American Health Care Reform

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Re: American Health Care Reform

Postby Mick » 02 Jul 2012, 21:27

GuyInTaiwan wrote:Your first paragraph has merit, and whilst I may even agree with you on some of the other points, they're irrelevant to the discussion. The health system should be affordable in and of itself, not because you tweak A to give money to D, which you tweak to give to C, which gets tweaked to give money to F, which gets tweaked to give money to B... This is the whole problem with how everything gets done by both sides: everyone is trying to attach all their other axes they want to grind and the entire thing is a massive, convoluted mess that no one but (some) lawyers understands.

Here's a novel idea: deal with each issue on its own merits, one issue at a time. To do otherwise is disingenuous.


I hear you Guy. However, health care, which I think should be available to everyone in a civilized developed country is part of a system. In the US they are already paying something like 18% of their GDP on health care, whats that, like 3 trillion dollars or something and way more than any other country in the world. The U.S. Does Not Have A Debt Problem ... It Has A Health Care Cost Problem How much money could be saved if it were even close to the next highest in the word which is around 12%.

Everyone should be covered already. It's not disingenuous to point out that trillions of dollars collected in taxpayers money is being spent on questionable projects like wars on drugs or wars in Iraq and Afghanistan and over inflated military expenditure, when people ask where will the money come from to fund this. It's there already, get the cost of heath care down is one, second is use money collected in taxes wisely.
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Re: American Health Care Reform

Postby GuyInTaiwan » 02 Jul 2012, 21:53

The money is used unwisely because it's there in the first place. As long as the trough is there, the snouts will sniff it out.
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American Health Care Reform

Postby headhonchoII » 02 Jul 2012, 22:15

Not really, health care is something that is not really optional. So you can be very much forced into paying more for it one country than another. Don't go to the hospital, don't get tested, ignore your condition, sayonara baby. You have only got one life. Many people don't have the money to pay for medical treatment in the US, but they will somehow find the money when absolutely necessary.

There is a trend of global health care services but it only works for a subset of cases. A lot of American pensioners try to bring their Meds in from Canada but the US government is doing everything it can to block that. Supposedly there are buses of seniors that cross the borders just to purchase drugs. The US govt claims it's a health risk. Well a real health risk is not getting any medicine whatsoever!

There needs to be a huge focus on cost vs effectiveness there and some hard choices need to be made. But simple things like reducing the number of scans may actually be better for patients as MRI scans also increase the overall cancer rate.
Same for Mab drugs. Ridiculously expensive yet only prolong life by a couple of months in many cases. The cost of production is a massive part of this but if they opened up to generics and biosimilars the costs could come down by factors of 10. Stem cell infusions are going to cost a fortune too, that's one where a big medical trade is already starting to take off in South America and China.
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Re: American Health Care Reform

Postby Gao Bohan » 03 Jul 2012, 02:51

CraigTPE,

Retirement age impacts the health care system in two ways. First, the Medicare retirement age is 65, meaning simply that the federal government will pay for most of the medical costs for Americans age 65 and older. Raising the retirement age would lower government costs. Second, raising the Social Security retirement age would reduce pressure on federal outlays, allowing more money for direct medical subsidization.

Raising the retirement age for those systems is an option that should be on the table, but then so should reducing defense spending and raising taxes.
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Re: American Health Care Reform

Postby Chris » 03 Jul 2012, 03:22

Healthcare should not be a for-profit endeavor.
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Re: American Health Care Reform

Postby CraigTPE » 03 Jul 2012, 04:39

Gao Bohan wrote:CraigTPE,

Retirement age impacts the health care system in two ways. First, the Medicare retirement age is 65, meaning simply that the federal government will pay for most of the medical costs for Americans age 65 and older. Raising the retirement age would lower government costs. Second, raising the Social Security retirement age would reduce pressure on federal outlays, allowing more money for direct medical subsidization.

Raising the retirement age for those systems is an option that should be on the table, but then so should reducing defense spending and raising taxes.

