Healthcare Reform - Obama

[SamuraiBigEd]

There's no "now" about it. Insurance companies have been required to do just that ever since HIPAA was enacted in 1996 (by a Congress with Republican majorities in both houses, I might add). HIPAA prevents insurance companies from denying coverage to individuals who become part of a group policy. That means if my company hires someone who's in exceptionally poor health, our health insurer is required to cover them.


If you take that into account and do the math, it means nearly half (48%) of American personal bankruptcies were caused by people's health insurance not covering their expenses. If you ask me, the only thing that proves is that health insurance in this country is only insurance until you actually need it to cover something.

--Mark

I am going to comment on these two.

My wife and brother are uninsurable, no matter where they get hired, I don't care what HIPPA says. If you don't believe me, try getting insurance with diabetes or a history of breast cancer, it doesn't happen, period! Unless, of course, you go high risk pool, which is taking a very high portion of my brothers disposable income, over $500.00 a month, and that is not full medical coverage!

And I am not sure where you are getting your statistics, but my brother and father both handled numerous bankruptcy cases, and not a single one of them was related to medical expenses. In fact, the largest reason for bankruptcy is poor credit practices.

 

[SamuraiBigEd]

Notice the date when this takes full effect and the penalties start "2014"
why thats after the next presidential election (I bet thier hopeing all the lemmings will have forgotten by then). Romney (a republican governor at the time) did the same here in MA, after he enacted his version of free healthcare Ins., he beat feet for the presidential election before it was implemented, leaving the next Governor (Deval, a Dem) a real mess that will probably not get him reelected.
Makes ya wonder.
I'm not going to go into all the ways they have raised taxes and state fees trying to pay for this bill, just pisses me off!

Did you notice we have to start paying for it almost immediately though?

 

[Blrfl]

1)Immigration status does factor into the numbers since they are trying to deceive us with saying 32 million are going to be covered when they have said this bill will not cover illegals, so the real cost is 1 trillion for about half of the 32 million and the coverage really doesn't take place until 2014.

See my comment earlier about an $80 GP visit and $20 worth of antibiotics vs. $10,000 in ER care under EMTALA. That's two orders of magnitude difference and is part of the reason health care is so expensive. If 16,000,000 legal residents can get care at primary physician prices before things get out of hand, they'll never show up in the ER requiring emergency care at ER prices that will eventually filter back to their paying patients.

16,000,000 Illegals are still going to get no basic care, land in the ER, get cared for and those two orders of magnitude are going to get passed on to you. As much as the idea of illegals having recourse to public funds bothers me, covering them would cut back on those expenses and would probably end up cheaper in the long run. And as a side benefit, we'd be able to identify them and get them out of here, which is something we're almost completely incapable of doing now.

2)So your rates HAVE GONE UP by forcing them to cover people that are going to cause them to lose money, this is proof government interference doesn't mean they can fix the issue.

Actually, it doesn't prove a thing, and you're going to break an ankle jumping to conclusions like that, because you don't have all of the facts for my group.

When I was hired by my company in 2003, there were about a hundred of us, mostly aging males. We've since swelled our ranks to about 300, and a sizable percentage of the new employees have been relatively healthy people, many well under age 40. Our rates were reasonably stable -- we even had reductions for a couple of years -- until they started to rise three years ago. Last year our insurance company came to us and said they wanted an increase in premiums of 20%, which was largely justified by externalities such as rising hospitalization costs. We were able to negotiate the increase down to 13%, which makes me wonder why they couldn't have started there instead of trying to milk us for all we're worth. They're clearly still making a profit with the smaller increase or they'd have dropped us like a hot potato. Whatever the case, it's going to cost north of $16,500 to insure my family this year.

So given that government interference had been in place for seven years prior to 2003, that we've enlarged our pool by a factor of three and significantly reduced its risk level, how do you explain stable rates until 2007 and this year's increase?

3)Yes people will go to the cheaper states which will cause the more expensive states to find ways to lower their rates which means people will be more likely to end up getting it locally, I guess that would be the American people solving the problem instead of asking the government to save them.

