Americans do stand up to help. Especially the non progressive Americans who donate a lot to charity. No one is arguing that sometimes people need help. We are arguing that destroying the healthcare system and stealing from people in Robin Hood style are in appropriate responses to that problem. Obamacare and any other progressive "solution" is not about Americans. It is about political power and forcing things by govt power.
I don't disagree with any of the above, but my comments are not defacto intended in any way as some form of support for Obama Care/Universal health care via govt intervention per se; they were general comments to others making general comments 'screw 'em if they can't afford it and it's their own fault' oriented comments
Look at my original post: I'm in MA, and the "MA experiment" has been a disaster. :mad:
Allowing people to be devoured by cancer and illness with an emergency room solution is nothing short of red cape, horns and tail demonic evil.
How many people are out of work currently? A lot. People that have done nothing wrong other than get caught up in a down economy. They no longer have health insurance.
I dont think sitting back, and saying "F U, good luck. Hope your kids dont get a toothache" is a viable solution.
So... what, you're going to rob the other people to help them out?
Stop ignoring the other side of the equation where you **** over all the other people in the process of helping poor little Johnny out with his toothache that those other people did nothing to cause.
I don't disagree with any of the above, but my comments are not defacto intended in any way as some form of support for Obama Care/Universal health care via govt intervention per se; they were general comments to others making general comments 'screw 'em if they can't afford it and it's their own fault' oriented comments
Look at my original post: I'm in MA, and the "MA experiment" has been a disaster. :mad:
understood. Just a hotbutton with me when people start talking about society and Americans as if somehow that equated to the govt
You have a right to your opinion. I have a right to mine. However when you start labeling another political view as evil that shows great intolerance on your part. Politics is politics and morality is morality. There are good capitalists and evil ones same with socialists.
You swore an oath to uphold the Constitution, which is now on the brink of being trashed by an unconstitutional individual mandate to carry health insurance.
Your support of full-blown socialist health care is not merely an opinion, on the same level as your favorite flavor of ice cream. It has much more gravity to it.
That is highly debatable. Obviously the hands off approach has not worked. That approach has gotten us what we have now a broke health care system.
Pat
The notion that the system has been hands-off is a myth perpetuated by the left. I would argue that the tampering done by politicians are what has caused most of the problems. Reflecting on your earlier sentiments that a country must care for its sick etc...I can understand your point of view, but I must add, to what end? As a country, is it morally right to continue to expect/force people who make the right decisions in life to pay for the mistakes of those that don't? People no longer view their own health as their responsibility. If they neglect themselves and wind up having problems, they expect someone else to pay for their negligence.
That is highly debatable. Obviously the hands off approach has not worked. That approach has gotten us what we have now a broke health care system.
Pat
I highly suggest you educate yourself on these matters. The healthcare system has been anything BUT handsoff. The politicians have been hands-on mucking with it since at least the mid 60s when Medicaid etc came out. Today's trainwreck is a direct result of a non-hands off approach by DC and state govts. Progressive policies have resulted in a wrecked system. Progressive policies won't fix it.
---
As an aside: any fix that gets implemented needs to make sure that any help people receive if they truly cannot pay themselves is a type of last resort help and that there is a sort of stigma attached. People need to be responsible for themselves and their actions first and foremost. If they are not, they will not make the decisions that best lead to good health. My RN wife sees this every day. People come in, and not the first time, with all sorts of problems. These people are 400lbs plus and don't see any need to try and change that nor lead a better lifestyle and they know they are not paying for it and expect everyone to serve them. She tells me stories all the time, almost after every shift, of such people. (Obviously she tells the stories without any sort of identifying traits of the people for all the snitches reading this).
+1 to the reply quoted from dbrowne1:
So... what, you're going to rob the other people to help them out?
Stop ignoring the other side of the equation where you **** over all the other people in the process of helping poor little Johnny out with his toothache that those other people did nothing to cause.
Honestly, really...? You all do understand that life is not with a warranty. Folks die. They die at birth, and all levels from birth to old age.
So should I get cancer and not have coverage.... I should expect all of you guys to buy me chemo and whatnot? That is absurd and insane.
Dude, you live and you die. Sure, I hope to not die today, but if I do.... the world will still turn.
You folks act like my life (or any one elses life) is paramount to the country and of (even) some minor importance. Your life is meaningless in the grand scheme, you are less than dust.
I owe you not one thing and should any of you (the "you" being any fellow humans) get sick and not have the means to fight the illness.... I owe you not one damn thing. As a matter of fact, I will walk a wide path around you as I look on at you in your death throws. During this time, I will pull the resources that I have and fight for my life and the life of my family the best that I can. And when the time to die approaches, I will never call upon you. I will never ask you to suffer my pain, financially or otherwise.
I will shed a tear as I await death, but the tear will be for the thought of the life that I will miss, not for the aid/money/medicine I feel I deserved only for the reason that I walk on 2 legs and suck air.
So many humans feel as if thier life has some special meaning or that a human life is more valuable than any other, that makes me sick. Watch any hunted animal fight for his life as you blow holes in his body and tell me that too him.... and to each living animal...each feels that in the moment of life and death that thier particular life is just about the very most important life on the planet.
So we live at various levels or stations in life. Some are poor and some are rich. I am happy too have the poor, I need someone to take out my trash. I need a ditch dug. It is those of weaker mind and stronger back that do the things that many of us do not wish too do.
I believe that we all choose a path, we work towards a goal. I had a plan since 9th grade to get a degree and get married and have at least my one son. I had been raised by a family that worked hard. My parents started in a 20 year mobile home, poor and scared as 2 18 year children with a child on the way.... and ended up owning a business, living in a $500,000 house and driving sports cars while flying around the world on vacations 2-3 times a year. No one... not anybody... gave my father shit. He worked 4 seperate jobs at one time. While doing this, my mother was out working full time. They forced themselves forward and provided me and my sister an amazing childhood.
I wanted to live this same lifestyle, and though in my opinion I missed the mark by a bit, I am doing fine. My children have what they need and much of what they want. I work hard and care about what I do. My wife works as well. We do not sit here and see who will take care of us, we go out and take what is ours. We earn what we take.
Some of the entitlement attitudes make me want to vomit. Where the hell did this come from in my country?
Larry0071-
Not sure why you quoted my post along with yours above - I agree with you.
My wife asked the same thing. I was agreeing with your post and taking it further in detail. Ill edit a bit....
Will- The MD you quoted says he is in his 14th year of post-secondary training. That would be 4yrs. college, 4 yrs. med. school, 2-6 yrs. Residency depending upon specialty, and possibly a Fellowship. I do not believe he has entered into private practice yet so for him to comment upon the habits of MD's in private practice is somewhat speculative. Going through clinicals and possibly working in a Residency based clinic is not the same. He is still in training.
For him to suggest that an MD could receive enough CME's by attending drug-sponsored "dinners" is ridiculous. I do not think he has a grasp of what is required yet. There is no way appropriate CME's could be obtained that way.
I have been constantly amazed by MD's in private practice that are up to date and current. After completing Residency, my wife(and I) interviewed at 12 practices. Yes, the spouse(if there is one) is being scrutinized as well. I have been in on many conversations where the the questioning was two-way. A good candidate asks as many questions as the interviewer.
We are currently in the process of final contract negotiations that has taken us to 6 states and had site visits with 8 practices. At every one, the MD's were up to date on the latest surgical techniques, or in the process of developing the new skill sets such as advanced laproscopic techniques. This included many MD's that were over 50.
Are all MD's 100% up to date? Of course not. However, to quote someone that is in all likelihood not even out of training as an expert on private practice, I find to be misinformed or disingenous.
As far as MD's being paid by drug co.'s, they are paid for travel expenses, speaking fees, and consulting. I am not going to get into this for one reason: I feel most of us have been to, know, have been operated on by MD's, and/or have interacted with MD's through family medical issues. The vast majority of people know that, by and large, MD's are good people we would like to have as a neighbor and friend. Most MD's go into the field for the right reasons(My wife certainly didn't go into it for the debt we now carry). Do not misunderstand my post. I in no way take exception to your post b/c my wife is an OG/GYN Surgeon. I only would like for you to see the other side of the coin and hopefully consider all angles in the debate. I feel most people realize most MD's are good, honest people that practice medicine the right way.
The way I read your posts it seems as if you have had your vision colored by focusing on the exception rather than the rule. Many MD's I have known and know make an extra effort to not be influenced by the pharma companies. It is really not hard at all. The pharma co.'s are not going to stop their practices(which aren't all they are demonized to be anyway) and so the MD's are free to use their best clinical judgment in the patient's interest b/c the free lunches are going to be there anyway. As far as getting paid to speak, the % of MD's that do this is prob. less that 1% and if the MD believes it is a superior product or the speech is to the local charity with info. that is beneficial to the population, what is the problem? Many drugs do great good and where is the harm in an MD getting paid to speak about a quality drug he/she prescribe anyway? Just for the record, my wife has not ever spoken for a fee from a drug co. She does do community education programs at the hospital, local churches, etc. If she was ever offered a paid speaking engagement and she believed in the product, I would say why not?
understood. Just a hotbutton with me when people start talking about society and Americans as if somehow that equated to the govt
I don't know the answer, but I will admit I am not sure the for profit - free market - model works for health care. The other extreme is what it is, with the known pitfalls there, so some balance between the two may be in order. Those who simply look to the 'gubment' to solve all their problems are idiots. It's clear to me at least the problem far too large and far too complex for any simple "let the free market deal with it" or "let government deal with it via regulation" comments.
So should I get cancer and not have coverage.... I should expect all of you guys to buy me chemo and whatnot? That is absurd and insane.
Have you walked that path Larry? I was a healthy 20 year old. Lifted weights, took a (albeit) crappy multi vite, had a pretty good diet for a 20 year old in the early 80s. Partied a bit like any 20 year old, but was mostly focused on studies and lifting weights.
I was diagnosed with Hodgkins Lymphoma, stage 2. I didn't have a pot to piss in, could barely afford books and school, and now I had cancer.
I was taken care of, and taken care of well, and treated (for 1983) as best they could do. I lived. The costs went to the state of NH, and perhaps government pools, etc.
Those docs told me, not to worry about it, I would get that second chance, and I did. Due to the treatments and other issues, took me a long time to finish school, and secondary health problems have existed also, which I have paid for with insurance and or out of pocket, etc.
We are a civilized society, and that's how we should act. There is a primary cost of the treatments to society for those who were like me, and there is a long term (potential) pay off: I have given more back to helping others with their own health, weight, etc etc issues a million times over what it cost the NH tax payers. I have also earned, given to charity, added back to the tax base, etc far more then the NH tax payers put out.
I'll say it again, as with so many things, it's easy to have an opinion 'till you walk in those shoes.
I have nothing against my tax dollars going into a pool that helps those truly in need, I wish more was directed to education, prevention, etc, etc. so everyone has at least a chance to live their American dream.
Everyone has a chance in this great country, but not everyone starts at the same starting line. Abuse the system, cause most of your own health problems, expect the 'gubment' to pay for everything 'cause you are too damn lazy to work, etc, then you are a drain on the system and the system needs to do a better job of dealing with those types.
However, everyone who has walked in my shoes, and or had similar experiences, please raise your hand then tell us how it is.
6933,
If the medical practices your wife is interviewing with are asking a non-practicing spouse to be involved in interview process, they are on very dangerous ground with regard to their employment practices. If they deny her employment and you have reason to believe it was because of you, that could be grounds for a lawsuit.
Then again if they have only a few employees they might be under the legal threshold for EEOC regs. Either way, it is WAY out of the norm for professional hiring practices in any other industry.
Not really on-topic but seeing this was very surprising to me. Getting back to the topic:
I took Sporinox for a few months last year due to a fungal infection in my lung. One time the doctor prescribed the name brand although a generic is available. I asked him every time to make sure he allowed generic substitution, but one time he didn't. The pharmacy didn't even carry the name brand because it is so expensive no one ever gets it - they just carry the generic so I had to call the on-call doctor and get the generic substitution called in. Why do I have to ask the doctor to allow the generic, he should be advising me only to get the generic.
With generics for Zocor and Pravachol available now, why does any MD still prescribe name brand Lipitor, or Crestor? Maybe we should ask for a show of hands of people taking a name brand to see if they have been advised to see if one of the generics works for them?
I took prescription Zocor until it was pulled from my plan's preferred list. So my doctor switched me to Pravachol which was on the preferred list and now it's generic so it's at the minimal cost now. Works well enough that my doctor is satisfied with my test results. But I had to ask to be switched to something on the preferred list in the first place.
When I was prescribed an anti-inflammatory by a rheumatologist due to joint pain that was a side effect of my lung infection, he suggested something and my first response was to ask if it was available generic. He said no, and somewhat reluctantly said we could try something else that was available as a generic if cost was a concern. The generic worked fine.
In every case, I have to make a conscious effort to steer my doctors to a generic med instead of a name brand, and the generics always seem to work fine. Do I just randomly pick and/or get referred to doctors who are "part of the problem". Or is there some reason why they seem to want to prescribe name brands all the time? These are good doctors, but it just seems strange that they wouldn't be actively interested in helping me minimize my out-of-pocket costs and the amount charged to my medical plan.
Have you walked that path Larry?
Why does that matter? Why does it matter whether he has "walked that path" when we're talking about broad public policy? What if Larry could have afforded health insurance if he didn't have to pay medicare and social security payroll taxes to support others, but didn't get it because of those taxes and then got cancer? You can what ifs and anecdotes to death. That is not the basis of good policy.
