Health Care Reform

Frnkd213

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Okay except for the part that say all American will have to get health care insurance. or be fined. What is the other part of health care reform that is bad, and what is GOOD. To LPSG members.

I find it very disturbing that the platform of the republican candidates and tea party specifically is to get rid of Health Care Reform (I purposefully not use the "obamacare" nomenclature). Which made me think of why get rid of the entirety if the only "unconstitutional" part is, as I understand it, the part that mandates health care insurance need to be gotten by everyone.

The part that enables the parents insurance to cover their children till 25 or so, whats wrong with that?
Insurance comp cannot drop your coverage because of illness. What wrong with that?

Cannot be denied because of a per-existing condition. I heard that pregnancy or the ability to get pregnant is a per-existing condition by definition and the insurance comp. could deny a woman coverage, true,not true?

enlighten me on what is absolutely the reason why the entire health care reform should be gotten rid of, please.

PS. This has nothing to do with the question but the auto correct for Obamacare is "macabre" hmmm.
 

dandelion

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I would suggest from my perspective, the government needs to become more directly involved in providing care and cut out the middlemen. Other suggestions are that liitigation over health care is excessive and out of control.
 

FuzzyKen

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Healthcare in the present form is completely broken and no longer workable for anyone.

The bill that was passed was a disaster. It has few redeeming qualities in any manner except for one. It passed two bodies of government and a judiciary that cannot agree on which end to crack an egg is appropriate. That is the ONLY thing it has done.

What now exists is a basic framework from which those who really do care and want reform can build on.

The legal precedents here come from Medicare which came about in the mid 1960's.

Those most opposed to reform are those who want to preserve the status quo mainly for insurance carriers who only want to give health care insurance to healthy people. They do not want to spend a nickel of their profits towards actually helping anyone. The benefits that most of us have now have been eroded and reduced markedly in the name of corporate profit. Currently, most policies have a cap and a second policy is necessary for "catastrophic illness". That policy begins when the cap or maximum policy value is reached on the primary coverage.

The concept right now is to throw anyone who creates a major expense to the wolves at some point anyway. Most individuals facing common cancer exhaust their front line policies or coverage. At a point when they are most ill and unable to have any from of employment they are then forced to pay ever escalating rates through various systems to continue their care. In the end these sick people end up with care via State and Federal programs anyway. The private carriers "walk away" leaving the patient sick, broke, and often create situations where care lapses and this results on occasion in the death of the patient.

Why there is such incredible opposition by a vocal group of individuals in government is that the reform as it now stands would FORCE carriers to insure people with health care issues. It does not allow them to drop or screen out people because of pre-existing conditions. This means that all of us would be entitled to care at a price which as yet has not had caps or limitations placed on it.

It is well known that the fines and or mandatory subscription is a demand of the private companies this means that by law you are required by law to ensure their profits. The thinking is that the larger the base of individuals the less the impact sick individuals requiring care will have on the profit margins generated by the healthy individuals not needing care.

In most countries operating under a single payer plan the difference is that your health care costs are taken out of your payroll as a tax charge. The cost of that coverage per month depends on the salary you earn. Minimal rates in Canada might be in the area of $40-$50 per month for a person at a low wage to a much higher rate for an individual making $250,000 per year.

Right now you are beginning to see the problem. The guy making 250,000 does not want to pay that rate based on his income under what would appear to be a direct tax to pay for health care for "the other guy".

In most countries that offer single payer health care plans there are alternatives and the opposition to these plans seems to always leave out the details.

You can purchase a supplemental private policy that upgrades your coverage in some areas. For instance: A given amount per month would guarantee you a private room in a hospital versus a multi-bed room and other amenities of luxury during your care or recovery. Basic care would be the same for all, but the insurance pays for many upgrades in what you get.

In the United States, we have a framework already in place for a single payer plan and that is Medicare. This could be expanded at minimal cost with regards to infrastructure to cover all Americans. If it were expanded who would win? The American People would get care and universally so. The problem is that if the American People received decent care and found the system to work even with a few rough spots, most Americans would not choose to "opt out" into private insurance. This would bankrupt numerous carriers who are not prepared, and do not care to move their role into the supplemental market as is or has been done in most foreign countries with single pay systems.

A great deal of pressure has been applied to medical professionals from the insurance industry crying gloom and doom to support the current system, because under what we have right now, they the carriers have the legal ability to discriminate right and left and of course maximize profits. They can pay Executives and those occupying the Board Room multi-million dollar salaries and bonuses, and they most of all can deny you care when the chips are down.

