The Health Care Reform Address Thread

[budw38]

We all would like better health care / coverage . Im not sold on Capitol Hill making good sound policies , here is another state program to cover all that has ,,,,, you be the judge ..Tennessee Experiment's High Cost Fuels Health-Care Debate - WSJ.com

[budw38]

Originally Posted by SmootSmack

Not even a genius like Norman Einstein could understand your posts

What .... I don't understand

[saden1]

Originally Posted by JoeRedskin

I would love to actually sit down and read the bill. But at 1000 pages that is just impossible for me to do on a comp. Plus, to really make sense of it, you need to have access to the various cross references within it.

I am used to reading these types of things and, when I tried to read through it on my comp, it just made my eyes hurt and my head spin. Is any one aware of: 1) where I can get a full copy of the bill w/out spending an arm an a leg in printer ink and paper; 2) a legislative synopsis so that I can cut through some of the legalese or least track down the meaning?

It might be helpful to watch The Committee on Energy and Commerce markup meeting (day 1, day 2, day 3). Note that they've put out a section by section summary of the bill.

[joethiesmanfan]

They changed our health coverage at work, I now pay nearly 400 bucks a month. If it wasn't to cover my son I would just let the tax payers pay for me whenever I go to the emergency room and not pay the cost of health insurance. In my opinion any kind of insurance is a scam.

[FRPLG]

Originally Posted by Schneed10

Well at least someone's getting something out of it. Glad to hear there's still an appetite to talk about the issues intelligently.

It's just tough to keep at it when you need to read through 3 pages of garbage just to find the one post by someone who has something meaningful to add.

Frustrated!

I think the issue is basically this. You know how complicated this issue is. Probably as complicated as anything, and for various reasons. But, BIG BUT, everyone is involved in some way so everyone has an opinion. Most of the opinions are based on extremely limited experience in the system and a rather limited (nice way of saying it) understanding of the industry and economics in general. But they still have opinions and because they are based on "experience" and self-belief so they are ingrained opinions. On the other hand those who have payed attention and tried to "know" what they are talking about are mostly partisan hacks who believe one way because they lack the ability to adequately remove political bias from their opinions.

The ones who actually know how this bad boy works, or at least have a more in depth knowledge, are people like you, doctors and insurance companies. But no one wants to listen to you all because you all "created the mess".

[FRPLG]

Originally Posted by Trample the Elderly

I got hit by an old lady who got her foot stuck on the accelerator. It seemed like BS to me too. I was current and it wasn't my fault either? Allen times 4 got me the money back for the hospital bill. It all worked out in the end. What should I've already known?

How your insurance works. They don't make up the policies on the spot when you show up.

[Schneed10]

Originally Posted by FRPLG

I think the issue is basically this. You know how complicated this issue is. Probably as complicated as anything, and for various reasons. But, BIG BUT, everyone is involved in some way so everyone has an opinion. Most of the opinions are based on extremely limited experience in the system and a rather limited (nice way of saying it) understanding of the industry and economics in general. But they still have opinions and because they are based on "experience" and self-belief so they are ingrained opinions. On the other hand those who have payed attention and tried to "know" what they are talking about are mostly partisan hacks who believe one way because they lack the ability to adequately remove political bias from their opinions.

The ones who actually know how this bad boy works, or at least have a more in depth knowledge, are people like you, doctors and insurance companies. But no one wants to listen to you all because you all "created the mess".

I agree that the issue's complexity really muddies the waters when it comes to productive discussion.

But still, focusing on the heckler during the speech is flat out unproductive.

But in the end you're right. It takes a more global view than the typical "I pay $500 a month for crappy coverage and that shit ain't right" viewpoint. Of course your coverage is expensive, that's why congress is trying to do something!

The questions are what are they planning to do, why, what affect will it have, and how will it help. Without trying to get at those answers, not much thoughtful discussion can take place.

[Schneed10]

So let's get to it:

What are they doing?: Trying to reduce malpractice costs.

Why?: Because doctors pay out the nose to keep themselves covered, all because juries keep awarding people multi-millions. That cost of malp insurance drives up the cost of doc appointments as docs pass the cost on.

How will they do it? Unknown at this point, no specifics are available, but ultimately the only way to substantively reduce this cost is to somehow reduce the amount of money awarded to victims of malpractice.

How will it help? Over time malpractice insurance premiums will drop for docs. They'll stop raising prices for their appointments.