If insurance companies are allowed to sell across state lines (and again, I don't have any objections to that), they're going to homogenize their risk pools and rates will be averaged out and applied nationally. The concept of the cheaper state will disappear.

4)It proves having insurance is not the answer affordable medical care is since having insurance did not prevent the majority from going bankrupt.

Sure, and why do we not have affordable medical care? Because insurance companies are in the business of taking in as much in premiums as they can while paying out as little as possible in claims. That lands people in the ER when less-expensive basic care that would have taken care of it is denied. See my comments above about $100 vs. $10,000.

5)I agree that the current tax system favors the poor but you will also not hear an aruement that we need to change it.

I'd be delighted to make that argument: Our current tax system sucks eggs and needs to change. Why I think so, how I think it should be done and why I don't think it will happen any time soon is the subject of an entirely different discussion.

... I was making refrence to all the services he mentioned that are paid for with local or city taxes that are paid through property taxes which even end up getting paid for by renters since the landlord is taking them into consideration.

You're going on the assumption that all local revenues are raised through property taxes, which isn't true in every state. In Maryland, for example, counties tax real estate, but they also receive an income tax levied as a percentage of an individual's state income tax, which is based on federal adjusted gross income. So under the right circumstances, some Marylanders are going to have zero income tax burden and will still be using public services paid for by others.

--Mark

 

[Blrfl]

My wife and brother are uninsurable, no matter where they get hired, I don't care what HIPPA says. If you don't believe me, try getting insurance with diabetes or a history of breast cancer, it doesn't happen, period!

My wife is diabetic and has been covered without objection by every insurer we've had since the day she was diagnosed. Her best friend beat breast cancer and as far as I know continues to be covered. (I'll ask her if you want.)

And I am not sure where you are getting your statistics ... In fact, the largest reason for bankruptcy is poor credit practices.

I based my number on a claim made in post #150. The study on which that claim is based can be found here: CLICK

--Mark

 

[SamuraiBigEd]

We have been told by every agent we have spoken with and a friend who is the CFO for Humana in this region that she will not be able to get insurance now.

My brother has not been able to get coverage other than the high risk pool since he contracted diabetes in the 80's.

I will review the study you provided.

 

[Wraithbane]

1. For people that don't like this bill what do you think should have been done to make the our current healthcare system better than it was?

I've listened to a lot of Doctors talk over the last year about the problems. We need more doctors, the reason we don't have enough is that there aren't enough medical schools. The reason we don't have enough medical schools goes back to a deal between the AMA and the government that limits the medical schools in this country. If your solution does not address getting more professionals into the medical field, your solution is not addressing actual health care. When Doctors talk about costs, two things stand out, administrative and insurance costs. The admin costs have come about due to the governments involvement, you must reduce the administrative overhead. Doctors have been claiming as many as 3 to 4 employees just to deal with the admin side. You only see the one person, but you have to pay for all of them. Insurance - Get freaking real about mistakes doctors make. If it's a reasonable mistake, then sorry, you didn't just hit the jackpot and you're not going to get umpteen billion dollars because the doc didn't run a test for microelephantitus on you due to only like one in a million people actually having that disease and you not showing the typical symptoms to start with. It's insane that we bitch that Doctors think they are gods, then we demand a god-like infallibility from them. New rule, if the Doctor did everything reasonable given the information provided, and ordered the tests that would be reasonably expected to be ordered, he's off the hook. Sorry if you're that one-in-a-million exception to the rule.

Eliminate those two costs, add the additional doctors, and health care costs would drop drastically.

For a truly radical savings, learn to accept that people DIE! The vast majority of costs in our system are end of life care, procedures and care given to people who are not going to survive no matter what is done. One thing that is ignored when we talk about the higher costs of medicine in America is that fact, we spend way more money on treatment of terminal cases than other countries do, and it's literally wasted money that is not going to save a life.