Now, under circumstances where people were good and benevolent and cared about their fellow man and where people came in ahead of corporate greed, the system we have would be far better. The unfortunate truth is that many are now being denied care or thrown into situations where "red tape" causes a total of denial of care in the name of profit allowing people to die because death to an insurance carrier eliminates the continued expense of a sick person. I know that this sounds incredibly cynical, but after several experiences before my Mother died in 2001 it is unfortunately the facts.

The only thing of value in what was passed is the infrastructure. The actual system that was passed is a disaster. What those opposed fear most is the framework under which something good could be built.

America is a great Nation with many great people. The unfortunate situation now is that we have a select few who have gained power and great wealth who fully intend to maximize that wealth even if it costs people their lives.

I have watched this, and I have experienced this with the death of my own Mother back in 2001. As much as I hate the concept of a single payer system, I have to admit that it is now the only alternative. I have seen too much of what we have right now, versus what others under single pay systems have, first hand. I have friends in the United Kingdom and Canada. I have friends in France as well.

The United States was once the world leader in health care for it's citizens. Right now the United States has monumental technology and research, and yet, not all Americans can benefit from this technology because that technology and those developments cost money.

One example is a treatment for cancer called "particle beam". This has saved numerous lives as part of the arsenal against cancer. However ten years after it's inception and proof that it works, many insurance carriers refuse to pay for it classifying it as "experimental". This is now a common dodge for good treatments that are expensive. If we don't want to pay for something we simply re-classify a drug or a treatment or drug as "experimental".

Change must take place, and in a few years fixing health care will begin in the Court System. If that is what it takes, then it will at least be considered a beginning.
 
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Frnkd213

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FK,
Thanks for the extensive explanation!
You would think that this is the result of extensive debate and negotiations, and after all the compromises we have this?

I wonder what part of it is the republicans doing, you know, won't approve unless this or that is added.

It becomes even more apparent as to who is running our govt. Lobbyists and big business!

This is appalling as the people who gets the shaft are the ones the spirit of the bill is to assist, the American people, not some insurance company owned by foreigners.
 

Redwyvre

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This will be getting more interesting as time goes on. Re: Keeping the kids on the parents company insurance policy until they reach age 25. My insurance agent told me she is seeing an uptick in folks coming to her saying the company is now only going to cover the employee. Everyone else in the family will have to have seperate insurance. Re: Forcing insurance companies to cover everyone and anyone makes about as much sense as forcing folks who are broke to buy health insurance policy. I think the problem comes down the entire concept of health insurance doesn't make sense. Life insurance makes sense. Car insurance makes sense. Property insurance makes sense. Health insurance from a moral and financial perspective is whacked. I'm pretty sure this will become more apparent as time goes on.
 

dude_007

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Yes, you have the Washington lobby machine to thank for the mess with Health Reform. Too many organizations profiting on the current system are funding leaders in our government and pointing the finger elsewhere.
 

Frnkd213

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Don't get me wrong I'm all for health care reform. I'm from a state where employers provide health care insurance by law to full time employees and partial to part time(20+hr) How much the employee pays is part of a package that is offered to the employee.

Unionized employees have negotiated 100% employer paid plans but with the economy many employees are now being asked to pay at least 10-20%. the private sector employers usually pay 80 % any way. So unionized establishments including the state and city is starting to share the cost. If the employee opts to purchase a family plan, health care reform has enabled the parent to continue coverage till the child is 25, prior to this only if the child was attending a post high school program(college, voc school) could continue to be covered with no difference in premiums. Otherwise when the child graduated coverage ended. There is no mandated that all residence of the state has to have insurance or face a fine. As in the health care reform bill.

Because insurance cannot drop peoples coverage because of illness it was news to hear this kind of practice in the majority of states. Also in order to offer insurance the company must abide by this stipulation of coverage fo individual, spouse, or family. Interestingly enough how many kid you have makes no difference. A one child family pays as much for the family plan as one with 11 kids. Guess it balances out in the end.

It was actually disheartening to hear that the model was Massachusetts. In particular the mandated coverage.

I'm still wondering what was the republicans demands in the final bill. I'm sure theirs had all kind of profit making loopholes and stipulations for the insurance company.
 
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BF2K

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Healthcare in the US is completely broken!! I have diabetes since three year, not my choice, paid insurance since I was a kid. Insurance should be linked to the person NOT the job - in the US if you lose your job your lose your insurance. However, this should not be managed by the US govt. only waste and corruption would occur in this plan. Tell insurance companies that they need to cover ANYONE with a minimal care and not make a profit from it - they can make profits for additional care paid by their employer.
 

