[Buckaroo]

Sentenced to death on the NHS

Patients with terminal illnesses are being made to die prematurely under an NHS scheme to help end their lives, leading doctors have warned.

http://www.telegraph.co.uk/health/he...n-the-NHS.html

On top of that, the IRS may be the Health Care enforcer. This is a nightmare no one should ever have to deal with. Government Health Care is a disaster that will happen.

Health care reform means more power for the IRS

http://www.washingtonexaminer.com/po...-56781377.html

[OldManMac]

Get back to us when you have some more reliable sources.

[turtle777]

Originally Posted by OldManMac 

Get back to us when you have some more reliable sources.

You mean, what Obama and the clowns in Washington have to say ?

-t

[hyteckit]

Poor Stephen Hawking would have been left to die by the NHS.

Luckily Stephen Hawking had great US medical insurance.

Those people from the UK as such Nazis.

[OldManMac]

Originally Posted by turtle777 

You mean, what Obama and the clowns in Washington have to say ?

-t

Better them than the the insurance industry, whose main goal is to deny your claims, so they can make enormous profits for a select few, or the pharmaceutical industry, which isn't concerned about what ails you, as long as they can convince you to "ask your doctor about Brand X, so they can jack up their profits. They love stupid people, and they're currently spending over $1 million a day (which is your money, BTW) to make sure they stay in charge of your "health care."

(See, I can do that also)

[ebuddy]

Originally Posted by OldManMac 

Better them than the the insurance industry, whose main goal is to deny your claims

Wrong. Medicare is actually more likely to deny claims than commercial health insurers

so they can make enormous profits for a select few, or the pharmaceutical industry, which isn't concerned about what ails you, as long as they can convince you to "ask your doctor about Brand X, so they can jack up their profits.

I grant you, PhRMA is extremely influential. In fact, they've set up a negotiation with a very naive administration that will ensure the government cannot approach individual pharmaceuticals. At the end of the day, it's still up to you whether or not you want to buy Brand X.

They love stupid people

No one depends on and appreciates stupid, uninformed people more than our current administration OldMan. They're parading the dumbest of them around the country to sell their ideal.

and they're currently spending over $1 million a day (which is your money, BTW) to make sure they stay in charge of your "health care."

... which of course doesn't hold a candle to how much of your money the government is throwing around to take charge of much more than just your healthcare my friend.

[ebuddy]

Originally Posted by Buckaroo 

Sentenced to death on the NHS

Patients with terminal illnesses are being made to die prematurely under an NHS scheme to help end their lives, leading doctors have warned.

http://www.telegraph.co.uk/health/he...n-the-NHS.html

On top of that, the IRS may be the Health Care enforcer. This is a nightmare no one should ever have to deal with. Government Health Care is a disaster that will happen.

Health care reform means more power for the IRS

http://www.washingtonexaminer.com/po...-56781377.html

Medicare has already beat 'em to it.

[turtle777]

Originally Posted by OldManMac 

(See, I can do that also)

You're a quick study, my friend.

Let's see how long it will take for you to see how Obama wants to f*** us all with his health care plans.

-t

[lpkmckenna]

Originally Posted by ebuddy 

Wrong. Medicare is actually more likely to deny claims than commercial health insurers

Oh yeah, and have you heard? Soldiers in a war have higher life expectancy than the general population!

The most important detail was in the article itself:

Another reason for the differential claims denial rates is the demographics of Medicare and commercial insurance enrollees. Almost all Medicare enrollees are over 65, while commercial insurers have enrollees who are of varying ages. Since older individuals are more likely to demand high cost medical procedures, if high cost medical procedures are the ones that are more likely to be denied then Medicare’s higher denial rate may simply be due to the composition of its enrollees.

Let's see comparison of similar people, shall we?

[hyteckit]

I heard people on Medicare have a higher rate of heart attacks than people with commercial health insurers.

Conclusion?

Medicare causes heart attacks.

[ebuddy]

Originally Posted by lpkmckenna 

Oh yeah, and have you heard? Soldiers in a war have higher life expectancy than the general population!

The most important detail was in the article itself:

Let's see comparison of similar people, shall we?

That wasn't the point however lpk. The point is that there is this fallacious notion that Medicare will not deny coverage when in fact it denies a great deal of coverage. The fact that their clientele consists exclusively of those over 65 means very little unless you can establish that their healthcare needs are somehow less necessary than the healthcare needs of those under 65 that they'd incur a higher denial rate. The proposal is to take an insolvent system and attempt to put it into play for all age-groups. People are advocating this move out of a higher trust in government health care over free market health care when they are comparing government health care to a not-so-free market health care system.

For those who want competition, let the 1300+ health insurance companies in this country compete. You'd be just as amazed at the decrease in cost and increase in coverage as you'd be if you knew the dichotomy in premiums from one state to another.

[ebuddy]

Originally Posted by hyteckit 

I heard people on Medicare have a higher rate of heart attacks than people with commercial health insurers.

Conclusion?

Medicare causes heart attacks.

No. The conclusion is;

- Coverage for the heart attack of those below 65 is more "medically necessary" than coverage for a heart attack of those over 65.

[turtle777]

Originally Posted by hyteckit 

I heard people on Medicare have a higher rate of heart attacks than people with commercial health insurers.

Conclusion?

Medicare causes heart attacks.

B+ for effort.

-t

[ghporter]

Originally Posted by hyteckit 

Poor Stephen Hawking would have been left to die by the NHS.

Luckily Stephen Hawking had great US medical insurance.

Those people from the UK as such Nazis.

Wow. Godwin's Law pops up on only the FOURTH post in the thread. Amazing.

Reliable facts are short in this thread. Buckaroo's sources are rather well known for competing with the Weekly World News for "facts" (yes, that's hyperbole), and most people's information on the US healthcare issue is third-hand (or worse) and completely devoid of real facts.

By the way, Stephen Hawking has survived approximately THIRTY times the expectation for most ALS patients. It ain't "stellar health care that's done that. Stephen is a fighter, and he has a purpose in life; most ALS victims succumb to things like pneumonia, but they really die because they give up.

[subego]

Originally Posted by ghporter 

By the way, Stephen Hawking has survived approximately THIRTY times the expectation for most ALS patients. It ain't "stellar health care that's done that. Stephen is a fighter, and he has a purpose in life; most ALS victims succumb to things like pneumonia, but they really die because they give up.

I recall reading awhile back they finally decided Hawking had something similar to, but not precisely ALS.

I know you didn't mean it this way, but a whole bunch of people with ALS have a purpose in life, and are fighters as well.

They all end up dying within a few years. All of them.


Edit: hyteckit may be referring to an Investors Business Daily editorial which claimed Hawking "wouldn't have a chance" if he was saddled with the healthcare they have in the UK.

[finboy]

Originally Posted by ebuddy 

Wrong. Medicare is actually more likely to deny claims than commercial health insurers

Shhh! Don't bring the FACTS into it! Facts don't matter! Using the facts isn't FAIR, either.

[hyteckit]

Originally Posted by finboy 

Shhh! Don't bring the FACTS into it! Facts don't matter! Using the facts isn't FAIR, either.

The problem is not the facts. The problem is misinterpreting the facts.

Private Insurers denied 21% of all claims.

http://blog.aflcio.org/2009/09/03/in...deny-coverage/

http://www.emaxhealth.com/2/124/3329...21-claims.html

CNA/NNOC researchers analyzed data reported by the insurers to the California Department of Managed Care. From 2002 through June 30, 2009, the five largest insurers operating in California rejected 31.2 million claims for care -- 21 percent of all claims.

PacifiCare denied 40 percent of all California claims in the first six months of 2009.

[hyteckit]

How is Aetna 6.5% when the others are 28% and greater. This is the opposite of ebuddy's link where Aetna has the higher rejection rate. Aetna seems to have the lowest rejection rate among private health insurance companies.


