Health care reform could be so simple. Just expand Medicare to cover everyone.

People fought Medicare from the 50s and into the 60s, but nobody would consider getting rid of it now.

Why shouldn't a 45 year old mother and her two kids have the same guaranteed coverage as a 78-year-old executive?

I would consider getting rid of it in a second by not adding new workers into the entitlement . Let it wither on the vine and replaced with worker contributions into their own private accounts. Medicare is insolvent and is getting worse(funds depleted by 2017 ). God know how long it will last when boomers retire . It already distorts the market and forces non-Medicare patients to overpay for the same service.

Hey, Tom. You and I have almost the same number of posts!

You have 4 more. :(

... or three.

Health care reform could be so simple. Just expand Medicare to cover everyone.

Should it cover illegal immigrants too?

How about people who never paid into the system the way you and I have? Should they get the same coverage as someone who paid into the system their whole life?


People fought Medicare from the 50s and into the 60s, but nobody would consider getting rid of it now.

Really? I would get rid of it in a second if I could.

Medicare is bankrupting MOST states. Medicare spending is 20% of the budget in most states, and increasing. In fact, the cost of Medicare is actually rising 35% FASTER than the costs of health care in the private medical system. It costs more, covers less, and is less efficient than private insurance. It also takes doctors, hospitals, nursing homes and other service providers up to 18 months to collect money owed from Medicare. In fact, the system is so screwed up that many doctors are refusing to accept any Medicare patients.


Why shouldn't a 45 year old mother and her two kids have the same guaranteed coverage as a 78-year-old executive?

First of all, the coverage ISN'T the same. Medicare's coverage doesn't come close to what good private health plans cover. So the coverage that the mother of two gets will not be the same as the coverage that the 78-year-old exec gets.

Second, why should that mother get a level of coverage she has neither paid for nor earned with her work? The exec either pays for his own insurance coverage, or else it is provided to him by the company he works for in exchange for the services he provides that company. Either way, he EARNED that coverage. The 45 year old mother of two should do the same. And if she is one of the 95% of legal Americans that have private health care coverage through their employers, then she IS getting the same coverage as that exec.

The expansion of an already broken Medicaid system to cover another 46 million people (or 300 million people if you want EVERYONE to have it) would not only overwhelm the system, it would also drive health care costs through the roof and cause a massive increase in taxes.

Elliot

4


here is an op-ed I found on the Huffpo. It is a take I basically agree with in that I think government intervention is the root cause of the health care issues that we have.



After fifty years of growing government programs, health care costs continue to rise. The U.S. government now controls nearly half of all health care dollars, and the crisis is becoming acute. The plans we are seeing from Washington are not innovations, but rather extensions of the government interventions we have embraced for three generations.
But rather than assume that more government involvement is the answer, should we not at least consider that the source of the problem may be those very interventions? And, more deeply, should we not even consider that the reason for this decades-long pattern is not economic, but moral: the idea that people have a "right" to medical care?

Historically, the huge rise in health care costs began in the 1960s, when Medicare and other programs threw billions of dollars into the industry. Fiscally, Medicare is approaching monumental insolvency, with liabilities in the range of twenty-trillion dollars. To create another bureaucratic labyrinth now -- which advocates are proud to say will cost only a trillion dollars over ten years -- all but guarantees higher prices, and a greater crisis in the next decade.
But such economic arguments have not stopped the train to further government interventions, and we should ask why.
The reason is that advocates of government medicine are upholding health care as a moral right. The moral goal of a "right" to health care is blinding people to the cause and effect relationship between government actions and rising prices.
But the very idea that health care -- or any good provided by others -- is a "right" is a contradiction. The rights enshrined in the Declaration of Independence were to life, liberty, and the pursuit of happiness. Each of these is a right to act, not a right to things. "To secure these rights governments are instituted," which means to secure the rights of each person to exercise his or her liberty in pursuit of his or her own happiness.
By this understanding of rights, no one may force you to act in ways contrary to your own interests, as long as you do not demand that they act contrary to their own interests. There is no right to a good outcome -- no right to food, clothing, shelter, or economic security -- only a right to pursue that outcome, with the voluntary cooperation of others if they wish to offer it.

But consider what a right to a guaranteed outcome would mean. It would require an infringement upon the lives and liberty of those who are forced to provide it. If there is a right to food, there must be farmers to provide it -- or taxpayers forced to pay for it. Government medical plans with unique privileges, such as Medicare, institutionalize force against those who are to provide the claimed "right." And yet, neither the principle nor the consequences are changed if the force is spread out over millions of people in the form of a tax return.
These two concepts of rights -- rights as the right to liberty, versus rights as the rights to things -- cannot coexist in the same respect at the same time. If I claim that my right to life means my right to medicine, then I am demanding the right to force others to produce the values that I need. This ends up being a negation of personal sovereignty, and of individual rights.
To reform our health care industry we should challenge the premises that invited government intervention in the first place. The moral premise is that medical care is a right. It is not. There was no "right" to such care before doctors, hospitals, and pharmaceutical companies produced it. There is no "right" to anything that others must produce, because no one may claim a "right" to force others to provide it. Health care is a service, and we all depend upon thinking professionals for it. To place doctors under hamstringing bureaucratic control is to invite poor results.
The economic premise is that the government can create prosperity by redistributing the wealth of its citizens. This is the road to bankruptcy, not universal prosperity. The truth of this is playing out before our eyes, as medical prices balloon with every new intervention, and we face the largest deficits in human history.

