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View Full Version : Obama HC Question for Liberals....


MarcBulger
01-29-2010, 08:13 PM
Dems have indicated that there HC bill will:
1. Cover another 30-40 million more people.
2. Make Insurance Companies Insure all no matter what their current health situation is.
3. Add benefits to Insurance Plans.
4. Will not make your premiums will go up.
5. Will not make your taxes will not go up.
6. Will be Deficiet Nuetral...

Do you honestly believe this?

MarcBulger
01-31-2010, 06:33 AM
I thought It was a pretty easy question....

Saul Good
01-31-2010, 07:07 AM
I think you got your answer.

RedNeckRaider
01-31-2010, 07:42 AM
I think you got your answer.

Oh give them time thet will spin up an answer~

mlyonsd
01-31-2010, 07:51 AM
Oh give them time thet will spin up an answer~

It would appear this week it's "all the republican's fault".

AndChiefs
01-31-2010, 09:33 AM
I'm not a liberal....but the main problem is the way the system is set up. Currently doctor's and hospitals are paid "fee-for-service" so they are incentivized to perform as many operations as possible on each payment to get their maximum payment. There needs to be some sort of independent panel that can determine what an average person in a municipality needs in a year and then reimburses hospitals based on those numbers. That way the hospitals are incentivized to do more preventative care and be more proactive in their treatment. Getting away from the fee-for-service would not only lower costs but raise overall health.

Mile High Mania
01-31-2010, 09:54 AM
I'm not a liberal....but the main problem is the way the system is set up. Currently doctor's and hospitals are paid "fee-for-service" so they are incentivized to perform as many operations as possible on each payment to get their maximum payment. There needs to be some sort of independent panel that can determine what an average person in a municipality needs in a year and then reimburses hospitals based on those numbers. That way the hospitals are incentivized to do more preventative care and be more proactive in their treatment. Getting away from the fee-for-service would not only lower costs but raise overall health.

Huh? How is a panel going to be able to determine within any sort of reason what a certain group of people will need in a year?

Who would be the target people for this panel and how would anyone know they were best suited to make this sort of judgement? This is just more big government and red tape BS.

AndChiefs
01-31-2010, 10:13 AM
Huh? How is a panel going to be able to determine within any sort of reason what a certain group of people will need in a year?

Who would be the target people for this panel and how would anyone know they were best suited to make this sort of judgement? This is just more big government and red tape BS.

First of all...it wouldn't be government. It would be an independent panel of experts in the field. Insurance companies already have guesstimates on how much an average 26-year old, non-smoker with no pre-existing conditions will cost in a year...it wouldn't be overly difficult to determine these rates.

The fee-for-service system is especially bad for raising rates due to the fact that government insurance programs re-pay for pennies on the dollar (depending on the program, but all below 1 to 1) for services provided. Therefore, doctors perform all these frivolous tests to ensure that they get paid. However, the hospital itself takes a loss on these tests and charges more to the privately insured to make up the difference. In one non-profit hospital I know this is about $1.56/$1 for services provided. The fee-for-service program combined with high malpractice costs is one of the main problems behind increasing health care costs.

Saul Good
01-31-2010, 10:16 AM
I'm not a liberal....but the main problem is the way the system is set up. Currently doctor's and hospitals are paid "fee-for-service" so they are incentivized to perform as many operations as possible on each payment to get their maximum payment. There needs to be some sort of independent panel that can determine what an average person in a municipality needs in a year and then reimburses hospitals based on those numbers. That way the hospitals are incentivized to do more preventative care and be more proactive in their treatment. Getting away from the fee-for-service would not only lower costs but raise overall health.

In many cases, preventative services are much more expensive than treating the actual condition. If a preventative service costs $100 while treating the condition would cost $10,000, that's not a good financial move if the condition only afflicts 1 person out of a thousand.

Taco John
01-31-2010, 10:25 AM
I'm not a liberal....but the main problem is the way the system is set up. Currently doctor's and hospitals are paid "fee-for-service" so they are incentivized to perform as many operations as possible on each payment to get their maximum payment. There needs to be some sort of independent panel that can determine what an average person in a municipality needs in a year and then reimburses hospitals based on those numbers. That way the hospitals are incentivized to do more preventative care and be more proactive in their treatment. Getting away from the fee-for-service would not only lower costs but raise overall health.