HMO Claims-Rejection Rates Trigger State Investigation - Consumer Watchdog

Rejecting medical claims

California's top health plans reject an average of 1 in 5 claims for treatment -- 45.7 million claims over the last seven years. Here's how their rejection rates compared during the first six months of 2009:

PacifiCare: 39.6%

Cigna: 33%

Health Net: 30%

Anthem Blue Cross: 28%

Kaiser Permanente: 28%

Aetna: 6.5%

Blue Shield: Data not available

Source: California Nurses Assn.

[ebuddy]

Originally Posted by hyteckit 

How is Aetna 6.5% when the others are 28% and greater. This is the opposite of ebuddy's link where Aetna has the higher rejection rate. Aetna seems to have the lowest rejection rate among private health insurance companies.


HMO Claims-Rejection Rates Trigger State Investigation - Consumer Watchdog

Rejecting medical claims

California's top health plans reject an average of 1 in 5 claims for treatment -- 45.7 million claims over the last seven years. Here's how their rejection rates compared during the first six months of 2009:

PacifiCare: 39.6%

Cigna: 33%

Health Net: 30%

Anthem Blue Cross: 28%

Kaiser Permanente: 28%

Aetna: 6.5%

Blue Shield: Data not available

Source: California Nurses Assn.

Missing in your breakdown is California Medicaid/Medicare claims denials. Link please. You'll be amazed at what you find my friend.

[hyteckit]

Originally Posted by ebuddy 

Missing in your breakdown is California Medicaid/Medicare claims denials. Link please. You'll be amazed at what you find my friend.

I'll just go with your numbers on Medicare - 6.9%

[ebuddy]

Originally Posted by hyteckit 

I'll just go with your numbers on Medicare - 6.9%

BTW, two of those "high-rate of denial offenders" in California are non-profits similar to one of the proposals in several of the bills. You knew that right? No need to simply go with my numbers. One of the major problems with Medicare or "MediCal" (In California) (as with private insurers) is the incredible differences in costs and coverages from state-to-state. Besides, Medicare as a program is insolvent. It is not resourced to cover the 38+ million it presently covers and there's absolutely nothing to suggest it could cover hundreds of millions.

[shifuimam]

Originally Posted by ebuddy 

At the end of the day, it's still up to you whether or not you want to buy Brand X.

I hate to disagree with you, ebuddy. It doesn't happen often.

It's not always a choice between brands, or between brand-name or generic. Sometimes, the only medication that really works is still in-patent, available from a single company, and costs a shitload without insurance.

That being said, there's a reason why in-patent medications are so expensive. Pharmaceutical companies spend billions and billions of dollars on R&D, and that money has to be recouped (while turning a profit and affording the salaries of all those people with biomedical PhDs and whatnot).

The particular antidepressant I'm on, Cymbalta, is offered by Lilly, and it's still under patent. Even with insurance, it costs about $80 a month.

On the other hand, without it, I'm a basket case and more or less incapacitated by my own mind going all batty on me. In the end, I'd rather pay the premium so that Lilly can more rapidly research, find, and develop these new medications that allow people like me to lead normal, fulfilling, productive lives. If Lilly's research were slowed by government-enforced price fixing on drugs (which is essentially what people want), it might be another five or ten or twenty years before they came up with Cymbalta.

If it weren't for that drug, in five years, I likely would have committed suicide long before that five years were up. I'd say it's worth the expense.

[hyteckit]

Originally Posted by ebuddy 

BTW, two of those "high-rate of denial offenders" in California are non-profits similar to one of the proposals in several of the bills. You knew that right? No need to simply go with my numbers. One of the major problems with Medicare or "MediCal" (In California) (as with private insurers) is the incredible differences in costs and coverages from state-to-state. Besides, Medicare as a program is insolvent. It is not resourced to cover the 38+ million it presently covers and there's absolutely nothing to suggest it could cover hundreds of millions.

Your arguments are all over the place.

What does being a non-profit, a LLC, an S Corp, or whatever structure of business have anything besides how they are being taxed?

So what if Kaiser Permanente is a nonprofit? Kaiser Permanente is the guys behind this Health Insurance scam with the help of Pres. Nixon.

Howard Hughes donated his Hughes Aircraft to his nonprofit Howard Hughes Medical Institute to avoid taxes.



The point remains, most private insurance companies denies 28% to 40% of claims in California.

[ghporter]

Originally Posted by subego 

I recall reading awhile back they finally decided Hawking had something similar to, but not precisely ALS.

I know you didn't mean it this way, but a whole bunch of people with ALS have a purpose in life, and are fighters as well.

They all end up dying within a few years. All of them.

Since it's not actually known what ALS really is (no definitive blood test, no biopsy, etc. that's categorically diagnostic), the "not quite really ALS" discussion is simply an abstract exercise. Dr. Hawking's disease has been behaving just like ALS for decades, just slower.

And no, I didn't mean to suggest that only he "is a fighter" or only he "has a purpose in life." Far from it. But as a notable individual, Dr. Hawking has apparently made a point of staying alive while breaking newer and newer ground with his work.

Finally, while most ALS sufferers do indeed succumb within a few years, extended survival (over 10 years) is rare but not unknown. To quote The ALS Association:

About twenty percent of people with ALS live five years or more and up to ten percent will survive more than ten years and five percent will live 20 years. There are people in whom ALS has stopped progressing and a small number of people in whom the symptoms of ALS reversed

Demographics of ALS sufferers are all over the place, especially when socioeconomic status is considered-and thus availability to health insurance.

[ebuddy]

Originally Posted by hyteckit 

Your arguments are all over the place.

What does being a non-profit, a LLC, an S Corp, or whatever structure of business have anything besides how they are being taxed?

The profit-motive has been cited as one of the primary sources of higher denial rates. I overestimated how closely you've been following the debate. BTW, your claim that my arguments are all over the place will likely have little traction while mentioning Howard Hughes and Nixon. I'm just sayin'.

The point remains, most private insurance companies denies 28% to 40% of claims in California.

The point remains flawed.

A. You're citing California which you understand is absolutely laughable while their governor appeals to the Federal Government for an emergency loan of $7 billion dollars. They are facing enormous cuts in State programs and personnel including, you guessed it; state managed health care. This, while they enjoy being ranked the 6th highest tax burden as percent of income in the nation. Think about it, you're touting the merits of an insolvent system sponsored by an insolvent State. How long do you suppose they'll sustain this track record of low denials and what do you suppose the low denial rate is? (I'll answer in a minute)

B. Your link touches on the 6 largest insurers which speaks to exactly the point I've been trying to make. Anthem for example is in violation of established antitrust standards yet given a pass as are many of the nations' largest insurers. Antitrust has got to be enforced. This is a government beholden to special interest. We need government reform.

C. I'd like to see the Nurse's Assoc actual study. I have a couple of problems with your article as well including their use of the statement; "The rejection rates ranged from a high of 39.6% for PacifiCare to 6.5% for Aetna for the first half of 2009. Cigna denied 33%, and Health Net 30%."

There's no end to cherry-picking States and even cherry-picking dismal quarter-years. Let's use a study by Physicians Practice Payer Rankings by region-2008;
- MediCal-CA denies 19.55%
- Medicare B CA Southern denies 16.43%
- Medicare B- Nothern CA denies 10.98%
physicians practice

What this means is that there are some 11 private insurers outperforming the State-managed payers in California. As far as ranking the West region as a whole, MediCal and Medicaid-TX ranked 25th and 26th out of 26 with Medicaid-TX 25.78% denial rate.

D. It should be noted however that flat denial rates are often misleading because they do not indicate the final outcome. I'm assuming you know that there are also pass-rates to be considered. This is the percentage of times a payee (physician) is compensated at first request. In terms of "First Pass Rates" MediCal-CA scored a dismal 74.77% compared to Cigna/HealthSource's 96%.

