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Obama Urges Quick Action on Insurance

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Obama Urges Quick Action on Insurance

Old 06-03-09, 12:07 PM
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Obama Urges Quick Action on Insurance

http://www.nytimes.com/2009/06/03/us.../03health.html

WASHINGTON — President Obama on Tuesday affirmed his support for the creation of a government-sponsored health insurance plan, but he acknowledged that such a plan would sharply reduce the chances for Republican support of legislation to overhaul the health care system, Democratic senators said.

The senators, who met with Mr. Obama at the White House, said he also set forth a timeline, calling on Congress to send him a comprehensive health care bill by October.

“He wants the bill through the Senate and the House before the August recess, so we can conference and have it done in September and signed in October,” said Senator Barbara A. Mikulski, Democrat of Maryland. “He said we need to be unflinching and unflagging.”
More in the link. Chief among the administration's plans are taxing employee health benefits and limiting pay for doctors and other healthcare workers.

To help control costs, the administration indicated support on Tuesday for a proposal to strengthen a federal panel that recommends how much Medicare should pay doctors, hospitals, nursing homes and other health care providers.
Now I don't know how much they expect to recoup by taxing employee health benefits, but this article from the CBO leads me to believe that physician reimbursement is not the core problem behind rising healthcare costs.

http://www.cbo.gov/doc.cfm?index=5416&type=0
Annual Payment Rate Updates for Services on the Medicare Physician Fee Schedule, 1992 to 2005


Medicare's spending for services on the physician fee schedule grew at an average annual rate of 3.2 percent during the 1992-1998 period, but the changes in spending varied substantially from one year to the next, ranging from a reduction of 2.6 percent in 1992 to increases of almost 10 percent in both 1994 and 1995. That volatility led the Congress and the President to modify the VPS in the Balanced Budget Act of 1997, replacing it with the sustainable growth rate mechanism in place today.
While cutting what physicians will receive for the same amount of work, operating costs continue to rise.

http://www.gao.gov/new.items/d03702.pdf
Beginning in 1999 and 2000, medical malpractice insurers in our seven
sample states increased their premium rates18 for the physician specialties
of general surgery, internal medicine, and obstetrics/gynecology faster than
they had since at least 1992. These specialties were the only ones for which
data were available, and 1992 was the earliest year for which we could
obtain comprehensive survey data.19 However, both the extent of these
changes and the level of the premium rates insurers charged varied greatly
across medical specialties, states, and even areas within states. From 1999
through 2002, one large insurer raised rates more for internal medicine
than for general surgery, while another raised rates 12 times more for
general surgery than for internal medicine. Changes in premium base rates
among some of the largest insurers in each state ranged from a reduction of
about 9 percent for obstetricians and gynecologists insured by one
California company to an increase of almost 170 percent for doctors in the same specialty in one area of Pennsylvania. At the same time, premium
rates for the same amount of coverage for the same medical specialty
varied by a factor of as much as 17 among states—that is, the rate in one
state was 17 times higher than the rate in a different state.
I am not optimistic about the current proposals to 'save' us from rising healthcare costs.
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Old 06-03-09, 12:20 PM
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Re: Obama Urges Quick Action on Insurance

I thought the answer was a 25% VAT... ha! Barring something ridiculous like that, I don't see how this is going to get paid for.
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Old 06-03-09, 12:29 PM
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Re: Obama Urges Quick Action on Insurance

Originally Posted by fujishig View Post
I thought the answer was a 25% VAT... ha! Barring something ridiculous like that, I don't see how this is going to get paid for.
That hasn't stoped new programs in the past. Why should it matter now?
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Old 06-03-09, 12:41 PM
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Re: Obama Urges Quick Action on Insurance

From what I have seen, Obama doesn't actually need money to pay for things. He just spends money that he doesn't have.

And quick action my ass. He said the same thing about the Stimulus Bill, and then has sat on the bulk of it after telling us the world would fall apart if it didn't pass within the hour.
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Old 06-03-09, 01:29 PM
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Re: Obama Urges Quick Action on Insurance

Putting aside the issue of how it will be paid for - How will any of these proposals "improve" our healthcare system? What are the main features that need to be improved?