 

[CampD]

I've listened to a lot of Doctors talk over the last year about the problems. We need more doctors, the reason we don't have enough is that there aren't enough medical schools. The reason we don't have enough medical schools goes back to a deal between the AMA and the government that limits the medical schools in this country. If your solution does not address getting more professionals into the medical field, your solution is not addressing actual health care. When Doctors talk about costs, two things stand out, administrative and insurance costs. The admin costs have come about due to the governments involvement, you must reduce the administrative overhead. Doctors have been claiming as many as 3 to 4 employees just to deal with the admin side. You only see the one person, but you have to pay for all of them. Insurance - Get freaking real about mistakes doctors make. If it's a reasonable mistake, then sorry, you didn't just hit the jackpot and you're not going to get umpteen billion dollars because the doc didn't run a test for microelephantitus on you due to only like one in a million people actually having that disease and you not showing the typical symptoms to start with. It's insane that we bitch that Doctors think they are gods, then we demand a god-like infallibility from them. New rule, if the Doctor did everything reasonable given the information provided, and ordered the tests that would be reasonably expected to be ordered, he's off the hook. Sorry if you're that one-in-a-million exception to the rule.

Eliminate those two costs, add the additional doctors, and health care costs would drop drastically.

For a truly radical savings, learn to accept that people DIE! The vast majority of costs in our system are end of life care, procedures and care given to people who are not going to survive no matter what is done. One thing that is ignored when we talk about the higher costs of medicine in America is that fact, we spend way more money on treatment of terminal cases than other countries do, and it's literally wasted money that is not going to save a life.

Full of Win!
First one to mention administration costs, anyone care to guess what the biggest dept. of a Hospital is?
But alas cutting down on paperwork will never happen,, they would have to cut more jobs and Nancy's not gona let that happen under her watch!

 

[toasty]

New rule, if the Doctor did everything reasonable given the information provided, and ordered the tests that would be reasonably expected to be ordered, he's off the hook.

Great rant, but that's actually the existing rule.

 

[Wraithbane]

Great rant, but that's actually the existing rule.

Unfortunately, it doesn't always work that way. Juries tend to be more empathetic than rational. There are a lot of "emotional" damages awarded that have no basis in reality.

 

[toasty]

Unfortunately, it doesn't always work that way. Juries tend to be more empathetic than rational. There are a lot of "emotional" damages awarded that have no basis in reality.

And there are a lot of claims about awards of "emotional damages" that don't have any basis in reality, either. I'm actually an attorney myself -- spent 3 years defending doctors in med mal actions, and have been doing plaintiff's work for the last ten years with the occasional med mal case.

Part of the reason that I don't do many med mal cases from the plaintiff's side is that, contrary to popular belief, they are extraordinarily difficult to win. Doctors are understandably sympathetic defendants, and unless the doc has done something really egregious, juries are inclined to give them the benefit of the doubt.

To listen to the beating drum, you'd think that we just file suit willy nilly and doctors get tagged with huge verdicts as a matter of course, but the truth is that juries get it right more often than they get it wrong, and that very often results in a verdict for the defendant. I very rarely take them because they are extremely expensive to pursue without any guarantee that you're going to see any sort of recovery. I'm fairly confident that at least as many docs are let off the hook when they really have done something wrong as innocent docs who get tagged with big verdicts because, again, juries want to give them the benefit of the doubt.

Remember: nobody cares the 99 times out of a hundred when the system works -- only the outliers get any press, and the press rarely follows up when the trial judge knocks the verdict down to something reasonable and appropriate, or it gets reversed on appeal.

 

[paleodust]

Whether this has been posted here already or not, it deserves to be read or re-read...

REPEAL | The Weekly Standard

 

[paleodust]

You tyrannophiles do realize that when you read 1984 you're supposed to be rooting for Winston, not O'Brien.

+1

 

[3devious]

Toasty, the problem with medmal is that it still costs someone a ton of money no matter who wins. If the doctors win, they still laid out resources to fight off the suit. If the patients win, they still don't see much of their winnings as the lawyers take almost 2/3 of it sometimes.

The other costs of course are those paid by doctors and institutions keeping up with their lawsuit insurance. In fact, everything seems to get expensive because insurance is a part of the picture.

