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Author Topic: ObamaCare? You say Why Not? I ask, "Why?"  (Read 3410 times)

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Offline RubySlippers

Re: ObamaCare? You say Why Not? I ask, "Why?"
« Reply #25 on: August 20, 2009, 02:50:03 PM »
The health care model being worked opn looks alot like Switzerland the insurance and providers essentially not for profit with government mandates on basic care. Extras however would be possible as supplemental policies I suspect.

In that country the providers and insurance are private but the government sets demands that cost be fixed at some level and everyone be covered, the needy though the government covers.

In any case I would still argue the weak link is not using the global free market no other nation has even tapped that and making lawsuits nearly impossible unless there was GROSS negligence, as opposed to a possible side effect of a drug that is known. A review by a mediation panel or something could handle that.

Offline Callie Del Noire

Re: ObamaCare? You say Why Not? I ask, "Why?"
« Reply #26 on: August 20, 2009, 02:56:11 PM »
Usually I hear Canada... some proposals involve subsidized mandated insurance (like France), but I'm not sure which Scandinavian country we're being compared to - no one is proposing that the government actually run the hospitals, for example.

Mostly I just worry that we are going in with faulty info because someone (and yes, the someone's I'm pointing at are Democrat this time) are doing it to do it.. not to do it RIGHT.

And what I've read is way beyond my understanding (Beuracrat (sp?_) isn't my favorite form of english.. makes my head hurt.. and I have already got enough problems with reading stuff for my OWN tricare policy)

Offline BayushiTopic starter

Re: ObamaCare? You say Why Not? I ask, "Why?"
« Reply #27 on: August 20, 2009, 03:19:05 PM »
And what I've read is way beyond my understanding (Beuracrat (sp?_) isn't my favorite form of english.. makes my head hurt.. and I have already got enough problems with reading stuff for my OWN tricare policy)

Indeed. That, apparently, is a part of the problem.

Quote
IN the summerís debate over health care reform, weíve been told a lot about private payers, the public option, cooperatives, exchanges and fee-for-service arrangements. What we havenít yet addressed is the need for consumers to be able to read and understand the provisions of their own health insurance policies.

From the New York Times Opinion article, English is the Best Policy

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Re: ObamaCare? You say Why Not? I ask, "Why?"
« Reply #28 on: August 20, 2009, 08:00:40 PM »
     I still think the largest, single problem is that US costs are grossly inflated.  Increase competition, encourage prevention.  Reduce the overall costs and redistribute some of the savings.  Do that, and many of the other complaints will diminish.  Or do not do it, and we will continue to have some of the worst health stats of the developed world at the highest cost.  Not great for that economy and deficit, either.  Two cents on some of this thread:

I wish they would use competition and I mean GLOBAL competition. If we can simply take patients where treatment can be put off for a few weeks and planned send these people to the best medical tourism centers around the world.
     While we are stuck with systems that make domestic procedures and overhead much greater than the same plus airfare abroad, I think this makes sense for at least some cases.  I've heard that major dentistry, for example, is a fairly common impetus for foreign travel.

One thing I've noticed about the examples in europe are areas of smaller populations, less diverse ethnicities. I don't want to come off as racist folks, but different ethnic groups have a much different medical profiles.
     I think you're right that it's possible to find different profiles.  However, only 10% or so currently hold no insurance.  If some others who can afford to pay somewhat pay the national option on a sliding scale, and assuming competition and efficiency gains reduce overall costs for most people, there could still be savings to cover for ethnic differences.   

     We also have to consider the economic costs of not providing a more affordable option to people in higher-risk profiles.  It is partly an issue of mobility and job opportunities (one reason so many Dollar Meals are consumed), education and other social services.  However, not covering that demographic helps to drain money from the state in other ways: Lower productivity, lower quality work, lower sense of worth and increased chance of violence...  And keeping health care beyond the reach of those in these groups who want it, tends to perpetuate the situation where they are at higher risk while their percentage of the population grows.  Last but not least, you could disagree that all of the preceding two paragraphs are monetarily worth the cost of health care for at-risk minorities.  In that case, and even if the population of besieged minorities were perpetually expendable/"renewable" through births and migration (a risky proposition at best), we'd still be taking on huge moral exposure.