Hmmm... People who decide who gets to live, and who gets to die. And what would you call such a panel?

mlyonsd
01-31-2010, 10:27 AM
Hmmm... People who decide who gets to live, and who gets to die. And what would you call such a panel?Now you did it.

Saul Good
01-31-2010, 10:27 AM
Hmmm... People who decide who gets to live, and who gets to die. And what would you call such a panel?

A life panel?

Taco John
01-31-2010, 10:27 AM
First of all...it wouldn't be government. It would be an independent panel of experts in the field. Insurance companies already have guesstimates on how much an average 26-year old, non-smoker with no pre-existing conditions will cost in a year...it wouldn't be overly difficult to determine these rates.

The fee-for-service system is especially bad for raising rates due to the fact that government insurance programs re-pay for pennies on the dollar (depending on the program, but all below 1 to 1) for services provided. Therefore, doctors perform all these frivolous tests to ensure that they get paid. However, the hospital itself takes a loss on these tests and charges more to the privately insured to make up the difference. In one non-profit hospital I know this is about $1.56/$1 for services provided. The fee-for-service program combined with high malpractice costs is one of the main problems behind increasing health care costs.


Sounds like too much government involvement, and too little government follow-through on obligation is the problem here, doesn't it?

Saul Good
01-31-2010, 10:27 AM
A pro choice panel?

MarcBulger
01-31-2010, 10:41 AM
Where are the "yes" or "no" answers?

AndChiefs
01-31-2010, 10:54 AM
In many cases, preventative services are much more expensive than treating the actual condition. If a preventative service costs $100 while treating the condition would cost $10,000, that's not a good financial move if the condition only afflicts 1 person out of a thousand.

I'm talking yearly physicals, nutritional programs...simple things that many people now avoid because they can't afford the co-pay or don't have insurance. Until...something that could've been detected early is now in the advanced phases (and most likely brought to the emergency room as a cost to the rest of us) and costs hundreds of thousands to treat at a lesser chance to cure.

You can't tell me that this would not be cheaper and better for overall health. We currently pay more than double anyone else in the world per capita for health care yet are ranked in the 40's in overall health. Does this not speak of some problems?

I'd like to recommend taking a look at Japan's health care system for anyone looking to do some research.

AndChiefs
01-31-2010, 10:55 AM
Hmmm... People who decide who gets to live, and who gets to die. And what would you call such a panel?

LOL. Yeah that's not what I said but way to make it sound like it. The word panel does not mean we're going around lopping people's heads off.

Taco John
01-31-2010, 10:55 AM
I'm talking yearly physicals, nutritional programs...simple things that many people now avoid because they can't afford the co-pay or don't have insurance. Until...something that could've been detected early is now in the advanced phases (and most likely brought to the emergency room as a cost to the rest of us) and costs hundreds of thousands to treat at a lesser chance to cure.

You can't tell me that this would not be cheaper and better for overall health. We currently pay more than double anyone else in the world per capita for health care yet are ranked in the 40's in overall health. Does this not speak of some problems?

I'd like to recommend taking a look at Japan's health care system for anyone looking to do some research.


Yeah, Japan doesn't have to fund a military. It's pretty easy to fund health care schemes when defense costs aren't a concern. Do you have any examples of successful health care systems where their national defense isn't being subsidized by American might?

AndChiefs
01-31-2010, 10:59 AM
Sounds like too much government involvement, and too little government follow-through on obligation is the problem here, doesn't it?

At least you finally hit on a sticking point rather than throwing out crap about death panels. The main problem with this system is the monitoring of the follow-through and I certainly don't claim to have all the answers.

However, one way to help on follow-through would be to make hospitals success rates on surgeries and care readily available and searchable on the internet. There, patients could make informed decisions on their treatment and hospitals would be incentivized to improve their overall care.