You are arguing for changes in policies that affect hundreds of millions of people based upon your own personal experience.
We are a civilized society, and that's how we should act.
So it's civilized to rob the general public at gunpoint to pay for the bad luck of others?
Will- My hat's off to you and hope your health continues until ripe old age.
I do disagree with you on one point which is a "We'll just have to agree to disagree." I do not think anyone has a right to health care. What that means is one has a right to a care provider's time, regardless of whether that person wants to give their time to that person. What about the convicted child molester that is an IV drug user that refuses to change his behavior? For me, that person deserves nothing. He has no right to my money. This an an extreme example but I think most understand where I am going with it.
Just b/c all are not born into the same circumstances, it is not up to the gov. to level the field. Life is not fair. Let private charities, which people voluntarily contribute to, try and help the so-called "less-fortunate." This term disgusts me. What it says is; individuals that work hard to achieve were "lucky" and that the "less-fortunate" are in their circumstances due to luck, not personal decisions.
I am glad you recovered from your health issues and I'm sure you have contributed back to the gov. for their expenditures. However, I still do not feel the gov. has a right to take from others to provide health care for some.
The way I read your posts it seems as if you have had your vision colored by focusing on the exception rather than the rule.
No sir, I think you are taking my comments wrong I think. I know and or work with many an MD, and it's all over the place in terms of how up to date they are, etc. I was just posting his opinions of my post. I'm not in a position however to say if it's the exception or the rule as it's a tad out of my lane. Also, as you know, different people, in the exact same profession can come to totally different conclusions on any topic.
If she was ever offered a paid speaking engagement and she believed in the product, I would say why not?
No reason, but at the same time, I think you are painting a bit of a rosy picture on the other extreme. One of my best pals is the head rep for a large pharma in this region, and I have seen first hand how it works, and he laughs about it. He had a specific budget for things like dinners to show a group of docs his song and dance about their latest greatest drug (while admitting to me he knew full well said new drug was no better then their older cheaper drugs BTW) which was at expensive places, which was really his marketing budget to wine and dine. He said he had to at least show them some sort of show legally speaking, but in truth, it was an expensive dinner and a party....There were all manner of ways he used his rather large budget to get docs to prescribe these drugs, and prescribe they did.
Now, and this is important, last time I talked to him (he moved away to become a regional manager) he mentioned a lot of that type of stuff has toned down and it's not nearly so easy to do the wine and dine, etc, etc, thing as policies have been set at various places, and so on, but I wanted to add, I think the truth there seems to fall some place between the two, and a conflict of interest between X doc promoting Y drug for Z company, etc, is alive and well also.
Many of my friends are docs, and my own docs, are very good and decent people who keep me well, so nothing should be seen as some sort of anti MD rant, 'cause it aint.
However, I do have a unique access and perspective some times on what they deal with and such, and I don't always like what I see.
Hope that makes sense.
Will- My hat's off to you and hope your health continues until ripe old age.
I do disagree with you on one point which is a "We'll just have to agree to disagree." I do not think anyone has a right to health care. What that means is one has a right to a care provider's time, regardless of whether that person wants to give their time to that person. What about the convicted child molester that is an IV drug user that refuses to change his behavior? For me, that person deserves nothing. He has no right to my money. This an an extreme example but I think most understand where I am going with it.
And I addressed it. There are differences and the system needs to do a better jobod addressing those differences.
Just b/c all are not born into the same circumstances, it is not up to the gov. to level the field. Life is not fair. Let private charities, which people voluntarily contribute to, try and help the so-called "less-fortunate." This term disgusts me. What it says is; individuals that work hard to achieve were "lucky" and that the "less-fortunate" are in their circumstances due to luck, not personal decisions.
Agreed, but there are also those who are in fact in a specific circumstance that is not a reflection per se of poor personal decisions. And unlike some here, who are giving the "just pull yourself up from your boostraps" comments, I grew up poor as dirt in a $90 apartment in Brooklyn NY with rats, cats, roaches, junkies, and heat on occasion, so I have walked in those shoes and did exactly that. Never took no for an answer and decided short of death, I would be an educated man, etc,
I can also say, that some help along the way, may or may not have kept me headed in the right direction. I know many others who have been in those shoes.
I am glad you recovered from your health issues and I'm sure you have contributed back to the gov. for their expenditures. However, I still do not feel the gov. has a right to take from others to provide health care for some.
In principle, I agree with you, but as I said, I'm also not convinced the for profit free market works in health care alone.
A few points I would everyone to consider:
-We know based on small scale models, such as Massachusetts, that when you start providing universal health care the individual fee goes up unless you fall below the poverty line where your share is covered in whole or in part. Have you considered what will happen to the portion of the population that is above the poverty line but is barely able to afford the insurance or monthly bills they currently have? What I am saying, right now I pay roughly 6% of what my average income (3 year average) totals into private health insurance. The CBO said a few months ago that under current plans at the time individuals would be responsible for nearly 12% (functionally double of what I pay now). Do you think all families that are above the line of receiving a subsidy but can afford that? If they can not afford it, where does that put them?
It puts them in the shitter - hence my hypothetical above about somebody paying medicare and socialist security payroll taxes to support others but being unable to afford health insurance, or qualify for those programs, themself.
You have a very interesting view on one of the greatest american presidents to ever live. FDR. He was a great man that lead this nation out of the last depression. He was also very popular with the people winning 4 terms in office. The US spends far more in forign aid and on the war than they do on social programs to help our own people.
Pat
Not everyone views him as that "great" of a President. He is also thought to have extended the Great Depression by 7 years!
http://newsroom.ucla.edu/portal/ucla/FDR-s-Policies-Prolonged-Depression-5409.aspx
C4
This thread is a great example of where bias helps form opinions based upon "life experiences". What one person can relate to many others cant relate to even a little....
Somehow people feel entitled to things that are not free and yet they expect others to foot the bill for things that they "feel" are important. It seems to have started with the pandering of the 30's-40's where the Federal government started to take on the role of churches and charities.
The Gov has no business in health care or any other forms of free market commerce.
They need to focus on reducing the size of government, not growing it. Hell I would be happy if they could simply balance a checkbook and not have a need to raise the debt ceiling on Christmas eve... Kinda reminds me of 1913...
Health care is just another way of giving .gov more power and control. It diverts the public eye away from things of far greater importance and the things that they are mandated to do. If they focused on many of those issues there quite possibly would be no need for health care "reform"...
What has .gov ever done well that the private sector cant do better?
Health care reform could be accomplished in a 10 page bill not a 2000+ page bill of special interest projects. Simply start an HMO for those who are uninsured and let charity and churches help those in "need". America gives more to charity that the rest of the world combined. Americans love to give when it is their choice, not when they are forced to by the "kings tax"...
Just my opinion and I wont argue it, so don't bother trying to get me to...;)
Why does that matter? Why does it matter whether he has "walked that path" when we're talking about broad public policy?
Guy comes onto this forum and says "I have just read X book and such, and in my opinion, troops should all be stationed as such, and researched this topic, and in my opinion troops should be using X weapons, and should stop shooting in X fashion during engagements. I think the majority of funds currently spent should go to Y weapons platform"
And rightly so, a member responds:
"WTF do you know of war? Ever shot someone and watched them bleed out in front of you? No, then how about you STFU."
It's kinda like that...:D
But seriously, no, you don't base large policies in n =1 experiences, but the experiences of some can help us to see what perhaps we didn't see before, realize what we think we know about a topic, has other costs and benefits we hadn't considered, and so on.
I didn't suggest policy based on my experience, but I did suggest minus any actual personal experience in an area, they might want to reconsider their positions.
What if Larry could have afforded health insurance if he didn't have to pay medicare and social security payroll taxes to support others, but didn't get it because of those taxes and then got cancer? You can what ifs and anecdotes to death. That is not the basis of good policy.
I didn't claim to have the answers, and yes, we are over taxed, and yet more taxes, aint gonna solve shit.
You are arguing for changes in policies that affect hundreds of millions of people based upon your own personal experience.
No, I'm not actually, and I hope you can see the difference. If not, then we will have to agree to disagree! Sorry, couldn't resist.:D
Again highly debatable. Some right wing ecomomist may think he prolonged it. WWII definately got us out. But his programs were helping if you look at netral views on the subect rather than politically biased ones.
pat
The article I linked too came out of UCLA. Hardly a hot bed for "Right Wing" thinking.
C4
\
I didn't suggest policy based on my experience, but I did suggest minus any actual personal experience in an area, they might want to reconsider their positions.
So somebody who has had to pay payroll taxes and other taxes, has suffered financially as a result, and recognizes that this imposes a cost on everyone else as well, doesn't have "personal experience" in this just because they've never had cancer?
Methinks your definition of personal experience is rather narrow.
You have a very interesting view on one of the greatest american presidents to ever live. FDR. He was a great man that lead this nation out of the last depression. He was also very popular with the people winning 4 terms in office. The US spends far more in forign aid and on the war than they do on social programs to help our own people.
Pat
I assume you are joking??!?!?!? Does the "new deal" ring a bell? Does trying to change the make up of SCOTUS ring a bell when they found his programs to be unconstitutional?!?!?
I could go on for hours about the harm that FDR caused this nation... Unions anyone?
Nevermind...
So somebody who has had to pay payroll taxes and other taxes, has suffered financially as a result, and recognizes that this imposes a cost on everyone else as well, doesn't have "personal experience" in this just because they've never had cancer?
I pay all those things too and didn't/don't deny their burden. I live in Tax happy MA, and it's killin' me and it sucks. Also said, clearly, I am in the MA "experiment" and it's an f-ing disaster and why i started the thread. I also said, I don't have answers. If you feel the personal experiences (which I am also part of...) of paying taxes is on par with my and others experiences, that's OK by me. Again, I can at least speak from both experiences at least.
So... what, you're going to rob the other people to help them out?
Stop ignoring the other side of the equation where you **** over all the other people in the process of helping poor little Johnny out with his toothache that those other people did nothing to cause.
Right.
There is really no reason for being poor in this country. None. You CAN be anything you want and make as much money as you want. It all depends on how hard you want to work for it.
If people do not have money to pay for medical insurance when they lose their job, then my question is, where is their emergency fund??? As a gun dealer (one of the most hated people on the planet), my head is always on the chopping block. Not only is the ATF looking to pull my license for paper work violations, but the Govt wants to ban what I sell. Because of this, I keep about 2 years salary in the bank.
Was it fun working two jobs and not buying what I wanted for the last 6 years? Hell no! I did it because I have to provide for my family. Period.
Peoples inability to live below their means and save money is not my fault and my wallet should not be required to bail them out.
C4
I'm not sure why it is, but there are very duifferent ways of thinking, and they seem to swing dramatically to polar opposites.
Let me start with this, lets say I am dieing. I will be dead in a year tops, maybe 6 months. Who cares at this point about who pays what....
Every one of you who will be effected by my death, please tell me.
Not one person on here. That is correct, not one. Not at work, not really any friends, only my wife/kids/parents. Nope, not my aunts/uncles/cousins. They won't really care, it will just something to talk about. Each of you have a SMALL circle of folks that truly depend on your sucking air, this circle is small.
Should I die, it is less than meaningless to you all. You will not notice when I stop posting here because I hace ceased to exist.
Based on this, you strangers are less than meaningless to me. I am OK with admitting this, it is a fact. I do not need you as an individual. I do care for the general well being of the civilization, or the machine that provides the structure around me. You see, I need the people to remain alive... but not the person. If you were my garbage man, and you pass away... a new garbage man is hired. I will miss you as much as you miss my posts that stop.
So, being that I really don't care on a personal level for you, and you can likely admit that you do not care on a personal level for me.... why should I ask that they increase your financial obligation so that you can ensure my health and well being? Maybe I should go get a 2nd job and ensure my own health and well being! Ins (at least in Pa.) is not terribly expensive until you get old or have issues like smoking/obesity/blood pressure/cholesterol that you are taking along with you while shopping for the ins. So if you only have one 8 hour job, what the heck do you doo with the other wasted time of your life that you are sucking air? You can get a job working evenings and get a job working weekends at a gas station. This is how you survive, not by asking me for help.
When I was in school trying to get that degree, I worked at the A-Plus gas station on 65 North about 10 miles from Pittsburgh. I went to work straight from school and worked from 6 till midnight 4 days a week.
I also worked at the local parts store Saturday and Sunday, I worked open to close. (9am-6pm saturday and 9am to 3pm sunday) I paid cash for my car, my gas/maintenance, food, books, and dated once in a while. My parents paid for tuition, but this was a perk I got because my father has been a working fool since he was 12 years old. I was working and going to school and had very little non productive time.
Some how, there is this group of folks that can't afford this or can't afford that. How many jobs do they work? You only need to sleep 5-6 hours a day.... you don't need weekends off if you can not afford to have weekends off. If you need to work more..... then work more!
This is what we lost in our country. The way I worked and went to school was something that at one time was "normal" morals. We expected young men that were building a family to start at the bottom and work himself LITERALLY to the bone. A man was expected to provide, and men provided. Now.... men say thay have a job but it has no benefits. This man sets his lazy ass down every night after work (or every day after nightshift) and sobs for himself. This man should be kicked in the ass.