So... if your point is supposed to somehow relate to "competition", you've got several private insurers (even with your nurse's assoc breakdown) outperforming the public options. The best option is not a public option as those do not compete very well at all. The best option is to allow the wealth of private insurers to compete.

[ebuddy]

Originally Posted by shifuimam 

I hate to disagree with you, ebuddy. It doesn't happen often.

That being said, there's a reason why in-patent medications are so expensive. Pharmaceutical companies spend billions and billions of dollars on R&D, and that money has to be recouped (while turning a profit and affording the salaries of all those people with biomedical PhDs and whatnot).

I cannot disagree here. In fact, this was one of my points about the differences between pharmaceuticals in the US and abroad in another health care discussion. I'm interested in your Cymbalta example below...

The particular antidepressant I'm on, Cymbalta, is offered by Lilly, and it's still under patent. Even with insurance, it costs about $80 a month.

On the other hand, without it, I'm a basket case and more or less incapacitated by my own mind going all batty on me. In the end, I'd rather pay the premium so that Lilly can more rapidly research, find, and develop these new medications that allow people like me to lead normal, fulfilling, productive lives. If Lilly's research were slowed by government-enforced price fixing on drugs (which is essentially what people want), it might be another five or ten or twenty years before they came up with Cymbalta.

If it weren't for that drug, in five years, I likely would have committed suicide long before that five years were up. I'd say it's worth the expense.

I certainly cannot argue with your success shifuimam and when it comes down to it, I really wouldn't want to because I cannot personally understand what you're going through. Cymbalta, or duloxetine is marketed generally as "depression hurts" to address the compelling link between physical pain and depression. The more pain you feel, the less effective an antidepressant can be historically.
carlat psychiatry report
Several clinical trials have compared Cymbalta to a placebo in treating depression. In some of these studies, physical pain was also assessed. A meta-analysis including data from 714 patients taking duloxetine and 562 patients taking placebo from five such trials found that the advantage of Cymbalta over placebo was not quite statistically significant (p = .057)...

... How does Cymbalta compare to other antidepressants? Five trials have compared Cymbalta to Paxil (paroxetine) in treating pain in depression. However, two of these Lilly-sponsored trials did not report how pain outcomes compared between the two drugs, which may indicate that Cymbalta did not outperform Paxil in these trials. The Spielmans meta-analysis found no difference between Cymbalta and Paxil in two trials (p = .76). An additional trial had similar results (Lee P. et al.; Psychiatry Clin Neurosci 2007;61:295-307).

While a handful of studies have compared Cymbalta to Lexapro (escitalopram) and Effexor (venlafaxine), pain measures were not a focus of these investigations. For depression, the studies showed mixed results, with two trials showing statistically significant but small advantages for Lexapro on some measures.

I cite the above only to indicate that your situation (neuropathic pain and/or fibromyalgia?) is not only very complex, but is the exception; not the norm.

[ghporter]

Originally Posted by ebuddy 

D. It should be noted however that flat denial rates are often misleading because they do not indicate the final outcome. I'm assuming you know that there are also pass-rates to be considered. This is the percentage of times a payee (physician) is compensated at first request. In terms of "First Pass Rates" MediCal-CA scored a dismal 74.77% compared to Cigna/HealthSource's 96%.

Initial denial can be because of a huge number of factors. Was the care properly documented? Was it properly coded (using the correct DRG or other required codes, which must match the narrative description of the care)? Was the documentation submitted in a timely manner? Was the practice submitting the documentation current in its affiliation with the insurer? Etc., etc., etc. Resubmissions are VERY common, and frequently (though not universally) result in payment.

So your statement is spot on-the FINAL result is the important point in denials, and that data is almost impossible to obtain. Also impossible to obtain is how good the practices that submit for payment are at their documentation, timeliness, and persistence in resubmitting.

[subego]

Originally Posted by ghporter 

Finally, while most ALS sufferers...

I stand corrected.

[OreoCookie]

@ebuddy
While I don't take psychotropic drugs myself, I know for a fact that the exact combination and dosage is always very personal. They are typically very strong and have a wide range of side-effects, ranging from hair loss, loss of appetite, weight gain, drowsiness, etc. etc. You don't always have the luxury of choosing generic drugs.

However, this is a problem you encounter also if you have private insurance. Insurances don't like to pay if at all possible.

[hyteckit]

Originally Posted by ebuddy 

The profit-motive has been cited as one of the primary sources of higher denial rates. I overestimated how closely you've been following the debate. BTW, your claim that my arguments are all over the place will likely have little traction while mentioning Howard Hughes and Nixon. I'm just sayin'.

Sorry, but that just isn't true about a non-profit having no profit-motive, which is what I tried to explain earlier.

One of most common misconception about a nonprofit organization is that they have no profit-motive. Must be because of the name "nonprofit".

http://www.bizjournals.com/sanfranci...5/daily36.html

Kaiser Permanente's first 9 months' PROFIT in 2007 was $2.5 BILLION. That's right. Profit of $2.5 billion in just 9 months.


Forming a nonprofit protects the profits from being taxed, like what Howard Hughes did with Hughes Aircraft. Nonprofit just determines how your profit is taxed and how the profit is distributed. Nonprofit doesn't mean it has no profit-motive.

[hyteckit]

Originally Posted by ebuddy 

D. It should be noted however that flat denial rates are often misleading because they do not indicate the final outcome. I'm assuming you know that there are also pass-rates to be considered. This is the percentage of times a payee (physician) is compensated at first request. In terms of "First Pass Rates" MediCal-CA scored a dismal 74.77% compared to Cigna/HealthSource's 96%.

Because comparing the denial rates of Medicare which is available to those 65 and older, with private insurance which is available to all ages is so not misleading.

We all know that the medical needs for teenagers and those under 40 are exactly the same as those 65 and older.

**END SARCASM**

[ebuddy]

Originally Posted by hyteckit 

Because comparing the denial rates of Medicare which is available to those 65 and older, with private insurance which is available to all ages is so not misleading.

We all know that the medical needs for teenagers and those under 40 are exactly the same as those 65 and older.

I've already touched on this. Medicaid is actually a more direct comparison and they fare worse than Medicare. Notwithstanding, If you can establish how the medical needs of a 65 year old are somehow less necessary that they'd incur a higher denial rate, then you might have a point. The fact remains, in your example there were approximately 11 private insurers who were more competitive than the government option. If we had the opportunity to choose between any of those other options, we'd be better off than with the government option.

[ebuddy]

Originally Posted by hyteckit 

Sorry, but that just isn't true about a non-profit having no profit-motive, which is what I tried to explain earlier.

One of most common misconception about a nonprofit organization is that they have no profit-motive. Must be because of the name "nonprofit".

http://www.bizjournals.com/sanfranci...5/daily36.html

Kaiser Permanente's first 9 months' PROFIT in 2007 was $2.5 BILLION. That's right. Profit of $2.5 billion in just 9 months.


Forming a nonprofit protects the profits from being taxed, like what Howard Hughes did with Hughes Aircraft. Nonprofit just determines how your profit is taxed and how the profit is distributed. Nonprofit doesn't mean it has no profit-motive.

Good points hyteckit. In light of how profitable Planned Parenthood is as a non-profit as well for example, I retract my statement on non-profits. Please strike that from the record as well as any non-profits proposals in the health care reform bills. Thank you.

[hyteckit]

Originally Posted by ebuddy 

Good points hyteckit. In light of how profitable Planned Parenthood is as a non-profit as well for example, I retract my statement on non-profits. Please strike that from the record as well as any non-profits proposals in the health care reform bills. Thank you.

I think you are confused with nonprofits and co-op.