AndChiefs
01-31-2010, 11:01 AM
Yeah, Japan doesn't have to fund a military. It's pretty easy to fund health care schemes when defense costs aren't a concern. Do you have any examples of successful health care systems where their national defense isn't being subsidized by American might?

Yes it is pretty easy to fund something without a military. But is it easy to have an excellent health care system that costs monumentally less than American health care?

How much they spend on military has absolutely nothing to do with how effective a country's health care system is. Frankly, I'm insulted that you would even allude to such a ridiculous argument as this.

Mile High Mania
01-31-2010, 11:02 AM
First of all...it wouldn't be government. It would be an independent panel of experts in the field. Insurance companies already have guesstimates on how much an average 26-year old, non-smoker with no pre-existing conditions will cost in a year...it wouldn't be overly difficult to determine these rates.


So, doctors? Are you suggesting an independent panel ... determine rates on the guesstimates provided by the insurance companies?

Would that just make it a panel, sans the independent part? It would not be a part of government? Ok, so who would they answer to? Who is paying them?

AndChiefs
01-31-2010, 11:03 AM
Also, I see a lot of trying to tear apart my points without having any ideas from your side. I'd be willing to listen to your arguments on what should be done.

I don't claim to have all the answers and I'm surely not an authority on health care but I'm at least trying to put some real ideas out there.

Mile High Mania
01-31-2010, 11:03 AM
LOL. Yeah that's not what I said but way to make it sound like it. The word panel does not mean we're going around lopping people's heads off.

No, but you're talking about a rationing of services... are you not? Improving the HC system shouldn't include a rationing of services.

patteeu
01-31-2010, 11:04 AM
Where are the "yes" or "no" answers?

Where are the answers period?

patteeu
01-31-2010, 11:04 AM
In many cases, preventative services are much more expensive than treating the actual condition. If a preventative service costs $100 while treating the condition would cost $10,000, that's not a good financial move if the condition only afflicts 1 person out of a thousand.

Hear, hear!

Mile High Mania
01-31-2010, 11:06 AM
Also, I see a lot of trying to tear apart my points without having any ideas from your side. I'd be willing to listen to your arguments on what should be done.

I don't claim to have all the answers and I'm surely not an authority on health care but I'm at least trying to put some real ideas out there.

That's what happens when you throw something out there.... if I had the answers, I wouldn't be killing time on CP.

AndChiefs
01-31-2010, 11:06 AM
So, doctors? Are you suggesting an independent panel ... determine rates on the guesstimates provided by the insurance companies?

Would that just make it a panel, sans the independent part? It would not be a part of government? Ok, so who would they answer to? Who is paying them?

I'd prefer medical doctors that know what really is the best treatments for patients in certain situations yes...though I'd think you'd want some professorial types, insurance I suppose would have to be represented....and than a couple normal people who could call them on BS.

And who pays for independent panels right now? It's not like its a novel idea.

AndChiefs
01-31-2010, 11:13 AM
No, but you're talking about a rationing of services... are you not? Improving the HC system shouldn't include a rationing of services.

At some point there should be a logical cut-off point. If I have massive brain damage but can live on machines for 60 years without ever having a conscious thought then frankly you should let me die. And I would expect you to.

However, the real thought behind what I suggest is incentivizing preventative services that are proven to reduce long-term health issues (and costs) in order to rein in some of the spending. I'm not saying they should ration services but they should use rational thought before determining what services need to be provided.

The current system allows doctors to be paid every time they prescribe certain drugs (from the drug's makers) so they prescribe these newer drugs when an older drug that is 100x cheaper would have done the same job. There's plenty of room for improvement but no one is willing to actually look at doing it.

Mile High Mania
01-31-2010, 11:15 AM
I'd prefer medical doctors that know what really is the best treatments for patients in certain situations yes...though I'd think you'd want some professorial types, insurance I suppose would have to be represented....and than a couple normal people who could call them on BS.

And who pays for independent panels right now? It's not like its a novel idea.

Sounds well thought out...

Mile High Mania
01-31-2010, 11:16 AM
At some point there should be a logical cut-off point. If I have massive brain damage but can live on machines for 60 years without ever having a conscious thought then frankly you should let me die. And I would expect you to.