[Schneed10]

What are they doing?: Demanding that everyone buy at least basic health coverage.

Why?: There's a federal law that says hospitals can't turn people away from the emergency room, whether you have insurance or not. So people without insurance go when they get sick. Most of them never pay the hospital bill. Guess who pays that bill? Those of us who are covered have higher insurance premiums to pick up the uninsured's slack. If everyone has to buy coverage, then ER visits will actually be paid for by those who go to the ER.

How will they do it? Pretty simple, pass a law. You must buy coverage. How they enforce it will be interesting to see, but that's doable through the threat of fines, etc.

How will it help? When everyone is covered, their insurance actually will pay for their ER visits. Your premiums should stop going up as fast. And it's fair after all, as long as ERs have to care for people, then someone has to pay for it. If you want to play, you have to pay, it's only fair. There will still be people who choose to break the law and go uninsured, but when they end up in the emergency room for who knows what, they'll end up with a fine for being uncovered.

[JoeRedskin]

Originally Posted by joethiesmanfan

They changed our health coverage at work, I now pay nearly 400 bucks a month. If it wasn't to cover my son I would just let the tax payers pay for me whenever I go to the emergency room and not pay the cost of health insurance. In my opinion any kind of insurance is a scam.

Well, and with all due respect, your opinion is BS. Putting aside the health care issue for a moment, insurance is an absolute neccessity for business. If there was not someway to insure against risk, substantially fewer risks would be taken - buildings wouldn't be built, investments wouldn't be made. Risk pooling (insurance) allows big risks and big investments to be made.

Back to health care - and as to mandatory universal coverage, my main concern is that I don't see enough in this plan to address costs. To me, as I have stated elsewhere - the tension is between "can we afford this program now" and "if not, when?".

I am unconvinced - b/c I can't unravel all the economic implications of all the legalese - that the bill as written does much, if anything, to attack costs and the natural anti-market forces at work within the healthcare system. While the mandatory coverage aspect is significant, the economics of it and its relation to the public option are of concern. If the public option is the cheapest and provides bare minimum coverage (the level of coverage being mandated is something I am still trying to decifer), it will attract the poor and the young healthy uninsured. If that occurs, then the system may not, and I stress may, be cost prohibitive. On the other hand, if private insurers provide better service then the public option - (hate on private insurers all you want, I suggest that the public option will be just as difficult and likely moreso to deal with) - at the same mandated cost, only the poorest and uneducated will end up in the public option. From an actuarial stand point, I am pretty sure this is one of the most expensive groups to insure.

Looking through the bill (and it may be obvious), do the affordability credits only apply to the public option?

Right now, I oppose this bill b/c (1) - I don't understand it and the myriad of economic changes it proposes; (2) - based on my understanding of its function, I am unconvinced that it does anything to truly attack costs; and (3) - I am just not convinced that this thing will be in any way affordable.

Obama, I think identified many issues that need to be addressed, but as Schneed said earlier there is MUCH to be ironed out. Too much, I think for this bill to pass.

[FRPLG]

Originally Posted by Schneed10

So let's get to it:

What are they doing?: Trying to reduce malpractice costs.

Why?: Because doctors pay out the nose to keep themselves covered, all because juries keep awarding people multi-millions. That cost of malp insurance drives up the cost of doc appointments as docs pass the cost on.

How will they do it? Unknown at this point, no specifics are available, but ultimately the only way to substantively reduce this cost is to somehow reduce the amount of money awarded to victims of malpractice.

How will it help? Over time malpractice insurance premiums will drop for docs. They'll stop raising prices for their appointments.

Here's my question...and it's a lazy one I'll admit. I attended our local town hall meeting which was of course dominated by discussion on health care. It was a very civil affair with probably a good 70-30 split against the current debated HR3200. I live in a heavily conservative area so this is to be expected. Now there were a good amount of the "we simply don't like this crowd". Mostly base on philosophical grounds. The other side was better "prepared". They had answers for everything it seemed but a lot of it sounded like spin to me personally. One woman claimed that her husband had been studying the entire industry for years and that medical-malpractice as it stands now causes only a 2-3% increase in costs. This sounded baffling to me but I admittedly have no reason other than it seems like doctors say that isn't true. So what is the deal? What affect does malpractice judgement in general have on the system? Is it only 2-3% or is it more or even far more? Anyone have anything that answers this conclusively?