I got out of school and starting working in 1993. I was a contractor, I had no benefits provided to me. I worked approx 6 months a year for the company I was contracting to, I traveled all over the USA. While not working as a contractor, I did concrete work and general construction in my home area. I still worked at that parts store on weekends any time I was not contracting up until the day the business closed. Somewhere around 1998 that parts store job ended.
So during this time I got married and started to have babies. I had to provide my own ins. and I did. My wife also worked, she worked 40 hours a week of nightshift that was 2 16 hour night shifts (Friday night to Saturday morn and then Saturday night to Sunday morning and one 8 hour evening shift during the week) helping care for the mentally retarded. Between her, me, my parents and her parents... we covered the children. So I am traveling... or I am home... depends on the month. While traveling I work 70-90 hours a week. I worked days or nights, each contract was unique. But damn it..... I was doing it. No one was paying for me.
I was a man. I was 22 years old, but I was taking care of my business.
Blah...blah...blah.... So on and so forth. I am where I am, not by accident but because I have put in the time and worked myself into a good reputation with a solid background in what I do. I'm not the best and smartest SOB in the world, but I get my share and I work hard to try to get more tomorow.
The way I was raised, the values implanted into my head from my grandparents (farmers) and my father/mother do not allow for one to give up and lay down when the shit gets ugly. If you knock my father down, he will... absolutely rebound. And likely that he will learn from his failing and come back smarter and stronger than ever... you know why I say this? Because he has been knocked down in life. He has fallen from the comfort of a long term career and been down and out. He would not ever look to welfare. He looked at his past and what he knew how to do, and he struck out and starting doing it. Construction. While doing that he was still searching and working and not giving up. He was facing total failure. He only had so much time that he could play the game and adjust the money.... so long before he lost everything. The pressure was was on and it was so thick you could feel it when you walked in the house.
And he kept going. He worked and he searched and within a year he was on track to survive... if he could hold it together. He did. Today, it is but a memory. But it was very real to us.
You see, some folks around here (Pittsburgh steel mill towns) lost thier jobs in the late 70's and are still setting on the couch bitching that there is no work any more. They tell of the high school drop outs that went to work at the mill and raised families. They say that our children have nothing today. This is not true!
Make your child understand that he must get an education and do it in a field that is usefull! So many get a degree in basket-weaving... while we need no baskets weaved!
Back to my point, those guys that lost thier jobs in the mills and did not rebound.... those guys had the same mentality of those that feel that national health care is required and a god given right to every human. No one owes you a damn thing. If you want it, get up... and go get it. Find a way. Make a way. Fight for a way. There is always a way. Don't go down and wait to be picked up. No one may come to aid you. I know I won't help you.
Like I said, we all come from various backgrounds. Some came from families that were born into entitlement. Some came from salt of the earth, hard working folks. Some came from a silver spoon. And there is every level in between. But folks, we need these levels. We need poverty. If the govt begins to even the playing field, you take the incentive away from the true genious' and you take the motivation away from those that are truely motivated.
If this system begins to effect the doctors pay and the pharmacudical companies pay..... what will drive them onward into the risk? Why invent that new drug? Why become a doctor? If you break down the financial free market system too far, you start to create ripples that can create waves that can create chaos and devastation.
We walk upon dangerous ground my friends. Tread lightly, and prey.
Derek_Connor
01-03-10, 14:09
I've only worked in medicine for the last 4 years FWIW, from my view:
If we want sweeping reform? Start with the money-grubbing hospitals.
No, I am not against making money, I am all for it. Although, these hospitals are run so poorly, so inefficiently, and with the shittiest business goals in mind that they are raping individual patient on the personal level, all the way down to the pair of "$120" socks they put on their feet before surgery.
People point fingers at insurance companies, law makers, ourselves and so on. Lets not forget the institutions that are banging away at our deductibles on a daily basis.
I am not a proponent of state/fed gov't insurance, we already have it. Medicare/Medicaid is almost 40% of total billings, and the system is failing. And we want to push it even further?
That, on top of the absolute push to get it done ASAP is a decision that we will all pay for. But not until 2014, when we can actually " get our benefits ". :o
+1
It saddens me to see such a lack of compassion in my fellow americans. What happened to the compassionate conservatives. They seem to be few in number these days.
Pat
The compassion is there. My family writes thousands of dollars in checks to all kinds of charities EVERY YEAR.
You see, the difference between a liberal and a conservative is that the liberal wants to force you to give by taxing you. The conservative wants you to keep more of your money and let you WILLINGLY give it.
C4
It is compassionate to steal from me so I cannot afford to take care of my own family?
Have you ever looked at charitable giving statistics in this country? People who would probably be in the "conservative" category tend to give a lot more to charity than those who would not be in the "conservative" category. True compassion is helping the poor and needy out of ones free will and heart. Not stealing from your neighbor to give to the poor and needy out of your neighbors pocket.
There is NOTHING compassionate about socialism, progressive policy, and state sponsored health care.
Bingo!
Conservatives give more than Liberals: http://abcnews.go.com/2020/story?id=2682730&page=1
C4
Left Sig- No probs. Wife offered a job everywhere she has ever interviewed. Grat time to be a female OB/GYN with the latest surgical skills. I guess I should have clarified. When on the hospital tour, at dinner with practice/hospital officials, the spouse is always checked out; informally. Well thought out questions and comments can be used to learn quite a lot about someone which, to me, is also somewhat of an indicator of the prospective candidate. I 100% agree with this unwritten policy. When it is my wife in the position to interview candidate's for her practice, I will also do the informal scrutinizing of the potential candidate's spouse. MD's have a lot invested monetarily and in sweat, in their practice. Most also work very hard to make it a reputable and important community member.
Will- I understand where you are coming from, I just come at it from a different angle. Glad to see you are not taking my opinions in a negative/mean-spirited way because they sure aren't meant that way. I do feel you are being honest b/c you admit the pharma/MD "interface" has much less gift-giving/speaking fees, etc. than just 10yrs. ago. All true. It seems you and I are more alike than different. We are both wrestling with the pharma co.'s relationship with MD's. My wife and her partners simply avoid them as much as possible. The co.'s do much good and to sever any relationship at all would be bad for her patients. She treats many patients that are Medicare/non-payers and free samples she receives from the pharma's are used to help those that are indigent. They do go a long way.
. America gives more to charity that the rest of the world combined. Americans love to give when it is their choice, not when they are forced to by the "kings tax"...
Sums it up... Grant.
Derek- That $120 pair of socks has most of it's markup due to the fact the hospital probably treats many patients that never pay the hospital one penny for their care. Somewhat similar to car insurance. I have a clean record but my rates are higher b/c of uninsured motorists getting into accidents. Just my .02.
I assume you are joking??!?!?!? Does the "new deal" ring a bell? Does trying to change the make up of SCOTUS ring a bell when they found his programs to be unconstitutional?!?!?
I could go on for hours about the harm that FDR caused this nation... Unions anyone?
Nevermind...
LOL, stop right there. AKPopo is a fan of unions (FYI). ;)
C4
Will- I understand where you are coming from, I just come at it from a different angle. Glad to see you are not taking my opinions in a negative/mean-spirited way because they sure aren't meant that way. I do feel you are being honest b/c you admit the pharma/MD "interface" has much less gift-giving/speaking fees, etc. than just 10yrs. ago. All true. It seems you and I are more alike than different. We are both wrestling with the pharma co.'s relationship with MD's. My wife and her partners simply avoid them as much as possible. The co.'s do much good and to sever any relationship at all would be bad for her patients. She treats many patients that are Medicare/non-payers and free samples she receives from the pharma's are used to help those that are indigent. They do go a long way.
Excellent info sir. Again, some times it's real world experiences that can effect large scale understanding, or at least help to see other sides. Your comments are quite helpful to balancing out my general negative impressions of Pharma, and am also happy to see you as docs, know of their pitfalls and benefits. Bravo to you. ;)
Derek_Connor
01-03-10, 14:27
Derek- That $120 pair of socks has most of it's markup due to the fact the hospital probably treats many patients that never pay the hospital one penny for their care. Somewhat similar to car insurance. I have a clean record but my rates are higher b/c of uninsured motorists getting into accidents. Just my .02.
6933,
Couldn't agree more in regards to patients not paying in the ER Depts. of Hospitals/Trauma Centers.
I work exclusively in the OR - where no insurance, means no surgery (99% of the time).
The sickening and KNOWINGLY practiced SOP is that the hospital keeps those socks after you are done, and they re-use them. I am sure this doesn't happen in all the hospitals, but I've seen it very frequently across the SE CONUS. And the "socks" issue is really just an analogy for 100s or 1000s of other items you pay in full for, that are recycled.
Extremely ethical on their part, I could only imagine how more materials and monies are mis-used.
I could only imagine how much the problem will be amplified with another 60million of people insured.
Liberals are only compassionate with other peoples money.
Stealing from me is not compassionate.
To all those who wish to buy other people health insurance, by all means do so, just don't legalize stealing from me to do it, and further genocide.
The compassion is there. My family writes thousands of dollars in checks to all kinds of charities EVERY YEAR.
You see, the difference between a liberal and a conservative is that the liberal wants to force you to give by taxes. The conservative wants you to keep more of your money and let you WILLINGLY give it.
C4
Amen brother.
To comment on what WB said earlier: Back when I was in grad school, I worked at Ruth's Chris steakhouse doing private banquets; mainly for various pharmaceutical companies courting docs. Almost without exception, I was handed the AMEX at the beginning of the night and told simply, "Whatever they want."
The only groups that ran up bigger tabs were lobbyists and politicians. ;)
Liberals are only compassionate with other peoples money.
Stealing from me is not compassionate.
To all those who wish to buy other people health insurance, by all means do so, just don't legalize stealing from me to do it, and further genocide.
Good stuff!
I wonder how many bleeding heart liberals have stroked a check to pay for someone elses medical insurance. ;)
For those of you that want a socialized medical program, find some "poor" people with no insurance and cover them for awhile. Even better yet, insure someone that has no interest in having medical insurance. Let that $500 a month check sink in for a couple months and then get back to us about your interest in doing it for the rest of your life.
C4
If people do not have money to pay for medical insurance when they lose their job, then my question is, where is their emergency fund???
Probably parked in their driveways, mounted on their walls, or hanging in their closets.
I'm also convinced that, while some people who lose their jobs really do whatever it takes to get another job or start a business, most people have no fire under their ass at all due to all of these taxpayer-funded safety nets.
Let's think for a second what life would be like if there were no medical insurance at all:
Doctors would have to charge fees people can afford. They would have to compete for business based on price and quality like everyone else. They would have to find ways to become ever more efficient to keep costs down and profits up while competing in the market. The entire industry would be focused on cost containment - MRI machines and CT scanners would be built ever more efficiently and cost effectively to bring equipment prices down so that doctors could afford to buy them and charge their patients an affordable fee that recovers the investment cost.
This is how every other business operates, and it has resulted in incredible improvements in quality, efficiency, and cost effectiveness. Computers, cell phones, cell phone service, LCD TV's, etc. have all gone from high end luxury items to affordable and ubiquitous due to competition. Where government is involved - like cable TV monopolies - service is generally worse and costs always climb.
Now, I'm not trying to say a heat transplant, liver transplant, or other major surgery would be affordable without insurance to the average person. But there was a time before insurance when surgeries were paid in cash.
So we get back the same conclusion - the only way to fix the system is to get away from (ban?) "full service" health plans with coverage mandates and move to high deductible major medical coverage and pay cash for everything else.
In my last job I paid about $200 a month for excellent coverage for me and my son. My wife gets hers from her job at no cost. That $200 a month equals $2400 per year. But the full cost to my employer was more like $800 per month or almost $10,000 per year. If I was not covered through work I'm not sure I'd pay $10,000 a year for a similar plan. I'd probably choose to pay something like $400 a month for a plan with a $5000 deductible. Total annual costs would be similar, even if I hit the deductible, but I would save a lot in a "good" year.
Probably parked in their driveways, mounted on their walls, or hanging in their closets.
I'm also convinced that, while some people who lose their jobs really do whatever it takes to get another job or start a business, most people have no fire under their ass at all due to all of these taxpayer-funded safety nets.
Yep.
One of my vehicles is 9yrs old and the other one is 8yrs old. Both have over 100,000 miles. My "newest" company truck is now 3yrs old.
All the clothes in my closet are free (as I save my rewards points from Cabelas and Bass Pro shop).
C4
No doubt, live at or below your means.
Another "old" practice in America was saving money.
Another "old" practice in America was saving money.
Yes, that practice was banned many years ago (FYI).
C4
In principle, I agree with you, but as I said, I'm also not convinced the for profit free market works in health care alone.
The alternative has been shown NOT to work. Lets give the for-profit free market a chance. It has not had one in decades.
PT Doc- Not sure what your point is about the banquets. Are you trying to equate MD's with politicians and lobbyists?
What is the prob. with MD's getting a free meal and possibly good info. on a new product? I think we've already established the vast majority of MD's are ethical, honest people and many have favorable impressions of doc's they have interacted with through sick family or themselves.
I'm fairly certain MD's know the deal with the pharma co.'s and use good judgment when dealing with them. If someone chooses to interact with a used car salesman, does that mean they are suspect in their motives?
John_Wayne777
01-03-10, 16:39
It puts them in the shitter - hence my hypothetical above about somebody paying medicare and socialist security payroll taxes to support others but being unable to afford health insurance, or qualify for those programs, themself.
