washingtonpost.com

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The deteriorating economy has made things worse. The date when the Social Security trust fund will start running deficits has moved closer by a year, to 2016, and the date of trust fund depletion has advanced by four years, to 2037. The Medicare hospital insurance trust fund is already running a deficit and will be exhausted by 2017.

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Medicare has been around less than 45 years and is going bankrupt.

If government cannot keep this entitlement program fiscally sound, what makes some think that SPENDING MORE for a "universal health care " program anymore sense?

The reality is
a] costs will have to be contained, which means less benefits, stricter requirements, and defacto rationing
b] taxes will have to be raised

The Associated Press: White House advises senators on health care bill

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Among the possibilities are tax increases on alcoholic beverages, tobacco products and sugary soft drinks, and restrictions on other health care-related tax breaks, such as flexible spending accounts.

Senators also are considering limiting — but not eliminating — the tax-free status of employer-provided health benefits.

Employer-provided health insurance technically is considered part of workers' compensation, but unlike wages, it is not taxed. The forgone revenue to the federal government amounts to about $250 billion a year.

So even if they're lucky enough to avoid going to the doctor or hospital, and never use their job-based health insurance, some Americans may find themselves paying taxes on at least part of its value.

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c] the other part of increasing revenue for medicare is to improve the economy, is that possible with increasing the deficit?

CBO deficit estimates top Obama's - Mar. 20, 2009

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"According to CBO, the president's budget would double publicly held debt in five years and nearly triple it in ten years," Gregg said. "I strongly urge the Democratic majority to show the fiscal restraint needed to control spending, maintain a fair tax policy and cut the deficit, so that we can head off the avalanche of debt that is poised to crush the economy."

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d] lowering reimbursement rates will have doctors leave the program altogether which will lead to accessibility problems.






G&P

Yep. My generation's... screwed.

The Medicare scenario is really sad. It doesn't cover jack to begin with... And then it goes broke?

I think candy and sugary drinks should be taxed. Cinnamon rolls aren't good for us, why aren't they already taxed. Alcohol drinkers and tobacco smokers need some help with the stiff taxes they are forced to pay.

It's all dem double stuffed oreos I tell you!

Candy! Cheesecake! All empty calories beware, 'cause you're next in line for taxation. Hey, isn't obesity a contributor in disease states?

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Originally Posted by inthebox

The reality is
a] costs will have to be contained, which means less benefits, stricter requirements, and defacto rationing
b] taxes will have to be raisedP

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Hello in:

Containing costs just means some insurance salesman won't be able to send his children to private school. HIS benefits will be rationed...

This isn't surprising. We've had different realities from the git go.

excon

The AMA, PhRMA, the SEIU, AHIP, and AdvaMed, all told the President in a letter this week they would do their part to achieve the administration's goal of “decreasing by 1.5 percentage points the annual health care spending growth rate—saving $2 trillion or more” over the next decade.

All of that can be achieved by sleight of hand paper juggling to make the books look good. The paper was vague, full of generalities and empty rhetoric .
http://www.aha.org/aha/letter/2009/0...oups-obama.pdf

They propose to reduce over use and under use of health care by aligning quality and efficiency incentives;including ;Reduce the cost of doing business by addressing cost drivers in each sector, through common sense improvements in such things as care delivery models and workforce deployment and development.
Focusing on obesity prevention commensurate with the scale of the problem.

All these proposals are ,as Obama describes,taking a scalpel to the issue.

Streamlining administrative functions is a drop of water in the ocean compared to the issues of solvency that IN is describing ;and the letter is posturing designed to keep the President from bullying the industry the way he has handled the banks and auto industries.

As has been mentioned many times here. SS and Medicare are generational thefts. I don't blame ISneeze for thinking that the next generation is screwed ;and I would not blame the next generation if they revolted against the scam.

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Originally Posted by tomder55

The AMA, PhRMA, the SEIU, AHIP, and AdvaMed, all told the President in a letter this week they would do their part to achieve the administration's goal of “decreasing by 1.5 percentage points the annual health care spending growth rate—saving $2 trillion or more” over the next decade.

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Hello tom:

I don't know. If you were an industry about to get cut out of the goodies, you'd say anything to stay in the game, and that's what's happening here.