However, the real thought behind what I suggest is incentivizing preventative services that are proven to reduce long-term health issues (and costs) in order to rein in some of the spending. I'm not saying they should ration services but they should use rational thought before determining what services need to be provided.

The current system allows doctors to be paid every time they prescribe certain drugs (from the drug's makers) so they prescribe these newer drugs when an older drug that is 100x cheaper would have done the same job. There's plenty of room for improvement but no one is willing to actually look at doing it.

I think you should let the individual and/or the family (through their own decisions whether spoken or via will, trust, etc) determine when the plug will be pulled.

There is a lot to fix... rationing services and telling me when I should do something about my health isn't any of your concern.

AndChiefs
01-31-2010, 11:17 AM
Sounds well thought out...

Heh, I didn't realize I was claiming a 100% ready plan ready to be thrown out to the American public tomorrow.

AndChiefs
01-31-2010, 11:20 AM
I think you should let the individual and/or the family (through their own decisions whether spoken or via will, trust, etc) determine when the plug will be pulled.

I respect that....I really do.

Perhaps some system where you're required to answer end-of-life questions like this for a file? Hardly anyone will have answered this on their own and frankly, I doubt if anyone would know I would want the plug pulled myself. Too often, even if the person was express in life that they would want it pulled families still hold on when there is no hope.

Mile High Mania
01-31-2010, 11:21 AM
I'm not suggesting that a 100% GOP route is the way to go, but there are a number of things here that sound good.

http://gopleader.gov/UploadedFiles/Summary_of_Republican_Alternative_Health_Care_plan_Updated_11-04-09.pdf

Mile High Mania
01-31-2010, 11:24 AM
I respect that....I really do.

Perhaps some system where you're required to answer end-of-life questions like this for a file? Hardly anyone will have answered this on their own and frankly, I doubt if anyone would know I would want the plug pulled myself. Too often, even if the person was express in life that they would want it pulled families still hold on when there is no hope.

Tough one... how can you force someone to make an end of life decision? And, WHEN would you ask them to make that decision... when and how often can they change their stance? My thoughts at the age of 20 were different than they are now.

I would like to think that everyone would do that on their own, but that would never happen.

My wife and I put together our trust/estate plans after we had our kids... I think a lot of people look at this stuff from the perspective of "I'm no Donald Trump, I don't need it."

But, we have accounted for everything... just in case one or both of us dies before the kids are 18 and there are contingency cases as to where they go based on a number of factors. Insurance, savings, 401ks, etc... it's all accounted for and if either one of us is in that "do we or don't we pull the plug" situation, well it's clearly stated what happens.

I think it's wise for everyone to do this...

AndChiefs
01-31-2010, 11:26 AM
I'm not suggesting that a 100% GOP route is the way to go, but there are a number of things here that sound good.

http://gopleader.gov/UploadedFiles/Summary_of_Republican_Alternative_Health_Care_plan_Updated_11-04-09.pdf

I agree with several of these.

1. Ending Junk Lawsuits. (I've already alluded to this)
2. Prevent insurers from cancelling policies unjustly.
3. Pooling small business health care.
4. Buying across state lines.
5. Promoting healthier lifestyles (I've already alluded to this)
6. I do like HSA's.

7. And I could see letting children stay on until 25.

AndChiefs
01-31-2010, 11:28 AM
Tough one... how can you force someone to make an end of life decision? I would like to think that everyone would do that on their own, but that would never happen.

My wife and I put together our trust/estate plans after we had our kids... I think a lot of people look at this stuff from the perspective of "I'm no Donald Trump, I don't need it."

But, we have accounted for everything... just in case one or both of us dies before the kids are 18 and there are contingency cases as to where they go based on a number of factors. Insurance, savings, 401ks, etc... it's all accounted for and if either one of us is in that "do we or don't we pull the plug" situation, well it's clearly stated what happens.

I think it's wise for everyone to do this...

And that's the problem...people aren't willing to plan it out the way you have. Should it be done? Yes. But it's not getting done.

Saul Good
01-31-2010, 11:30 AM
Heh, I didn't realize I was claiming a 100% ready plan ready to be thrown out to the American public tomorrow.