...which is a real phenomenon. When you study the economics of public finance for practically any program you find that some people are helped...but others are discouraged from doing better for themselves even though they can because they will lose benefits if they do. Similarly people who are not on the program have increased incentive to get themselves on to the program...which is why means testing isn't nearly the panacea many think it to be.
In other words, programs encourage the poor to stay poor and convince others to become poor to get the benefits...and that's why they never actually solve problems. These problems are so severe that economists came up with terms like "moral hazard", "free rider" etc. to describe them.
Unfortunately it is that type of mentality that has helped bring us to this point . The proposal that "it takes a village" is pie in the sky and is literally tantamount to pure socialism if not communism. This nation was not founded on ANY principle that is even remotely similar to what you espouse. In fact it was founded on minimal, limited government and the responsibility of the individual to apply themselves and take advantage of all the opportunities that come with living in a free society. You make your choices and live with the results. You are allowed to succeed, and you are allowed to fail also.
I spent my 30 year career as a firefighter/EMT in SoCal and I got to witness all socio/economic aspects of our society. There is a growing and insidious trend that is destroying the fabric of individual responsibility that helped make this nation great. Most folks in the upper or middle class seldom called on us for field medical care. Usually they simply took responsibility for whatever needed done and got on with it. What is literally bankrupting the system is the growing number of people with an untold number of years of bad choices and decisions written all over their faces, demanding that someone else pick up the tab for their individual lack of personal responsibility. You see that also whenever "the system" diverts blame from the individual and places it on "social circumstances", ie. "it's not their fault!" If I am reading you right, you want responsible people to pick up the tab for those that made poor or bad choices, and you imply that it is our responsibility as a society to do that. Sorry. With all the information out there about the hazards of smoking, drug abuse, and alcoholism, in light of it all, someone still makes the personal choice to partake, I have zero, nada, none, compassion for the results of that self inflicted behavior. Same applies to personal health issues such as diet, exercise, weight control, etc.
Certainly there are instances when someone is born with an affliction or is struck down by one during their life. That circumstance has been with mankind from the beginning and there are options available to address those on a case by case basis.
Health care is a business, not an inalienable right. Part of the problem with prices today is that the government overstepped their Constitutionally mandated limitations and waded into that field. The "laws of supply and demand" were disolved at that point. No industry, as you will soon see in the automobile sector, can compete with a government that has unlimited taxing authority to support their poor, uncompetitive market decisions. Think FannieMae and Freddie Mac. The "government" became the Healthcare Industry's cash cow through MediCare and Medicaid and traditional market forces became moot. Remember the old admonition about fearing the "Military/Industrial Complex"? It's that complex that gave us $500 toilet seats on military aircraft and $300 screwdrivers. Wait until you witness the effects of the "Medical/Government Complex". You think you've seen bad? You haven't seen anything yet.
Pat. I do appreciate that you have a different view on this subject. Both our personal experiences are probably vastly different, although I'm sure we have many similarities also. There is a solution to this current healthcare cost issue. I for one simply cannot, after being witness to their managing the USPS, Social Security, Veteran's Adminstration, MediCare & MedicAid, trust the Federal bureaucracy to properly and fairly administer it's citizens personal healthcare issues. If and when they try to force compliance through a "mandate" they had better start building a lot more incarceration facilities, because I and millions like me are simply not going down that road peacefully and obligingly.
Well said!
PT Doc- Not sure what your point is about the banquets. Are you trying to equate MD's with politicians and lobbyists?
What is the prob. with MD's getting a free meal and possibly good info. on a new product? I think we've already established the vast majority of MD's are ethical, honest people and many have favorable impressions of doc's they have interacted with through sick family or themselves.
I'm fairly certain MD's know the deal with the pharma co.'s and use good judgment when dealing with them. If someone chooses to interact with a used car salesman, does that mean they are suspect in their motives?
Influence is influence. The phama reps wouldn't have the budget to pay for the nice meals if it didn't work. Reps get their stats tracked like a hawk. Their employers know exactly how many prescriptions are filled in their territory, and their performance is judged based on those results. If the meals mean nothing, then banning such favors from being given shouldn't have any effect, should it? That's an area where governmental action might work - ban direct-to-consumer drug advertising, and ban pharma reps from doing favors for docs.
Most companies have ethics guidelines about accepting meals and favors from supplier representatives to prevent corruption. Suppliers put a lot of effort into trying to do favors and thus influence people in the position to make purchasing decisions. It is up to the employee to refuse what is prohibited by policy. Wal-Mart has a strict policy with their buyers - absolutely nothing from the supplier reps at all, and all negotiations occur in Wal-Mart offices. That's one of the reasons why they keep their prices so low - they prevent their buyers from being corrupted. Not so with other stores - this type of back scratching has been going on for decades and it's ingrained in some purchasing organizations.
I might have some of the best "experience" with all the different health care programs out there.
1. Used the Military health care system (which is as close to socialized medicine as you can get without being socialized). VA hospitals are some of the worst with some of the worst Doc's available (not all are bad of course). My wife had a botched surgery leaving her classified as 30% disabled for the rest of her life.
If people believe that a socialized program (where we all pay in and the Govt controls everything) is the "best option" ask a veteran that has suffered through the "system" what they think.
C4
This is not a defense of the system, but an explanation of why people oftentimes have had a bad experience with the VA. First off, the VA Eye Centers (optometry) where I have worked at (West Los Angeles, Tucson, Vegas) are staffed by some of the brightest doctors in that field. Note I said STAFF. Most optometry residents are in the top 1/3 of their class. Only about 10% of an optometry class usually gets into their choice in a residency (many don't try). The rest go straight into practice. I believe most ophthalmology residents are also near the top of their class as it is a very coveted field to get into. VA hospitals are teaching hospitals and here is where the "botching" occurs. I am not a surgeon, but I will say through experience that the most mistakes probably occured around june-july of every year when the new residents got into surgeries for the first time. All surgeons have to start somewhere and mistakes get made. Its no excuse for poor care, but even the best surgeons in the world have botched their share of surgeries. Unfortunately, when that happens, people are hurt for life. Grant, I am saddened to hear that your wife had to go through that.
Many may ask, how dare they treat our vets this way? When you're on a tight budget, its simple math. They can have 4-6 residents for the price of one doctor with 15 years of experience. Like Grant said, the VA is the closest thing to socialized medicine we have.
Freedom has risks, it's like it's a dirty little secret.
Is there coruption in free enterprise, yes, but at least a company can't steal your money or imprison you for changing companies.
Just a guess on my part, but I believe government coruption is far more costly than private enterprise.
I will choose free enterprise every time over any government program.
Left Sig- Thanks for quoting my response to PT Doc. It shows you do think doctors should be equated with lobbyists and politicians. Shows your true colors.
Most do not agree with that comparison. Your "logic" is that if it didn't work, they wouldn't do it. Really? So there is no chance that a doctor has enough sense to know what the pharma companies practices are? Surely wouldn't want to go to that MD. Guess you forgot that most individuals know/interact/talk/are in the care of a/are friends with a/several physician(s) the "community hive" they live in knows quite well.
Simply by implying MD's are even in the same ballpark as lobbyists and politicians undermines your argument.
To take your "suggestion" to it's conclusion you suggest, then MD's, lobbyists, and politicians are the same.
Nice try. What you don't say says as much as you don't say.
Your logic is flawed, and your argument weak.
Why don't you tell us what dog you have in the flight? I have as have others.
Hospitals practice Barbary piracy on working people without insurance or with poor insurance as the only way to make a profit.
Medicare/medicaid pays fine, in fact they pay about 80% of the actual cost. I WISH I had some bad customers that paid me 80% of cost before they went belly up. Private insurers often pay much less than this. They are forced to give a good deal to political cronies, government types (but not you .gov types that sling a gun for a living), and massive businesses with good union/political connections... then they come like thugs to tear down everything it took you 30 years to build.
A couple things would solve this.
1) For people who can pay, there is one price. For people that can't, we'll keep a tab of that same price, you can pay down as applicable.
2) Private insurance means what you and the insurer are willing to negotiate, individually. No more brokering, or price fixing, if the doctor feels something is necessary, the insurer must honor its contract with you. If insurance companies don't want to play, f*ck 'em, it was cheaper when we had company doctors.
3) Doctors should only be sued if they cut you wrong, or read your tests wrong, in which case they need to get hosed. Rather than diagnostics and procedures being the problem, doctors should probably be paid only for diagnostics and cutting when they want to engage in the risk of doing business (what a concept).
4) There needs to be a mandatory high-deductible plan-tax managed by individual states, something ridiculous like 5-10k plus a year, they need to take it out of peoples paychecks, because some people would rather buy beer than insurance or won't save money, and we end up paying anyway.
5) Nobody should be denied medical care based on an inability to pay, but there needs to be a running tab with the state tax office. Like my dad always told me, everybody gets a job some time or another.
6) Society needs to stand behind doctors. They need to be able to tell people that they won't issue a prescription or perform an operation because all the patient really needs to do is stop eating so much, or stop drinking like a fish.
People who won't listen to their doc can get what's coming to them. They get it anyway these days, but it costs a lot of money, because doctors aren't allowed to hurt peoples feelings. These days doctors must run a zillion tests under the standard operating procedures or Pedro's illegal mother will sue them because she might have aborted Pedro had she known Pedro had one ear smaller than the other... not that she would have, but she might have.
If you let the federal government manage healthcare you'll have the same healthcare that the Duke got in the Shootist, only you won't even see Jimmy Stewart, he'll be hiding under a desk from his patients. Under obamacare it would take the Duke 10 hours to see some drowsy pale-skinned cubicle-sized receptionist on anti-depressants just to get his bottle of opium. You don't want the federal government anywhere near the doctors office, they'll just do what they always do, steal your money and give it to someone you don't like and who likes you even less.
One of the things that comes through in all this discussion, is that even though many have similar interests and some commonality (M4 carbine), they can be in total disagreement on so many other things. Gotta' say, by and large this thread has been well mannered. It does however show why so many of the hot button social issues facing our country do not lend themselves to easy solutions.
One could go down the list and identify just where each poster comes down on this topic. that's a good thing in that each one makes their case and provides various means(some anecdotal, some personal) to support their views. The one thing that I think comes thru for most here, is that we are very reluctant to trust our Federal bureaucracy to efficiently manage something as personal as our healthcare.
I know it was mentioned that there were proposals made by the GOP that never were allowed into consideration and that simply shows that elections do in fact have REAL consequences. If the only approach we are being allowed to consider and accept in trying to get control of spiraling healthcare costs, are those proposed and put forward by only one political party, and that party tends towards progressive/socialism in a big way, then how can we say it is in any way is in the best interests of all Americans?
Like some here I worked in EMS and had a first hand observation of how the system works, good and bad, and how it is oft times abused. In spite of that it is better than anything anywhere else as far as I can determine. It isn't yet totally broken, but it is sliding down the slippery slope real fast. As I said before, I believe it was at the point that the Federal government decided to wade into an area totally outside their Constitutionally mandated role, that the wheels on the American healthcare industry wagon began to wobble. Medicare and MedicAid are in fact socialist programs and they were the foot in the door. Now that door is about to be totally obliterated and I simply don't see any plus side of it , even for those who will supposidly now be the recipients of "affordable' healthcare.
There are many ideas right here on this forum as to what is wrong. The missing, critical aspect in the debate, is what do we do to fix the wrongs and bring most into agreement on it. There are many such as Pat and others who believe it is society at large's responsibility to make healtcare affordable to all. I think most would agree that that is an honorable view steeped in compassion for their fellow man. Some think it would all work itself out if we could just extricate the government out of it and simply let market forces ( supply and demand) determine the ultimate floor or ceiling on costs. I tend to this position.
Big question for those who have a similar view as mine, how does one go about putting the genie (Federal Government) back in the bottle? Not only are they hell bent on going even further off the rails in this area, they are also making inroads into other market areas such as banking/financial institutions and the auto industry to name a few. Is government the solution or is it the problem? I suppose we will have as much disagreement on that question as the one that stimulated this whole thread. I do enjoy civil discourse and the passion that comes with it, as long as it doesn't cross the line into personal attacks. Let's roll!
Medicare/medicaid pays fine, in fact they pay about 80% of the actual cost. I WISH I had some bad customers that paid me 80% of cost before they went belly up. Private insurers often pay much less than this.
You're wrong about that. Medicare/Medicaid pay much lower reimbursement rates than private insurers (generally speaking). Medicare/caid pays nowhere close to 80% of what the "sticker price" is on a given medical bill. They operate just like private insurers, whereby doctors/facilities agree to accept their greatly reduced rates in exchange for the volume of patients. The difference is that those programs have the coercive power of government, enormous market power due to their millions of "subscribers," and can basically pay crap reimbursements and get away with it.
One thing about indigents is that many of them are not all that indigent, they just can't be identified because of refusal or false identification. The rapper DMX got in big trouble for this in Maricopa county.
Left Sig- Thanks for quoting my response to PT Doc. It shows you do think doctors should be equated with lobbyists and politicians. Shows your true colors.
Most do not agree with that comparison. Your "logic" is that if it didn't work, they wouldn't do it. Really? So there is no chance that a doctor has enough sense to know what the pharma companies practices are? Surely wouldn't want to go to that MD. Guess you forgot that most individuals know/interact/talk/are in the care of a/are friends with a/several physician(s) the "community hive" they live in knows quite well.