In the average person's lifetime, when is the bulk of their healthcare money spent?
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Old 06-03-09, 01:31 PM
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Re: Obama Urges Quick Action on Insurance

I think government run = improved in their minds.
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Old 06-03-09, 01:45 PM
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Re: Obama Urges Quick Action on Insurance

Originally Posted by Birrman54 View Post
Putting aside the issue of how it will be paid for - How will any of these proposals "improve" our healthcare system? What are the main features that need to be improved?
Providing healthcare to people who currently do not have coverage?
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Old 06-03-09, 01:45 PM
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Re: Obama Urges Quick Action on Insurance

Originally Posted by kvrdave View Post
I think government run = improved in their minds.
Government run = no insurance companies = no profit motive = lower cost
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Old 06-03-09, 01:54 PM
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Re: Obama Urges Quick Action on Insurance

Originally Posted by CRM114 View Post
Government run = no insurance companies = no profit motive = lower cost
It also = run for political reasons = decisions made for political reasons = favors given out for political reasons = monopoly = no incentive to provide quality care

It also does not necessarily mean that it is run as well or that quality of care is better or equal to what we have now.
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Old 06-03-09, 02:03 PM
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Re: Obama Urges Quick Action on Insurance

Originally Posted by CRM114 View Post
Government run = no insurance companies = no profit motive = lower cost
I gaurentee you that what comes out of congress will not have the nessisary qualities to lower costs (if we can consider lower quality of care a cost) over time. That said, there are universal healthcare options that would lower costs.
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Old 06-03-09, 02:07 PM
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Re: Obama Urges Quick Action on Insurance

Originally Posted by CRM114 View Post
Providing healthcare to people who currently do not have coverage?
Do you disagree with the basic numbers outlined here?

http://www.usnews.com/blogs/capital-...uninsured.html

1) There were 45.7 million uninsured people in the U.S. in 2007.
Of that amount, 6.4 million are the Medicaid undercount. These are people who are on one of two government health insurance programs, Medicaid or S-CHIP, but mistakenly (intentionally or not) tell the Census taker that they are uninsured. There is disagreement about the size of the Medicaid undercount. This figure is based on a 2005 analysis from the Department of Health and Human Services.

2) Another 4.3 million are eligible for free or heavily subsidized government health insurance (again, either Medcaid or SCHIP), but have not yet signed up. While these people are not pre-enrolled in a health insurance program and are therefore counted as uninsured, if they were to go to an emergency room (or a free clinic), they would be automatically enrolled in that program by the provider after receiving medical care. There’s an interesting philosophical question that I will skip about whether they are, in fact, uninsured, if technically they are protected from risk.

3) Another 9.3 million are non-citizens. I cannot break that down into documented vs. undocumented citizens.

4) Another 10.1 million do not fit into any of the above categories, and they have incomes more than 3X the poverty level. For a single person that means their income exceeded $30,600 in 2007, when the median income for a single male was $33,200 and for a female, $21,000. For a family of four, if your income was more than 3X the poverty level in 2007, you had $62,000 of income or more, and you were above the national median.

5) Of the remaining 15.6 million uninsured, 5 million are adults between ages 18 and 34 and without kids.

6) The remaining 10.6 million do not fit into any of the above categories, so they are: U.S. citizens;with income below 300% of poverty;not on or eligible for a taxpayer-subsidized health insurance program;and not a childless adult between age 18 and 34.
Obviously some people are hurt in the current system. There are also significant complications caused by job-based health insurance and transitions between employment. I'm not defending the status quo, but I challenge the concept that healthcare is unaffordable or unattainable for the majority of Americans.

There are very significant issues with nationalizing the country's health industry. Do you disagree that payments to doctors are not the primary force in rising healthcare costs? At some point you either have to drastically reduce the amount you pay, or you need to reduce the amount of care that is provided.
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Old 06-03-09, 03:30 PM
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Re: Obama Urges Quick Action on Insurance

Why should it be paid for? Most of his proposals are not paid for.

I'm for a plan to insure the uninsured, but I think should have some idea of the cost what it covers before we leap. Another thing - it's not going to reduce cost, because it increases third-party payments.
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Old 06-03-09, 04:07 PM
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Re: Obama Urges Quick Action on Insurance

Originally Posted by classicman2 View Post
Why should it be paid for? Most of his proposals are not paid for.

I'm for a plan to insure the uninsured, but I think should have some idea of the cost what it covers before we leap. Another thing - it's not going to reduce cost, because it increases third-party payments.

That's old fashioned thinking. Need is all the justification we need to do this no matter the cost, and actual cost increases is not relevant because we need this.
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Old 06-03-09, 04:15 PM
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Re: Obama Urges Quick Action on Insurance

Government run = no insurance companies = no profit motive = lower cost
Government run generally equals failure. From what has been discussed this is headed the same way. You have to address utilization. Any given weekend you can visit an emergency room at 3 a.m. and find a mother on a medical card who has taken her kid in for the sniffles.

They have no skin in the game. They need to tweak HSA's and institute them as the solution.
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Old 06-03-09, 04:42 PM
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Re: Obama Urges Quick Action on Insurance

You have mothers with medical cards in your emergency rooms? Lucky...