Forget co-ops.

Public option all the way.

[ebuddy]

Originally Posted by hyteckit 

Public option all the way.

Why? Just because?

• It certainly can't be in the interest of "competition" as there are already over 1300 insurers in this country not allowed to compete and nothing in any proposal to address this problem.
• Certainly not out of concern for the "45 million uninsured" because at last check the proposal will cover less than a third of them while moving several million off of their current coverage.
• It can't be because of the shining examples of those insolvent systems abroad because they are increasingly privatizing their models to keep up.

This attitude seems to stem from the notion that the free market is greedy and bad, government is good and virtuous. This, in light of the fact that just 10 months ago we were talking about unprecedented civil rights abuses, croneyism, deceit, fraud, waste, and rampant spending.

[besson3c]

ebuddy: I still have a problem with the notion that a lack of financing for a public option = insolvent = increasingly privatizing their models because of some failure of the public system. There are many possible different explanations and reasons for this, I think you are drawing the conclusions you want to draw.

[hyteckit]

Originally Posted by ebuddy 

Why? Just because?

Why?

Because the role for the government is to promote the General Welfare of its citizen.

I believe saving lives is in the interest of General Welfare of its citizens.

The government should protect its citizens from foreign agents that can kill them, whether these foreign agents are human terrorist or microscopic bacteria/virus.

I say why not have a public option? Cost to taxpayers?

Isn't both the goal of national defense and a public option is to protect the lives of its citizens?

Originally Posted by ebuddy 

• It certainly can't be in the interest of "competition" as there are already over 1300 insurers in this country not allowed to compete and nothing in any proposal to address this problem.
• Certainly not out of concern for the "45 million uninsured" because at last check the proposal will cover less than a third of them while moving several million off of their current coverage.
• It can't be because of the shining examples of those insolvent systems abroad because they are increasingly privatizing their models to keep up.

This attitude seems to stem from the notion that the free market is greedy and bad, government is good and virtuous.

• I guess Republicans don't care about competition either since Republican has done nothing to promote competition in the healthcare insurance industry while they were in power for 6 years with a Republican President and a Republican majority in congress.
  
  
  If you want to talk about supply and demand, and the effects of competition, you have to realize that the doctors and hospitals are the supply curve, and the supply is limited.
  
  Health insurance companies are just the distribution channel for these healthcare services provided by the hospitals and doctors.
  
  If there are 100,000 Nintendo Wii's available for sale, increasing the number of distribution channels isn't going to affect the price of the Nintendo Wii. If there are 1000 stores selling the Wii, that would mean there are about 100 Wii's in each store if they supply is evenly distributed. If you increase the number of stores selling the Wii to 10,000, that would mean each store has 10 Wii's if supply is evenly distributed. Seems like less Wii's to choose from at each store by increasing the number of distribution channels.
  
  
  
  I wonder how having 1000 insurance companies in California would work. Is it even manageable or doable to have 1000 health insurance companies in one state? 10,000 hospitals and 1000 health insurance companies.
  
  Great, now I have 1000 health insurance companies to choice from. But instead of having 1000 in-network providers to choose from as part of my HMO network, I now have 10 providers to choose from. Doctors still want their high salary and drug companies still want to sell drugs at their current prices, so insurance prices still remain the same since insurance prices are largely influence by cost factors.
  
  - 1000 health insurance companies to choose from.
  - Health insurance prices remain high because the cost of doctors and drugs remain the same.
  - Instead of having 1000 healthcare providers to choose from, I now have 10 in-network providers to choose from as part of my HMO.
  
  
  More choice in insurance companies seems to be less choice in terms of in-network providers.
  
  
  Wow, sounds great. Not!
  
  
  
  
• Then have a public option that covers everybody.
  
• US government is insolvent. US National Defense is insolvent. US can't be a shining example of capitalism and democracy. Maybe we should model ourselves after China, whom the US borrow about $1 trillion from.

Originally Posted by ebuddy 

This, in light of the fact that just 10 months ago we were talking about unprecedented civil rights abuses, croneyism, deceit, fraud, waste, and rampant spending.

Let's not talk about the Bush administration shall we.

[ebuddy]

Originally Posted by besson3c 

ebuddy: I still have a problem with the notion that a lack of financing for a public option = insolvent = increasingly privatizing their models because of some failure of the public system. There are many possible different explanations and reasons for this, I think you are drawing the conclusions you want to draw.

- There's a lack of financing which certainly =insolvent; that is not solvent; unable to satisfy creditors or discharge liabilities, either because liabilities exceed assets or because of inability to pay debts as they mature.
- increasing privatization
- the system was more public and now it is becoming less public.

You don't have to call it a failure of the public system if you don't want to besson3c. I suspect you probably wouldn't because of course that's the conclusion you've drawn right?

[hyteckit]

California has the highest number of HMOs - 47

Number of HMOs - Kaiser State Health Facts

[besson3c]

Originally Posted by ebuddy 

- There's a lack of financing which certainly =insolvent; that is not solvent; unable to satisfy creditors or discharge liabilities, either because liabilities exceed assets or because of inability to pay debts as they mature.
- increasing privatization
- the system was more public and now it is becoming less public.

You don't have to call it a failure of the public system if you don't want to besson3c. I suspect you probably wouldn't because of course that's the conclusion you've drawn right?

No, I would say it is inconclusive, and your conclusions unreasonable and probably warped to match your view. There are any number of reasons why a government may not increase financing to a program in a democratic society.

Whether a public health care program is solvent or not depends on how it is run, who is running it, how it is regulated, etc. There are many of countries with solvent public health care systems, they've been running them for years. In fact, if you travel to many of them many would be puzzled with the debate that is going on here, because in many of these countries people are entirely happy with their health care (I believe something like 92% of Canadians, for instance, are happy with theirs). I know happy does not equal solvent or insolvent, but your image of an ineffective system that every country is urgently trying to abandon and no country can continue to afford is skewed, put it that way. Either that, or my perception of your image is skewed, and granted my perception is colored (or coloured) by over 20 years of living in Canada.

You may be thinking that these poor schmucks who are happy with their care don't know any better, although the reverse could be true, no?

[ebuddy]

Originally Posted by hyteckit 

Why?

Because the role for the government is to promote the General Welfare of its citizen.

Really? We should be able to go back to our past then to see how our forefathers approached health care. Surely, of all the things as basic as health care, food, water, and... wait a minute. Does the government really have the authority under "General Welfare" to provide health care to all? Really? It seems to me the powers of the government are very clearly documented;
- Congress can tax
- Pay its debts
- Provide for the common defense
- It can borrow, regulate commerce with foreign nations, and among the States
- It can establish rules for naturalization
- adopt bankruptcy laws
- Congress can coin money, regulate its value and fix a system of weights and measures as well as punishment for counterfeiting.
- It can establish post offices...
- ... laws for patents
- It can set up a system of courts and punish piracy
- It can declare war and raise armies, navies, and a militia and it can make all laws necessary and proper to carry out the above powers.

Why so clear about the powers of Congress and those not granted them, granted the State? This must mean that Congress has unlimited authority? No, sorry.

Surely, through smallpox and other serious medical concerns during the times of our forefathers, there should be examples of their intent to provide health care to all? No? Strange don't you think? Come to think of it, there were absolutely zero proposals for a "public health care" provision until the 1900s. You might not be familiar with the concepts of "positive rights" and "negative rights", but some reading may be in order for you to clear up what I can only describe as a severe misinterpretation of our founding documents.

I believe saving lives is in the interest of General Welfare of its citizens.

You may believe it, but it isn't so.

The government should protect its citizens from foreign agents that can kill them, whether these foreign agents are human terrorist or microscopic bacteria/virus.

Should they likewise assume control of food in case of food shortage crises? How about water? Means of getting to and from work?