I've got a plan of my own that's in a similar stage as yours. Obviously, there are a couple of minor details that need to be worked out, but overall it's pretty solid:


Health care should be better, cheaper, and everyone should have it.

AndChiefs
01-31-2010, 11:36 AM
I've got a plan of my own that's in a similar stage as yours. Obviously, there are a couple of minor details that need to be worked out, but overall it's pretty solid:


Health care should be better, cheaper, and everyone should have it.

I'd love to hear it.

Also, this brings up another sticking point and problem with any plan out there nowadays. Shortage of doctors. Covering everyone in the US would understandably cause more traffic into doctor's offices. And if you've been in a doctor's office recently you know that every one of them seems like a madhouse with people waiting around for their appointment (partly the cause of the doctor scheduling poorly). You put 40-50 million more people in those doctor's offices and try to provide the care they need.

Unfortunately, this is not a quick or easy problem to fix. We can't just import doctors. We need to find ways to make being a doctor "sexy" again for kids deciding what to do with their lives. The 10 years of school just doesn't seem worth it to the best and brightest anymore.

WilliamTheIrish
01-31-2010, 11:54 AM
In many cases, preventative services are much more expensive than treating the actual condition. If a preventative service costs $100 while treating the condition would cost $10,000, that's not a good financial move if the condition only afflicts 1 person out of a thousand.

Can anybody name a condition that gets $100 of preventative treatment per person, where the possible costs of curative treatment is 10k ( less/more) and it affects 1 person in 1,000 (or thereabouts)?

Mammography most likely. But that will never stop as it's now rooted in the conscious of every American that every woman is going to lose her cans to a tumor. But the statistics have been used in very odd ways: 1 in 8 women will deal with an invasive breast BCa in their lifetime.

In their lifetime? It's rare before the age of 35. It's rarer after the age of 65. It's rarer still after 70. 40k die per year from some type of invasive breast cancer. 40k divided by the number of women = way rare.

Same with prostate cancer. Although the ol' finger sweep isn't as fun as getting your tits squeezed by two plastic molds with the force to flatten a marble, from two angles, it is less expensive.

mlyonsd
01-31-2010, 12:03 PM
Same with prostate cancer. Although the ol' finger sweep isn't as fun as getting your tits squeezed by two plastic molds with the force to flatten a marble, from two angles, it is less expensive.

I'm getting to the age the ol' finger sweep will become a common event in my annual checkup.

I found out last night from a friend who works at our local clinic that my general practitioner wears size 17 shoes. Time to get a different doctor.

Oh, and now that I've had knee surgery had received the first bill in the mail I'm all for free government health care now.

Saul Good
01-31-2010, 12:03 PM
I'd love to hear it.


You just did.

WilliamTheIrish
01-31-2010, 12:12 PM
I'm getting to the age the ol' finger sweep will become a common event in my annual checkup.

I found out last night from a friend who works at our local clinic that my general practitioner wears size 17 shoes. Time to get a different doctor.

Oh, and now that I've had knee surgery had received the first bill in the mail I'm all for free government health care now.

I just spilled my coffee. LMAO

AndChiefs
01-31-2010, 12:19 PM
I just spilled my coffee. LMAO

LOL...I missed that at first look. Thanks for pointing that out.

Taco John
01-31-2010, 01:16 PM
Yes it is pretty easy to fund something without a military. But is it easy to have an excellent health care system that costs monumentally less than American health care?

How much they spend on military has absolutely nothing to do with how effective a country's health care system is. Frankly, I'm insulted that you would even allude to such a ridiculous argument as this.

Your grasp of economics, then, could be fit into this circle: o

You have no business talking about solutions. You are clearly just blowing hot air.

Taco John
01-31-2010, 01:19 PM
Also, I see a lot of trying to tear apart my points without having any ideas from your side. I'd be willing to listen to your arguments on what should be done.

I don't claim to have all the answers and I'm surely not an authority on health care but I'm at least trying to put some real ideas out there.


Reduce government involvement, and thus waste in our healthcare system, and allow the market to function.