[tomder55]

Anyway according the NY Slimes , former Democrat leader in the House of Representatives Richard Gephart,who ran for the Presidency with UHC as his signature issue ,is now urging the President to slow down his rush towards UHC .

According to Mr. Gephardt, incremental additions of coverage for children or low-income workers may be the most Congress can muster to complement cost containment. But better to build confidence by pocketing those gains, he said, than to insist on more drastic, immediate steps and face a dispiriting repeat of the Clinton-era fiasco he experienced up close as House majority leader.

http://www.nytimes.com/2009/04/13/us...ucus.html?_r=2

That is always the left's backup plan... incrementalism.

I agree that there is a need to get ambulance chasers out of the game.

The answer to the insurance concern could be "health-status insurance" which has been proposed by University of Chicago economist John Cochrane.Cochrane claims that with health-status insurance, free markets can solve the problem of how to insure people with pre-existing medical conditions and "provide life-long, portable health security, while enhancing consumer choice and competition."
"Health-Status Insurance: How Markets Can Provide Health Security" by John H. Cochrane (Cato Institute: Policy Analysis)

"Market-based lifetime health insurance has two components: medical insurance and health-status insurance. Medical insurance covers your medical expenses in the current year, minus deductibles and copayments. Health-status insurance covers the risk that your medical premiums will rise."

He proposes that each person would start by buying a health-insurance policy, with or without the aid of an employer or a government subsidy for the poor at a competitive rate for a healthy person . They would also have a separate "health-status insurance" that would pay out anytime a serious illness drove up the basic premium. The health-status-insurance payout would make up the difference between the original premium and the new premium.


Under Cochrane's proposal, if an insured person develops an expensive condition, a lump-sum payment would be deposited into a health-status insurance account that would be available only to pay medical insurance premiums. This restriction would limit the temptations to commit fraud or to spend it and then show up at an emergency room unable to pay. In addition, if the insured becomes healthier and his premiums decline, the money could then be returned to the insurer.

Insurance companies would no longer have an incentive to dump sick people because those with pre-existing conditions would have the funds to pay higher premiums. Insurance companies instead would compete for their business and have an incentive to specialize in cost-effective care for chronic diseases.

[excon]

I agree that there is a need to get ambulance chasers out of the game.

Hello again, tom:

But, you're happy to leave the insurance companies IN the game... I don't know why. The insurance company never made me well. They're just there sucking off the deal. They don't NEED to be there. If you want to pay them, you MUST be a stockholder. I cannot imagine WHY you want them to make money off your health care. I really can't imagine it.

excon

[tomder55]

I do not believe that the government insuring me is going to work. Oh I know ;in a pinch they can always bleed us to death with taxes or deny us services when they go in the red like they do with the so called Social Security insurance . I've seen too much delay in services from the combined Medicare Medicaid systems or shoddy care at medicaid and VA hospitals/facilities to know that I don't trust them running the whole show.

[excon]

I don't trust them running the whole show.

Hello again, tom:

But you DO trust the insurance company?? Wow. Maybe your experience is better than mine - or speech's.

I don't have a bad insurance story to tell you. Fortunately, I've been able to cover my health care out of my own pocket lo these many years.

But, I just bought insurance. I'm paying through the nose for it, and I bought it through AARP. It ain't a second rate company. Do I have a good policy?? I have no idea. I didn't read through that fat document with all the small print... But, I wonder what all that small print was saying... I'll bet it WASN'T saying how many procedures I'm going to be eligible for... Nahhhh. It was listing all those services I WOULDN'T be eligible for.

I'll bet the chances are that I'll get one of THOSE fine print diseases, and not one of the GOOD kinds... The insurance company has to make a profit, after all.

The bigger question is, why should I have to worry? I'm paying my hard earned dollars for coverage, and I'll bet I don't have any, when it counts.

Steve?? Your fellow right winger?? He was having some difficulties with his insurance a while ago. I can't remember what it was exactly, but I'll bet it didn't turn out well for him... The insurance company has to make a profit, after all.

excon

[ETWolverine]

Tickle,

Do you work for a living? If you do, your would likely have insurance in our system. Even if you didn't have insurance, though, the hospitals would have given you care anyway. That's how our system works.