Simply by implying MD's are even in the same ballpark as lobbyists and politicians undermines your argument.
To take your "suggestion" to it's conclusion you suggest, then MD's, lobbyists, and politicians are the same.
Nice try. What you don't say says as much as you don't say.
Your logic is flawed, and your argument weak.
Why don't you tell us what dog you have in the flight? I have as have others.
No, I didn't say I agree that doctors are no different than politicians and lobbyists. People are people - some are honest some aren't. Some are more corruptible than others.
In my experience I have not seen any profession that didn't have it's mix of good and bad, honest and dishonest, ethical and unethical. Doctors are people too, and just because they have completed an MD and a medical residency doesn't mean they should automatically be put on pedestals as examples of all that is good, honest, and ethical. Individual behaviors vary, and I judge each person I deal with accordingly.
What I'm saying is that Pharma companies wouldn't have spent all that money on reps to promote the product if it didn't have an appreciable effect on what doctors prescribed. Reps wouldn't be tracked on total prescriptions filled in their territory if their employers didn't reward them based on getting their numbers and increasing prescription volume. I know this from contact with actual phama reps. Competitive businesses generally don't throw money away on things that don't work - they can't afford to, unlike the government.
The new rules Mike G mentions were put in place specifically to avoid the conflicts of interest the reps were believed to have been causing, and that is a good thing.
My doctor has a sign on the door of the practice shooing away drug reps except during very limited times once or twice a week. I like seeing that sign, and it tells me she's got her head on straight.
I'm not sure what exactly you think I'm not saying. What dog do I have in the fight? None. If you must know, here's what I do:
I have a BS degree in Mechanical Engineering and an MBA in General Management. I've worked in the auto industry most of my career (13 of 15 years) and have held roles in design engineering, manufacturing engineering, production management, and maintenance management. The plant I worked in closed this summer so now I'm working a new job (contract with no benefits) as a project manager for another company in advanced prototype field service support.
No one in my immediate family works in any medical field, or in any legal field. My wife worked for two years at a marketing firm that did work for Lilly. I have a step-sister-in-law in Illinois that is a nurse, an aunt-in-law that's a school nurse, an uncle that was an OB/GYN in California, an aunt that is a state mental health case worker in Alaska, a cousin-in-law that's a Neurology resident in California, a cousin-in-law that's a PhD in child development psychology. Oh, and I think I have a cousin in Wisconsin that's a lawyer now - public defender.
My experience with the medical industry is mostly as a patient, although I have spoken with my extended family members about what they do. I live near Indianapolis and Eli Lilly is headquartered here so I have some contact with pharma reps and other employees - a rep lives two doors down from me. Some health insurance companies are based here as well, so I have some contact with their employees as well.
Big question for those who have a similar view as mine, how does one go about putting the genie (Federal Government) back in the bottle? Not only are they hell bent on going even further off the rails in this area, they are also making inroads into other market areas such as banking/financial institutions and the auto industry to name a few.
History has proven that once an entitlement program is created, and particularly once it's been entrenched for a generation or more, it is politically impossible to scale it back, let alone get rid of it. Old people would have an absolutely violent seizure if you even dared to suggest that Medicare needed to be undone. They're already going batshit about the mere possibilty of cuts in it to help finance this latest health care bill. I guess the idea of including health care/insurance in their retirement plans was too much to stomach.
Realistically speaking, there is no way to unring these bells. I wish there were, but it's not going to happen unless and until there is a complete collapse/reformation of our government and society. This is why it is so critically important to stop these things NOW, before they get put in place. Once they're there, they're never going away.
I work for a mjoar pharmaceutical company, the largest in fact. Was just bought by that company at the end of last year in the biggest pharma acquisition in history and it is not all rosie in the pharma business.
We are doing so well that 20,000 employees will be laid off over the next year or so alot of those are americans.
those layoffs are all because of small margins on many drugs. sure you hear about the blockbusters but those fund much smaller margin drugs.
Also with the current generic market being out of control and the generic companises willing to infringe on patents knowing that they will rpobably win 2 out of 4 suits because of sympathetic juries they are taking larger and larger market shares.
Finally, lawsuits against pharma is out of control. One prime example is the celloist that lost her arm due to a nurse administering a migraine drug that has been around and safely used for 50 years. However she sued that Wyeth should have put a stronger lable on the packaging or prevented that admisntering route all together even though they were cmplying with all FDA rules and the drug had been safely used by the same route of adminstering for years. But even though the nurse was found negligent wyeth was still found to be guilty as well and lost millions over it.
Just my 2 cents
On the note of forced insurance, they should be suing over that. that is unconstitutional and will never hold up in court. If it does it is time to a new country to live in as we have gone completely to socialism.
The only solution is to remove all government regulations and licensing. Also an understanding of the differences between health insurance and healthcare wouldn't hurt either.
tsconver,
Same thing is happening here in Indy with Lilly. They've been laying off for years, and just announced even bigger cuts. The patents are running out soon, and there is nothing in the pipeline. Almost all of the big bets ended up failing.
History has proven that once an entitlement program is created, and particularly once it's been entrenched for a generation or more, it is politically impossible to scale it back, let alone get rid of it. Old people would have an absolutely violent seizure if you even dared to suggest that Medicare needed to be undone. They're already going batshit about the mere possibilty of cuts in it to help finance this latest health care bill. I guess the idea of including health care/insurance in their retirement plans was too much to stomach.
Realistically speaking, there is no way to unring these bells. I wish there were, but it's not going to happen unless and until there is a complete collapse/reformation of our government and society. This is why it is so critically important to stop these things NOW, before they get put in place. Once they're there, they're never going away.
Yep. The greatest irony right now is the Republicans are railing against any new socialized medicine while demanding that we preserve the socialized medicine we already have! Talk about self-contradictory.
Medicare needs to be fixed as well, but I have come to the conclusion that when payouts exceed tax income, they will simply raise the tax from the current 1.5% to 2.0% to buy a few more years. And then 2.5%, and so on. It will get unanimous support in Congress because everyone is afraid of senior citizens that actually vote!
Derek_Connor
01-03-10, 21:29
6) Society needs to stand behind doctors. They need to be able to tell people that they won't issue a prescription or perform an operation because all the patient really needs to do is stop eating so much, or stop drinking like a fish.
This.
The massive epidemic in our country in regards to diabetes, heart disease, addiction to nicotine, cancer, and so on, could have a big ****ing dent put into it if we could turn around our diet as a country.
The FDA has done has absolutely 0 favors in the last 50 years with their recommended food pyramid.
This is a whole separate discussion though.
Yep. The greatest irony right now is the Republicans are railing against any new socialized medicine while demanding that we preserve the socialized medicine we already have! Talk about self-contradictory.
I don't think the GOP is against reform. I think they are against this sudden urge to fumble **** our nations Health Insurance Industry, 15% of our GDP, into some grand monstrosity, aka Government Health Insurance.
This.
The massive epidemic in our country in regards to diabetes, heart disease, addiction to nicotine, cancer, and so on, could have a big ****ing dent put into it if we could turn around our diet as a country.
The FDA has done has absolutely 0 favors in the last 50 years with their recommended food pyramid.
This is a whole separate discussion though.
It is a separate discussion, but it's very much related to the issue of "rising health care costs." I am routinely disgusted by people I see in public. I was just at a Walmart last night, and the number of people there who were severely obese and buying all order of junk food, soda, and tobacco was enough to make me get up today and run for 30 minutes in the 20 degree weather.
These are the people who we will be paying for under "health care reform," because, you know, they have a right to health care too.:rolleyes: They are also more likely to be the ones on SSDI or workers' comp because of "disability" caused by back problems or knee problems from being 450 pounds.
History has proven that once an entitlement program is created, and particularly once it's been entrenched for a generation or more, it is politically impossible to scale it back, let alone get rid of it. Old people would have an absolutely violent seizure if you even dared to suggest that Medicare needed to be undone. They're already going batshit about the mere possibilty of cuts in it to help finance this latest health care bill. I guess the idea of including health care/insurance in their retirement plans was too much to stomach.
Realistically speaking, there is no way to unring these bells. I wish there were, but it's not going to happen unless and until there is a complete collapse/reformation of our government and society. This is why it is so critically important to stop these things NOW, before they get put in place. Once they're there, they're never going away.
I told a neighbor today that one of the aspects of this current healthcare debate that I see as somewhat positive, is that finally many of those who promoted and belonged to AARP are finally getting their wakeup call. I've been a strong critic of that organization since their arrival on the scene.
I am one of those who factored healthcare/insurance into my retirement. My wife has been battling cancer for going on 5 years now and at at some point we will probably reach our lifetime maximum primarily due to the high cost of the cutting edge chemo drugs. The reality is that when that time comes, if she is not in remission, then it is most likely the cancer will take her life. We have come to terms with that probability. I am 67 and in good health, she is soon to turn 65. The amount of paperwork and solicitation she has been recieving regarding MediCare is tremendous. Due to the rules of our health insurance carrier, she will have to enroll in Medicare and pay for it as I did and our carrier will get those MediCare fees to offset some of their costs. Our collective annual costs this year are right at $6K for the coverage not including all the associated co-pays and out-of-pocket costs and of course our costs for MediCare. My former municipal employer pays an amount considerably more than that on our behalf. I think we have what is referred to as one of the "Cadillac Plans" that the unions do not want affected by their cohorts in the Democratic Party's plans.
As I mentioned earlier, I'm not enamored with the high costs of insurance and healthcare, but as I embarked on my career I payed attention to those that cautioned me about relying on anyone other than myself to look out for my current and future interests, ESPECIALLY the government and I took their admonitions to heart. That is paying off now as we are much better off than many others. I suspect however that with the House/Senate reconcilliation, that next year may come close to putting us into the same boat that some others here are presently in. Only time will tell but I'm not very optimistic. Life's a b*itch, and then you die. :(.
Derek_Connor
01-03-10, 21:46
Im all for paying for some strangers health care, but only under the following conditions, known as, Connor's Conditions if you want free god damn health insurance:
1.) they submit to drug tests monthly for the following chemicals:
nicotine
alcohol
any substance considered illegal now (cocaine, LSD, heroin, etc)
High Fructose Corn Syrup, Corn Syrup, or any derivative
If any of the above pop, health insurance is MF'ing cancelled.
2.) they have to do AT LEAST 120 minutes of exercise a week, averaging at least 60% of their AHA recommend, maximum heart rate. This MUST begin by the age 10, if not, you do not qualify.
3.) They have to get 8 hours of sleep a night, no exceptions.
4.) No risky behaviors (multiple sex partners, sky diving, racing, speeding, not chewing your food 22 times before swallowing)
5.) Use Birth Control
6.) They can only eat food that flies, swims, or can run. Or is green and grows from the ground up.
7.) They have to go to doctor for their yearly physicals.
8.) they have to pay out of pocket for all 1-7 listed above. No refunds.
These would be my top 8..feel free to add anything you can think of
Excellent info sir. Again, some times it's real world experiences that can effect large scale understanding, or at least help to see other sides. Your comments are quite helpful to balancing out my general negative impressions of Pharma, and am also happy to see you as docs, know of their pitfalls and benefits. Bravo to you. ;)
Will, just to confirm what 6933 was saying, the relationship isn't as predatory as the impression you got from your friend. Most of us docs aren't naive. I will say that when attending a sponsored CME course, we are lectured on a general topic (such as a condition that the sponsor's drug treats) by a paid doctor, then many of the treatment options are discussed with the said sponsor's drug taking the limelight.
Now, I personally will research the drug or other product more, and if I find that it has some merit I will try it on a limited basis on some patients. These patients know that this is new and that I am looking for their feedack. This is especially true with contact lenses. In fact, I will personally use every new lens I prescribe for about a month before a person even gets it in their eyes. Despite this, I still won't be able to predict all the results and feedback I get from my patients. If the product works, it gets used more, if it doesn't it goes. I am actually quite honest/blunt when I tell a drug rep how the product is doing. If it isn't succeeding at a high level, I will let them know, and stop using it. There are some reps who don't come to visit my office much because I refuse to use their company's products.
Now this might be a bad analogy, but lets just say Daniel Defense, Larue Tactical, or BCM hosted a show/dinner where they introduced their latest product to 500 M4C members. Out of those who attended, some would buy one right away to try it/experiment with it. Others would wait to research it and wait for reviews, and finally some would decide that this new thing was not any better than what they were already using. I venture to say that a group of docs would behave in a similar manner. After being introduced to a product, there will likely be an uptick in sales as physicians conducted their own patient-based research.
There are many newly enacted laws starting 2009 that restrict Pharma's ability to get their product name on things. For example, we get significantly fewer (probably none) pens, notepads, and other "schwag". Also, CME is no longer allowed to happen inside of a restaurant because the lawmakers felt that it wasn't conducive to a learning environment. So, they are still getting their information out, but things have gotten more restricted.
It is a separate discussion, but it's very much related to the issue of "rising health care costs." I am routinely disgusted by people I see in public. I was just at a Walmart last night, and the number of people there who were severely obese and buying all order of junk food, soda, and tobacco was enough to make me get up today and run for 30 minutes in the 20 degree weather.
These are the people who we will be paying for under "health care reform," because, you know, they have a right to health care too.:rolleyes: They are also more likely to be the ones on SSDI or workers' comp because of "disability" caused by back problems or knee problems from being 450 pounds.