To the folks who are having the dialog about HIPPA, I got turned down for health insurance, but because I had coverage at a previous job, they had to cover me. They also had price caps on what they could charge me for the insurance and man those caps were high. It was still cheaper than the treatments I need.

The current bill still doesn't make coverage any more obtainable for those with pre-existing conditions as it still doesn't do much to make that coverage affordable.

 

[toasty]

Toasty, the problem with medmal is that it still costs someone a ton of money no matter who wins. If the doctors win, they still laid out resources to fight off the suit. If the patients win, they still don't see much of their winnings as the lawyers take almost 2/3 of it sometimes.

The other costs of course are those paid by doctors and institutions keeping up with their lawsuit insurance. In fact, everything seems to get expensive because insurance is a part of the picture.

Before I get into the larger point, it bears mention that you're actually double counting here. Doctors don't typically "[lay] out resources to fight off the suit," they buy insurance. Either they buy insurance or they outlay their own cash to defend suits and pay judgments, if applicable, but typically not both.

The bigger point, though, is this: yes, litigation is expensive for all involved, but what exactly would you propose as an alternative? Damage caps or outright barring people from bringing suit and things of the like sound like a fantastic idea until the sole breadwinner of a young family dies on an OR table unnecessarily. Are you going to tell them, "Look, I realize you've lost your father and are now facing financial ruin, but hey, these things happen?"

I actually don't generally take these cases because unless the amount in dispute is a really big number, the costs associated with a medmal case can take so much of the recovery that it does seem like the attorneys take 2/3, when we're really just taking our fee plus the (exorbitant) costs that we incur in working these cases up which, ironically, are typically paid to other doctors to shepherd us through the medical issues. When it looks like we're taking that much, the client isn't happy, and then I'm not happy, and it's a real losing proposition all around. Unfortunately, however, that means that a lot of people who have sustained real injuries on account of real fault of doctors don't get any compensation.

 

[IOWA]

Before I get into the larger point, it bears mention that you're actually double counting here. Doctors don't typically "[lay] out resources to fight off the suit," they buy insurance. Either they buy insurance or they outlay their own cash to defend suits and pay judgments, if applicable, but typically not both.

The bigger point, though, is this: yes, litigation is expensive for all involved, but what exactly would you propose as an alternative? Damage caps or outright barring people from bringing suit and things of the like sound like a fantastic idea until the sole breadwinner of a young family dies on an OR table unnecessarily. Are you going to tell them, "Look, I realize you've lost your father and are now facing financial ruin, but hey, these things happen?"

I actually don't generally take these cases because unless the amount in dispute is a really big number, the costs associated with a medmal case can take so much of the recovery that it does seem like the attorneys take 2/3, when we're really just taking our fee plus the (exorbitant) costs that we incur in working these cases up which, ironically, are typically paid to other doctors to shepherd us through the medical issues. When it looks like we're taking that much, the client isn't happy, and then I'm not happy, and it's a real losing proposition all around. Unfortunately, however, that means that a lot of people who have sustained real injuries on account of real fault of doctors don't get any compensation.

Well in my opinion suing for medical whatever reason here has become a disease, running rampant and needs to be stamped out. I think people should have to sign waivers before they enter any kind of procedure releasing the doctor from liability unless he really goofs bad. But things that are common risks and suck doctors should have 0 liability. Same goes with pharmacueticals. I'm growing tired of did you take x pill and get x disease? Sue! Well, would you have been better off without the pill? Did someone force it down your throat? Well too bad you should know there are risks with introducing foriegn chemicals into your body. Of course, always exceptions like if the pharm company were to blatantly ignore research showing something bad was going to happen.

 

[3devious]

Before I get into the larger point, it bears mention that you're actually double counting here. Doctors don't typically "[lay] out resources to fight off the suit," they buy insurance. Either they buy insurance or they outlay their own cash to defend suits and pay judgments, if applicable, but typically not both.

That was my fault, I thought they have to buy insurance. Even if the insurance is taking care of the logistics of the suit, you might be required to testify. That isn't just a time sink, you not only have to defend your professional actions but it becomes a bit of a PR issue, too. (Sort of like when you stand accused of being a child molestor, when you are not convicted of it you are still permanently harmed because your reputation will never be the same once you've done the "perp walk" regardless of the truth.) I speculate that it would also be emotionally draining but that isn't really quantifiable.

