What's the big deal on Health Care Reform?

[Miroslav]

Re: What's the big deal on Health Care Reform?

that should have been a "quote"
referring to this:

http://joemygod.blogspot.com/2009/08/whole-foods-ceo-people-have-no.html

"Whole Foods CEO: People Have No Intrinsic Right To Health Care"

Emergency Health Care v.s. Doctors visits, immunizations, checkups are not one in the same to me.

I apologize, I thought you were making that statement. But just out of curiosity...what should be the measure of privilege that allows for people to have doctors visits, immunizations, etc.? Should be solely be having the education and luck of landing with an employer that currently provides those benefits?

[subterFUSE]

Re: What's the big deal on Health Care Reform?

Here are my concerns, or at least questions I would like answered before I am convinced this health care reform is the correct move:

I keep hearing that one of the goals is to provide 50 million uninsured people with coverage and affordable care. How soon after passage of this plan will these people get their coverage? Is this an immediate implementation? Does it take a few months? Years?

The reason this concerns me is that if we add 50 million new people to the health care system overnight, without adding any doctors..... then what happens to the level of service for everyone? How do the doctors handle the increased load of patients if we add them to the system overnight? Does this lead to longer waits for care? Will the care I have been receiving be negatively affected? We can't train doctors overnight so I will be very concerned if the plan is to add 50 million new patients to the system without having more doctors to treat them. I have not heard what the plan is for adding doctors to the health care system, only that they want to add more insured people.


I pay for my own health care since I am self employed. United Healthcare. It costs me $300 per month. The coverage is excellent, though.... as I learned when I developed a large tumor in my left shoulder a few years ago at the age of 27. My primary care doctor referred me to a local orthopaedic surgeon who was unable to diagnose the tumor though needle biopsies. He recommended I have the whole tumor taken out for an open biopsy. However, before he would schedule me for the surgery he shoved a bunch of waivers in my face. He said that the tumor was so large that the surgical procedure posed a significant risk to my axillary nerve. (nerve that controls your deltoid muscle) Damaging that nerve could result in partial paralysis of my arm, he said.... and the waiver was covering him in the event this happened. Not very encouraging to say the least.

Since I play a lot of sports, including golf and lacrosse, I was not keen on risking possible paralysis in my arm. I decided to start researching the topic of soft-tissue tumors and doctors who specialize in them. I found an expert at Johns Hopkins University. She is an orthopaedic oncologist and specializes in tumors like mine. There are no orthopaedic oncologists in Orlando at all. I decided if I was going to have someone operate on my arm, then I wanted a real expert like her. And so I contacted my insurance company to see if they would cover my visiting Hopkins without a referral, which they did. I flew up to Baltimore and had the surgery. She never mentioned any risks to my axillary nerve. She actually laughed when I mentioned the other doctor wanting me to sign waivers. The surgery was a success and my insurance covered it.

After removing the tumor the pathologist diagnosed it as a sarcoma and I had to do 6 months of radiation treatment. No chemo, fortunately. The tumor was low-grade. But it was definitely a good thing I got it taken out. They did CT scans for my lungs to make sure the cancer did not spread there, which it had not.

Several years later and I'm doing great. No recurrence of the tumor, no evidence of it having spread. I must continue with MRIs periodically to monitor for recurrence, but we have been spreading out the scans over longer periods of time now that I'm two years post-surgery. (Recurrence is most likely in the two years after surgery)

The point I'm very slowly getting to is that I'm happy with my insurance. And I am happy that I was able to select my doctor, even though I had to fly across the country to find her. I want to know if my coverage is going to be affected by these changes, but no one can give an answer.


Toasty feels that having a government option that competes with private insurers is rather innocent and harmless:

What exactly is the downside of having a government-funded competitor in the marketplace, by the way? Serious question. Seems to me that if the government is able to offer health insurance coverage -- and note that I'm talking about coverage, not care -- at a cost that is less than what the market is offering, why should it be prohibited from jumping into the fray? This is particularly true where the government is also one of the largest consumers of health care (or at least health care bills, in the form of Medicare), and it can leverage its position as a market participant to drive down the costs that it pays as a third party payor.