If Congress wants to address health care issues, it can begin with three things: (1) tort reform, to free medical specialists from annual insurance costs of hundreds of thousands of dollars; (2) Medicare reform, to face squarely the program's insolvency; and (3) regulatory reform, to roll-back the onerous rules that force doctors, hospitals and pharmaceutical companies (who produce the care that others then demand as a "right") into satisfying bureaucratic dictates rather than bringing value to their patients.
John David Lewis: Health Care, Why Call it a 'Right'? (http://www.huffingtonpost.com/john-david-lewis/why-say-there-is-a-right_b_258188.html)

First of all, the coverage ISN'T the same. Medicare's coverage doesn't come close to what good private health plans cover. So the coverage that the mother of two gets will not be the same as the coverage that the 78-year-old exec gets.

I think Asking is talking about the 78 y/o's Medicare coverage, not his private insurance.

I think Asking is talking about the 78 y/o's Medicare coverage, not his private insurance.

Oh... well in that case, I think the exec ought to be dropped from the system and the money he paid in returned to him. He doesn't need it if he has private insurance and the means to continue to pay for it (or have it covered by his employer), and if he's not getting the coverage, his money should be reimbursed to him.

Simple enough.

No government handouts.

Should it cover illegal immigrants too?
Does private health insurance cover illegals if they pay the premium?


How about people who never paid into the system the way you and I have? Should they get the same coverage as someone who paid into the system their whole life?

You mean like children and mothers who stay home with their kids?

Medicare is expensive because it is subsidising TWO major industries, Big Pharma and the health insurance industry, which is freed from having to pay for medical care for the elderly. Insurance can collect premiums from the young and the healthy and as soon as people actually begin to be likely to need health care, Insurance backs out and turns them over to Medicare. If those premiums went to a single system that covered everybody, you would have a true pooling of risk.

Health Care Reform means using the huge profits these two industries currently make (by charging big fees to the sick and to Medicare) to treat the sick, instead of using it to pay for jets, yachts, and still another tacky mansion.


Medicare's coverage doesn't come close to what good private health plans cover.

How many people in this country have "good" private insurance as opposed to adequate. In any case, in the two recent cases I'm familiar with, my father and my godmother, Medicare paid for everything and Blue Cross paid nothing.


Second, why should that mother get a level of coverage she has neither paid for nor earned with her work?

So you think raising the next generation is not work and has no value? What would you compare it to? Flying model airplanes or building model railways in the basement? Watching sports in the evenings?

How is it in the interest of this country for mothers raising the next generation to be ill or sick because they have neither income nor health care coverage?

Oh... well in that case, I think the exec ought to be dropped from the system and the money he paid in returned to him. He doesn't need it if he has private insurance and the means to continue to pay for it (or have it covered by his employer), and if he's not getting the coverage, his money should be reimbursed to him.

Simple enough.

No government handouts.

Great idea. And that is a legitimate form of health care reform--although not one I'd happen to support.

But you won't see private insurance supporting that position! They LIKE that Medicare has to pay for most of the care of anyone over 65--the very people who "spend" the most on medical care, especially in the last six months of life. And if private insurance doesn't want it, "it any gonna happen," as so many people have been saying about any form of health care reform.

Aetna, Blue Cross, and Health Net would fight your idea like pit bulls.

He doesn't need [Medicare] if he has private insurance and the means to continue to pay for it (or have it covered by his employer), and if he's not getting the coverage, his money should be reimbursed to him.
My uncle had an excellent plan with BC/BS for years, and was healthy, so didn't have to take advantage of the coverage. After he hit 65 and had Medicare coverage too, he visited doctors for heart and gall bladder and diabetes problems. I kept track of his medical paperwork for him. Medicare paid almost 100% of his medical costs; BC/BS paid virtually nothing.

I would consider getting rid of it in a second by not adding new workers into the entitlement . Let it wither on the vine and replaced with worker contributions into their own private accounts.

Whose money will be promptly "lost" on Wall Street and mysteriously found by the money vacuum cleaners.


Medicare is insolvent and is getting worse(funds depleted by 2017 ). God know how long it will last when boomers retire . It already distorts the market and forces non-Medicare patients to overpay for the same service.

That's because Medicare is Subsidizing the Health Insurance industry and the executives who get millions of dollars a year for denying coverage to as many people as they can legally justify.

My uncle had an excellent plan with BC/BS for years, and was healthy, so didn't have to take advantage of the coverage. After he hit 65 and had Medicare coverage too, he visited doctors for heart and gall bladder and diabetes problems. I kept track of his medical paperwork for him. Medicare paid almost 100% of his medical costs; BC/BS paid virtually nothing.

Yep! That's what I keep seeing with my aging relatives.