I don't know of a good alternative. Maybe there could be some sort of incentive offered for settling things outside of court (maybe even outside of arbitration.) I am not trying to be an ass, but the average person isn't completely stupid and we don't need you (lawyers.) There seems to be a widening gap between what is legal and what is fair. Perhaps fairness actually comes into play with how the law is executed, not always the laws themselves but when you start arguing over what the definition of what the word "is" is, it is time to get rid of that nonsense.

 

[burton71]

4.) Keep the pre existing condition clause, AND, extend it to children.

This is the second time you posted this and it is STILL wrong. The preexisting condition covers children.

 

[IOWA]

This is the second time you posted this and it is STILL wrong. The preexisting condition covers children.

And the point of your post is?

 

[toasty]

Well in my opinion suing for medical whatever reason here has become a disease, running rampant and needs to be stamped out. I think people should have to sign waivers before they enter any kind of procedure releasing the doctor from liability unless he really goofs bad. But things that are common risks and suck doctors should have 0 liability.

What evidence do you have that these suits are, in fact, running rampant? I recognize that if you listen to the drumbeat, it sure sounds like that, but what actual empirical evidence there to back up that statement?

Also, people DO sign informed consent forms, and doctors DO get off when what occurs is a known, disclosed risk. What you're asking for is pretty close to the existing rule -- so what's the problem exactly?

Doctors do get reamed on their med mal insurance, and its a damn shame, but if you think that things like damage caps and other legislative steps to reduce their exposure results in decreased med mal premiums, you'd be wrong -- it isn't like the premiums in states that have caps are less than in states that are unrestricted. They just aren't. Insurance companies' profit margins are much higher in those states, but that's about it. If you want doctors to pay less in insurance, how about some common sense regulation on the insurance industry? Right now, there's basically nothing that operates as a check on their ability to raise rates -- the market should, but it isn't for whatever reason.

Same goes with pharmacueticals. I'm growing tired of did you take x pill and get x disease? Sue! Well, would you have been better off without the pill? Did someone force it down your throat? Well too bad you should know there are risks with introducing foriegn chemicals into your body. Of course, always exceptions like if the pharm company were to blatantly ignore research showing something bad was going to happen.

I have documents in my office right this very moment that reflect the machinations a pharmaceutical company has gone through where they concluded that notwithstanding that they knew that their drug would KILL X number of people and harm Y% of the people that took it, it was still worth releasing it, because they would make $Z in revenue, which would be sufficient to pay the wrongful death claims and still turn a healthy profit. Of course, they declined to offer any sort of warning on that somewhat important point. Personally, I consider that criminal.

Here's the deal: warn about the known dangers, and let the consumer make an informed decision about whether or not the benefit of the drug is worth the risk. I don't know why that is too much to ask, but the truth of the matter is that companies don't warn you of the dangers out of altruism, they warn because they are forced to and they fight those warnings tooth and nail. Look at the drug labels for the same drug in 10 different countries, and you'll probably see at least 3 or 4 different warnings, depending upon how stringent the regulatory body is in that country.

 

[IOWA]

What evidence do you have that these suits are, in fact, running rampant? I recognize that if you listen to the drumbeat, it sure sounds like that, but what actual empirical evidence there to back up that statement?

Also, people DO sign informed consent forms, and doctors DO get off when what occurs is a known, disclosed risk. What you're asking for is pretty close to the existing rule -- so what's the problem exactly?

Doctors do get reamed on their med mal insurance, and its a damn shame, but if you think that things like damage caps and other legislative steps to reduce their exposure results in decreased med mal premiums, you'd be wrong -- it isn't like the premiums in states that have caps are less than in states that are unrestricted. They just aren't. Insurance companies' profit margins are much higher in those states, but that's about it. If you want doctors to pay less in insurance, how about some common sense regulation on the insurance industry? Right now, there's basically nothing that operates as a check on their ability to raise rates -- the market should, but it isn't for whatever reason.



