"Affordable" health care advocates explain this please.

tvb wrote:Jeff, I really hope you never lose your job because it's going to be a joy for the rest of us to watch you eat crow and accept public insurance if that should happen. Unless of course you believe your family doesn't deserve health care and all.

A split system is a ploy by the left to eliminate the private system. Of course the government will be the biggest buyer in the health care system and get the best prices. But in the end the suppliers will say "screw you uncle sam, we aren't working for peanuts anymore" and there will end any significant advances in technology unless uncle sam captitulates. Probably US will and then you'll see the reverse happen: higher costs to everyone as Uncle Sam decides to pay more to attract the needed talent. Without a free market approach, it's curtains for truly good health care.

I personally feel the same way as jpete that if you can't afford it, you can't afford it but, I also feel that charity is the better part of mankind. I would help pay for jpete, or tvb or stockingfull who I know are productive souls. I will not oppose a safety net health care delivery system for the misfortuned or underprivileged but I will always oppose subisidies for the lazy and a cadillac system for everyone.

Mike, that's one of the reasons why a public-private combined system can have benefits. Sure, the pvt insurers are worried about the big gov't buyer "crowding them out" initially -- and they should be, they've been abusing the buying power they've had for the last 15-20 yrs and have gotten quite fat in the process. Real competition would have fixed that but there hasn't been any; the insurers have covered each other and the pharma biz quite well, thank you very much.

But the pvt boys will be there to offer a choice in the future, in case any of the terrible "big brother" scenarios you fret about come to pass. And you'll be able to migrate relatively easily from one plan to another.

But private insurers have become experts at delay and denial too. So it's not like there's some "ideal system" out there now that we'll be taking a hammer to.

Stockingfull, what evidence do you have to affirm your belief that people will easily go from one insurance to another? I posted a story from Britain where a woman was prevented by the government from buying her own private insurance because it would make a two tiered system between those who can afford it and those who can't. And the "ideal system" you can't find is called the "free market" as much as the thought of it makes you sick. Repeal the HMO Act of 1973 and let doctors run their businesses like the one I one I started this thread about. Then you get everything you want. Affordable, accessible care and you cut out the greedy insurance companies. Best of all, I won't have a draft dodging, tax evading, child molesting politician making decisions about my health care.

stockingfull wrote:Mike, that's one of the reasons why a public-private combined system can have benefits. Sure, the pvt insurers are worried about the big gov't buyer "crowding them out" initially -- and they should be, they've been abusing the buying power they've had for the last 15-20 yrs and have gotten quite fat in the process. Real competition would have fixed that but there hasn't been any; the insurers have covered each other and the pharma biz quite well, thank you very much.

But the pvt boys will be there to offer a choice in the future, in case any of the terrible "big brother" scenarios you fret about come to pass. And you'll be able to migrate relatively easily from one plan to another.

But private insurers have become experts at delay and denial too. So it's not like there's some "ideal system" out there now that we'll be taking a hammer to.

Sorry, but once the gov is in the market there isn't going to be any free market left; case in point, Freddy and Fannie. They are GSE's like the gov insurance will be. As the lender of last resort, F&F, like all government programs was abused. 80% of mortgages are in the hands of Freddy and Fannie. Thus, we already have a nationalized mortgage system and that's not working out too well.

Part of the problem, as I see it, is the rapid rise of technology. It is expensive to discover, invent and create. If that technology must be granted to everyone on demand to be "fair" then, we will indeed go bankrupt. If not, then who will decide who gets treatment? If the gov decides to make it affordable to everyone, who will decide how much money the health care pros will be paid for their work? None of the options for a socialized system are pleasant.

More importantly, your socialized system is anathema to the system that brought that technology to fruition. It is unlikely that the rapid rise in tech would continue under such a system.

But in the end the suppliers will say "screw you uncle sam, we aren't working for peanuts anymore" and there will end any significant advances in technology unless uncle sam captitulates. Probably US will and then you'll see the reverse happen: higher costs to everyone as Uncle Sam decides to pay more to attract the needed talent. Without a free market approach, it's curtains for truly good health care.

MIke, it's not a free market approach anymore - it hasn't been for decades. The insurance companies already have the suppliers over the proverbial barrel with their own take it or leave pricing schemes. They pay hospitals and doctors only a small percentage of what the actual bill is and the vendors aren't in much of a position to negotiate it because the insurer can simply cut that supplier off and make them "out of network". They also decide what drugs they'll cover and for how much they'll pay for it.

The only folks paying the medical vendors full rate these days are the uninsured - those who are most likely to be able to least afford it.

The only way you are ever going to see a true free market approach is to eliminate all private insurance leaving each person to negotiate their own rates and favors and that not going to happen.

Hey tvb, you have it wrong. My wife is a hospital accountant and they get more money from private ins. then the gov programs. And they get paid in a more timely fashion. In this state, the state gov. owes the hospitals 100's of millions of dollars and one of their solutions to balancing budgets and covering shortfalls is simply not pay it. I have seen the manual for medicare and medicaid and it is staggering in complexity. Just like our tax codes. Everything the gov does is overcomplicated, overcharged and basically inefficient. And they dont mind just not paying for something and telling you to get over it already. But don't be late paying them!

Kevin

Actually, tvb has it exactly right. Pvt HMO's acquired a monopoly by getting control of the patient populations, then methodically drove docs and hospitals out of business by "negotiating" (that is, dictating) "contract allowances" to them. A "contract allowance" is the discount % which the HMO will apply when paying the provider for a particular service or procedure. (That is, if a hospital would charge you or me $100 for an X-ray, if the CA was 40%, they'd pay the hospital $60 for it. And, if the hospital didn't like that, they wouldn't be in the network and then would be starved for business.)