The RN wife tells me all the time about the 400+ lb people who expect free healthcare (and are rude in addition to those giving it to them). I marvel every time I shop and see what other people are buying. Tons of Soda, sugar cereals, and other junk food. And they are walking battleships half the time.
And then the ones that pay for 1/2 their basket with WIC (women, infants, children -- may be a state program I don't know) and then pay cash or use their debit card for all the junk food and crap.
We're not rich; we have our struggles and debts to pay etc. But we don't have our hand out either.
Makes me mad! :mad:
You're wrong about that. Medicare/Medicaid pay much lower reimbursement rates than private insurers (generally speaking). Medicare/caid pays nowhere close to 80% of what the "sticker price" is on a given medical bill. They operate just like private insurers, whereby doctors/facilities agree to accept their greatly reduced rates in exchange for the volume of patients. The difference is that those programs have the coercive power of government, enormous market power due to their millions of "subscribers," and can basically pay crap reimbursements and get away with it.
Which the rest of us have to make up! Causing our costs to go up who are not on the govt healthcare dole.
I won't make an claims of causation, but it was interesting to once upon a time to see a graph of medical costs versus when federal medical legislation was passed. Interesting to see costs spike up the year medicaid passed, etc...
Big question for those who have a similar view as mine, how does one go about putting the genie (Federal Government) back in the bottle? Not only are they hell bent on going even further off the rails in this area, they are also making inroads into other market areas such as banking/financial institutions and the auto industry to name a few. Is government the solution or is it the problem? I suppose we will have as much disagreement on that question as the one that stimulated this whole thread. I do enjoy civil discourse and the passion that comes with it, as long as it doesn't cross the line into personal attacks. Let's roll!
You start by getting things in order locally and then at the state level. If you can convince your fellow citizens that the government sponsored "senior center" is a bad idea, then you have a chance of convincing them of similar stuff at the federal level...
People have the bad idea in their head that it's what you eat that hurts, not how much you eat. Your body uses calories, the only measure of intake and weight. You don't magically absorb hamburger fat, your body produces more fat (storage fuel) because you eat too many calories, it also produces a lot of other things in overdrive when you eat too much.
Virtually all heart disease and diabetes is caused by overeating. Some people get those horrible diseases when they're young, or if they're otherwise healthy and that's tragic. I knew a man who's first wife was born with a heart condition that was fixable had she been born several years later, but she was fated to have a shorter time on the planet than most and they made the best of their time together.
If people are making poor lifestyle choices, there needs to be an attitude in the medical community that first people change their behavior, then they treat what's left. The medication and destructive lifestyle is often much worse than changing personal habits. Worse still is the over testing and over prescribing hurts people who are otherwise normal if not for their condition, some of them invariably pick up remainder of the tab from those who got a discount at below cost.
Many people are demoralized, they don't believe there is truth, or right, only perception. Forget religion, they don't even believe in calories.
People have the bad idea in their head that it's what you eat that hurts, not how much you eat. Your body uses calories, the only measure of intake and weight. You don't magically absorb hamburger fat, your body produces more fat (storage fuel) because you eat too many calories, it also produces a lot of other things in overdrive when you eat too much.
Virtually all heart disease and diabetes is caused by overeating. Some people get those horrible diseases when they're young, or if they're otherwise healthy and that's tragic.
Actually it is a combination of how much and what you eat. Too many calories gives you a weight problem -- can make you obese. This can lead to diabetes, heart disease, etc.
Too much of the "wrong" kinds of food can also cause/help cause you all sorts of health problems including diabetes etc
Eating 3000 calories a day of broccoli, spinach, carrots, etc. plus some fish, and an egg, and some whole grain versus eating 3000 calories of hamburgers, white bread, potatoes, sugar items and coke or pepsi and your body will know it.
Assuming that 3000 calories is more than you need, depending on your metabolism and exercise patterns, both may lead to some weight gain but your body will be hating it much more with the hamburger diet than the vegetable and fish diet.
Your body metabolizes white flour and sugar differently than whole grain and low glycemic foods. And fish oils differently than saturated beef fats.
America has a double-whammy of bad habits -- overeating plus a meat and potatoes diet low in fiber, high in saturated fat, processed sugar and white flour (both non nutritious and high glycemic), with entirely too much soda.
I think if we could get rid of soda out of the diet that would save a ton of healthcare dollars right there and reduce obesity by 1/2 or so. In my family we drink soda when we eat out, which is not often, and not always when we eat out either. And on special occasions like a b-day party. My parents raised me that way and when I went away to college I went on a soda drinking binge since the dorm cafeteria had all I could drink. I got so sick of it that I went back to the way my parents raised me.
My wife is from Japan and we go there every 18-24 months to visit her family. Totally non-random sampling but the first time I was there in 2000 (by myself at a trade show for 2 weeks) I saw no fat Japanese person and I was in Tokyo area. The next time in 2003 I saw maybe one or two and then in 2005 another 2 or 3 and then in 2007 and 2009 even more. Still a real minority but I noticed more and more fat kids and people in Japan. Maybe coincidence. But I also noticed lots of kids coming out of 7-11 or Circle-K (or family mart or AM/PM or any of the other 5 convenience stores) with large cokes and crap food in their hands. It was enough that I noticed it when I had not earlier seen that or it had not hit me over the head. Japan has pretty good eating habits and diet and they live the longest of anyone and have relatively lower health problems with the traditional things that hurt us in America but it is becoming more western (ie American -- more hamburgers and fast food and coke/pepsi for snacks or fast food out) and I would bet that they go down in the overall longevity ratings and health ratings by the end of the century.
Anyway, enough rambling. Somehow we need to get it into people's heads that they need to eat more healthily and drop the soda and sugar foods except for once in a while on special occasions. Making people responsible for 1st-dollar payment of health costs may be one way to encourage this as people would have to pay out of their pocket for most routine health stuff and might eventually see a correlation between diet and their wallet.
Will, just to confirm what 6933 was saying, the relationship isn't as predatory as the impression you got from your friend. Most of us docs aren't naive. .
As I mentioned, I made sure to clarify things have changed a bit, and for the better in that respect... I also have much additional contacts, friends, etc in the pharm, medical, science community then just the one rep to see the larger picture, so my comments don't boil down to a rep by any means... I do think the pharm industry has a greater grip and effect on what ends up as SOC then you may appreciate.
That's just my opinion, but I find docs are like any profession, a small % that are really competent and a bunch of others you can't figure how the hell they got the job. You know who I am talking about....:cool:
Actually it is a combination of how much and what you eat. Too many calories gives you a weight problem -- can make you obese. This can lead to diabetes, heart disease, etc.
Too much of the "wrong" kinds of food can also cause/help cause you all sorts of health problems including diabetes etc.
The vast majority of food related problems are caused by overeating, and while nutrition is indeed slightly more complex than just eating the correct amount of calories, the actual weight is killing people before other potential factors can even come into play.
That's just my opinion, but I find docs are like any profession, a small % that are really competent and a bunch of others you can't figure how the hell they got the job. You know who I am talking about....:cool:
I would say that you are correct with a small modification. You will have a small % that are amazingly knowledgeable and competent, a few more that are excellent to pretty good, and a good number that are competent. Then there are probably about 20-30% who are in the "you can't figure how the hell they got the job" category. It sucks to say it, but there were probably about 20 people in my graduating class who I wouldn't trust to take care of me or my family.
the actual weight is killing people before other potential factors can even come into play.
While being overweight is a primary thing I do not believe the above
Same person eating low glycemic diet with abundant fish and similar oils, lots of veggies, and fiber/complex carbs, and low on read meat and saturated fat and low on high glycemic starches and simple carbs, even if eating too many calories, will have fewer health problems than if he ate the exact same calories made up of saturated fat, red meat, and high glycemic simple carbs and starches and it would be apparent in his lifetime.
I am not an expert at all but have done a bunch of reading and come to this conclusion based on other experts as well as evidence from around the world comparing other diets to the typical American diet.
I am not saying that it is OK to overeat. But someone who overeats "good" foods will be healthier and have fewer health problems than someone who overeats crap foods. I am not saying that that person overeating good foods won't have any health problems.
Derek_Connor
01-05-10, 09:01
The vast majority of food related problems are caused by overeating.
I'd say your on track.
Most of the food related problems are related to overeating man-made, processed, HFCS ridden things. I was in CVS a couple of nights ago, and I see a rather large lady walking through the Diabetes supplies near the pharmacy, with a hand cart carrying (2) 2-Liters of Regular Pepsi. She eventually blood a blood glucose
meter. Hmmmm, was it just irony? Or, was someone who was diabetic buying Pepsi? I'll never know..
While being overweight is a primary thing I do not believe the above
Same person eating low glycemic diet with abundant fish and similar oils, lots of veggies, and fiber/complex carbs, and low on read meat and saturated fat and low on high glycemic starches and simple carbs, even if eating too many calories, will have fewer health problems than if he ate the exact same calories made up of saturated fat, red meat, and high glycemic simple carbs and starches and it would be apparent in his lifetime.
I am not an expert at all but have done a bunch of reading and come to this conclusion based on other experts as well as evidence from around the world comparing other diets to the typical American diet.
I am not saying that it is OK to overeat. But someone who overeats "good" foods will be healthier and have fewer health problems than someone who overeats crap foods. I am not saying that that person overeating good foods won't have any health problems.
Any macro-nutrient eaten in excess can be stored as body fat.
I'll agree w/your overall point though, Diet is damn near 80% of our overall health. But our bodies are a lot more complicated than Calories In vs Calories out.
I'd keep researching and reading up red meat/saturated fat part of your post though ;)
I digress, this is Health Insurance.
People want government options? Welcome to the suck...
It took my wife (timed it) 92 minutes, 3 different phone numbers, and multiples of operators to schedule an eye appointment with base medical. 92 minutes.
This isn't a podunk military hospital either, rather large one.
Thats government work to its finest.
ForTehNguyen
01-05-10, 09:31
http://en.wikipedia.org/wiki/McCarran%E2%80%93Ferguson_Act
Why the whole diet thing and what sort of crap you eat regularly is important is because it has a big effect on our health and hence need for health care.
I am not saying that the govt should tell us and regulate what we eat by force of law. No worries.
It makes consumer first payer even more important and making insurance real insurance for big catastrophic illness and injury and not for routine maintenance. If people had personal responsibility for their health they might be more apt to eat better.
Like the fat probably diabetic lady by blood glucose meters and regular pepsi, my wife sees this almost every time she goes to work. Big fat people who eat crappy and who expect everyone else to pay their multitude of health bills.
ForTehNguyen
01-05-10, 11:39
make the consumer care more about the cost and i guarantee you will see people eating healthier, not to mention falling prices
FlyAndFight
01-05-10, 12:04
Getting back to the proposed Obama-care plan, please keep the following points in mind:
1) 98% of the bill's benefits (well not benefits, expenses...) kick in 4 years later. Some money will be kicked to the Childrens health insurance fund, and to community clinics. This is so they can say, we're giving immediate help to the children and the poor. Yet we're balanced!!!!
10 years of taxes and 6 yrs of benefits. No one questions what will happen in the second decade when you don't have a 4 year buffer to be "balanced".
2) No amendments or repeal... as in Nancy and Harry are the smartest people who ever lived, or will ever live, they are omnipotent and can see into the future, that this legislation is better than the Constitution (which has been amended). This proves that they know that this is a suicide pact. That the vast majority of Americans do not want it, and that they will do all they can to undo it. This is truly a "let them eat cake" moment.
Now just look at it from a long term set of goals direction:
Pay the fine to the government until you get sick, then go to the insurance company that has to accept you with a pre-existing condition, without any impact to premiums. Insurance companies will be forced out of business. At which point the government will take over.
You see.. it all moves along with small steps. The biggest building starts with a single piece of rebar.
(Who ever thought that saving cute polar bears in the 1970's would mean that we couldn't drill for oil in the desolation of Alaska forty years later.)
It's disgusting, and it would make me sick except I no longer feel comfortable getting sick, as I will no longer have any trust in the care afforded to a registered republican.
This thread is a great example of where bias helps form opinions based upon "life experiences". What one person can relate to many others cant relate to even a little....
Somehow people feel entitled to things that are not free and yet they expect others to foot the bill for things that they "feel" are important. It seems to have started with the pandering of the 30's-40's where the Federal government started to take on the role of churches and charities.
The Gov has no business in health care or any other forms of free market commerce.
They need to focus on reducing the size of government, not growing it. Hell I would be happy if they could simply balance a checkbook and not have a need to raise the debt ceiling on Christmas eve... Kinda reminds me of 1913...
Health care is just another way of giving .gov more power and control. It diverts the public eye away from things of far greater importance and the things that they are mandated to do. If they focused on many of those issues there quite possibly would be no need for health care "reform"...
What has .gov ever done well that the private sector cant do better?
Health care reform could be accomplished in a 10 page bill not a 2000+ page bill of special interest projects. Simply start an HMO for those who are uninsured and let charity and churches help those in "need". America gives more to charity that the rest of the world combined. Americans love to give when it is their choice, not when they are forced to by the "kings tax"...
Just my opinion and I wont argue it, so don't bother trying to get me to...;)
I agree.
John_Wayne777
01-05-10, 12:15
Im all for paying for some strangers health care, but only under the following conditions, known as, Connor's Conditions if you want free god damn health insurance:
1.) they submit to drug tests monthly for the following chemicals:
nicotine
alcohol
any substance considered illegal now (cocaine, LSD, heroin, etc)
High Fructose Corn Syrup, Corn Syrup, or any derivative
If any of the above pop, health insurance is MF'ing cancelled.