I just wonder where these guys were earlier. Oh, I know where they were. They were RIPPING US OFF, which caused the problem in the first place!!

Screw them!

excon

No they weren't . Costs are rising because the population is aging and there is more demand for the services;and health care has been so good that people live longer. It is as simple as that.

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Originally Posted by tomder55

Costs are rising because the population is aging and there is more demand for the services;and health care has been so good that people live longer. It is as simple as that.

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Hello again, tom:

You're dreaming... The US is 66th in life expectancy. Even Libia's people live longer than we do.

excon

I think it's more like in the mid-40s but that is not what is important . Americans are living longer than previous generations regardless of ranking ;in fact the average age is at an all time high .
N C H S - 2008 Press Release - U.S. Mortality Drops Sharply in 2006, Latest Data Show

Americans are also eating more and have a more leisure time and generally choose bad lifestyle compared to the developing world. Obesity is a problem here ,but I doubt it is an issue in Libya.


Will universal care fix that without draconian measure to compel people to lose weight ? Maybe rationing their care will help the American ranking when they start dying off quicker.

Also the US numbers are distorted by a number of other factors. Homicide among minority males for one makes a big difference . Women in America live on average into their 80s... right up there with other top nation averages.

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Originally Posted by excon

Hello again, tom:

You're dreaming... The US is 66th in life expectancy. Even Libia's people live longer than we do.

excon

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First of all, we're 42nd, not 66th. Second of all, life expectancies have been increasing steadily in the USA, regardless of our world ranking. See below:

Year Life Expectancy at birth for general population
2005 77.8
2004 77.8
2003 77.5
2002 77.3
2001 77.2
2000 77.0
1999 76.7
1998 76.7
1997 76.5
1996 76.1
1995 75.8
1994 75.7
1993 75.5
1992 75.8
1991 75.5
1990 75.4
1989 75.1
1988 74.9
1987 74.9
1986 74.7
1985 74.7
1984 74.7
1983 74.6
1982 74.5
1981 74.1
1980 73.7
1979 73.9
1978 73.5
1977 73.3
1976 72.9
1975 72.6
1974 72.0
1973 71.4
1972 71.2
1971 71.1
1970 70.8
1960 69.7
1950 68.2
1940 62.9
1935 61.7
1930 59.7

Source: National Center for Health Statistics, National Vital Statistics Reports, vol. 54, no. 19, June 28, 2006.

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Originally Posted by ISneezeFunny

yep. my generation's...screwed.

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Are you less than 50? Then yes.

Imagine if you are 50, and you have been working since for the past 30 years. You have been paying into Social Security and Medicare with every paycheck, double if you are self employed or an employer, for the past 30 years and there won't be any medicare or social security for you when you turn 65. :(:mad:





G&P

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Originally Posted by excon

Hello in:

Containing costs just means some insurance salesman won't be able to send his children to private school. HIS benefits will be rationed...

This isn't surprising. We've had different realities from the git go.

excon

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The cost containment will mean less access to health care. For example


Walgreen to Cut Washington State Medicaid Business | Medicare and Medicaid Center: Medicare Medicaid Information, Tips & Information

The state gov did this to pharm and pharm will just pull out. If they do this with doctors, that will drive doctors to not accept medicaid and medicare - it already happens now.

Cost containment from the government will be no different than it is from the private insurance companies - COST SHIFTING
- higher deductibles
- higher co-pays on brand vs generic medications
- higher co-pays for ER vs office visits
- higher co-pays to see specialists vs primary care
- work ups and procedures done as an out patient vs. doe as an inpatient

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I doubt if most insurance salesman make enough to send a kid to private school.
If it is the HMO or Health insurance CEO[s] - well they will probably take their business acumen to another sector of industry and make as much money and still send their kid[s] to private school.


EX - your class envy is not very becoming ;)






G&P

I'm all in favor of healthcare for all, but I am a realist. How will it be done? Obama continues to talk in platitudes and concepts but be transparent and let us citizens know what OBAMA ACTUALLY PLANS.

Health Costs Are the Real Deficit Threat - WSJ.com

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How can we move toward a high-quality, lower-cost system? There are four key steps: 1) health information technology, because we can't improve what we don't measure;

how much will HIT cost in terms of hardware, software and labor? The VA already has a national electronic medical records - I've used it. Will it be free to doctors and hospitals? If not, how much will it cost?