I say why not have a public option? Cost to taxpayers?
Isn't both the goal of national defense and a public option is to protect the lives of its citizens?

No. If the goal was to protect the lives of the citizens, the proposal would not cover only a third of the ones in need of this protection. Just as the "national defense" expenditure and purpose has been abused as so-explained through arguments provided by you and others, what is it of health care that gives government all this sudden credibility, capability, and virtue?

I guess Republicans don't care about competition either since Republican has done nothing to promote competition in the healthcare insurance industry while they were in power for 6 years with a Republican President and a Republican majority in congress.

I thought you didn't want to talk about Bush. They haven't either and I've been just as harsh on the inaction of Administrations prior. The reason this is a major point of contention with me now is the proposals that are on the table, the "sell" used to thrust them, and the proposals not on the table.

I wonder how having 1000 insurance companies in California would work. Is it even manageable or doable to have 1000 health insurance companies in one state? 10,000 hospitals and 1000 health insurance companies.

Is there a law that there be so many hospitals per insurer??? I'm not even sure what you're arguing here. The market needs to be regulated by a Federal Standard of minimum requirements for all States, anti-trust legislation enforced, and the market opened up at the national level instead of tax policies and regulatory measures that have created intra-state monopolies. People are charged what they're charged because they can be. From looking at expenditures between Medicare and VA for example, there's no such sign of any integrity with price controls anyway. Again, I'm not sure where all this confidence in the integrity of the government is coming from.

Great, now I have 1000 health insurance companies to choice from. But instead of having 1000 in-network providers to choose from as part of my HMO network, I now have 10 providers to choose from. Doctors still want their high salary and drug companies still want to sell drugs at their current prices, so insurance prices still remain the same.

So... how is a public option going to address this problem?

- 1000 health insurance companies to choose from.
- Health insurance prices remain high because the cost of doctors and drugs remain the same.
- Instead of having 1000 healthcare providers to choose from, I now have 10 in-network providers to choose from as part of my HMO.

Ironic isn't it? You believe the answer is 1001 insurers with the 1 being a public option? How does that solve the sky-rocketing costs of health care? I thought it was the "evil insurers" not the "evil medical practice". Try to stay on task because as it stands right now you're arguing with yourself here.

More choice in insurance companies seems to be less choice in terms of in-network providers.

How do you get here? If clinics and providers need patients and those patients have the choice of hundreds of insurers as opposed to those preferred only by the State, they will have to accept patients from a growing number of insurers.

[*] Then have a public option that covers everybody.

It can't. There are already over 3 million children eligible for a form of Medicaid/Medicare yet remain unenrolled. The current proposal only touches the surface of the uninsured while addressing the none of the actual problems with increasing health care costs.

US government is insolvent. US National Defense is insolvent. US can't be a shining example of capitalism and democracy. Maybe we should model ourselves after China, whom the US borrow about $1 trillion from.

- government run media
- caps on freedom of speech
- censored internet
- rural working permits
- repressive Chinese factories
- all religions required to register with the government who then selects their leadership and content.
- No due process
- One child policy
- Crimes punishable by death include tax evasion
- immigrants to China are "non-persons living in China"

Sure and while we're busy emulating such a compassionate model we could borrow another few trillion dollars from them to make our health care system really zip for the uninsured!

Let's not talk about the Bush administration shall we.

I'll let you decide.

[besson3c]

ebuddy: in your opinion, how should private health care provision be regulated? We've talked a little about anti-trust, but in terms of all of the pre-existing condition stuff, the percentage of payment that goes into health care, pricing, dropping of coverage, controlling who you can go see, rationing, etc.?

[ebuddy]

Originally Posted by besson3c 

ebuddy: in your opinion, how should private health care provision be regulated? We've talked a little about anti-trust, but in terms of all of the pre-existing condition stuff, the percentage of payment that goes into health care, pricing, dropping of coverage, controlling who you can go see, rationing, etc.?

The first thing I can tell you from the examples of the government managed care already operating in the US is that pricing, dropping of coverage, controlling who you can see, and rationing are already problems that a public option (based on precedent) would not address.

As far as pre-existing conditions, if a government can create from nothing an entirely new public option that all in the know agree will be the beginning and the end of the private insurance market, can it not at least simply mandate minimum care expectations not unlike what it has already done with HIPAA? To be clear, IMO this is a last resort and should be the only "trigger" afforded under current proposals.

Here's the fundamental problem besson, health insurance is a service-oriented industry. The only way to drive down the costs under such an industry is competition. A competitive market is the absolute best means of consumer protection. What we're proposing with a public option is a lot like looking into your cupboard to find 5 pesticides and while having used none of them, decide to buy another pesticide. The market is already there, let it operate. Remove the ban on cross-state insuring now, enforce anti-trust, encourage HSAs and HSA-compatible plans with tax incentives much like what employers are getting now, set minimum guidelines like those already mandated under HIPAA, and guarantee the right to future insurance.

Term life insurance for example is guaranteed renewable. Health insurers just like life insurers, can issue contracts that treat all of their consumers equally. I've already discussed HSAs that would actually have insurers competing for your business regardless of your condition. Again, there is a fundamental mistrust in the free market, but you're not comparing the public option to a truly free market. Everything you can possibly mention around this issue points back to the need for government reform, not health insurance reform. You're not going to solve all of our health care woes overnight regardless. There's this notion that a public option cures all these ills starting the day it's passed and this is incredibly naive in light of the fact that we already have these examples both in the US and abroad showing us otherwise; even when established over decades of practice. What we can do are simple, non-contentious things right now to begin to solve this problem without absolutely overturning the entire system.

[ebuddy]

Originally Posted by besson3c 

No, I would say it is inconclusive, and your conclusions unreasonable and probably warped to match your view. There are any number of reasons why a government may not increase financing to a program in a democratic society.

You can say the evidence is inconclusive all the way up until a plan you find reprehensible makes its way into law or you can decide that you have enough information and evidence to make a decision. Just because someone has decided to oppose a measure you support does not mean they are shaping facts to meet a presupposition any more than you already have in your indecision.

Whether a public health care program is solvent or not depends on how it is run, who is running it, how it is regulated, etc.

Correct. The precedent already exists for knowing how it is run, who is running it, how it is regulated, etc... and is a substantial basis for opposing the public option.

There are many of countries with solvent public health care systems, they've been running them for years. In fact, if you travel to many of them many would be puzzled with the debate that is going on here, because in many of these countries people are entirely happy with their health care (I believe something like 92% of Canadians, for instance, are happy with theirs).

The overwhelming majority of Americans are happy with their care as well. What if the US has an opportunity to show the world how to accomplish better health care for all without invoking a massive, insolvent government program that abuses their tax dollars?

I know happy does not equal solvent or insolvent, but your image of an ineffective system that every country is urgently trying to abandon and no country can continue to afford is skewed, put it that way. Either that, or my perception of your image is skewed, and granted my perception is colored (or coloured) by over 20 years of living in Canada.

38 years here and couldn't be happier. You realize of course this argument means nothing. In reality, you have to cite an example of a system less than a third the size of our proposed system to find a public option that is plausible, but you still will not find a sustainable system. This is simply a fact. Cite any country, any example you want-Canada of course included. I've cited Canada's increasing privatization and I've cited studies of 8 EU members' increasing privatization in the attempt to keep up with rising demand and costs. You can think what you want of course as are many others, but I find the lack of substantive information produced by proponents of a public option to back the claims indicative of a presupposition in search of a conclusion.

You may be thinking that these poor schmucks who are happy with their care don't know any better, although the reverse could be true, no?

Let's just stick with what I'm saying and not what you think I'm thinking. k?