Between the late 80's and the turn of the century, the HMO's drove many more docs and hospitals out of business than the tort lawyers ever did, and nobody batted an eye. (I know, I represented the CFO in the bankruptcy of a small Boston hospital that went down in 1999, essentially due to the de facto monopoly that the HMO's had developed by the mid-90's.) Plus, those which were left were forced to, ahem, "improve efficiency" to match whatever some hospital halfway across the country was doing, because every time a cost went down somewhere, the HMO's stopped paying more everywhere.

So, if you want to know why your family doc doesn't have time to ask how your family is anymore, or what happened to that old hospital close by, you know, the one where the nurses were nicer and the food was better, you need look no further than the HMO barons, who skimmed billions in profits off while they were wrecking the healthcare industry.

The plan, as I understand it, is to essentially expand Medicare access to everybody, while preserving private HMO's for anybody who wants to stay in them. And I can just hear you guys screaming when the gov't can underprice all these pvt HMO's you think are helping you and everybody flocks to the "public option." It'll never occur to you that what was good for the goose has been turned on the gander.

stockingfull wrote:So, if you want to know why your family doc doesn't have time to ask how your family is anymore, or what happened to that old hospital close by, you know, the one where the nurses were nicer and the food was better, you need look no further than the HMO barons, who skimmed billions in profits off while they were wrecking the healthcare industry.

And who handed them that ability on a silver platter? CONGESS Mainly your buddy Ted Kennedy. But you keep blindly following him. It's been working out well so far.

Actually, it was Nixon doing a favor for his buddy Henry Kaiser of Kaiser Permanente, one of the very first HMO's.

http://uspolitics.tribe.net/thread/b46391c0-55d0-45c4-91af-3e8793c1512b

But the intention, to provide preventative care in order to reduce the incidence of acute illnesses, was and is laudatory. The problem was, and is, that monopolies, whether private or governmental, aren't good. And the answer to that is to keep competition in the business -- but honest competition.

So the plan is to allow the private HMO's to compete with the "public option" going forward.

stockingfull wrote:Actually, it was Nixon doing a favor for his buddy Henry Kaiser of Kaiser Permanente, one of the very first HMO's.

Actually, Ted Kennedy introduced the bill

S.14
Title: An Act to amend the Public Health Service Act to provide assistance and encouragement for the establishment and expansion of health maintenance organizations, and for other purposes.
Sponsor: Sen Kennedy, Edward M. [MA] (introduced 1/4/1973)

http://thomas.loc.gov/cgi-bin/bdquery/z?d093:SN00014:

Look, I'm not sure what the point is of assigning responsibility for a good idea (preventative care), the exclusive franchise for which was given to a group of private insurers who proved in the long run, just like the Wall St investment bankers, to be corrupt.

But, if we're going down that road, it obviously couldn't have happened without Nixon's OK. Do you dispute that?

(BTW, the link didn't work for me.)

stockingfull wrote:Look, I'm not sure what the point is of assigning responsibility for a good idea (preventative care), the exclusive franchise for which was given to a group of private insurers who proved in the long run, just like the Wall St investment bankers, to be corrupt.

But, if we're going down that road, it obviously couldn't have happened without Nixon's OK. Do you dispute that?

(BTW, the link didn't work for me.)

No dispute that Nixon was doing a favor for Kaiser. Also no dispute, and my point to all this, is that there would have been no bill for Nixon to sign if it wasn't for Congress and specifically Ted Kennedy.

And now you reach out to the very group who created this abomination to fix it. I'm still trying to figure out how you think that's a good idea.

http://www.cnn.com/2007/WORLD/europe/10 ... index.html
Valerie Halsworth, 64, told British television's GMTV she had removed seven of her own teeth using her husband's pliers when her toothache became unbearable and she was unable to find an NHS dentist willing to treat her

Yeah just can't wait for affordable Government Healthcare.

Even those of us that think we have free or paid for by union or employer ins. just remember nothing is for nothing, the cost is part of your pay. Hospitals can`t turn away the sick. We all pay for them. If we had preventive health care we would all pay less. Look into the Jap. health system, very good, affordable & working well. The trouble here & now is the people that know how to work the system. They don`t have ins. so no family doc, if they feel ill or are just bored they go to the ER, not by bus or taxi they call 911 to send the paramedics (min. $400 trip) go to the ER make a scene & claim they aren`t getting equal treatment. Run up a couple grand worth of ER tests & time all the while someone that is ill has to wait. The bottom line is we all pay. If there were other care centers to handle the small stuff we would all pay less.

jpete wrote:

stockingfull wrote:Look, I'm not sure what the point is of assigning responsibility for a good idea (preventative care), the exclusive franchise for which was given to a group of private insurers who proved in the long run, just like the Wall St investment bankers, to be corrupt.

But, if we're going down that road, it obviously couldn't have happened without Nixon's OK. Do you dispute that?

(BTW, the link didn't work for me.)

No dispute that Nixon was doing a favor for Kaiser. Also no dispute, and my point to all this, is that there would have been no bill for Nixon to sign if it wasn't for Congress and specifically Ted Kennedy.

And now you reach out to the very group who created this abomination to fix it. I'm still trying to figure out how you think that's a good idea.

Simple.
1. Preventative care is not only a good thing from a public health perspective, it's a much more cost-effective thing.
2. The only way to fix our broken healthcare system is to get care to everybody.
If you don't see the logic in those objectives, you're beyond help.

And all the existing "abomination" proves is another abject failure of the private sector effectively to compete in order to efficiently deliver a service to the public. In other words, the HMO's are still getting rich while your premiums and co-pays have been soaring. Instead of competition, they've created an effective monopoly.

Time for the "public option."