2) more research into what works and what doesn't, so doctors don't recommend treatments that don't improve health;

Only a bureaucrat with no clinical experience will talk like this. There is certainly a lot of guidelines for a lot of diseases and illnesses, but not every individual fits into a neat cookbook, most don't. What of new technology? - there can be no research into what is yet to be done .How about new surgical techniques or imaging technology? - every advance comes at a cost which includes a lot of error. This approach to healthcare will kill innovation!

3) prevention and wellness, so that people do the things that keep them healthy and avoid costs associated with health risks such as smoking and obesity; and

Easier said than done. Behavioral change is very hard to come by, but good to hope for and expect. But again practically speaking I've seen recovering drug addicts and alcoholics that have been unable to give up smoking, and we all know that the percentage of the population that is obese is increasing, heck in my day pediatric obesity was almost unheard of, now it is sadly commonplace

4) changes in financial incentives for providers so that they are incentivized rather than penalized for delivering high-quality care.


This is and insult to most doctors and nurses - the majority of us went into this field to help others and by the nature of our training, we tent to be OCD and perfectionist about what we do. How about removing or reducing the malpractice threat that incentivizes ordering to many tests and doing more procedures so we feel we have everything covered including our a....s?

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I'm interested in what you all who favor universal healcare think.
How will it be paid for?
What will be covered?
Who will be providing healthcare?




G&P

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Originally Posted by inthebox

I'm all in favor of healthcare for all, but I am a realist. How will it be done?
How will it be paid for?
What will be covered?
Who will be providing healthcare?

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Hello in:

There are just too many people feeding at the health care trough... Something has to be cut. We have NO argument about that. You and the Wolverine think the only party at the trough who should or will suffer are the patients through a loss of services... In my view, the people who should suffer are anybody BUT the patients.

Let's just take the health insurance industry. They don't manufacture health gizmons, they don't make drugs, and they don't treat patients. What they do, is write checks, and they make a hefty profit by doing so.

How big a profit do they make?? I'll bet it's TRILLIONS and TRILLIONS. We don't need them to write checks. The government can write the checks, and all those TRILLIONS can pay to cover all those people who aren't covered now. We can get rid of them in one fell swoop, and I would.

Now, there are business's that government shouldn't do. Writing checks isn't one of them.

That, of course, isn't the ONLY fix. There's TRILLIONS more available for savings, if the government would only let Medicare negotiate the price's they pay for drugs. There's TRILLIONS and even more TRILLIONS available to be saved. I've only just started.

excon

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Originally Posted by excon

Hello in:

There are just too many people feeding at the health care trough... Something has to be cut. We have NO argument about that. You and the Wolverine think the only party at the trough who should or will suffer are the patients... In my view, the people who should suffer are anybody BUT the patients.

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As usual, you misunderstand me. I believe that the only ones that should be cut are the GOVERNMENT. Anyone else who benefits from the system (patients, providers, insurance companies) are welcome.

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Let's just take the health insurance industry. They don't manufacture health gizmons, they don't make drugs, and they don't treat patients. What they do, is write checks, and they make a hefty profit by doing so.

How big a profit do they make?? I'll bet it TRILLIONS and TRILLIONS. We don't need them to write checks. The government can write the checks, and all those TRILLIONS can pay to cover all those people who aren't covered now.

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So you believe that insurance companies serve absolutely no purpose? The fact that they make health insurance affordable to those who, if they had to pay for a $250,000 hospital stay out of their own pockets, would go broke is of no value?

I have three grandparents who died in the past year. I saw their final hospital bills. My granfather's bill for a 3 1/2 day stay with no actual procedures performed was well over $120 K. Do you really think that he could have paid that out of pocket. My grandmother spent 2 weeks in a hospital just six weeks prior to him. The cost of her stay was more than twice his bill. If not for their insurance, they would both have been driven into poverty... had they survived. My other grandmother died a year and three days ago. Her month-long stay with various procedures performed topped half a mil.

The only reason they were able to afford these stays was because they had health insurance. Medicare and Medicaid didn't cover it. Private insurance did. Do you see no value in that service? I certainly do. The value is the cost of the services minus the cost of the insurance... the difference is the value added. In the case of my grandparents, that value was about a million dollars... give or take a bit.