Which brings up the point, is this supposed to be for legal citizens only?
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Old 06-03-09, 04:58 PM
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Re: Obama Urges Quick Action on Insurance

Originally Posted by fujishig View Post
You have mothers with medical cards in your emergency rooms? Lucky...

Which brings up the point, is this supposed to be for legal citizens only?

Yeah, like this is the one time we are going to exclude illegals.
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Old 06-03-09, 05:46 PM
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Re: Obama Urges Quick Action on Insurance

Until someone grows the balls to address the death grip the pharmaceutical industry has on the entire health care system in this country, the less significant but similar issue with medical equipment companies, we're not going to lower costs.

No one has the balls to even brings up the real reason for health care costs as it would piss off the people who fund and organize their campaigns, and end their careers.

"Unless we put medical freedom into the Constitution, the time will come when medicine will organize into an undercover dictatorship to restrict the art of healing to one class of men and deny equal privileges to others; the Constitution of the Republic should make a special privilege for medical freedoms as well as religious freedom." - Benjamin Rush, MD., Founding Father, signer of the Declaration of Independence, and personal physician to George Washington
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Old 06-03-09, 05:55 PM
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Re: Obama Urges Quick Action on Insurance

How is 'medical freedom' being defined?

I've read that 50% of the money you'll spend on healthcare occurs in the last 6 months of your life? Has anyone else heard that?
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Old 06-03-09, 06:02 PM
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Re: Obama Urges Quick Action on Insurance

Originally Posted by Dr Mabuse View Post
Until someone grows the balls to address the death grip the pharmaceutical industry has on the entire health care system in this country, the less significant but similar issue with medical equipment companies, we're not going to lower costs.
Perhaps we should dictate what those companies profit margins are allowed to be.
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Old 06-03-09, 06:09 PM
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Re: Obama Urges Quick Action on Insurance

Won't somebody please think of the children?!?

And was it Biden (correct me if I'm wrong) or Reid who wrote the book on the 'new' Health Care Czar position, a Governmental Position that would decide which procedures would actually be performed on which patients, and that decision would be made by non-medical personnel, with the goal of saving money and cutting costs. 65 years old and need major surgery? Not going to happen, it's not "worth it".

I'm not going to get into the bashing of Big Pharma and Big Healthcare equipment (disclaimer: I work for a medical equipment company). We make money, and are set to make money this year, but let's just say that the amount we're making, for creating devices that help people save lives, is infinitesmal compared to the money "made" by government in taxing any one of a number of industries. Our "profit" is not what Iwould have expected.

Don't forget Big Insurance, and the skyhigh malpractice premiums; and Big Law, with their commercials every five minutes offering to Sue Sue Sue somebody who may or may not have done anything medically wrong. And the whole concept of "deep pockets".

The issue is very big and complex, and there's lots of "fault" in it (including, of course, government with many federal requirements and obstacles to virtually every practitioner in the medical field), but I do think "more government involvement/control" is NOT the answer. And when has "lowering cost" EVER been a real priority of the federal government (what's the debt at now, and how far in the red is Obama's budget?)
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Old 06-03-09, 06:19 PM
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Re: Obama Urges Quick Action on Insurance

I want to control your profits so much that you don't even continue research or making new products. Bastards.
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Old 06-03-09, 06:59 PM
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Re: Obama Urges Quick Action on Insurance

Originally Posted by kvrdave View Post
Perhaps we should dictate what those companies profit margins are allowed to be.
Or perhaps... 'we' should look into exactly what I meant by that, not just assume we already know when we obviously don't?
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Old 06-03-09, 07:06 PM
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Re: Obama Urges Quick Action on Insurance

Yeah, that sounds like more fun. Commie!
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Old 06-03-09, 07:10 PM
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Re: Obama Urges Quick Action on Insurance

I could rant all day about health insurance and medical costs right now.

We're having a baby with no maternity coverage so everything is out of pocket.

Got a nice bill for $1200 for the routine blood tests etc the other day. The estimate before the appointment was $250. So I called to complain when we got the monster bill. After being on hold for who knows how long, sent through a series of departments, and finally ending up who knows where, the response is "Oh, that's the rate we charge the state and insurance companies. You only owe $100. Just send $100 with the invoice and we'll take care of it."

Say what? I mean... thanks. I guess I get this good rate thanks to the "big guys" getting screwed, but things are seriously jacked up all over the place when it comes to both insurance (why we have no maternity coverage now with after moving, when we had it 9 months ago) and health care costs.
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Old 06-03-09, 07:31 PM
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Re: Obama Urges Quick Action on Insurance

Originally Posted by CRM114 View Post
Providing healthcare to people who currently do not have coverage?
Are you sure it is worth having if they are limiting pay to Dr's and other providers?
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