2.) they have to do AT LEAST 120 minutes of exercise a week, averaging at least 60% of their AHA recommend, maximum heart rate. This MUST begin by the age 10, if not, you do not qualify.
3.) They have to get 8 hours of sleep a night, no exceptions.
4.) No risky behaviors (multiple sex partners, sky diving, racing, speeding, not chewing your food 22 times before swallowing)
5.) Use Birth Control
6.) They can only eat food that flies, swims, or can run. Or is green and grows from the ground up.
7.) They have to go to doctor for their yearly physicals.
8.) they have to pay out of pocket for all 1-7 listed above. No refunds.
These would be my top 8..feel free to add anything you can think of
...and this is exactly why government healthcare should NEVER be passed. Ever. It begs for an intrusive nanny state where (legitimate) calls to reduce waste and abuse will turn into an absurd array of regulations that are Orwellian in scope.
...and this is exactly why government healthcare should NEVER be passed. Ever. It begs for an intrusive nanny state where (legitimate) calls to reduce waste and abuse will turn into an absurd array of regulations that are Orwellian in scope.
Yup. First they'll socialize medicine, then they'll have to expand out to regulate everything else to "control costs" of health care due to tobacco, alcohol, food, driving, "gun violence," pollution ... the possibilities are endless.
I couldn't care less if people want to use tobacco, drink excessively, waddle through life at 400 pounds and diabetic, etc. None of my business and I'm not going to tell them what to do. I'm just not paying for their health care or any other consequences of their lifestyles.
I couldn't care less if people want to use tobacco, drink excessively, waddle through life at 400 pounds and diabetic, etc. None of my business and I'm not going to tell them what to do. I'm just not paying for their health care or any other consequences of their lifestyles.
Unfortunately, it appears that, yes, you will be paying for the consequences of their lifestyles.
I agree with you 100% though.
Derek_Connor
01-05-10, 13:42
...and this is exactly why government healthcare should NEVER be passed. Ever. It begs for an intrusive nanny state where (legitimate) calls to reduce waste and abuse will turn into an absurd array of regulations that are Orwellian in scope.
Couldn't agree more.
And hopefully my sarcastic undertone of the "list" made it clear that I do..
Couldn't agree more.
And hopefully my sarcastic undertone of the "list" made it clear that I do..
Well done. No better way to show that control of health care will lead to control of everything we do than a seemingly absurdist example.
Derek_Connor
01-05-10, 19:30
Well done. No better way to show that control of health care will lead to control of everything we do than a seemingly absurdist example.
You guys remember that horrible yet classic movie, Demolition Man? With Stallone and Snipes?
Pretty soon we'll be fined for cursing, and only allowed to eat Taco Bell.
Mark B. Constantian: Where U.S. Health Care Ranks Number One
http://online.wsj.com/article/SB10001424052748704130904574644230678102274.html?mod=rss_Today's_Most_Popular
Alaskapopo
01-11-10, 02:50
A view that I, and many other Americans who have looked at history objectively and not through the rosy lens of public school history books, share about FDR.
He was a tyrant and a socialist. He could have just as easily led America through the depression and WWII without creating all of the permanent government dependency that he did - but he didn't. He deliberately and knowingly created programs that he intended to be permanent in order to fix temporary problems. He flat out said it himself.
He was not a tyrant and who cares if he was or was not a socialist. Not all socialist's are evil men and not all capitalist are good men. A tyrant would not have gotten elected as many times as he did.
Pat
He was not a tyrant and who cares if he was or was not a socialist. Not all socialist's are evil men and not all capitalist are good men. A tyrant would not have gotten elected as many times as he did.
Pat
Read your history books again.
WRT to getting elected many times: lots of tyrants get elected multiple times. Chavez for example in our modern times.
Alaskapopo
01-11-10, 13:41
Read your history books again.
WRT to getting elected many times: lots of tyrants get elected multiple times. Chavez for example in our modern times.
No matter how many times I read history I doubt I could see the facts the way you do. I know a lot of ultra conservatives feel that way. Your entitled to that view. But its not reality.
Pat
No matter how many times I read history I doubt I could see the facts the way you do. I know a lot of ultra conservatives feel that way. Your entitled to that view. But its not reality.
Pat
It is reality. I am sorry you are stuck on FDR but he WAS a tyrant. Trying to end run around the Constitution and treat it like toilet paper? Stacking the supreme court by adding in extra justices? Setting up programs that he knew would lead to dependency of the population on the govt?
Confiscation of all privately held Gold in the US? That is not the act of a tyrant?
He basically thought he was above the law and could do what he wanted. Again, look at Chavez in our modern times for someone who behaves in a similar way.
There is a reason that term limits for Presidents were introduced (by Democrats I believe). That reason was FDR.
Alaskapopo
01-11-10, 13:58
It is reality. I am sorry you are stuck on FDR but he WAS a tyrant. Trying to end run around the Constitution and treat it like toilet paper? Stacking the supreme court by adding in extra justices? Setting up programs that he knew would lead to dependency of the population on the govt?
Confiscation of all privately held Gold in the US? That is not the act of a tyrant?
He basically thought he was above the law and could do what he wanted. Again, look at Chavez in our modern times for someone who behaves in a similar way.
There is a reason that term limits for Presidents were introduced (by Democrats I believe). That reason was FDR.
He was a man in tough times and was trying to get the country back on its feet and it worked. The people loved FDR. I can not see how with fair elections a tyrant could keep getting elected. Who did he have killed, who did he illegally imprison? These are the acts of a Tyrant. FDR make some tough choices that were not popular with some people.
Pat
He was a man in tough times and was trying to get the country back on its feet and it worked. The people loved FDR. I can not see how with fair elections a tyrant could keep getting elected. Who did he have killed, who did he illegally imprison? These are the acts of a Tyrant. FDR make some tough choices that were not popular with some people.
Pat
I don't know who he had killed or imprisoned.
However, running roughshod on the Constitution, acting as if it does not apply to you, etc are the acts of a Tyrant.
Confiscating Gold? Stacking the Supreme Court (at least trying to)?
FDR was a tyrant. Those are the facts. Tyrants can be "benevolent."
"Tough times" does not excuse bad behavior.
Remember, Chavez and many other modern day tyrants keep getting elected in free elections. When you promise people free stuff and that you will take care of them you get votes. Even tyrants.
Alaskapopo
01-11-10, 14:07
I don't know who he had killed or imprisoned.
However, running roughshod on the Constitution, acting as if it does not apply to you, etc are the acts of a Tyrant.
Confiscating Gold? Stacking the Supreme Court (at least trying to)?
FDR was a tyrant. Those are the facts. Tyrants can be "benevolent."
"Tough times" does not excuse bad behavior.
Remember, Chavez and many other modern day tyrants keep getting elected in free elections. When you promise people free stuff and that you will take care of them you get votes. Even tyrants.
We obviously have a different view on this topic. No point in keeping this up. Stay safe down there.
Pat
Just FYI
ty⋅rant [tahy-ruhnt] Show IPA
Use tyrant in a Sentence
–noun
1. a sovereign or other ruler who uses power oppressively or unjustly.
2. any person in a position of authority who exercises power oppressively or despotically.
3. a tyrannical or compulsory influence.
4. an absolute ruler, esp. one in ancient Greece or Sicily.
FDR certainly falls under number 1 with Gold confiscation and with trying to add in more justices to rubber stamp his opinions.
Probably #4 as well. He thought he was an absolute ruler judging by his behavior
Again, there is a reason the 22nd Amendment with presidential term limits was passed. FDR was the reason for it. They recognized his tyrancy and put in limits
We obviously have a different view on this topic. No point in keeping this up. Stay safe down there.
Pat
E-Guns,
I think we all appreciate your unrelenting enthusiasm with FDR and history and all, but Alaska is trying hard to just drop it, and honestly... it's getting boring to watch the same point be made over and over again! I love you man, really... but just grab a cold beer and for the moment.... relax and forget all about it.
So, enough about that.... any word on what is going on with the health care? Has it been ever-morphing since new years or is it stagnant? I have not had time to follow this in the last week and a half.
I hope it tuckers out and gets dropped in the trash can. Any updates from those of you that are following it?
E-Guns,
I think we all appreciate your unrelenting enthusiasm with FDR and history and all, but Alaska is trying hard to just drop it, and honestly... it's getting boring to watch the same point be made over and over again! I love you man, really... but just grab a cold beer and for the moment.... relax and forget all about it.
I was doing my last reply before I saw his last one.
I haven't had time to read this whole thread and I only have a minute but here is my $0.02
BTW, I'm a medicl doctor and I've been in practice for 11 years.
Insurance reimbursements for my care decrease at about 1-2%/year, it will be more this year and certainly more when the Obama plan comes out.
The increased cost of health care has ABSOUTELY NOTHING to do with your doctor and those who actually provide the care!
Medicare is bankrupt and cannot support the baby boomer generation, how in the world do you think our government will do with a national healthcare plan for "everyone".
CMS (Center for Medicare Services) has instituted a beaurocracy with people who sit around and come up with more ridulous rules, restrictions (i.e. PQRI) that medical doctors actually laugh about because they only increase our time and cost and have no improvement in clinical outcomes.
There will be an abundance of patients with a shortage of doctors. Less people will enrol in medical school because physicians are usually caring, emphathetic, driven individuals-not typically people who want to spend their live as a government employee (this is no knock on VA docs, or military docs-I have worked in a VA and trained in a Naval hospital and the docs were great).
If you are really sick, I hope you know a doctor personally who can help facilitate getting in to see the people to you really need to see, otherwise you're screwed and just another sheep in the herd.
I forget the actual stats but I think something like 5% of the US population pays 95% of the taxes.
It took about 230 years for this country to be a socialist society. My guess it will take another 50-100 to become communist (The Supreme Court really decides what the consitution says anyway)
I seem to remember a revolution that occurred when people were screaming "Taxation without Representation".
I recently had a family tragedy and it reminded me of what's important in life. It's about sharing your love and it's not what you got, it's what you give. Unfortunately our government supports policy and has created a generation and imported a population that exploits these attributes from the truly great Americans!
The real question is how can we get back to what founded this country and restore it to the great place it once was. Many say that restoring good values and having a strong family and local and community is where it needs to start. Well our government policy completely contradicts this.
Every year I have given more financially in free care, written off charges for those who can't afford it, and given to other non-medical charities than the average American family makes in a year. This year, because of certain financial hardships, it will be half of what I usually give. If a patient comes to me and says, "I can't afford this, what can I do", I ALWAYS waive my fee. Only about 10% of my patients who refuse to pay their bills, do this. This is the entitlement generation and our government breeds it!
Here are some quick thoughts on how to improve things.
1. 2-4 year term limits in Congress and Presidency
2. Flat tax rate
3. Abosolute transparency of campaign contributions with financial limits and mandatory jail time for any violations.
4. Eliminate Federal government run health care (I think this should be left to the states if they desire)
5. A balanced budget for social security-HAA HAAA HAAAA
6. A bloody revolution
Even with this, it will never happen.
Sadly, I must confess, I'm looking for the next great country and I'm not alone.
Alaskapopo
01-11-10, 16:32
I
1. 2-4 year term limits in Congress and Presidency
2. Flat tax rate
3. Abosolute transparency of campaign contributions with financial limits and mandatory jail time for any violations.
4. Eliminate Federal government run health care (I think this should be left to the states if they desire)
5. A balanced budget for social security-HAA HAAA HAAAA
6. A bloody revolution
Even with this, it will never happen.
Sadly, I must confess, I'm looking for the next great country and I'm not alone.
I agree with you on number 2. Everyone from rich to poor should pay the same % of their income. The irony is the rich would actually have to pay a lot more.
Pat
I agree with you on number 2. Everyone from rich to poor should pay the same % of their income. The irony is the rich would actually have to pay a lot more.
Pat
I would make myself more familiar with the numbers before I made such statements. The rich pay a LOT higher percentage of their income in taxes than do middle class or poor people. That is why it is called a progressive tax system.
Alaskapopo
01-11-10, 16:43
I would make myself more familiar with the numbers before I made such statements. The rich pay a LOT higher percentage of their income in taxes than do middle class or poor people. That is why it is called a progressive tax system.
Actually the rich pay less due to Tax shelters and other loopholes. There is a progressive tax system but the rich hide their money in a lot of ways.
Pat
Actually the rich pay less due to Tax shelters and other loopholes. There is a progressive tax system but the rich hide their money in a lot of ways.
Pat
Again, check your numbers. What you have said above is the progressive mantra but for most rich people is not true. Truly rich who do not have incomes may not pay a lot in income taxes, but most rich people do not fall into that category.
The top 1% of people pay more than 1/2 the taxes. The bottom 95% pay less than 1/2 the taxes. Approximately 41% (2006) pay no fed income taxes.
see taxfoundation.org
Alaskapopo
01-11-10, 17:12
Again, check your numbers. What you have said above is the progressive mantra but for most rich people is not true. Truly rich who do not have incomes may not pay a lot in income taxes, but most rich people do not fall into that category.
The top 1% of people pay more than 1/2 the taxes. The bottom 95% pay less than 1/2 the taxes. Approximately 41% (2006) pay no fed income taxes.
see taxfoundation.org
The Rich pay a higher total amount of taxes but not a higher percentage of their income.