Klingsor

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Healthcare in the US is completely broken!! I have diabetes since three year, not my choice, paid insurance since I was a kid. Insurance should be linked to the person NOT the job - in the US if you lose your job your lose your insurance. However, this should not be managed by the US govt. only waste and corruption would occur in this plan. Tell insurance companies that they need to cover ANYONE with a minimal care and not make a profit from it - they can make profits for additional care paid by their employer.

So health insurance shouldn't be linked to your job . . . but additional care should be paid for by your employer? :confused:
 

OhWiseOne

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Insurance is not a perfect world. But don't tell me I have to buy insurance or I will be fined. You can put that where the sun don't shine. When gov. starts to regulate anything it is done in a manner to benefit the people pulling the political strings.

Just a note my employer only pays the employees insurance and if you have family members you foot the bill. Let me say it's not pretty.

Maybe it would be more affordable if the medical field got thier costs in line and we put a limit on lawsuits which is a huge portion of insurance costs. Deal with the root causes.
 

Industrialsize

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Insurance is not a perfect world. But don't tell me I have to buy insurance or I will be fined. You can put that where the sun don't shine. When gov. starts to regulate anything it is done in a manner to benefit the people pulling the political strings.

Just a note my employer only pays the employees insurance and if you have family members you foot the bill. Let me say it's not pretty.

Maybe it would be more affordable if the medical field got thier costs in line and we put a limit on lawsuits which is a huge portion of insurance costs. Deal with the root causes.
Fact check:
That’s wildly exaggerated. According to the actuarial consulting firm Towers Perrin, medical malpractice tort costs were $30.4 billion in 2007, the last year for which data are available. We have a more than a $2 trillion health care system. That puts litigation costs and malpractice insurance at 1 to 1.5 percent of total medical costs. That’s a rounding error. Liability isn’t even the tail on the cost dog. It’s the hair on the end of the tail.

Would Tort Reform Lower Costs? - NYTimes.com
 

dandelion

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Perhaps, but you also need to consider all the defensive medicine which may take place to prevant any risk of litigation. If every doctor carries out extra tests to cover himself from being sued, that could amount to an awful lot more than the payouts.
 

Industrialsize

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Perhaps, but you also need to consider all the defensive medicine which may take place to prevant any risk of litigation. If every doctor carries out extra tests to cover himself from being sued, that could amount to an awful lot more than the payouts.
How about some facts instead of supposition:
Costs Of Defensive Medicine May Be Overstated


Costs Of Defensive Medicine May Be Overstated : Shots - Health Blog : NPR

[FONT=Arial, Helvetica]And on Jan. 8, 2004 , the Congressional Budget Office also said the Kessler-McClellan study wasn’t a valid basis for projecting total costs of defensive medicine.[/FONT]
[FONT=Times New Roman, Times]CBO: When CBO applied the methods used in the study of Medicare patients hospitalized for two types of heart disease to a broader set of ailments, it found no evidence that restrictions on tort liability reduce medical spending. Moreover, using a different set of data, CBO found no statistically significant difference in per capita health care spending between states with and without limits on malpractice torts.
[/FONT]
[FONT=Times New Roman, Times][/FONT]
FactCheck.org: President Uses Dubious Statistics on Costs of Malpractice Lawsuits
 

OhWiseOne

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Perhaps, but you also need to consider all the defensive medicine which may take place to prevant any risk of litigation. If every doctor carries out extra tests to cover himself from being sued, that could amount to an awful lot more than the payouts.


I forgot about that portion generated by the fear of doctors being sued. Good point.
 

Klingsor

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How about some facts instead of supposition:
Costs Of Defensive Medicine May Be Overstated


Costs Of Defensive Medicine May Be Overstated : Shots - Health Blog : NPR

[FONT=Arial, Helvetica]And on Jan. 8, 2004 , the Congressional Budget Office also said the Kessler-McClellan study wasn’t a valid basis for projecting total costs of defensive medicine.[/FONT]
[FONT=Times New Roman, Times]CBO: When CBO applied the methods used in the study of Medicare patients hospitalized for two types of heart disease to a broader set of ailments, it found no evidence that restrictions on tort liability reduce medical spending. Moreover, using a different set of data, CBO found no statistically significant difference in per capita health care spending between states with and without limits on malpractice torts.
[/FONT]
[FONT=Times New Roman, Times][/FONT]
FactCheck.org: President Uses Dubious Statistics on Costs of Malpractice Lawsuits

One other element to take into account: the higher insurance premiums doctors have to pay to offset their risk of liability--charges which get passed on to the consumer, whether or not an actual lawsuit is ever filed.
 