People pay the premiums to private insurers when they are young and healthy and as soon as they get sick, the government pays the bills. It's a great racket for the health insurance executives, but how long are we going to keep giving these fat cats a free ride on our backs?

I think we should extend it to pets, too.

As one who is running the medicare/supplemental insurance gauntlet for his spouse I can tell you for a fact that medicare does not pay diddly squat. That is one of the main reasons you must have a supplemental policy. That is unless you have unlimited resources. Which most of us don't thanks to the Government. Medicare pays a minimum amount toward some things. IF and that is the biggest you can find a doctor that actually will take the medicare payment or actually is willing to take on a medicare patient you will be darn lucky. Medicare only pays a portion of doctors and hospital visits, is so slow in making those payments that most health care professionals are only willing to accept about 10% of their total patients with medicare. If they take any more they will be bankrupt within a year. Just go ask any rural doctor about the health of his practice and you will get an ear full.

I think we should extend it to pets, too.

So you are saying that children and women who raise kids instead of earning big bucks are comparable to animals?

So you are saying that children and women who raise kids instead of earning big bucks are comparable to animals?

Thanks for a good chuckle, how in the world could you get that out of my comment? Don't our pets deserve affordable health care, too?

Does private health insurance cover illegals if they pay the premium?

Yes. But they sure don't get it for free.

[quote]You mean like children and mothers who stay home with their kids?

Mothers who stay at home with their kids don't get Medicare. They either have husbands who work and get insurance from their employers or they pay out of pocket. If they are single mothers, however, they generally get jobs and get insurance through their employers just as their husbands would. Unless they are DISABLED and unable to work, they don't get Medicare. If they are earning less than 150% of the poverty line, they qualify for MediCAID which is a different program than Medicare.

So, yes, single mothers are EXACTLY who I mean.


Medicare is expensive because it is subsidising TWO major industries, Big Pharma and the health insurance industry, which is freed from having to pay for medical care for the elderly.

Where did you get that idea from?

BIG PHARMACEUTICAL COMPANIES are the biggest donors of FREE MEDICINES to the people who can't afford it. Every single major pharmaceutical manufacturer in the USA has a program to help those in need get free or low-cost drugs.

Check out some of these web pages:
Abbott Citizenship: Patient Assistance Program (PAP) (http://www.abbott.com/global/url/content/en_US/40.40.10:10/general_content/General_Content_00066.htm)
Amgen - Patients - Patient Assistance (http://www.amgen.com/patients/assistance.html)
Amylin Pharmaceuticals Patient Assistance Program (http://www.amylin.com/products/patient-resources/patient-assistance-program.htm)
AstraZeneca: Patient & Prescription Assistance Programs (http://www.astrazeneca-us.com/help-affording-your-medicines/)
Bristol-Myers Squibb:Patient Assistance Programs (http://www.bms.com/products/Pages/programs.aspx)
The Patient Support Coordinator® Program (http://www.celgene.com/patient-support/coordinator.aspx)
[DAIICHI SANKYO] (http://www.dsi.com/news/patientassistance.html)
Patient Assistance Program for Patients on Oncology or Specialty medicines (http://www.commitmenttoaccess.com/)
Access to Medicine - Johnson & Johnson (http://www.jnj.com/connect/caring/medicine-access/?flash=true)
Eli Lilly and Company Patient Assistance Programs (http://www.lilly.com/responsibility/programs/)
Patient Support Programs (http://www.lundbeckinc.com/usa/patients/assistance_programs/default.asp)
Merck Programs to Help Those in Need (http://www.merck.com/merckhelps/)
MILLENNIUM: The Takeda Oncology Company | Patients | Financial Assistance (http://www.millennium.com/patients/financial_assistance.asp)
Patient Assistance Enrollment (http://www.pharma.us.novartis.com/about-us/our-patient-caregiver-resources/paf-enrollment.jsp?usertrack.filter_applied=true&NovaId=2229645048071968661)
Patient Assistance Programs for Prescription Drug Medicines - Pfizer Helpful Answers ® (http://www.pfizerhelpfulanswers.com/pages/misc/Default.aspx)
http://www.sanofi-aventis.us/live/us/en/layout.jsp?cnt=34FFDF5A-E281-466F-BDCE-2658D8763A11
Social Responsibility - Patient Assistance and Support Programs (http://www.schering-plough.com/responsibility/patient-assistance.aspx)
Sigma-Tau :: Patient Support (http://www.sigmatau.com/sxSupport/support.asp)
TPNA-Pharmaceutical Patient Assistance Program (http://www.tpna.com/responsibility/patient_assistance_program.aspx)
Patient Assistance Program - Information for Patients (http://www.wyeth.com/contact?rid=/wyeth_html/home/shared/footer/Patient/contact_patient_assist.html)

Pharmaceutical companies are GIVING AWAY their meds to the tune of literally billiobs of dollars every year... but you think that Medicare is getting shafted by them because they don't give their fair share?

Try again.


Insurance can collect premiums from the young and the healthy and as soon as people actually begin to be likely to need health care, Insurance backs out and turns them over to Medicare.

You're right. We should get rid of Medicare.


If those premiums went to a single system that covered everybody, you would have a true pooling of risk.