One problem I see with globalized health care is that some other countries do not have the same scrutiny applied to new drugs and treatments before they are made available to the public.  The FDA has certain regulations regarding what kind of trials can and should be done before a product can be determined as a safe and effective treatment... [snipped: about energy drinks]  Even then, there have been notable failures, even with all those regulations in place.
     The last sentence may undercut the rest.  As I understand, since the push for AZT, "fast-tracking" of pharmaceuticals has resulted in many ineffective or dangerous ones being granted approval.  Ruby also partly addressed foreign quality by noting that globalized care would require informed choice.  I still think that if the available options are prohibitively expensive (or just significantly inflated) care in the US or similarly or marginally riskier but affordable care abroad, especially for major procedures, the only thing standing between people's needs and the airplane would be 1) will we subsidize this at all and 2) state of the overall economy (who can or cannot  pay to get on the plane).

i want to see it done right..not done quick to make political payday for one group or another.
     How do you propose to achieve that, and get it done at all?  The Republicans shot the entire idea down for Clinton.  They've had plenty of time since to return to it.  If you don't want them to take the credit (although they have taken credit for freezing the status quo), and you don't want the Democrats to take the credit, is there another alternative? 
     Granted, we have a legislative system (among others) that suffers from lack of transparency.  The play of sound-bites usually don't do justice to the issue.  It may take patching down the road.  Our Constitution sometimes brings a world of trial and error (not to mention bad compromises).  All the same:  As much as I'd like to see some government soul-searching and better transparency, lots of suffering is happening over health care in the meantime.
« Last Edit: August 20, 2009, 08:04:08 PM by kylie »

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Re: ObamaCare? You say Why Not? I ask, "Why?"
« Reply #29 on: August 20, 2009, 08:26:09 PM »

     ... Australia, which is not only more ethnically diverse, it's a better system.

The reason why it works in other countries is due to a number of factors.

1) Prevention is cheaper than curing.
2) Healthy people are more productive.
3) Insurance companies provide no actual service except for providing as large a risk pool as possible, sharing the burden between them and taking a cut. "Everyone" is the largest possible risk pool.
4) Without a single payer system, hospitals have to absorb bankruptcy and insolvency costs - which are one of the main driving factors behind current health care costs.
5) The self employed are quite thoroughly fucked by the current system, and they're the ones who drive economic growth.

     I like this because it addresses where cost overruns are located in the system, and how health care is related to the rest of the economy. 

     Given the clout/intransigence of insurance company backers and apparent inability of leadership to sell anything more socialized than a public option, I've been rather hoping it would at least prove more step in the right direction than half-measure.

     However, it would be more ideal if we could implement a sustainable option that would cut costs further, and sooner rather than later.
   

Offline Vekseid

Re: ObamaCare? You say Why Not? I ask, "Why?"
« Reply #30 on: August 20, 2009, 10:43:47 PM »
Costs in the US are also driven by the underpayment of Medicare/Medicaid, health insurance overhead, and pharmaceutical advertising costs. There are some inefficiencies elsewhere, but they don't make up double-digit percentages like those do.

Offline Cold Heritage

Re: ObamaCare? You say Why Not? I ask, "Why?"
« Reply #31 on: August 21, 2009, 12:34:15 AM »
Canada's not a terribly good model. Our system's in some need of reform. It's not too bad, but I see far too many senior citizens paying hundreds of dollars every three months for medications that the healthcare system does not cover.

We need a lot of public education, too. People don't bother to enroll in our provincial healthcare program, and then expect special authorization for that healthcare program subsidize the cost of their drugs to be approved.

Offline Oniya

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Re: ObamaCare? You say Why Not? I ask, "Why?"
« Reply #32 on: August 21, 2009, 12:38:46 AM »
It's still an example of a large-scale health-care program, which the European models aren't.  One can always learn from the mistakes that have already been made.

Offline Callie Del Noire

Re: ObamaCare? You say Why Not? I ask, "Why?"
« Reply #33 on: August 21, 2009, 12:41:52 AM »
Two examples of why I'm worried about the 'Hurry up for glory' model of political capital making.

Brac 2: Yeah.. let's shut down a lot of bases without thinking about anything beyond the color of the state.

andd.. NAFTA.. 'It will only eliminate some low paying blue collar jobs'.

Offline Cold Heritage

Re: ObamaCare? You say Why Not? I ask, "Why?"
« Reply #34 on: August 21, 2009, 12:55:11 AM »
You did not get the poor end of the stick on NAFTA, guy. Seriously. You did not.