Industrialsize

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One other element to take into account: the higher insurance premiums doctors have to pay to offset their risk of liability--charges which get passed on to the consumer, whether or not an actual lawsuit is ever filed.
New Study Finds Medical Malpractice Insurance Premiums have Minimal Effect on Health Care Costs


Americans for Insurance Reform, a coalition made up of Consumer Federation of America, ConsumerWatchdog.org and nearly 100 other public interest organizations, released a major study Wednesday on the state of the medical malpractice insurance industry. It found that insurance rates for doctors have dropped significantly while the medical malpractice insurers are earning record profits. The conclusion is that the cost of medical malpractice insurance is not crippling doctors and that large profits are going to the insurance industry.
Specifically, the study found, adjusting for inflation, that:

  • Medical malpractice premiums are nearly the lowest they have been in 30 years.
  • Medical malpractice claims are down 45 percent since 2000.
  • Medical malpractice insurer profits are higher than the rest of the property casualty industry, which has been very profitable over the last five years.
  • In states that have substantially limited consumers’ ability to go to court for medical malpractice, the insurance premiums for doctors are basically the same as in other states.
New Study Finds Medical Malpractice Insurance Premiums have Minimal Effect on Health Care Costs


Malpractice-insurance premiums and liability awards account for less than 2 percent of overall health-care spending, according to a 2004 study by the Congressional Budget Office. Defensive medicine, the practice of ordering extra tests or procedures to protect against lawsuits, might add another few percentage points, according to some estimates.

http://www.consumerreports.org/heal...for-high-costs/health-care-security-costs.htm
 
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snakembl14

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Eliminate some of the overhead. Why is medical so different from other insurances? Insurance is to protect yourself from unexpected events.

Home Insurance: fire, storm (hopefully never happens)Life insurance: early death (hopefully doesn't happen, but would happen only once)Medical insurance: Every time I go to the doctor, including regular check ups/phsicals.

Why don't I get health insurance for say, medical procedures that cost more than $5,000? Or $1,000? (I don't know quite what that $$ would be) I would then pay/negiotiate my other costs (phsicals/check ups) with my doctor and pay him directly. After my check up, the doc sends paper to the insurance co, they enter it, decide what and what isn't covered, the doc wants to get paid so I pay him, then finally the insurance co sends a check to the doc for what is covered, then the doc has to send me a check. WTF! Health insurance should only be for the bigger/unexpected events + long or life diseases.
 

Klingsor

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New Study Finds Medical Malpractice Insurance Premiums have Minimal Effect on Health Care Costs


Americans for Insurance Reform, a coalition made up of Consumer Federation of America, ConsumerWatchdog.org and nearly 100 other public interest organizations, released a major study Wednesday on the state of the medical malpractice insurance industry. It found that insurance rates for doctors have dropped significantly while the medical malpractice insurers are earning record profits. The conclusion is that the cost of medical malpractice insurance is not crippling doctors and that large profits are going to the insurance industry.
Specifically, the study found, adjusting for inflation, that:

  • Medical malpractice premiums are nearly the lowest they have been in 30 years.
  • Medical malpractice claims are down 45 percent since 2000.
  • Medical malpractice insurer profits are higher than the rest of the property casualty industry, which has been very profitable over the last five years.
  • In states that have substantially limited consumers’ ability to go to court for medical malpractice, the insurance premiums for doctors are basically the same as in other states.
New Study Finds Medical Malpractice Insurance Premiums have Minimal Effect on Health Care Costs


Malpractice-insurance premiums and liability awards account for less than 2 percent of overall health-care spending, according to a 2004 study by the Congressional Budget Office. Defensive medicine, the practice of ordering extra tests or procedures to protect against lawsuits, might add another few percentage points, according to some estimates.

Health-care security, who is to blame for high costs

Since you've clearly devoted some thought and research to healthcare, I'm curious about where you stand on the issue as a whole (forgive me for being too lazy to hunt for it in other threads).

What, if anything, do you think needs to be done about healthcare in the U.S.?
 
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D_JuanAFock

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There needs to be an alternative to the patent system for drugs. 20 years for a new drug is ridiculous. I am diabetic and use Humalog and Lantus, both of which are patented until 2013 or 2014, which means they cost $150 a bottle. Once the generic versions are out that will drop to like $40.

Also, insurance costs for people like me are unreasonably high (partly because drug costs are so high)... it would cost me $550/month to be insured from the state (I have yet to find a private plan that can accept me).

Aside from the fact that I am diabetic, I am 100% healthy, and have been my entire life.
 

Industrialsize

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Since you've clearly devoted some thought and research to healthcare, I'm curious about where you stand on the issue as whole (forgive me for being too lazy to hunt for it in other threads).

What, if anything, do you think needs to be done about healthcare in the U.S.?
I am 100% behind a nationalized, single payer health care system. Medicare for all.