You would also lack options, because if all there is is ONE decision maker, and if that decision maker denies your claim, there is no other option. You won't be able to change insurance providers, you won't be able to pay out of pocket. You will be STUCK.

And insurance companies already pool risk. That's how they stay profitable and capable of paying out on claims.


Health Care Reform means using the huge profits these two industries currently make (by charging big fees to the sick and to Medicare) to treat the sick, instead of using it to pay for jets, yachts, and still another tacky mansion.

Here's a little bit of detail about those "huge profits" that the insurance companies and health care providers are supposedly making.

CARPE DIEM: Profit Margin: Health Insurance Industry Ranks #86 (http://mjperry.blogspot.com/2009/08/health-insurance-industry-ranks-86-by.html)

This shows exactly what the profitability of the various industries and their rankings.

Hospitals were 77th on the list with profitability of 3.6%.
Medical Insurance plans were 86th with profitability of 3.3%.

Compared to beer makers, who were #1 at 25.9% proifitability, or Wineries and Distilleries, who were 18th at 11.8%.

These companies are not making "huge profits" at all.

Your entire premise--- that health care costs are high because insurance companies and health care providers are making huge profits off the backs of the poor--- is completely false. Because they are NOT making huge profits, and they are GIVING AWAY CARE to those who need it rather than hurting those poor people.


How many people in this country have "good" private insurance as opposed to adequate.

How do you define "good" and "adequate"?

And do you think that Medicare is "good" or "adequate"?


In any case, in the two recent cases I'm familiar with, my father and my godmother, Medicare paid for everything and Blue Cross paid nothing.

Blue Cross is SUPPOSED to pay nothing. Blue Cross is supposed to kick in if and only if there is no other source of payment. The same is true of any other insurance company. If you have other sources of payment, like Medicare, Medicaid, Workman's Comp, Disability insurance, etc. then the insurance companies aren't SUPPOSED to pay. They only pay what isn't covered elsewhere.

So... if Medicare had failed to pay, your Blue Cross SHOULD have kicked in.


So you think raising the next generation is not work and has no value? What would you compare it to? Flying model airplanes or building model railways in the basement? Watching sports in the evenings?

I'm sure it has great value. But it doesn't pay for insurance. And it isn't supposed to.


How is it in the interest of this country for mothers raising the next generation to be ill or sick because they have neither income nor health care coverage?

That's what HUSBANDS are for. The breakdown of the traditional family is the reason that so many women are being left holding the bag on health care and other costs that would usually be born by the husband. This country has spent so much time trying to break down the traditional family and replace it with non-traditional families (single-mom, single-dad, two moms no dad, two dads non mom, etc.) that they failed to see the implication of what would happen when twice the responsibility fell on just one person.

That single mother has to make a hard choice now: she can either work and obtain insurance, or she can stay home for her kids and hope that she qualifies for Medicaid.

Traditional families don't have those problems to the same degree. Oh, they can still be there. But they are fewer. There is a deliniation of responsibilities. One parent works and provides financial care, the other stays home with the kids and provides parenting.

You are blaming on the health insurance companies a problem that isn't of their making and is beyond their control. FIX THE ISSUE OF NON-TRADITIONAL FAMILIES in the USA, and you will have fixed a HUGE part of the insurance crisis in terms of affordability.

But expanding Medicare isn't the answer to this problem. It only EXASERBATES the problem by driving medical costs HIGHER at a faster rate than the rest of the health care system.

I said it before, and I'll say it again: if you want to make health insurance more accessible to people, make the cost of it tax-free. That automatically lowers the effective cost by 15-30%. That will make it more affordable to more people.

Other fixes to the health care system (I've listed them before):

1) Create tax exempt Medical Savings Accounts
2) Lower taxes so that more have the disposable income to afford health care
3) Modify Medicare and Medicaid to cover those that SHOULD be covered under these programs but are not
4) Tort reform, if properly enacted, could lower medical spending by as much as 60%, especially in "high risk" specialties.
5) DEREGULATE the medical industry. Useless regulation costs money that could be spent better actually HEALING people.
6) De-unionize the hospitals. Union benefits cost a fortune. Union contracts require minimum numbers of employees even if those employees are redundant or not needed. That costs money that could be better spent elsewhere.
7) As an ABSOLUTE LAST RESORT, the government could give uninsured citizens a stipend to pay for their health insurance (adjustable based on family size). This stipend would have a time limitation built in so that it doesn't become an "evergreen" welfare program. But it will give families some time to get their feet back under them after a job loss that lasts more than a couple of months by allowing them to purchase the insurance plan of their choice. It is NOT meant to be a permanent benefit and should have a cut-off of, say, 18 months or 2 years. After that, you're on COBRA and pay for your insurance yourself.
8) Since private insurance is cheaper when you have group coverage, let everyone who is collecting unemployment insurance in every state form their own group via the state unemployment office. This group can then find the group coverage that suits them best. Even if they have to pay out of pocket, they'll be paying group rates that are cheaper than trying to pay the individual rate.
9) Create a "build-your-own-policy" service. It allows people to get the coverage they want and need without having to pay for the stuff they don't want or need. This can make policies WAY cheaper while still providing the coverage needed.
10) Keep the government out of running health care!! Government is the least productive and most wasteful organization in existence. It should not be used to try to bring efficiency to any part of the economy, much less the health care industry.