You are assuming that anyone who is not covered by government health insurance has no health insurance at all. Yes, if you had to pay out of pocket for the medical treatment for your family members, you would have gone broke. But not being on government health care DOESN'T mean that you aren't covered at all.

Everyone over 65 is covered by Medicare.

Everyone with low income and low resources is covered by Medicaid on a needs-based system.

Poor children are covered by S-CHIP.

There are free clinics throughout the USA that cover anyone who needs the care.

There are various state programs for healthcare for the poor.

Hospitals are required to treat anyone, regardless of ability to pay.

Pharmaceutical manufacturers have programs to give away needed medicines to poor families in need for free. (Every one of the major pharm. Companies has such a program.)

Your assumption that anyone who does not belong to a government-run single payer system is automatically going to go broke paying for their healthcare is incorrect. There are safety nets in place for those who need it. We do not need the government to go socialist in order for it to be done. We're already doing it.

[tickle]

Hi wolverine, I don't give a rats bum what you guys have down there. I am so through with all your attitudes about our healthcare system, and unless you have been under a rock, I think that's what we were all discussing.

Where did you get the idea that I was discussing YOUR healthcare needs. I lived down the states for quite a while years agoWITHOUT health insurance. So I know for sure not everyone is covered. I paid out of pocket to have my son down there, the most quick way I could on an in and out 'same day delivery' if you want a really good description. It cost me $700 in l982 and I wasn't young then either. I didn't find any free clinics in Flint Michigan then.

Yes, I work for a living and I am over 65, two jobs, over 65 and enjoying my socialized medical coverage,without any resrtrictions, because believe it or not I am healthy happy very young almost 67 years old.

Where did you get that I am assuming anything ?

Tick

[galveston]

Some thought should be given to CO-OP health insurance.
Where I live it works pretty will for real estate insurance. These companies were formed 100 years of so ago for the benefit of farmers. Their rates are MUCH better than commercial insurance companies, because the insured people are actally members of the company. Non-profit, as far as I know.

[inthebox]

Here is an interesting idea


Health Reform Without a Public Plan: The German Model - Economix Blog - NYTimes.com

None of these countries uses a government-run, Medicare-like health insurance plan. They all rely on purely private, nonprofit or for-profit insurers that are goaded by tight regulation to work toward socially desired ends. And they do so at average per-capita health-care costs far below those of the United States —...


Many Americans oppose such a mandate as an infringement of their personal rights, all the while believing that they have a perfect right to highly expensive, critically needed health care, even when they cannot pay for it. This immature, asocial mentality is rare in the rest of the world. An insurance sector that must insure all comers at premiums that are not contingent on the insured's health status — a feature President Obama has promised — cannot function for long if people can go without insurance when they are healthy, but are entitled to premiums unrelated to their health status when they fall ill.

I wonder if there any here from Germany, Switzerland, or the Netherlands that can give us their impressions.





G&P

[excon]

Hello again:

Can one Righty tell me why they want the insurance companies in the mix??

What is so great about paying an insurance company?? Especially, when you don't have to... I don't get it. You think they're going to approve more services than the government would?? Why would you think that??

excon

[inthebox]

Sorry to burst the liberal balloon, but health care does cost. And yes, you do have to pay either as an individual or as a society.

That is the IMMATURE mentality : I deserve the best, the instantaneous health care and not have to pay for it.

Why do you have to pay a third party [ insurance or the government through taxes ] for something that should be paid for out of pocket?

The thing is, the government makes you pay [ through medicare, medicaid, social security ] for the healthcare of OTHERS. It is a PONZI scheme.

BTW EX do you get your healthcare exclusively through the VA or Medicare, or do you have "gap" / supplementary insurance to cover what the VA or Medicare won't pay for?

Medicare only covers 80% of charges, and you still have to cover the 20 % don't you.

Imagine the tax increase to cover that 20%, then again you libs LOVE TAXES.





G&P

[galveston]

Why would a righty want insurance?

We might be fine paying office calls, immunizations, etc. But what happens if we get a diagnosis of some dread disease with the astronomical costs involved?

That's why ANYONE needs insurance. Right?

[excon]

Hello gal:

Ok, we're getting somewhere here. You just want your BILLS paid. Me too. Cool.