Let's stick with the Post Office analogy for a moment:

Generally speaking, the post office offers a low-cost delivery service. (i.e. you can send a letter almost anywhere for a few pennies.) FedEx and UPS compete with the Post Office, but do so by providing the service differently. (i.e. FedEx and UPS will guarantee overnight delivery) Of course, I realize the Post-Office has Express Mail Overnight to compete with FedEx.... but the difference is they can't guarantee overnight delivery to many places that FedEx can. For example, I live in Orlando, FL and the post office will not deliver Express Mail overnight to Charleston, SC which is only 500 miles away. So when I want to overnight my parents a package I must use FedEx or UPS, not the post office.

So the basic view of it for me is....

Post-Office, aka snail mail = cheap but slow
FedEx = expensive, but fast

There is a difference in the level of service which helps FedEx and UPS compete with the Post Office, even though they do cost more. I will pay for FedEx to ship my important package to my parents in Charleston because they can do it overnight. If the post office could provide that same service for less, I would use them.... but they can't get the package there overnight, so I pay extra for FedEx.

But how far does this analogy mirror the situation with health care?

You say the government option will compete with the private insurers, but at a cost that is below the market. So what will be the competitive advantage for the private insurers counter the government? Price is on the government's side. Does that mean the private insurers will have better service? Will I have an advantage by keeping the current insurance which I pay for? The way I see it, United Healthcare would have to offer me better coverage than the government option if I am going to continue paying for them. If they can't offer better service, then why would anyone pay more? I would just assume be on the cheaper, public option if the service is the same. And I believe most people in this country would do the same. It seems to me that it would have to be inferior coverage or else the private insurers will go out of business.

So what will be the differences between the public coverage option and my current insurance? I'm just not hearing anything about this from anyone, and I worry that my situation will be adversely affected.

[|Thrax|]

Re: What's the big deal on Health Care Reform?

But just out of curiosity...what should be the measure of privilege that allows for people to have doctors visits, immunizations, etc.? Should be solely be having the education and luck of landing with an employer that currently provides those benefits?

I don't really know, I thought blue cross, kaiser, etc already offered these plans.
Or an employer can buy into an HMO/PPO.
I guess it's different and way more complex all across the board(and USA)
Health care is outrageously overpriced, so, from what i'm hearing why not have a public option?
I agree.

As far as differences,
I'm sure that will be up for discussion.. but what these people are doing now is sabotage..
straight up, they should just let it roll. I guess we are in for it if we like it or not.

Thanks for the details, I better understand this now.

Next on the reform board should be clean energy.. where's my biodiesel.

[Lorn]

Re: What's the big deal on Health Care Reform?

Thanks for the post Subterfuse. I'm happy you were able to have a successful removal and treatment of that tumor. Scary stuff.

Another thing to add on the Post Office issue...the point I was trying to make bringing up Fedex and UPS is by law they can't deliver mail to a person's mail box, only the US Postal Service can do that. Anti competitive at its finest. This is what happens when government competes with private business.

[floridaorange]

Re: What's the big deal on Health Care Reform?

Wow, good story indeed Sf, makes one think twice about not having such coverage. You received the best treatment in the world. My friend had a similar situation occur recently when she had to have a tumor removed from her brain. Really thankful she's recovering now and just 30 yrs old.

[toasty]

Re: What's the big deal on Health Care Reform?

what subterFUSE said

good post, nice to have some intelligent, well-reasoned discussion around here. Glad to hear you're doing well, by the way.

My understanding is that, to the disappointment of many, any public option would take a while to implement. They were talking about it on CNN a couple of weeks ago, and it sounds like it would be like 2016 (going from memory, don't quote me on this) before a public option would be in full swing. While the concern about having too few doctors is a legitimate one, it isn't going to sneak up on anyone.

I do definitely view the public option as a cheaper, low-frills type of coverage. It's like anything else -- if you want something that will get you from place to place, buy a bus pass. If you'd like the flexibility to go where you want, when you want, buy a hyundai. If you'd like the flexibility to go where you want, when you want, and you'd like to do it in style, get a Benz.