Every one of these (except # 3) is a free market solution to health care reform.

Every single one of them is Feasible and would result in IMMEDIATE health care costs reductions, savings, and affordability for individuals.

But will those in favor of government-run health care even consider them?

Nope.

Elliot

That's because Medicare is Subsidizing the Health Insurance industry and the executives who get millions of dollars a year for denying coverage to as many people as they can legally justify.

You have that backwards.Why do you think so many doctors shun Medicare patients ? Because reimbursements suck. This isn't coming from a right wing blog (since my sources so frequently come into question ) ;it is coming from the NY Slimes ,

Many Doctors Shun Patients With Medicare - The New York Times (http://www.nytimes.com/2002/03/17/us/many-doctors-shun-patients-with-medicare.html)

http://www.nytimes.com/2009/04/02/business/retirementspecial/02health.html?_r=2&ref=health

For years, doctors have expressed frustration with Medicare, grumbling about reimbursement and complex federal regulations.

''I love my elderly patients,'' Dr. Krotowski said. ''But they are very sick. They need a lot of attention, a lot of medications and a lot of time. Medicare reimbursement has not kept up with inflation or the cost of providing care to the elderly.''

It's shocking! Shocking I say! I just can't believe that doctors, with families, mortgages, business expenses, liability insurance, school loans,property taxes ,payroll expenses , expenses for equipment and supplies ,hours of paperwork need to be filled out to satisfy gvt. Red tape , won't treat people for free. Those greedy B@$$ Turd$ !

Doctors who do take on Medicare patients do so because younger healthier patients make up the difference with higher payments for their services.

Medicare reimbursement is half of what it was 22 years ago and the dirty little secret the President refuse to say except for those times he lets it slip is that he intends to cut costs on the back of Medicare patients as part of this reform.(again I'll use a lib source )
Seniors uneasy over Medicare cuts in overhaul - Capitol Hill- msnbc.com (http://www.msnbc.msn.com/id/32225671/ns/politics-capitol_hill/)

and the executives who get millions of dollars a year for denying coverage to as many people as they can legally justify.

Well those greedy piggies at the insurance companies are raking in a whole 3.4% profit for all their efforts at providing health care coverage plans . That ranks somewhere around 86th in this ranking of industry profits in the country .
Industry Browser - Yahoo! Finance - Full Industry List (http://biz.yahoo.com/p/sum_qpmd.html)

Get that ? 85 industries more profitable than Health Care Plans.

I wonder if someone has forwarded this to the Obama brownshirts yet ?

That is unless you have unlimited resources. Which most of us don't thanks to the Government.

You feel you would have unlimited resources if there were no federal government?


Medicare pays a minimum amount toward some things. IF and that is the biggest you can find a doctor that actually will take the medicare payment or actually is willing to take on a medicare patient you will be darn lucky. Medicare only pays a portion of doctors and hospital visits, is so slow in making those payments that most health care professionals are only willing to accept about 10% of their total patients with medicare. If they take any more they will be bankrupt within a year. Just go ask any rural doctor about the health of his practice and you will get an ear full.

My father's end of life care was all rural medicine, and as I said, Medicare paid for 100% of it. I know that some doctors refuse medicare. If it was 90% nobody over 65 would be able to see a doctor in this country...

Doctors refuse to see patients on all sorts of grounds. I've had doctors outside my HMO refuse to see me even when I said I could pay myself. I really wanted to see a specialist at a major teaching hospital to get a second opinion and they repeatedly refused to make an apppointment. I had to offer to send a copy of my assets and bank statements before they would let me make an appointment for a consult. Another doctor inside my HMO said I could not make an appt with him unless I promised not to ever go any other doctor in his specialty. He had no grounds for demanding that of his patients, but I guess it was worth a try!

[quote=asking;1923699]Does private health insurance cover illegals if they pay the premium?

[QUOTE]Yes. But [illegal aliens] sure don't get it for free.
No. But as you know, single payer would be paid for with taxes, the same money you now give to a health insurer. You don't pay more, you just pay your premium to a different entity and call it "tax" instead of "premium." Illegals pay taxes, so they wouldn't be getting health care for free either IF they ended up being covered. I personally think they should not be excluded, but that's a problem that has lots of sides to it.


If they are single mothers, however, they generally get jobs and get insurance through their employers just as their husbands would.

Taking care of children is work. Husbands die or run off with secretaries or abuse their wives. A woman with one child can make enough to pay for day care. A woman with education and two children can just make it on her own. But a woman with 3-5 children and little education has no chance of ever making enough money to pay for day care AND pay for food and shelter. The least we can do is provide medical care for such a family. It shouldn't matter why the husband is out of the picture. The fact is that they often are.


Unless they are DISABLED and unable to work, they don't get Medicare. If they are earning less than 150% of the poverty line, they qualify for MediCAID which is a different program than Medicare.