[besson3c]

Originally Posted by ebuddy 

The first thing I can tell you from the examples of the government managed care already operating in the US is that pricing, dropping of coverage, controlling who you can see, and rationing are already problems that a public option (based on precedent) would not address.

I haven't gone over any of the bills yet, but I base my optimism on possibility, not precedent. The way I see it it is hard to imagine the system being any poorer than it already is. I truly think we have hit rock bottom, and that we can do so much better.

As far as possibility goes, it is absolutely possible to get prices more in line with something in the ballpark of sane (rethinking the role of the ER is a good start), as well as to prevent coverage being dropped and controlling who you can see if we use the realities of other countries as a model. I'll just go back to Canada because that's what I know best. There, you can see whomever you want, coverage is not dropped (in fact, the government even pays for referrals to the US in some cases and care received abroad). As far as rationing, as I thought we agreed upon, that is going to happen no matter what the system to some extent. All we can debate there is to what extent it will, and this would probably mostly be speculation.

So, perhaps you shouldn't use the broken systems of today as a precedent here? It's unlike me to be this optimistic, but again, I regard what we have so poorly that there logically only seems one direction we can go once we have hit rock bottom (as I feel we pretty much have).

As far as pre-existing conditions, if a government can create from nothing an entirely new public option that all in the know agree will be the beginning and the end of the private insurance market, can it not at least simply mandate minimum care expectations not unlike what it has already done with HIPAA? To be clear, IMO this is a last resort and should be the only "trigger" afforded under current proposals.

This is a pretty leading question. I don't agree that it will be the end of the private insurance market, far from it, so I'm sure how to respond to this.

Here's the fundamental problem besson, health insurance is a service-oriented industry. The only way to drive down the costs under such an industry is competition.

You can also regulate as Minnesota has done by saying that a certain percentage of our private health care expenses has to go to actual health care provision. This has helped somewhat, so it seems, and seems supported by both parties there.

However, I agree that whatever you can do to chip away a little bit at the fat executive insurance salaries and other excesses is more of a shim than a solution. Do you think that insurance companies that have become monopolies should be able to charge whatever they want and devote whatever percentage they wish towards actual health care? Normally I would say "sure", that provides an opportunity for a competitor to undercut them, but I just don't think this is as simple in this climate. I agree with you that this ought to change.

A competitive market is the absolute best means of consumer protection. What we're proposing with a public option is a lot like looking into your cupboard to find 5 pesticides and while having used none of them, decide to buy another pesticide. The market is already there, let it operate. Remove the ban on cross-state insuring now, enforce anti-trust, encourage HSAs and HSA-compatible plans with tax incentives much like what employers are getting now, set minimum guidelines like those already mandated under HIPAA, and guarantee the right to future insurance.

I agree with all of this, and might even go as far as to suggest that we start with this rather than bringing a public option into the picture if this will help us pass some sort of reform as opposed to having nothing passed and being back to square one, but I just don't see the mere possibility of a public option as an epic failure in the making the way you do, clearly. Understand that my opinions are greatly shaded by my experiences as a Canadian and the enormous amount of misinformation I hear relating to Canada, perpetuated most likely by ideologues with an agenda that is in nobody's interest but their own. It just doesn't align with anything I've come to know, and I think if you were to poll the many Canadians in here they would agree (except for Monique, I guess). Would you agree that some of the rhetoric about what health care in a country like Canada is like is exaggerated? I'll agree that the upsides are oversold a little, it's not like Canada is a utopia of health, but it's not some sort of major cluster**** as many here would have you believe either, and discussing this option doesn't instantly put Obama in the league of Hitler and all of that other immensely overblown nonsense we hear from the braindead part of the far right. Sorry, just ranting a little

Term life insurance for example is guaranteed renewable. Health insurers just like life insurers, can issue contracts that treat all of their consumers equally. I've already discussed HSAs that would actually have insurers competing for your business regardless of your condition. Again, there is a fundamental mistrust in the free market, but you're not comparing the public option to a truly free market. Everything you can possibly mention around this issue points back to the need for government reform, not health insurance reform.

How is preventing dropped coverage and denial of coverage due to pre-existing conditions and stuff like that not health insurance reform? Maybe we're just stuck on the meanings of these labels?

You're not going to solve all of our health care woes overnight regardless. There's this notion that a public option cures all these ills starting the day it's passed and this is incredibly naive in light of the fact that we already have these examples both in the US and abroad showing us otherwise; even when established over decades of practice. What we can do are simple, non-contentious things right now to begin to solve this problem without absolutely overturning the entire system.

I'm not sure exactly where you have gotten that notion, but I can't disagree with this.

[besson3c]

Originally Posted by ebuddy 

You can say the evidence is inconclusive all the way up until a plan you find reprehensible makes its way into law or you can decide that you have enough information and evidence to make a decision. Just because someone has decided to oppose a measure you support does not mean they are shaping facts to meet a presupposition any more than you already have in your indecision.

You've lost me here, sorry.

Correct. The precedent already exists for knowing how it is run, who is running it, how it is regulated, etc... and is a substantial basis for opposing the public option.

If you *really* think that public health care, which is more common than a purely privatized health care system (particularly as unregulated as ours) has been a complete disaster in every country, I really think you should reconsider the sources you put stock in. Canadians are happy with their health care, it works for them. Why is this hard to accept?

The overwhelming majority of Americans are happy with their care as well. What if the US has an opportunity to show the world how to accomplish better health care for all without invoking a massive, insolvent government program that abuses their tax dollars?

We aren't talking about actual health care, but the system in which it is obtained and paid for. If Americans were happy with this why are we even debating reform? Don't we all agree that some reforms are necessary? Logic would not suggest that a system with as many uninsured as we have and as many bankruptcies due to health care as we have (even experienced by those that have some sort of coverage) does not lead to happiness. What I said about Canada applies to both the care itself and how it is obtained and paid for. Canadians are happy with it, as a whole. It works for them. There is no sizable public debate about abandoning it. Again, you seem so sure that what everybody has is broken, but it seems like you haven't really approached the possibility of a system like Canada has working well for them as being a distinct possibility?

I'm not saying that this same system would work well for us, but I really think you are overreaching in your labels of these other systems. We can all Google articles that support our beliefs until we are blue in the face, but have you actually entertained an alternative viewpoint from the perspective of people actually in that country or having the experience which you lack?

38 years here and couldn't be happier. You realize of course this argument means nothing. In reality, you have to cite an example of a system less than a third the size of our proposed system to find a public option that is plausible, but you still will not find a sustainable system. This is simply a fact. Cite any country, any example you want-Canada of course included. I've cited Canada's increasing privatization and I've cited studies of 8 EU members' increasing privatization in the attempt to keep up with rising demand and costs. You can think what you want of course as are many others, but I find the lack of substantive information produced by proponents of a public option to back the claims indicative of a presupposition in search of a conclusion.

You are just cherry picking stuff that supports your view, like I said. There are plenty of Canadian citizens and politicians that are very proud of their system and feel it works just fine for them, and for good reason. The existence or alleged increase in private insurance does not change this, but it could be said that it supports my view that there is plenty of room for both to co-exist.

[ebuddy]

Originally Posted by besson3c 

I haven't gone over any of the bills yet, but I base my optimism on possibility, not precedent. The way I see it it is hard to imagine the system being any poorer than it already is. I truly think we have hit rock bottom, and that we can do so much better.

I am optimistic as well, but my optimism seems founded on something entirely different than yours. I don't believe our system has hit rock bottom. An alcoholic who hits rock bottom is not generally said to be "doing his job right" or "doing his relationships right", etc... an alcoholic who has hit rock bottom is generally one step away from suicide or terminal illness both physical and mental. I don't agree that this is a health care "crisis" and I certainly wouldn't use "rock bottom" to describe it though I can assure you a great number of those who have hit rock bottom are in need of health care. I am able to acknowledge that there are some things our system is doing extremely well, there are some things our system could be doing much better, and there are some things for which a fundamental change in the way we do business is in order. I do not want to upset what is being done well and I do want to improve upon those things that could be done better. The fundamental change I'm talking about is the current manner in which we address health insurance in this country. To me, this is a fundamentally different approach to the health care industry instead of just another player in it. If I were a bank, I would not grant the Federal government a loan for the current business models it has proposed and the majority of this country feels the same.