Right now, there is already an enormous amount of variation in the type of health care coverage that is available. Sounds like you've got a great plan, and the fact that you're younger no doubt helps keep your premiums low. Not everyone is so fortunate, however -- my parents, for example, are self-employed and therefore have to pay for their own health coverage, and they pay well over a thousand bucks a month for coverage that frankly sucks. They're actually looking forward to becoming eligible for Medicare because the coverage will be so much better. The public option may not be competing with the higher end plans, but it would certainly compete with lower-end plans.

There's another reason that it could have the effect of driving down prices more generally, though. Right now, one of the important benchmarks for insurance reimbursement is the Average Wholesale Price, commonly referred to as AWP. AWP is (or at least is supposed to be) a reflection of the average price paid for a product or procedure, and it is the primary metric for determining Medicare reimbursement. I am not aware of any health insurance plan that does not use AWP in some respect in determining what it will pay. If you get a large health care provider that is able to use its leverage to negotiate prices down, that drives down the AWP and, accordingly, drives down prices for the rest of us.

[subterFUSE]

Re: What's the big deal on Health Care Reform?

My understanding is that, to the disappointment of many, any public option would take a while to implement. They were talking about it on CNN a couple of weeks ago, and it sounds like it would be like 2016 (going from memory, don't quote me on this) before a public option would be in full swing. While the concern about having too few doctors is a legitimate one, it isn't going to sneak up on anyone.

This is good information to know, and I wish we would have heard it somewhere in all of this mess on the TV. My take on it is that the administration is being deliberately vague on this, although to be fair I cannot say I totally blame them. In the present political climate it's even more dangerous to be consistent and firm than to be elusive and vague when discussing plans for action. This information is important, however.... and I think we do need to hear answers which are at least more clear than what we are getting. Of the various objections I have heard re: public health care, the supply of care vs. the increased demand to be created is among the most compelling.... at least to me.

I do definitely view the public option as a cheaper, low-frills type of coverage. It's like anything else -- if you want something that will get you from place to place, buy a bus pass. If you'd like the flexibility to go where you want, when you want, buy a hyundai. If you'd like the flexibility to go where you want, when you want, and you'd like to do it in style, get a Benz.

Right now, there is already an enormous amount of variation in the type of health care coverage that is available. Sounds like you've got a great plan, and the fact that you're younger no doubt helps keep your premiums low. Not everyone is so fortunate, however -- my parents, for example, are self-employed and therefore have to pay for their own health coverage, and they pay well over a thousand bucks a month for coverage that frankly sucks. They're actually looking forward to becoming eligible for Medicare because the coverage will be so much better. The public option may not be competing with the higher end plans, but it would certainly compete with lower-end plans.

I figured this would be the case. My questions in the previous post were somewhat rhetorical and aimed at this point. If there is no difference in the service then it would lead to a situation where everyone is forced off the private plans and into the public plan, largely by choice due to price. This would kill competition. I would not favor this situation because I believe competition forces us to improve constantly. From your statements, my impression is you are favoring competition in the system for exactly the same reason. Because it will force insurers to improve their offerings.

So, as long as the system provides fair competition, high level service and choices for me.... I would be in favor.

I believe the administration is doing a lousy job of communicating this, if it truly is the intended plan. Like I said above, I can understand they must be cautious about taking too harsh a stance while these plans are still not firm.... but the ambiguity is harming them even more, I think.

[Michael^Heaven]

Re:

Washington (CNN) -- Democrats won a major victory in their push for health care reform early Monday morning as the Senate voted to end debate on a package of controversial revisions to a sweeping $871 billion bill.

The 60 to 40 party-line vote, cast shortly after 1 a.m., kept Senate Democrats on track to pass the bill on Christmas Eve. If it passes, the measure will then have to be merged with a roughly $1 trillion plan passed by House of Representatives in November. The Senate went into recess until noon Monday shortly after the vote.

http://www.cnn.com/2009/POLITICS/12/21/health.care.senate.vote/index.html

This is such bullsh#t, IMO. They're just trying to railroad this Bill through before anyone actually reads it. This includes the members of the Senate & the American public. In addition, Nebraska's Senator whored his vote out...