I'm arguing that everyone SHOULD be eligible for Medicare, not that they already are. You shouldn't have to have a job. And frankly, being a mother in this country IS a disability! It forces you to miss work to care for sick children, forces you to work shorter hours so you can care for them regularly... and so on.

BIG PHARMACEUTICAL COMPANIES are the biggest donors of FREE MEDICINES to the people who can't afford it. Every single major pharmaceutical manufacturer in the USA has a program to help those in need get free or low-cost drugs.

Great if your doctor happens to prescribe one of these specific drugs and you can satisfy the requirements for it. But each one has different requirements and paperwork.


. But you think that Medicare is getting shafted by them because they don't give their fair share?

I think the government is allowing itself to be shafted by the pharmaceutical industry--subsidizing is a nicer word--not because Pharma doesn't ever give anything away (and take a hefty deduction for same), but because pharma benefits from the system we currently have and yet produces very few drugs that are even marginally better than what's already out there, at least not in proportion to the amount they spend on research, marketing, and executive pay. Pharma drives up the cost of health care enormously. My doctor wants me to take a $300/month NSAID when I could be taking aspirin for $3/month. When you actually look at the differences between the new drugs and the old ones, they may be only 5% more effective than an older off-patent drug, yet they cost 10 or 100 times as much.



You would also lack options, because if all there is is ONE decision maker, and if that decision maker denies your claim, there is no other option. You won't be able to change insurance providers, you won't be able to pay out of pocket. You will be STUCK.

I have insurance I can't afford and I can't switch providers. I'm already STUCK!


And insurance companies already pool risk. That's how they stay profitable and capable of paying out on claims.

This is just flat out wrong. They try hard to eliminate anyone who has ever had a major problem anyone likely to have a problem. That's how they stay profitable, by collecting premiums from the healthy and eliminating the unhealthy from membership by dropping them, reducing benefits, or raising the premiums and copays until people are bankrupt. The idea is to take only the people with lowest risk. That's not pooling risk. That's skimming the cream. And leaving the rest to the government to take care of.

Furthermore, most hospitals that are supposed to take care of the uninsured, in fact don't. They turn most of them away. There is plenty of research to support this.


Here's a little bit of detail about those "huge profits" that the insurance companies and health care providers are supposedly making.

CARPE DIEM: Profit Margin: Health Insurance Industry Ranks #86 (http://mjperry.blogspot.com/2009/08/health-insurance-industry-ranks-86-by.html)


3.6% is great for a high volume business like Aetna or Health Net! These numbers are AFTER executive pay and all sorts of other expenses. If your small business paid you 3.6% after you paid yourself $5 million a year, I bet you'd be content with it.


This shows exactly what the profitability of the various industries and their rankings.

Hospitals were 77th on the list with profitability of 3.6%.
Medical Insurance plans were 86th with profitability of 3.3%.

These companies are not making "huge profits" at all.


Yeah, they are.


That's what HUSBANDS are for.

So the price of health care is a good beating every few months from an abusive husband? Or putting up with chronic infidelity? Or getting an alcoholic out the door every morning to his job? This is an appalling argument. You really don't know anything about what it's like to be a woman in this country.


That single mother has to make a hard choice now: she can either work and obtain insurance, or she can stay home for her kids and hope that she qualifies for Medicaid.

She can't work if she can't find a job that pays A LOT more than all day child care.


But expanding Medicare isn't the answer to this problem. It only EXASERBATES the problem by driving medical costs HIGHER at a faster rate than the rest of the health care system.

No it takes the same money you'd pay in premiums to Aetna and transfers to them to a system that genuinely pools risk and has less overhead--from fewer expensive office buildings, less redundancy in middle management (think of all those different companies all doing the same thing), and FAR, FAR less CEO pay.


I said it before, and I'll say it again: if you want to make health insurance more accessible to people, make the cost of it tax-free. That automatically lowers the effective cost by 15-30%. That will make it more affordable to more people.


How does that help someone who is so poor that they pay no taxes? Last year, I paid no federal taxes, yet half my gross income went to a single health insurer. This year it will be more than half unless I drop my coverage and go without insurance.

You think my family doesn't feel that? You complain about taxes, but I bet you don't pay 50% of your income as I am. And you think the insurer has my interests at heart and that the solution is that I should not have divorced my abusive ex husband. That's what he says too. But I don't agree. No one should have to live like.

No. But as you know, single payer would be paid for with taxes, the same money you now give to a health insurer. You don't pay more, you just pay your premium to a different entity and call it "tax" instead of "premium." Illegals pay taxes, so they wouldn't be getting health care for free either IF they ended up being covered. I personally think they should not be excluded, but that's a problem that has lots of sides to it.

So... let me get this straight. You are OK with illegal aliens getting health care that YOU pay for, even though they don't pay into the system.

And where did you get the idea that the amount that you will be paying in taxes is going to be the same as what you pay now?

It is not physically possible to pay for 46 million more people than are covered now without either limiting services or increasing the amoun that those who pay into the system will be paying. Taxes will HAVE to go up to maintain the same level of service, or services will HAVE to be limited in order to maintain the same cost.