I notice proponents are quick to cite how negative Americans view their health insurance, but they magically stop just before acknowledging how negatively they view government-run health care proposals.

As far as possibility goes, it is absolutely possible to get prices more in line with something in the ballpark of sane (rethinking the role of the ER is a good start), as well as to prevent coverage being dropped and controlling who you can see if we use the realities of other countries as a model.

Any health care proposal attempting to cover the 45+ million uninsured that does not take into account the actual demographic of those who are uninsured is lame.

• 14 million of the 47 million per 2006 Census Bureau, Department of Labor data are already eligible for government insurance, but aren't signed up. They often do not want to pay the small premium charged and end up enrolling when they need care. Pre-existing conditions do not exclude you from acceptance so this means they are essentially covered regardless of whether or not they are formally enrolled.
• $27 million of the uninsured earn more than $50k a year.
• Nearly 70% of the uninsured are without insurance less than 4 months
• They are between jobs
• 2/3rds of the uninsured are between the ages of 18 and 34, a great many of them are uninsured by choice and are in fine health.
• This leaves largely younger folks, healthy folks, and illegal immigrants. (an exact number is not available because of course this is a "don't ask, don't tell" kind of a thing)

The more pervasive problem IMO is the "underinsured". Immigration policy reform, affordable healthcare options available to those who've opted out of it in the past through a wide open market of insurers and a fundamentally different approach to the health care industry are all ways of addressing the root cause or virus, instead of addressing a bunch of its symptoms. This includes everything we've discussed from anti-trust reform and enforcement, through HSAs and HSA-compatible plans, decoupling health insurance from employers by incentivizing individuals away from employer plans, to opening the market by eliminating the state-by-state insurers restrictions.

I'll just go back to Canada because that's what I know best. There, you can see whomever you want, coverage is not dropped (in fact, the government even pays for referrals to the US in some cases and care received abroad). As far as rationing, as I thought we agreed upon, that is going to happen no matter what the system to some extent. All we can debate there is to what extent it will, and this would probably mostly be speculation.

... and I'll stay in America because that's what I know best. I've not had a problem with seeing who I want and I've not been dropped.

So, perhaps you shouldn't use the broken systems of today as a precedent here? It's unlike me to be this optimistic, but again, I regard what we have so poorly that there logically only seems one direction we can go once we have hit rock bottom (as I feel we pretty much have).

And I disagree.

This is a pretty leading question. I don't agree that it will be the end of the private insurance market, far from it, so I'm sure how to respond to this.

We disagree here. I fail to see how it wouldn't since that is what it is designed to do.

You can also regulate as Minnesota has done by saying that a certain percentage of our private health care expenses has to go to actual health care provision. This has helped somewhat, so it seems, and seems supported by both parties there.

Far be it for me to admit "I don't know", but I'm not sure how I feel about this just yet.

However, I agree that whatever you can do to chip away a little bit at the fat executive insurance salaries and other excesses is more of a shim than a solution. Do you think that insurance companies that have become monopolies should be able to charge whatever they want and devote whatever percentage they wish towards actual health care? Normally I would say "sure", that provides an opportunity for a competitor to undercut them, but I just don't think this is as simple in this climate. I agree with you that this ought to change.

Insurance companies in a more competitive environment will need to A. become more efficient real quick B. Accept a cut in their bottom line to remain competitive or ... C. Lose customers, charge more to compensate, and lose customers. Providers who need patients will have to accept them from a growing number of insurers and people will be more acutely aware of their health care dollar.

I agree with all of this, and might even go as far as to suggest that we start with this rather than bringing a public option into the picture if this will help us pass some sort of reform as opposed to having nothing passed and being back to square one, but I just don't see the mere possibility of a public option as an epic failure in the making the way you do, clearly. Understand that my opinions are greatly shaded by my experiences as a Canadian and the enormous amount of misinformation I hear relating to Canada, perpetuated most likely by ideologues with an agenda that is in nobody's interest but their own. It just doesn't align with anything I've come to know, and I think if you were to poll the many Canadians in here they would agree (except for Monique, I guess). Would you agree that some of the rhetoric about what health care in a country like Canada is like is exaggerated? I'll agree that the upsides are oversold a little, it's not like Canada is a utopia of health, but it's not some sort of major cluster**** as many here would have you believe either, and discussing this option doesn't instantly put Obama in the league of Hitler and all of that other immensely overblown nonsense we hear from the braindead part of the far right. Sorry, just ranting a little

Rant away. I'm not much for the braindead on either extreme. I come to this as a life-long participant in the US system and I have a vastly different perspective than you. For example, I think "rock bottom" is itself-overblown nonsense. For many it is the product of pessimism bolstered by as much misinformation as can be cited from any opponent to the Canadian model.

How is preventing dropped coverage and denial of coverage due to pre-existing conditions and stuff like that not health insurance reform? Maybe we're just stuck on the meanings of these labels?

IMO, there is a marriage of corporation and government that has created state-by-state monopolies that can be fundamentally dismantled by opening interstate competition. If interstate competition does not lead to insurers taking on preexisting conditions as a means of being more competitive (which would actually be quite a surprise given the number of insurers I'm able to find online already offering coverage for preexisting conditions), this can be addressed just as the government has enacted HIPAA and a host of various other regulations. I simply think government policy reform is the best place to start.

[ebuddy]

Besson, until you're willing to acknowledge that Canadians are also debating health care reform, your arguments are going to fall on deaf ears. Every single argument you present against our system exists in the Canadian system. Every single one. Every single point about "many are proud", "many are happy", "many are satisfied" are true of the US health care system as well. You're then left with statistics and to that I will refer you to your point about googling for affirmation.

As long as you continue to pretend the proposals are not already all on the table for review and in many cases have been reviewed and found wanting, your arguments are going to fall on deaf ears.

As long as you fail to recognize that the exact same human failures are at play in a government option that exist in the private market, your arguments are going to fall on deaf ears.

As long as you insist on arguing caricatures of my views (public options = complete disaster) instead of my views, your arguments are going to fall on deaf ears.

[hyteckit]

Originally Posted by ebuddy 

Really? We should be able to go back to our past then to see how our forefathers approached health care. Surely, of all the things as basic as health care, food, water, and... wait a minute. Does the government really have the authority under "General Welfare" to provide health care to all? Really? It seems to me the powers of the government are very clearly documented;
- Congress can tax
- Pay its debts
- Provide for the common defense
- It can borrow, regulate commerce with foreign nations, and among the States
- It can establish rules for naturalization
- adopt bankruptcy laws
- Congress can coin money, regulate its value and fix a system of weights and measures as well as punishment for counterfeiting.
- It can establish post offices...
- ... laws for patents
- It can set up a system of courts and punish piracy
- It can declare war and raise armies, navies, and a militia and it can make all laws necessary and proper to carry out the above powers.

Why so clear about the powers of Congress and those not granted them, granted the State? This must mean that Congress has unlimited authority? No, sorry.

If Right to bare arms can mean everyone has the right to own a gun.

I say provide for the common defense would mean protection against outside enemies including bacteria/viruses that can kill you.

Originally Posted by ebuddy 

Surely, through smallpox and other serious medical concerns during the times of our forefathers, there should be examples of their intent to provide health care to all? No? Strange don't you think? Come to think of it, there were absolutely zero proposals for a "public health care" provision until the 1900s. You might not be familiar with the concepts of "positive rights" and "negative rights", but some reading may be in order for you to clear up what I can only describe as a severe misinterpretation of our founding documents.