Nelson told CNN's "State of the Union" on Sunday that he would withdraw his support if the final bill gets changed too much from the Senate version under consideration.

Among other things, Nelson had a provision added to the bill requiring the federal government to cover Nebraska's costs for expanded Medicaid coverage after 2016. No other state is currently slated to receive such a benefit.

Prostitute!

[runningman]

Re: What's the big deal on Health Care Reform?

you know it is corrupt when it is done at 1AM on a Sunday night..

[chuckc]

Re: What's the big deal on Health Care Reform?

this is bad news.

they dont want anyone to read it because its a bad bill.

the only way they would be able to pass it is to ram it though by obamas deadline of xmas. they even had to buy off nebraska's bill nelson.

we are all about to get screwed big time. what a mistake obama is. funny all he could talk about is being transparent with this legislation. he is so full of crap!

[runningman]

Re: What's the big deal on Health Care Reform?

everything he says is backwards.

I worry because he talks a lot of peace.

[toasty]

Re: What's the big deal on Health Care Reform?

I'm as pissed at anyone at Nelson and think he's a complete and utter whore, but I'm not very concerned about the fact that it happened to pass at 1:00 am. FFS people, it's not like they decided to convene, in the middle of the night, to jam this through. They had been working on it for a while, and that's when it finally got done, with every single senator present, as I understand it.

The concerns about not having the opportunity to read the bill were legitimate back when they were, in fact, trying to ram it through on the rocket docket during the summer, but just as no one showed up at midnight to vote on this bill, the guts of this bill have been out there for a while, and it's not as if this bill was crafted out of thin air at 12:30, either. Everyone that voted on it had ample opportunity to digest and consider the salient provisions of the bill.

If you want to bitch about the contents of the bill, be my guest, but the timing in incident to how the process works when there's a filibuster -- no one leaves until there's a successful cloture vote, even if that means that the session stays active overnight -- so let's all calm down an have some fucking perspective here. Remember when Strom Thurmond filibustered the Civil Rights Act for more than a day?

[floridaorange]

Re: What's the big deal on Health Care Reform?

nebraska's bill nelson.

Just for the record, Chuck meant to say "Ben" not "Bill"

Bill Nelson is a Florida senator and former astronaut.

[subterFUSE]

Re: What's the big deal on Health Care Reform?

So according to the news, the major points in this health care legislation are:

1. No more denial of coverage for pre-existing conditions.
2. Everyone is forced to buy insurance coverage whether they want it or not, or else they pay a penalty of $750.


Sounds to me like I should cancel my health coverage under the new Obama plan. They will not be able to deny me for a pre-existing condition. So it sounds like the smart thing to do is not pay for insurance until you actually need it. Then sign up for that week, and then stop paying for it again and just pay the penalty.

[Michael^Heaven]

Re:

So according to the news, the major points in this health care legislation are:

1. No more denial of coverage for pre-existing conditions.
2. Everyone is forced to buy insurance coverage whether they want it or not, or else they pay a penalty of $750.


Sounds to me like I should cancel my health coverage under the new Obama plan. They will not be able to deny me for a pre-existing condition. So it sounds like the smart thing to do is not pay for insurance until you actually need it. Then sign up for that week, and then stop paying for it again and just pay the penalty.

Just because you cannot be denied coverage, that doesn't mean you can make a insurance claim for a medical procedure that may reflect or be the direct cause of a pre-existing condition. That's already in play for most policies. Also, you can't stop paying & then start again. That's not continuous coverage which I'm sure the insurance gestapo will be monitoring.

Also, regarding fines...

Penalties for failing to do so would start at $750 a year for individuals and $1,500 for families. Households making more than three times the federal poverty level — about $66,000 for a family of four — would face the maximum fines. For families, it would be $3,800, and for individuals, $950.

http://www.msnbc.msn.com/id/32733321/ns/politics-health_care_reform/

Don't forget you may also face madatory jail time in addition to being fined for not having health care insurance. A provision that Pelosi presonally made sure stayed in the Healthcare Bill.