And that doesn't even take the additional costs if government inefficiency into the equation. The CBO has estimated that the administrative costs of running government health care would be TWICE to THREE TIMES what corporations pay due to inefficiencies, waste and corruption. The Heritage Foundation estimates that it would be closer to 5 times as much. Which means that you would need to pay 2-5 times as much in taxes to the government as you are currently paying in premiums to insurance companies.

Then there's the fact that the costs of health care in Medicare are rising 35% FASTER than they are in private health systems. In order to pay for this faster increase in health care, we would have to be taxed 35% MORE than we are paying in premiums to our insurance companies.

Simply put, government health care is MORE EXPENSIVE than private insurance, and you would have to pay MORE to the government in taxes than you would be paying to a private health insurance company.


Taking care of children is work.

Agreed.

Now... explain to me why we need to change the entire health care system to fix this problem that is easily fixed through other means?

Medicaid should be covering this. So let's make sure this woman is covered under the already existing system rather than try to create a brand new system for EVERYONE just to cover her.

Lower the cost of health care for her by making insurance payments pre-tax. That creates an automatic IMMEDIATE savings on the cost of health care of 30%.

There is no need to create a brand new, HIGHER COST government system in order to help this woman.


I'm arguing that everyone SHOULD be eligible for Medicare, not that they already are.

So your solution for people who can't afford health care is to put EVERYONE on a system that is bankrupt, more expensive and less affordable. What a brilliant idea.


Great if your doctor happens to prescribe one of these specific drugs and you can satisfy the requirements for it. But each one has different requirements and paperwork.

Pretty much every drug out there is available through these patient assistance systems. And if you're not paying for it, I would think that the amount of paperwork would be the least of your complaints.


I think the government is allowing itself to be shafted by the pharmaceutical industry--subsidizing is a nicer word--not because Pharma doesn't ever give anything away (and take a hefty deduction for same), but because pharma benefits from the system we currently have and yet produces very few drugs that are even marginally better than what's already out there, at least not in proportion to the amount they spend on research, marketing, and executive pay. Pharma drives up the cost of health care enormously. My doctor wants me to take a $300/month NSAID when I could be taking aspirin for $3/month. When you actually look at the differences between the new drugs and the old ones, they may be only 5% more effective than an older off-patent drug, yet they cost 10 or 100 times as much.

Only marginally better, huh?

I guess the medicated stent that prevents you from needing a heart bypass is only a marginal improvement.

Or the chemotherapies available today are only marginally better than what was available 20 years ago, even though cancer survival rates have improved by 20-30% during that period.

Yes, it's true, some drugs are only a LITTLE BIT better than what came before it. And if the cost isn't justified, perhaps you should get the older drug. That choice is between you and your doctor. Free choice and all that.

But keep in mind that each new breakthrough builds on what happened before. And while the 2nd genereation drug might only be 5% better, the 6th generation drug might be 80% better, because it built on the prior 5 generations.

But if the government gets involved, they will only allow doctors to proscribe that first generation drug, because the 2nd generation drug is only 5% better and costs 100 times as much. Which means that no drug company will develop the 3rd -6th generations of that drug, because the government won't allow it to be prescribed. Which means we'll NEVER SEE ANY NEW DEVELOPMENTS IN THE DRUG INDUSTRY. Because it will never be cost effective to do the research and development of that drug.

So, not only does the government limit your choices (what if you want that 5% improvement in the drug), but it stifles research and development by taking away the incentive for R&D, which is PROFIT.


I have insurance I can't afford and I can't switch providers. I'm already STUCK!

Why can't you switch providers? If you already have insurance, you can't be denied another insurance due to a pre-existing condition. So the reason is most likely financial.

Tell me, would a 30% immediate decrease in your insurance cost be helpful?


This is just flat out wrong.

Not it's not. This is, in fact, how insurance companies work. They collect premiums from a bunch of people and pool them. When one of them gets sick, they use that pool to pay out for that person's needs. The rest of the people continue to pay into the system. It is very rare that EVERYONE in the system gets sick at once. That is how insurance works. It POOLS RISK and POOLS PREMIUMS. The statement was, in fact, 100% true.


They try hard to eliminate anyone who has ever had a major problem anyone likely to have a problem.

Of course they do. They try very hard to limit their costs as much as possible. That's their JOB. And yet they still cover people with major problems anyway in the vast majority of cases. And in cases where they contest the claim, generally speaking you can get the claim paid anyway, even if it takes some time to convince them.


That's how they stay profitable, by collecting premiums from the healthy and eliminating the unhealthy from membership by dropping them, reducing benefits, or raising the premiums and copays until people are bankrupt.

They do try that.

So what?

That's EXACTLY what the government is planning on doing. That's the whole point of having "efficiency counsels" and QALY calculations for services to be rendered. There is going to be a panel who's job it is to try to ELIMINATE services to people who have problems or who are getting too old from the system.

The difference is that if insurance companies do that enough times, people stop buying that insurance and instead go to a different company. In a single payer system, THERE IS NO OTHER COMPANY TO GO TO.

And again, after seeing three of my grandparents die very lingering deaths in the past 18 months, I have seen three people who had pre-existing conditions who were not denied a SINGLE TREATMENT by private insurance. Medicaid denied them certain services, but not their private insurance. The insurance companies lived up to their side of the contract in every case.