Look, I don't like the government. I don't want them involved in my life any more than you do. But, it seems to me, that if my health care has to involve either an insurance company (who has to make a profit), or my government (who doesn't), that it would be cheaper for everybody if we eliminated the insurance companies altogether, and had a single payer - the government.

That way everybody would be covered, and I wouldn't have to worry about gap insurance, supplemental insurance, part D, Part A, the doughnut hole. I could live my life and when I got sick I could just go in...

Did I say cheaper and better?? Sorry. I don't think I have insurance that covers dementia.

excon

[tomder55]

With insurance there is still a degree of choice. With everyone herded into gvt care ,a triage approach is adopted with everyone maybe getting essential care ;but expensive treatments restricted to those who can afford the 2nd level of the tier .Inevidibly those would also be gone as the much maligned big pharma opt out of the development of expensive drugs like cancer fighting Herceptin because the reduction in demand would not justify the costs of development .

Would a market system work to reduce costs and thus make health care more available and affordable ? Yes .
How do I know ?
Because market forces work already in non-coverable elective health services. Cosmetic surgery is one such example. Consumers compare prices and services because they know their insurance will not cover it. As a result it is one of the few sectors of the health care industry where prices are dropping;and have been in real costs for the last 15 years.


The growing popularity in the use of walk in clinics ,concierge doctors and even "medical tourism" shows that American people in fact want market choice ;not government run care .

[inthebox]

Good points TOM

Another area that prices have declined in because it is subject to supply and demand, and because there often is no third party payor, is in eye surgery to correct nearsightedness.


---------------------------------------------------

I think where the government should get involved in IS MANDATING minimum HEALTH INSURANCE coverage. This would be similar to laws mandating car insurance. This would allow a greater number of the "healthy" to contribute to insurance risk pools. It is these currently healthy people that have no health insurance coverage that unfortunantly may be involved in a major trauma [ car accident for example ] that really costs society as whole.
Or these folks get diagnosed with something really bad - like cancer or heart failure, and now they are uninsurable or the premiums are so high as to make them virtually uninsurable.



I think the government should also regulate the health insurance industry in at least this regard:
Mandate a certain minimum percentage of
"sick" [ cancer, heart disease and other chronic illnesses being the major costs ] people to insure. An insurance company should not only cherry pick the young and healthy and refuse to cover the sick or be able to raise the rates on the truly sick as to make them uninsurable.
-----------------------------------------------

We know the current state of healthcare is not acceptable [ in the US ]. It is easy to pick apart whatever system is currently used here or in other countries. The change should be in coming up with a better soultion.

What other suggestions are out there?






G&P

[speechlesstx]

Girl's heart operation cancelled THREE times because of a shortage of hospital beds

By Daily Mail Reporter
Last updated at 3:37 PM on 22nd April 2009

A three-year-old girl waiting for vital heart surgery has had her operation cancelled three times in as many weeks because of a shortage of hospital beds.

Ella Cotterell was due to have an operation to widen her aorta artery in her heart on Monday at Bristol Children's Hospital, but her surgery was cancelled 48 hours before because all 15 beds in the intensive care unit were full.

Ella, of Bradley Stoke, Bristol, had open heart surgery when she was just nine days old and suffered a stroke at 18 months.

Her parents Ian Cotterell, 44, and Rachel Davis, 40, were told in October that she would need the operation within 12 to 18 months.

The surgery was first scheduled for April 2, but was postponed because of last-minute emergency cases coming in.

It was re-arranged for four days later but again the operation was cancelled for the same reason.

A third date was organised for April 20 and last Thursday she went to the children's hospital for pre-operative tests.

But on Saturday morning her parents received another call from the hospital, explaining her operation would have to be cancelled yet again.

Michele Narey, manager of the Women's and Children's division at the University Hospitals Bristol NHS Foundation Trust, said: 'The decision to cancel any patient for any procedure is taken extremely seriously but is sometimes unavoidable because of the need to effectively manage emergency patients requiring beds on a day-to-day basis.

'We know that cancelling procedures can cause additional stress for patients so we will always seek to avoid this wherever possible.

'We are continually reviewing our procedures to improve the management of emergency patients through our hospitals to avoid cancellations.

'We cannot discuss individual cases because of our duty of confidentiality to patients and their families.