Offline Callie Del Noire

Re: ObamaCare? You say Why Not? I ask, "Why?"
« Reply #35 on: August 21, 2009, 01:00:42 AM »
You did not get the poor end of the stick on NAFTA, guy. Seriously. You did not.

Really? I suppose watching the textile industry in my home state dry up and blow away (to mexico) was just a random happenstance them.

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Re: ObamaCare? You say Why Not? I ask, "Why?"
« Reply #36 on: August 21, 2009, 06:06:12 AM »
It's still an example of a large-scale health-care program, which the European models aren't.  One can always learn from the mistakes that have already been made.
     While your point is valid, I think it has limited reach.  The British, French, and German populations are each around 1/5 to 1/4 the US size.  They are smaller, but I wouldn't exactly describe them as "small-scale."  While those are not precisely Switzerland, the principle that health care is a social good, with a sliding scale for premiums is generally consistent across Europe. ( http://economix.blogs.nytimes.com/2009/04/17/health-reform-without-a-public-plan-the-german-model/ ) I also wouldn't assume we would adopt the Swiss model with no tweaks whatsoever.

     Ultimately though, this concern boils down to saying we shouldn't try because it's too big and new.  However, we do have some "pilot" models in the Massachusetts, employer-based, and Medicare examples.  I also think the problem is important enough that we can't wait for a single, similarly populous country (who, Russia?) to perfect the deal before we make an effort.

   
« Last Edit: August 21, 2009, 06:11:30 AM by kylie »

Offline Zeitgeist

Re: ObamaCare? You say Why Not? I ask, "Why?"
« Reply #37 on: August 21, 2009, 07:24:27 AM »
Can we agree that people only disagree on the manner in which the reform should take place, and not that some kind of reform need take place? Personally I'm rather irritated by Obama trying to cast everyone who disagrees with his ideas as someone who thinks the status quo is fine. I don't know anyone who believes that, personally.

Offline Callie Del Noire

Re: ObamaCare? You say Why Not? I ask, "Why?"
« Reply #38 on: August 21, 2009, 08:37:18 AM »
Can we agree that people only disagree on the manner in which the reform should take place, and not that some kind of reform need take place? Personally I'm rather irritated by Obama trying to cast everyone who disagrees with his ideas as someone who thinks the status quo is fine. I don't know anyone who believes that, personally.

Yeah, that is quite true. Something needs to be done, but I am getting tired of hearing folks cast as being 'bad' because they disagree with the methods. Of course most of the dissenting folks I see cast in the media seem to be the 'loony faction'. LOL

I don't think the president is doing most of the casting in bad light actions. It seems more the media than  the President or his administration.

Offline Oniya

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Re: ObamaCare? You say Why Not? I ask, "Why?"
« Reply #39 on: August 21, 2009, 08:43:46 AM »
Can we agree that people only disagree on the manner in which the reform should take place, and not that some kind of reform need take place? Personally I'm rather irritated by Obama trying to cast everyone who disagrees with his ideas as someone who thinks the status quo is fine. I don't know anyone who believes that, personally.

Fully agreed.  I think some of my comments might have come across about 5 degrees off from the way I meant them, but a) we do need reform, b) we should be looking at aspects that address a large and very mixed population, and c) statements like 'COUNTRY$'s system is messed up with regards to X, Y, and Z,' should be followed with 'but if we change A, B, or C, we can fix that' instead of with 'so we have to completely discard COUNTRY$'s system as a possibility.'

Offline RubySlippers

Re: ObamaCare? You say Why Not? I ask, "Why?"
« Reply #40 on: August 21, 2009, 09:00:07 AM »
I simply would like to see two things in a health care reform:

1. Using the low cost foreign hospitals and might I add if we want to play it safe send people to SINGAPORE. The savings would still be half the US and they have under the WHO considerations the 6th best health care system in the world. And need foreign patients to pay for the health care system to help their people so will take our money. And as a government we can have a deal with their government over the costs maybe setting up an added savings. Then once the people here get used to the use of such medicine offer India and Thailand. BTW I would make this a choice for those not on Medicaid ,people getting a government handout are different, they should not get a choice in this if the system can save money. But in all cases I would require a family member or friend be offered a spot to go with them it wouldn't cost that much as I feel that is humane especially if a child is getting this care. And must I add these facilities would be on par with US standards they have ratings agencies for this that are very good.