The idea is to take only the people with lowest risk. That's not pooling risk. That's skimming the cream. And leaving the rest to the government to take care of.

No... that is paying out on what they are contractually obligated to pay out on, and NOT paying out for people with whom they have no contracts. I'm good with that.

If you don't pay the insurance company, why should the insurance company pay for your services? If you don't like the contract, negotiate another one that gives better coverage, or find a company that offers a contract you do like.

Or rely on the government and pay nothing. But you get what you pay for.


Furthermore, most hospitals that are supposed to take care of the uninsured, in fact don't. They turn most of them away. There is plenty of research to support this.

I've spent quite a bit of time in ERs. I'm a former EMT, and I've been in more ERs for longer periods than just about anyone on this board. I have never ONCE seen a patient turned away from a hospital for any reason. I have, on quite a few occasions, seen patients who have walked out because they didn't like having to wait 6 hours to get their sniffles checked, even though there were trauma and cardiac cases that took precedence. I have seen patients who have been recommended to be admitted to the hospital to care for some condition or other turn down the care by signing an RMA form... or by just walking out. I have seen patients who were trying to bum narcotics off the doctors to feed their habbits turned down for their drug of choice but offered rehab instead (guess how many took up the physicians on that offer). But I have never, EVER, seen a patient in need of care turned down in any ER. And precious few who didn't really need care are turned down either. You'd be surprised at how often ERs become shelters for drunks who just need a place to shag out for the night and so they make up fake illnesses that the doctors can see through right away, but the doctors, being people who want to help, go along with the farce in order to create an excuse to keep the guy off the street for a night.

Yeah, there are cases where "patients" don't receive the care they think they ought to get. But that is usually a result of the fact that they don't really need those services, didn't feel like waiting to get service for what was not a high-priority situation, or didn't get their drug of choice from the physician. I don't consider any of those to be cases of patients being turned down for care.


3.6% is great for a high volume business like Aetna or Health Net!

You just proved to me that you have no idea what you are talking about.

3.6% profitability is MARGINAL at best. Other high volume businesses would shut down with NPMs that low. The shareholders of other businesses would be up in arms at the idea that they are only making three and a half percent, and would be demanding heads to roll.


These numbers are AFTER executive pay and all sorts of other expenses. If your small business paid you 3.6% after you paid yourself $5 million a year, I bet you'd be content with it.

Sure, if I were the sole owner and I got to take home the entire profit, yeah, I'd be OK with it.

But with MILLIONS of shareholders, a 3.6% profitability equates to hundreths of a penny per share. People don't become stock owners to earn a hundreth of a penny per share.


So the price of health care is a good beating every few months from an abusive husband? Or putting up with chronic infidelity? Or getting an alcoholic out the door every morning to his job? This is an appalling argument. You really don't know anything about what it's like to be a woman in this country.

So... for you, the opposite of single parenthood is infidelity, abuse and alchoholism. There's no such thing as traditional family values? They no longer exist? Either a woman is abused or she's a single mother? There are no other options?

And you think that I don't know what it's like to be a woman in this country? I have to say the same for you, if you can see no other options besides abuse or single motherhood.


She can't work if she can't find a job that pays A LOT more than all day child care.

True. And your point is..

I said that she is left with a hard choice. And I also said that such a choice becomes easier in traditional families where each party knows their responsibility. What part of that statement do you disagree with?


No it takes the same money you'd pay in premiums to Aetna and transfers to them to a system that genuinely pools risk and has less overhead--from fewer expensive office buildings, less redundancy in middle management (think of all those different companies all doing the same thing), and FAR, FAR less CEO pay.

I've already ansewered this point. However, I want to address the "office buildings" argument.

Do you think that government agencies work outdoors?

In fact, the government is the single largest real estate OWNER and the single largest real estate RENTER in the entire world. And when they rent, they tend to pay HIGHER THAN MARKET for their space, which is one of the two major reasons that real estate owners LOVE having the US Government as a tenant. (The other reason is the fact that the US Government guarantees their rents with the same "full faith and credit of the US government" as they do their bonds and other debt instruments.)

Building costs for the US government are HIGHER than for private corporations, not lower.


How does that help someone who is so poor that they pay no taxes? Last year, I paid no federal taxes, yet half my gross income went to a single health insurer. This year it will be more than half unless I drop my coverage and go without insurance.

You think my family doesn't feel that? You complain about taxes, but I bet you don't pay 50% of your income as I am. And you think the insurer has my interests at heart and that the solution is that I should not have divorced my abusive ex husband. That's what he says too. But I don't agree. No one should have to live like.

Actually, between income taxes, real estate taxes, and insurance, I'm paying out well over 70% of my income. Then there's tuition of roughly $19K for 2 kids. I'm separated, so I'm paying child support as well. Frankly, I'm in the hole.

You say that nobody should have to live like that. And I agree.

But better that than becoming reliant on the Federal government and having to beg crumbs from the government and giving up my free choice to do it. Because on my own my financial situation can improve. Under the government's thumb, it can't.

Government cannot create wealth for a man, but it can surely take it away from him.

Elliot