Our forefathers intent? Surely if they wanted Blacks and Women to have full voting rights, they would have that in the initial Constitution. No? Strange don't you think? Come to think of it, there were absolutely zero proposals for a "woman's voting rights" provision until the 1900s. You might not be familiar with the concepts of "positive rights" and "negative rights", but some reading may be in order for you to clear up what I can only describe as a severe misinterpretation of our founding documents.

Originally Posted by ebuddy 

You may believe it, but it isn't so.

You might not believe it, but it doesn't make it so.

Originally Posted by ebuddy 

Should they likewise assume control of food in case of food shortage crises? How about water? Means of getting to and from work?

Means of getting to and from work? Sure. Highways. The airspace. Federal minimum safety for cars.
You mean the government won't take control of our airspace and ground all flights after 9/11? Oh right, the government did ground all flights after 9/11.

In case of severe shortage of food and water, the government not only should and does regulate/control the consumption of food and water. In California right now we can only water our lawns during certain days of the week.

In case we are being attack by smallpox, polio, and other deadly infectious diseases, the government should and does require its citizens to get vaccinations or protection against these foreign agents or outside enemy, so they can build up a "national defense" against these foreign agents that can kill you.

Should the US government force people to get vaccinated for the common good?

Oh right, the US government does mandate immunization of its citizen for the common good.

Originally Posted by ebuddy 

No. If the goal was to protect the lives of the citizens, the proposal would not cover only a third of the ones in need of this protection. Just as the "national defense" expenditure and purpose has been abused as so-explained through arguments provided by you and others, what is it of health care that gives government all this sudden credibility, capability, and virtue?

I keep reading from you that it will not cover 1/3 of those who need it. Care to provide some evidence to back up that claim?

Originally Posted by ebuddy 

Is there a law that there be so many hospitals per insurer??? I'm not even sure what you're arguing here. The market needs to be regulated by a Federal Standard of minimum requirements for all States, anti-trust legislation enforced, and the market opened up at the national level instead of tax policies and regulatory measures that have created intra-state monopolies. People are charged what they're charged because they can be. From looking at expenditures between Medicare and VA for example, there's no such sign of any integrity with price controls anyway. Again, I'm not sure where all this confidence in the integrity of the government is coming from.

Law? No. It's called practicality.

The same reason why most hospitals only accept 6 or less HMOs when there are 47 HMOs in California. You think increasing from 47 HMOs to 1000 HMOs will magically get those hospitals to accept 100 HMO plans? How does a hospital manage even 100 HMO plans? Each HMO plan with their own paperwork. Each HMO plan with their own list of drugs and procedures that are covered. Each HMO plan with the own agreements with the hospital.


So you are for big federal government? You want the federal government to regulate healthcare on federal level rather than have states regulating their healthcare system?

Originally Posted by ebuddy 

So... how is a public option going to address this problem?

Guess you haven't been listening to Pres. Obama and the public option plan have you?

Originally Posted by ebuddy 

Ironic isn't it? You believe the answer is 1001 insurers with the 1 being a public option? How does that solve the sky-rocketing costs of health care? I thought it was the "evil insurers" not the "evil medical practice". Try to stay on task because as it stands right now you're arguing with yourself here.

No, you believe in 1000 insurers. I believe in having just 1 universal healthcare plan. But for now, it's the public option. It's my believe that Increasing the number of HMOs in California from 47 to 1000 will have little effect on health insurance premiums.

Originally Posted by ebuddy 

How do you get here? If clinics and providers need patients and those patients have the choice of hundreds of insurers as opposed to those preferred only by the State, they will have to accept patients from a growing number of insurers.

There are 47 HMOs in California. Why is it that 6 HMOs dominate 90% the market? Why do most hospitals only accept 6 or less HMOs when there are 47 HMOs in California?

Practicality.

The HMOs have to negotiate with each hospital on the contract. You make it sound like accepting insurance from different HMOs is like accepting different forms of payment, when it is not.

Hospitals don't have the time, manpower, or ability to manage 1000 different contracts with 1000 HMOs, each with their own agreements, their own paperwork, their own list of drugs and medical operations covered, and so forth.

Negotiating with a HMO, a distribution channel for your healthcare services, is like negotiating with Walmart to distribute your products.

Hell, I can only get the iPhone from one cellular network which is AT&T because of contract agreements between Apple and AT&T because AT&T wanted exclusive distribution rights.

Originally Posted by ebuddy 

It can't. There are already over 3 million children eligible for a form of Medicaid/Medicare yet remain unenrolled. The current proposal only touches the surface of the uninsured while addressing the none of the actual problems with increasing health care costs.

So the problem in not that they are ineligible, it's because they are not enrolled. They are eligible though right? They would be covered if they took the effort to enrolled right?


So millions of US citizens are eligible to vote, but they have yet to register to vote. Do we need to reform our voting rights, or do we just need to encourage them to register to vote?

Originally Posted by ebuddy 

- government run media
- caps on freedom of speech
- censored internet
- rural working permits
- repressive Chinese factories
- all religions required to register with the government who then selects their leadership and content.
- No due process
- One child policy
- Crimes punishable by death include tax evasion
- immigrants to China are "non-persons living in China"

Sure and while we're busy emulating such a compassionate model we could borrow another few trillion dollars from them to make our health care system really zip for the uninsured!

Well, insolvency is your argument not the provide a public option. I would use the same argument of insolvency to get rid of capitalism and democracy and model the USA after China.

I guess insolvency isn't a good argument after all? Or maybe it is?

[besson3c]

Originally Posted by ebuddy 

Besson, until you're willing to acknowledge that Canadians are also debating health care reform, your arguments are going to fall on deaf ears. Every single argument you present against our system exists in the Canadian system. Every single one. Every single point about "many are proud", "many are happy", "many are satisfied" are true of the US health care system as well. You're then left with statistics and to that I will refer you to your point about googling for affirmation.

As long as you continue to pretend the proposals are not already all on the table for review and in many cases have been reviewed and found wanting, your arguments are going to fall on deaf ears.

As long as you fail to recognize that the exact same human failures are at play in a government option that exist in the private market, your arguments are going to fall on deaf ears.

As long as you insist on arguing caricatures of my views (public options = complete disaster) instead of my views, your arguments are going to fall on deaf ears.

I'm sorry, but it's sometimes hard to get a sense of how strongly you feel about the possible failure of a public option given your level of insistence.

Of course there is debate going on about health care. It's not as if any country can ever say "okay health care, we're all good now". It's an ongoing debate. My point is that there is no massive reform that is imminent there the same way that it is here. The urgency isn't the same. By and large Canadians don't want to give up their health care, because it works for them and produces good results. Problems sure, but it basically works. That's my point.

Our health care works too, but the system in which we obtain it and pay for it is completely broken. I include Medicare in this, it's all a massive, complicated mess.

I'm sorry if I've sounded a little defensive about this, but it's sort of hard to sit with a closed mouth when people go on about Canadian health care as if they live in the third world up there. I'm not saying that this is your viewpoint, but there is a tremendous amount of rheotoric and exaggeration out there, I'm sure you'll agree. More than anything I just want to get to a point where we can actually talk about this stuff in a framework that is much closer to reality than blowhard rhetoric coming from the extreme sides of both parties. I'm glad that we are doing so here, I'm just trying to get you to open your mind up a little bit to realize that Canadian health care is nowhere near as bad as some would have you think. In fact, it's a source of pride for many Canadians.

And again, I'm not saying that we should simply copy the Canadians. The truth is somewhere in between Canadian propaganda (wherever that would exist) and doomsday scenarios and FUD relating to the possibility of a public option here.