2. If any party involved in medicine takes $1 of Federal money invoke soveriegn immunity on the care. make it very hard to sue for expected problems since all drugs have side effects, all treatments risks then why allow people to sue for those. If the FDA approved the drug application or treatment. Require disputes go to a administrative judge before going to trial at least.

Offline Oniya

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Re: ObamaCare? You say Why Not? I ask, "Why?"
« Reply #41 on: August 21, 2009, 09:18:11 AM »
I simply would like to see two things in a health care reform:

1. Using the low cost foreign hospitals and might I add if we want to play it safe send people to SINGAPORE. The savings would still be half the US and they have under the WHO considerations the 6th best health care system in the world. And need foreign patients to pay for the health care system to help their people so will take our money. And as a government we can have a deal with their government over the costs maybe setting up an added savings. Then once the people here get used to the use of such medicine offer India and Thailand. BTW I would make this a choice for those not on Medicaid ,people getting a government handout are different, they should not get a choice in this if the system can save money. But in all cases I would require a family member or friend be offered a spot to go with them it wouldn't cost that much as I feel that is humane especially if a child is getting this care. And must I add these facilities would be on par with US standards they have ratings agencies for this that are very good.

2. If any party involved in medicine takes $1 of Federal money invoke soveriegn immunity on the care. make it very hard to sue for expected problems since all drugs have side effects, all treatments risks then why allow people to sue for those. If the FDA approved the drug application or treatment. Require disputes go to a administrative judge before going to trial at least.

Just to make things clear, regarding point 1, I avoided specifying countries because I know that there are other regulatory agencies.  However, for every person willing to travel to a well-regulated, and even superior facility, there's a person willing to travel to some snake-oil salesman who promises a miracle cure.  Probably more, if Barnum was right.  On point 2, I have no illusions that the FDA is infallible.  I remember the poor kid that flew a plane into a building because of a bad reaction to acne meds.  I remember seeing all the heart-related issues that came up after the last wave of arthritis meds that came out.  There should be a recourse for people injured by severe side effects that were written off or failed to come to light during trials.

Offline Serephino

Re: ObamaCare? You say Why Not? I ask, "Why?"
« Reply #42 on: August 21, 2009, 08:37:24 PM »
I agree that frivilous lawsuits have contributed to the problem.  However, I don't think immunity from lawsuits should ever happen.  Maybe instead of making it impossible, make it so lawsuits could only move forward if the doctor or drug company really did screw up.

The reason I say this is doctors do screw up.  There is a dirty underside to drug companies that I think needs to be cleaned up.  Drug companies push new drugs.  They lie on the research, and then offer incentives to doctors to prescribe there brand new wonder-drug instead of something else that would work better with fewer side effects.  I swear when I go to the doctor the clip boards and stuff have drug logos on them.  They could save a lot of money by cutting that shit out.

There are also advertisements for drugs.  People see them and realize they have some of those symptoms.  They rush to the doctor and demand that advertised drug.  A good doctor will decide if they really need it, and tell them no if they don't.  But there are doctors who just pull out their prescription pad whenever someone self diagnoses from a TV ad.

A good example comes from a friend of mine.  She was having issues with PMDD.  When she went to the doctor she was prescribed the birth control pill Yaz, the very one that I've seen ads for class-action lawsuits against. 

While helping her to do research on this pill I made a few discoveries.  For one, a doctor is supposed to perform a blood test to determine hormone levels to see if the pill would even be helpful.  My friend said the only test done on her was a pregnancy test.

Second, because of the potentially harmful increase of potassium, another blood test is supposed to be done after a month.  Her doctor wanted to see her in three months, and somehow I doubt any tests would've been done then either.  She has insurance, so that wasn't the problem. 

While I saw stories of doctors handing out this pill properly and it really helping people, there were just as many horror stories of doctors not doing the recommended blood tests and prescribing it as regular birth control when in was never meant for that.  Those people had serious, and sometimes life-threatening side effects. 

So no, I don't think doctors or drug companies should be able to be immune from being held responsible for fuck-ups.   

Offline RubySlippers

Re: ObamaCare? You say Why Not? I ask, "Why?"
« Reply #43 on: August 22, 2009, 12:06:46 AM »
I never meant cmplete immunity just if a drug was properly administered and there were Expected side effects that are known no lawsuits. And if a doctor screwed up then go before an adminstrative officer panel, prove serious imcompetence and then if they approve proceed with a lawsuit. Just add layers of protection in there. But I would remove the FDA for neutral labs like the Consumer Reports sort of group that would ok drugs.