[FRPLG]

Originally Posted by joethiesmanfan

In my opinion any kind of insurance is a scam.

I'd love to call you out on this man but I am not even sure what you are trying to say.

How is it a scam?

[Schneed10]

What are they doing?: Offering an OPTIONAL non-profit insurance coverage option through an online marketplace.

Why?: Insurance premiums are primarily driven by the number of people who belong to the plan. The more in the plan, the lower the premium (because then the insurance plan has more negotiating power with hospitals & docs and can demand lower reimbursement rates to providers). But if you work for a small business or if your employer offers terrible coverage, you end up in a very small "risk pool" (the number of people in your plan), which results in very high premiums. The online marketplace allows you to join a plan (or risk pool) with a large group of people.

How will they do it? The how part is very interesting. Obama said a non-profit insurance firm would have much lower overhead costs, because they won't need to generate a profit for Wall Street, and because they'll be able to reduce administrative costs. I buy the first part, that there will be no profits - that does help. But I don't buy the reduction of administrative costs. He underestimates how much regulation must be worked through within this industry - a non-profit will have just as much administrative overhead to work through, and will need just as many people to do it. And that assumes they'll operate with the same efficiency as a for-profit (I don't like those chances).

How will it help? Even if administrative costs can't be cut out, this still should give Americans with a semi-affordable coverage option. I just don't think it will be as cheap as he thinks, and plenty of the currently uninsured will still find it tough to afford. But it will still be better than options availabe now.

[JoeRedskin]

Originally Posted by Schneed10

So let's get to it:

What are they doing?: Trying to reduce malpractice costs.

Why?: Because doctors pay out the nose to keep themselves covered, all because juries keep awarding people multi-millions. That cost of malp insurance drives up the cost of doc appointments as docs pass the cost on.

How will they do it? Unknown at this point, no specifics are available, but ultimately the only way to substantively reduce this cost is to somehow reduce the amount of money awarded to victims of malpractice.

How will it help? Over time malpractice insurance premiums will drop for docs. They'll stop raising prices for their appointments.

Again, I will raise my idea again - mainly b/c I think it's f'ing brilliant, but here it is actually relevant.

Eliminate malpractice liability as a tort action. Instead establish a Medical Injury Compensation Commission similar to Workers Comp. Patients no longer need to show negligence caused their injury, instead they just need to demonstrate an injury to receive compensation. As in Workers Comp, recoveries are based specific losses, temporary/permanent, and partial/permanent disability.

Instead of paying high malpractice insurance costs, all hospitals, doctors and medical professionals pay MIC insurance (just like all employers pay Worker's Comp insurance) - it won't be cheap, but it should be less than current malpractice. Plus, it has the added benefit of spreading costs of all professions amongst all practitioners (instead of huge premiums for Obstetrics and ortho's). Malpractice litigation is all but eliminated and replaced with MICC litigation which, like Workers Comp, follows a more formulaic approach.

Further, this could be done separate from the current bill and, in fact, could be drafted as a companion to it so to show how the two would work in conjunction.

[Schneed10]

Originally Posted by FRPLG

Here's my question...and it's a lazy one I'll admit. I attended our local town hall meeting which was of course dominated by discussion on health care. It was a very civil affair with probably a good 70-30 split against the current debated HR3200. I live in a heavily conservative area so this is to be expected. Now there were a good amount of the "we simply don't like this crowd". Mostly base on philosophical grounds. The other side was better "prepared". They had answers for everything it seemed but a lot of it sounded like spin to me personally. One woman claimed that her husband had been studying the entire industry for years and that medical-malpractice as it stands now causes only a 2-3% increase in costs. This sounded baffling to me but I admittedly have no reason other than it seems like doctors say that isn't true. So what is the deal? What affect does malpractice judgement in general have on the system? Is it only 2-3% or is it more or even far more? Anyone have anything that answers this conclusively?

I can tell you that at our healthsystem malpractice premiums account for about 3-4% of our total expenses.

Malpractice premiums are increasing at about 15% per year.

So while the rest of our costs increase at about 6% per year, because malpractice is going up by 15%, it is responsible for a half of a percentage increase in overall expense growth within healthcare.

Reducing overall healthcare expenses across the nation by a tenth of a percent would cut the deficit drastically. This could be accomplished by getting malpractice premiums to increase by only 12% instead of by 15%.

Small changes in expense growth accumulate to massive savings across the system, at least when compared to the projected deficit.