I have documents in my office right this very moment that reflect the machinations a pharmaceutical company has gone through where they concluded that notwithstanding that they knew that their drug would KILL X number of people and harm Y% of the people that took it, it was still worth releasing it, because they would make $Z in revenue, which would be sufficient to pay the wrongful death claims and still turn a healthy profit. Of course, they declined to offer any sort of warning on that somewhat important point. Personally, I consider that criminal.

Here's the deal: warn about the known dangers, and let the consumer make an informed decision about whether or not the benefit of the drug is worth the risk. I don't know why that is too much to ask, but the truth of the matter is that companies don't warn you of the dangers out of altruism, they warn because they are forced to and they fight those warnings tooth and nail. Look at the drug labels for the same drug in 10 different countries, and you'll probably see at least 3 or 4 different warnings, depending upon how stringent the regulatory body is in that country.

Having "documents" doesn't mean much. I could type up several papers that say the us national debt is paid off and say the same as you did.

My "evidence" is what I personally see and hear, and just the "sue happy" mentality our nation has fallen into. Its not jut limited to medical, but everything. Need evidence? Open your eyes.

 

[toasty]

Having "documents" doesn't mean much. I could type up several papers that say the us national debt is paid off and say the same as you did.

I'm a bit hamstrung on what I can say, but for what it's worth, these documents are from a past case, and it was on the strength of this sort of evidence that this company that authored them paid settlements which collectively totaled well into the ten digit range. So yeah, I guess I could have typed them up myself, but as a matter of fact, I didn't, and the company that authored them found their disclosure troubling enough to pay an amount of money that is more than the GDP of a lot of countries. I don't mean to suggest that they are going out of their way to do you harm, but they are motivated by profit first, second, and third, and giving them carte blanche to do whatever they want with impunity is an invitation to a pretty unsafe environment.

Need evidence? Open your eyes.

Open MY eyes? Dude, this is what I do for a living and I speak from personal experience, whereas you're talking about something that you know at best second hand, as far as I know. My personal experience is that while there are certainly outlier cases that get a lot of press, the system works as a whole, and most cases with merit get paid, cases that don't get flushed, and attorneys who take bad med mal cases lose their shirts, because we're risking our own money in the form of expenses that we advance when we pursue them, which has an obvious chilling effect on bringing those sorts of cases.

People that don't know what they're talking about go on and on about people filing tons of frivolous cases against doctors, and my reaction is, "Huh? Where?" It happens, but it is the exception, not the rule, because you'd have to be an idiot to sink that kind of money into a case without some assurance that your case at least has merit.

 

[toasty]

Here's the deal: warn about the known dangers, and let the consumer make an informed decision about whether or not the benefit of the drug is worth the risk. I don't know why that is too much to ask, but the truth of the matter is that companies don't warn you of the dangers out of altruism, they warn because they are forced to and they fight those warnings tooth and nail. Look at the drug labels for the same drug in 10 different countries, and you'll probably see at least 3 or 4 different warnings, depending upon how stringent the regulatory body is in that country.

@ IOWA

I mean, read that again. Does that not trouble you? Pharma companies don't have different formulations for different countries and the side effects are therefore the same across the board, but they only warn of the dangers that they country they are marketing in force them to warn about. The reason they don't is simple -- more warnings = less scripts filled. That should snap into focus for you what they view as more important, so why are you looking to give them immunity?

 

[IOWA]

Granting a semi immunity with a clause, each and every study on said drug must be published, out in the open, and easy to understand. Then people can wiegh the risks.

And by open your eyes, I meant when's the last time you turned on a tv and didn't hear about some drug company getting sued?

 

[numus]

I have been staying out of all political discussions because of SDX and personal reasons, but this article is to good not to share:
washingtonpost.com

 

[3devious]

You fail for trying to equate it to a racial issue. Just like those who label Tea Partiers, (note to self: reconcile the fact that those guys have no concept of "party") conservatives, and anyone who thinks the president is doing a bad job as racist: you fail.

You get extra fail for citing the Washington Post. You may as well cite the New York Post.