As for foreign medical facilities like I wished to pioint out we could start with the nation of Singapore they need foreign patiants, charge around 40% what a US hospital would and less if our government cuts a deal and has the 6th best health care system in the world. [World Health Organization Standing] We can start there. And if a person is in need of expensive care its an option. I would require Medicaid patiants at least adults go there and make if a option that all insurers should offer. Then after we get more planning it use other facilities. Singapore would set the bar of the standards we would demand in any facility.

Offline BayushiTopic starter

Re: ObamaCare? You say Why Not? I ask, "Why?"
« Reply #44 on: August 22, 2009, 03:47:14 PM »
And if a person is in need of expensive care its an option. I would require Medicaid patiants at least adults go there and make if a option that all insurers should offer. Then after we get more planning it use other facilities. Singapore would set the bar of the standards we would demand in any facility.

As a recipient of Federal Medicaid insurance, I'd be happy to go to Singapore for 'expensive' procedures.

Hell, get my problem or other taken care of with some nice travel to an attractive foreign location? A city with a ton of cute Chinese and Malaysian women?

Yes please!

The only thing I see stopping such an idea, Ruby, is our very own bureaucracy and various unions. The unions want their members to be paid so they can extract dues. The bureaucracy is in bed with the unions, and wants control over things.

We need tort reform. Soon. But I know it won't happen, as Congress is loaded with lawyers, some of whom(John Kerry) make/made their living suing doctors. Conflict of Interest is a problem right now, and there really isn't a way around it.

Interstate Insurance regulations need to be relaxed or repealed, to allow insurance corporations to provide services in multiple states/regions. Doing so would break monopolies in places, and/or just decrease prices while increasing services through the good old American way of doing business: Competition.

Problem is, there is no competition in most markets in the United States. The State of Oregon is almost completely dominated by Providence Health Services. From my recollection(which may be wrong, mind you), Kaiser-Permanente has a stranglehold on California and Washington States. The only real 'options' outside of those are Medicaid and Medicare... but those have limits.

So the government wants to fix the problem of too much regulation by adding MORE regulation? Umm....??!

Offline RubySlippers

Re: ObamaCare? You say Why Not? I ask, "Why?"
« Reply #45 on: August 22, 2009, 03:55:24 PM »
Oddly insurers would be the best ally do you realize how much they would save on Medicare and standard patiants sending the ones that can benefit abroad? My insurer paid for me to go to Thailand then the government of my state banned that but if they did not I would never have gotten that procedure. The co-pay at 15% would have been to much. 15% of $14,000 (all costs included) was better than 15% of $80,000 (estimated). And I had awesome care and my mother traveled with me and stayed in my suite at the hospital and they paid for her to come along. There is no good reason not to look at this.

I just want to see choice, real competition and for me that must be global and use the best options.

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« Last Edit: August 22, 2009, 04:09:04 PM by Doomsday Jesus »

Offline BayushiTopic starter

Re: ObamaCare? You say Why Not? I ask, "Why?"
« Reply #47 on: August 22, 2009, 04:24:14 PM »

Online Doomsday

Re: ObamaCare? You say Why Not? I ask, "Why?"
« Reply #48 on: August 22, 2009, 04:48:27 PM »
Namecalling is how you really express maturity and knowledge.

Offline BayushiTopic starter

Re: ObamaCare? You say Why Not? I ask, "Why?"
« Reply #49 on: August 22, 2009, 06:25:24 PM »
Namecalling is how you really express maturity and knowledge.

Still doesn't explain 'bias'.

Here's something for you, guy. I'm not a Republican. Nor am I a "neo con". I'm an agnostic Financial Conservative and Civil Libertarian.

I consider both parties in charge to be just about equally reprehensible. I call them the Dimwit Party? Sure. I think they're loaded with a lot of clueless hippies who have no fucking clue what they're doing. Repubs? Similar, but they're motivated by other things... just not sure what. The one thing that's obvious is that neither major party seems to give a fuck about what the COUNTRY needs, just about what THEY "need"(more like want). Which, sadly, seems to be paying off the people who got them elected, and setting themselves up to get reelected.

So how am I "biased" again?