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Now, there are business's that government shouldn't do. Writing checks isn't one of them.

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Actually, that is the exact thing the government is not supposed to be doing. They are supposed to be running highways, fielding an army, maintaining a police force, enforcing border security, and managing the government. Spending OUR MONEY for us instead of letting us spend it for ourselvesis NOT what they are supposed to be doing. And spending our money on OTHER PEOPLE is most assuredly not part of their job.

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That, of course, isn't the ONLY fix. There's TRILLIONS more available for savings, if the government would only let Medicare negotiate the price's they pay for drugs. It's TRILLIONS, and even TRILLIONS more, and I've only just started.

excon

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The last time the government "negotiated" the price of drugs on our behalf (it's called "price fixing", and when companies do it, it's illegal) they drove 31 of 33 vaccine manufacturers out of business and caused the flu vaccine shortage of 2004-2005. The very people that the price fixing was supposed to help (those 65 and older who couldn't afford the expense of a flu shot) were the ones most adversely effected.

And you want to do more of it.

And you call me the one with no solutions...

Elliot

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Originally Posted by excon

Hello in:

There are just too many people feeding at the health care trough... Something has to be cut. We have NO argument about that. You and the Wolverine think the only party at the trough who should or will suffer are the patients through a loss of services... In my view, the people who should suffer are anybody BUT the patients.

Let's just take the health insurance industry. They don't manufacture health gizmons, they don't make drugs, and they don't treat patients. What they do, is write checks, and they make a hefty profit by doing so.

How big a profit do they make???? I'll bet it's TRILLIONS and TRILLIONS. We don't need them to write checks. The government can write the checks, and all those TRILLIONS can pay to cover all those people who aren't covered now. We can get rid of them in one fell swoop, and I would.

Now, there are business's that government shouldn't do. Writing checks isn't one of them.

That, of course, isn't the ONLY fix. There's TRILLIONS more available for savings, if the government would only let Medicare negotiate the price's they pay for drugs. There's TRILLIONS and even more TRILLIONS available to be saved. I've only just started.

excon

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I agree EX, the administrative costs of private insurance is higher than that of medicare.

The reason, you and I and patients will suffer through reduced benefits and or less accessibilty is that HEALTHCARE IS NOT FREE. Those who provide services cannot do it for free or less than the cost of doing business. Here is an experiment, look up local doctors in your area and tell them you have medicare or medicaid - now see how many accept medicare and medicaid - it isn't 100% - I guarantee it. This is rationing and lack of acess IN REALITY - now increase that by 2-3 times.

Obviously the health insurance co's make money, any business has to. Here is another thing, the reimbursements from private insurance to hospitals and doctors are generally higher than that of medicare and medicaid. It is private health insurance reimbursements that, in effect, subsidizes the care of those without insurance or those with medicare and or medicaid.

But lets say your fantasy comes true and there are no private insurance and the government runs healthcare:

This is the same government that can't keep medicare, medicaid, social security in the black.

This is the same government that has given billlions in taxpayor money to Chrysler and GM - and those businesses are still going bankrupt.

Do you walk the walk EX? Do you get 100% of your healthcare at a VA facilty?














G&P

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Originally Posted by inthebox

Are you less than 50? Then yes.

Imagine if you are 50, and you have been working since for the past 30 years. You have been paying into Social Security and Medicare with every paycheck, double if you are self employed or an employer, for the past 30 years and there won't be any medicare or social security for you when you turn 65. :(:mad:

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I'm 23. I own a business. Going off to med school... so I guess I'm not really looking forward to social security to help me out when I get to 65... but still. To a few of my friends...

... screwed.

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I don't blame ISneeze for thinking that the next generation is screwed ;and I would not blame the next generation if they revolted against the scam.

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And I stand by that, still the generation voted for those who would perpetrate the ponzi scheme and bring this theft to a whole new dimension .
They would seize assets of individual 401k plans and place them in a gvt. Managed "guaranteed retirement accounts" (GRAs) .This is being supported now by Rep. Jim McDermott Dem from Washington;chairman of the House Ways and Means Committee's Subcommittee on Income Security and Family Support.
I don't know where this is on their agenda ;but it's coming.