Pat
The Rich pay a higher total amount of taxes but not a higher percentage of their income.
Pat
Think that through very carefully. How much money do the rich make if they top 1% is paying over 1/2 the taxes and the top 5% is paying 60% percent of all taxes?
(for 2007 it is estimated that the AGI (adjusted gross income) of the top 1% was $410,096 or higher))
For 2008 the total receipts were 2.5 trillion, 45% of which came from personal income taxes.
So, 2.5 * .45 = 1.125 trillion approximately. 60% of that is 675 billion. So that year the top 5% of filers/taxpayers pay 675 billion. An approximate AGI for the top 5% is $210,000 for 2007 -- 2008 should be similar when you look at the historical trends. For 2007 there were approx 141.07 million returns filed. (This was calculated by takeing the top 1% $410k AGI 1x and the top 5% 160k 4x -- this is a rough calculation)
5% of that is 7.05 million returns paid 60% of all taxes. 7.05 million X $210,000 = 1,480,500,000,000 = 1.4805 trillion if I counted the zeros right. So that is the aggregate AGI for the top 5% who paid about 675 billion in taxes. That comes out to about a rate of 45.59%.
I know that I mixed 2007 and 2008 together but form looking at trends that should not throw things off more than a percent or two. (You got to take the data that is available)
Are you claiming the poor pay more than 45 percent of their income in federal income taxes? Most poor don't pay any taxes.
taxfoundation.org and ntu.org were the source for these numbers btw
Think that through very carefully. How much money do the rich make if they top 1% is paying over 1/2 the taxes and the top 5% is paying 60% percent of all taxes?
(for 2007 it is estimated that the AGI (adjusted gross income) of the top 1% was $410,096 or higher))
For 2008 the total receipts were 2.5 trillion, 45% of which came from personal income taxes.
So, 2.5 * .45 = 1.125 trillion approximately. 60% of that is 675 billion. So that year the top 5% of filers/taxpayers pay 675 billion. An approximate AGI for the top 5% is $210,000 for 2007 -- 2008 should be similar when you look at the historical trends. For 2007 there were approx 141.07 million returns filed. (This was calculated by takeing the top 1% $410k AGI 1x and the top 5% 160k 4x -- this is a rough calculation)
5% of that is 7.05 million returns paid 60% of all taxes. 7.05 million X $210,000 = 1,480,500,000,000 = 1.4805 trillion if I counted the zeros right. So that is the aggregate AGI for the top 5% who paid about 675 billion in taxes. That comes out to about a rate of 45.59%.
I know that I mixed 2007 and 2008 together but form looking at trends that should not throw things off more than a percent or two. (You got to take the data that is available)
Are you claiming the poor pay more than 45 percent of their income in federal income taxes? Most poor don't pay any taxes.
taxfoundation.org and ntu.org were the source for these numbers btw
the one logical fallacy in my reasoning is using AGI. I do not have real income figures at hand. So it is entirely possible, though I doubt it, that this top 1% of filers had real incomes on average of say $2 million and that their AGI is only 20% of their actual income and they were able to "hide" 80% of it. Across the complete 1%.
Somehow I severely doubt it
Chad
[chevy chase][gerald ford] It was my understanding that there would be no math! [/gerald ford][/chevy chase]
Seriously, those with high incomes can and do use private defined benefit pension plans to defer income before taxes. Such plans are virtually unlimited, but they DO reduce current income and penalties must be paid if distributions are made before retirement age is reached. The money grows tax deferred and is taxed when it is disbursed, so the government always gets its cut.
While the rich may use other tax shelters, or hide money if foreign accounts to avoid taxes, regular Joes do side jobs for cash and don't report the income, or they exaggerate the deductions for their personal business, etc. Lots of people cheat on taxes to avoid paying.
eguns is right, and almost every unbiased analysis I've seen says so.
But even rich people like Steve Forbes advocate the flat tax, so many people agree it would be a good idea. So let's just say we all agree that we should enact it, dump the phone book of tax code, and put most of the IRS out of work.
Insurance reimbursements for my care decrease at about 1-2%/year, it will be more this year and certainly more when the Obama plan comes out.
This is the case for all sorts of businesses - not just medical providers. To stay competitive you continually have to push costs down, do more with less, and become more efficient.
I haven't seen too many medical practices I would call "efficient", especially hospitals. My internist is actually pretty good - she charts on a laptop and writes prescriptions that are electronically faxed to the pharmacy. It's faster, reduces errors, eliminates transcription, etc. Allows more time with the patient, so it improves care as well.
But I agree that the insurance system with different rules for different carriers creates a lot of inefficiencies. Doctors have staff that is 100% dedicated to nothing but insurance claims and processing. Something has to be done with regard to standardization there.
Alaskapopo
01-11-10, 22:21
Think that through very carefully. How much money do the rich make if they top 1% is paying over 1/2 the taxes and the top 5% is paying 60% percent of all taxes?
(for 2007 it is estimated that the AGI (adjusted gross income) of the top 1% was $410,096 or higher))
For 2008 the total receipts were 2.5 trillion, 45% of which came from personal income taxes.
So, 2.5 * .45 = 1.125 trillion approximately. 60% of that is 675 billion. So that year the top 5% of filers/taxpayers pay 675 billion. An approximate AGI for the top 5% is $210,000 for 2007 -- 2008 should be similar when you look at the historical trends. For 2007 there were approx 141.07 million returns filed. (This was calculated by takeing the top 1% $410k AGI 1x and the top 5% 160k 4x -- this is a rough calculation)
5% of that is 7.05 million returns paid 60% of all taxes. 7.05 million X $210,000 = 1,480,500,000,000 = 1.4805 trillion if I counted the zeros right. So that is the aggregate AGI for the top 5% who paid about 675 billion in taxes. That comes out to about a rate of 45.59%.
I know that I mixed 2007 and 2008 together but form looking at trends that should not throw things off more than a percent or two. (You got to take the data that is available)
Are you claiming the poor pay more than 45 percent of their income in federal income taxes? Most poor don't pay any taxes.
taxfoundation.org and ntu.org were the source for these numbers btw
Even if I am totally wrong on the rich not paying their share. A flat tax would be fair for everyone.
Pat
Even if I am totally wrong on the rich not paying their share. A flat tax would be fair for everyone.
Pat
And you'd have a ton of supporters on the right. On the left? Not so much.
Based on my involvement with the last healthcare thread, I think that it's best if I stay out of the deep end of the rhetorical pool in this thread, except to add the following:
for the OP- look at the dates used in the article you sourced. Pharma was on the downslope back in 2002. Since then, the industry has had pretty serious trouble. Many of the truly huge blockbuster therapies have gone generic, others have been tainted with surveillance/safety data etc. The (evil) sales forces have been thinned tremendously- usually not a sign of happy doings in any business. Moreover, most of the business practices denounced by people like the author have long since stopped. ( and even then, it was never really the way it is routinely portrayed by those with an anti-pharma agenda ) Just food for thought.
Alaskapopo
01-11-10, 23:13
And you'd have a ton of supporters on the right. On the left? Not so much.
Based on my involvement with the last healthcare thread, I think that it's best if I stay out of the deep end of the rhetorical pool in this thread, except to add the following:
for the OP- look at the dates used in the article you sourced. Pharma was on the downslope back in 2002. Since then, the industry has had pretty serious trouble. Many of the truly huge blockbuster therapies have gone generic, others have been tainted with surveillance/safety data etc. The (evil) sales forces have been thinned tremendously- usually not a sign of happy doings in any business. Moreover, most of the business practices denounced by people like the author have long since stopped. ( and even then, it was never really the way it is routinely portrayed by those with an anti-pharma agenda ) Just food for thought.
Your probably right. I am on the left on a few issues. (union supporter, health care) and on the right on some issues (gun ownership, development of our natural resources etc)
As to health care I know this 23 year old who works at Subway. The kid is broke obviously as he works at subway but otherwise is a fine human being. The has a very bad case of exima (skin disease) that requires expensive medication that he can't afford on what he makes. So instead he just suffers and looks like world war 3 broke out on his skin. We need to have something for guys like him.
Pat
Alaskapopo
01-11-10, 23:17
Note to self: Do not eat at that subway.
There are provisions for him. They're called "0% payment plans offered by nearly every dr. office and hospital".
On another note:
Amish exempt from Health Care Mandate
http://www.watertowndailytimes.com/article/20100109/NEWS02/301099964
This 0% payment how would it work if he simply can't afford to pay what the drugs cost? I understand its no interest but the cost of the drugs themselves are too much for him.
Pat
Alaskapopo
01-11-10, 23:26
Absolutely nothing on earth is too expensive for anyone, if the terms are right. You could afford a ferrari if it cost $1 a month.
He needs to work with providers. It's done every single day with people suffering from worse conditions with less going for them (ie: employment) I won't even go down the path of, does he have an Ipod, cellphone, etc.
Thanks I will talk to him about it.
Pat
Even if I am totally wrong on the rich not paying their share. A flat tax would be fair for everyone.
Pat
I agree with you wholeheartedly on this.
I think a consumption tax with total elimination of the income tax (and repeal of the 16th amendment) and total elimination of the IRS would probably be better. Details would have to be seen of course.
Even if I am totally wrong on the rich not paying their share. A flat tax would be fair for everyone.
Pat
You are totally wrong. I will be writing the Federal Govt a check for around $100K this year. I do not pay myself anywhere near that.
Trust me when I say that the "rich" carry the heaviest burden in our tax system.
With that said, I would LOVE a flat tax. Why you ask? Beacause a large portion of the populace pays ZERO taxes and gets earned income credit. So for once, EVERYONE in the country would be paying tax.
C4
Your probably right. I am on the left on a few issues. (union supporter, health care) and on the right on some issues (gun ownership, development of our natural resources etc)
As to health care I know this 23 year old who works at Subway. The kid is broke obviously as he works at subway but otherwise is a fine human being. The has a very bad case of exima (skin disease) that requires expensive medication that he can't afford on what he makes. So instead he just suffers and looks like world war 3 broke out on his skin. We need to have something for guys like him.
Pat
Gosh, as much as I would like to help the guy, health care is NOT an inalienable right. Here is some key things to remember:
1. You are not guranteed to be rich.
2. You are not guranteed to be healthy.
3. You are not guranteed to be good looking.
4. You are not guranteed to have friends or family.
In a nutshell, life is unfair (get used to it). If the guy wants help with his skin issue, tell him to join the Military. The will provide him with all kinds of medical attention (good and bad).
C4
I agree with you wholeheartedly on this.
I think a consumption tax with total elimination of the income tax (and repeal of the 16th amendment) and total elimination of the IRS would probably be better. Details would have to be seen of course.
Ya, a consuption tax would be simply fantastic. It would also remove the ability for people to scam the IRS and not pay taxes.
If I see one more lawer commercial for helping people GET OUT OF PAYING THEIR TAXES, I'm going to shoot the TV!
C4
Ya, a consuption tax would be simply fantastic. It would also remove the ability for people to scam the IRS and not pay taxes.
If I see one more lawer commercial for helping people GET OUT OF PAYING THEIR TAXES, I'm going to shoot the TV!
C4
The biggest advantage of a consumption tax is it would force people to realize how much they actually pay in taxes. Now it is kind of "hidden" with the withholding. Sure, you get it itemized but how many people really look at their paystub? I bet that most people look at their NET pay as their actual pay and don't realize their taxes except once a year in April...
With a sudden realization, every time you go shopping, about your tax burden, you might see a lot less support for various programs that cost us a ton of money
People using the ER as their personal free medical care, was one issue the MA plan was supposed to stop. The idea was, if everyone had insurance, it would stop the vast majority of people who use the ER as their personal free medical care for minor issues, and overall costs would go down. However, so far, it has cost more, increased the states debt, raised everyone's insurance costs, etc, etc. Without built in cost containment - drugs being a major one due to major lobbying, threats, etc from pharma - costs have only gone up, vs down.
I am not claiming to be an expert on this topic, but I have experienced directly the effects of this plan. Here's some comments from the Cato Inst, which granted, is a tad right leaning, but as far as I know, the stats are correct and I have read them in other sources:
When Massachusetts passed its pioneering health care reforms in 2006, critics warned that they would result in a slow but steady spiral downward toward a government-run health care system. Three years later, those predictions appear to be coming true:
* Although the state has reduced the number of residents without health insurance, 200,000 people remain uninsured. Moreover, the increase in the number of insured is primarily due to the state's generous subsidies, not the celebrated individual mandate.
* Health care costs continue to rise much faster than the national average. Since 2006, total state health care spending has increased by 28 percent. Insurance premiums have increased by 8?10 percent per year, nearly double the national average.
* New regulations and bureaucracy are limiting consumer choice and adding to health care costs.
* Program costs have skyrocketed. Despite tax increases, the program faces huge deficits. The state is considering caps on insurance premiums, cuts in reimbursements to providers, and even the possibility of a "global budget" on health care spending?with its attendant rationing.
* A shortage of providers, combined with increased demand, is increasing waiting times to see a physician.
With the "Massachusetts model" frequently cited as a blueprint for health care reform, it is important to recognize that giving the government greater control over our health care system will have grave consequences for taxpayers, providers, and health care consumers. That is the lesson of the Massachusetts model.
http://www.cato.org/pub_display.php?pub_id=10268
Powered by vBulletin® Version 4.2.5 Copyright © 2024 vBulletin Solutions, Inc. All rights reserved.