Three-year-old Ella Cotterell with her parents Ian and Rachel and six-year-old brother Liam

'We take all complaints very seriously and we are working with the family to resolve this situation.'

At just a week old doctors discovered Ella's aorta hadn't formed properly and she had open heart surgery to repair it.

At 18 months old she suffered a stroke after falling down the stairs at her home and banging her head, temporarily paralysing the left side of her body.

In October, during one of Ella's six monthly reviews, an MRI scan found she had a narrowing of the aorta.

Doctors carried out two angioplasties, where small balloons are inflated to remove the blockage, but neither worked.

She is now taking an adult dose of medication to control her blood pressure.

Last week Ella went to hospital to undergo blood tests and a cardiogram in preparation for her surgery and was shown her hospital bed only to be disappointed for a third time.

Her mother Rachel Davis said today she was devastated when the hospital told her the surgery would be cancelled because there were not enough beds.

'My husband and I were in tears,' she said.

'When our six-year-old son Liam asked what was wrong we told him Ella's operation had been cancelled again and he said we should tell Gordon Brown.'

Ella, now three, at just nine days old after having emergency heart surgery

The family are now waiting for another surgery date.

'We have asked the doctors if she really needs the surgery as she is so happy at the moment and is running around like a normal little girl, but she could drop down dead at any moment,' said Ms Davis.

'Twice I have been told that she may not make it through the night and there have been times when I have gone into her room in the morning and wondered whether she'd still be breathing.

'She loves the attention and going to hospital is like an adventure to her, she doesn't realise they are going to cut her open, she just likes to play games with the nurses so she has been disappointed when we've told her the operation has been cancelled time after time.

'Its horrendous because you mentally prepare yourself that she may not survive the operation or she may be permanently disabled, because it is high risk surgery.

'We have been counting down the days, it is the waiting that is so hard.

'We have a family day out with Ella as the surgery gets closer and you can't help but think that it might be the last time we do something like this together.'

Ms Davis, who works part time as an accident and emergency nurse at Bristol's Frenchay Hospital, called on the Government to plough more money into the NHS before a child died on the waiting list.

'I have worked in the NHS for 22 years so I know what happens in hospitals,' she said.

'I cannot fault the doctors and nurses for all they have done for Ella, she would not be alive today without them.

'The surgeons at Bristol Children's Hospital take cases from all over the South West and Wales and they are desperately trying to get through the list.

'I believe Ella is the tip of the iceberg and that there are many other families out there that have had their operations cancelled many more times but have not spoken out about it.

'This is a national problem, there are not enough resources in the NHS and it is about prioritising.

'Children who need routine grommet operations are seen quickly yet the children who need life-saving surgery are waiting because there are not enough intensive care beds and staff.

'It is a matter of time before a child dies on the waiting list and I don't want it to be Ella.

'If that does happen the Government will have blood on their hands.'

[NeedKarma]

Patient Statements | Health Care Problems

Health Care Professional Statements | Health Care Problems

If you watched CBS's “60 Minutes” on Sunday, April 4, then you saw the same horrifying story I did. Budget cuts had to be made at the county hospital in the recession, the hospital CEO said. Outpatient chemotherapy clinic is closed. Letters go out to the patients. Treatment ends. People suffer with growing tumors, broken bones from metastasized cancers; people suffer to breathe. The budget is cut. It's horrifying stuff this national disgrace. (If you didn't see it, you can watch it here.)

[speechlesstx]

Patient Statements | Health Care Problems

Health Care Professional Statements | Health Care Problems

Thanks, NK. I'm supposed to be disturbed by a bunch of anonymous statements? For all I know you wrote them.

[NeedKarma]

There are clearly more people complaining there so it's obvious you have the broken system by your logic.

[speechlesstx]

There are clearly more people complaining there so it's obvious you have the broken system by your logic.

I guess I must have missed where it's "clear" that more people are complaining here. I'd also guess this Nevada situation is an isolated case, if they were never smart enough to provide more than one public hospital for the whole state then they're dumber than a box of rocks.

[NeedKarma]

I'd also guess this Nevada situation is an isolated case,

It funny how when I post it it's an isolated case but when you post it it's representative of the whole system. Yes, I'm laughing at you.