The topic is not the federal deficit, but health care. Retiring means to stop working. If you have money, pay your own insurance and hold off on collecting Social Security.

The bottom line is that this was the best that could be done to assure citizens have decent healthcare. Get everyone into the system. It's insane for conservatives to be railing against the mandate that THEY THEMSELVES suggested. Without national healthcare, there are only 3 choices:
  • insurance mandate
  • subsidize emergency room treatment for uninsured
  • let them die

Pick one.
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Re: American Health Care Reform

Postby Gao Bohan » 03 Jul 2012, 06:13

CraigTPE wrote:The bottom line is that this was the best that could be done to assure citizens have decent healthcare. Get everyone into the system. It's insane for conservatives to be railing against the mandate that THEY THEMSELVES suggested. Without national healthcare, there are only 3 choices:
  • insurance mandate
  • subsidize emergency room treatment for uninsured
  • let them die

Pick one.


Of course, I agree with you. I will only add that Obamacare includes, as you know, an expansion of Medicaid to the poor and subsidies for the lower middle class to purchase private insurance. The federal government's ability to finance these benefits is relevant to the discussion.
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Re: American Health Care Reform

Postby Gao Bohan » 03 Jul 2012, 06:16

fred smith wrote:We are going to have to start over on this whole thing.

No one knows what the Affordable Health Care Act really means. Anyone who says they do is fooling themselves first and foremost.

What I have been able to pick out of this mess is the following:

1. The costs need to be clearly stated so that businesses will hire and invest. Until the true costs are known, this uncertainty is going to weigh on the economy and unemployment. And no cop outs. No exceptions. No waivers. All companies must be in. No lobbying for exemption.

2. We need a mandate to force people to buy health care. This was a Republican idea and it was a good one. The politicizing of this need now is just hypocritical at best and criminal at worst. There are too many uninsured that either bankrupt themselves or bankrupt public assistance with excessive care on emergency rather than normal doctors appointments and preventive treatment. It is hoped that this would free up some of the excessive wait times in our emergency rooms because everyone is overusing them.

3. Everyone is going to have to be more responsible for their own health including diet, exercise, and reducing risk factors or they will have to pay the price. Sorry but part of this is going to be forcing people to get jobs and stay in them. Welfare reform has stalled and work requirement rules are going to have to be tightened. The stricter these are the more responsible people seem to become about having children and single parents and unwanted children is the greatest source of social problems in our nation from poor educational acheivement to teenage pregnancy to crime and drugs.

4. Retirement is going to have to be postponed to 72.

5. Medicare is going to have to be means tested.

6. We are going to have to tax premium health plans.

7. We are going to have to solve the immigration issue. We have too many illegal immigrants falling through the cracks. If we cannot achieve some kind of temporary legal status documentation then the only solution in my view is mass amnesty once again... I know this was not supposed to have again and again and again but... better than the alternative. With this, we are going to have to tighten our borders OR pay states on the frontlines like Arizona, New Mexico, Texas and California for bearing the costs of illegal immigration whether hospital, education, crime or need for new infrastructure.

8. The greatest cost of health care is in the last six months. Those who are going to be dying anyway should be sent home to die in dignity and not be kept alive for a few extra weeks or months at great cost. Let's be honest. The final days, weeks and months do not justify the costs.

9. Whether private health insurance or government money, there is going to have to be some kind of rational rationing of certain types of surgeries. This is already taking place but an 85 year old with a heart transplant? a 72 year old with a kidney transplant... we are going to have to weigh these things and the moral gray zone is going to be very big and very fraught with emotion and cries of unfairness. Call them death panels if you want but there are already people making these decisions under the old system. That will continue under the new. It is not something new and it is not Obama caused/created.


Thanks, fred. I agree with much of what you've written above. It's refreshing to speak with a thinking conservative on this issue again. By the way, premium health plans will be taxed starting in 2018. It will be one of the last provisions of the Affordable Care Act to be implemented.
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Re: American Health Care Reform

Postby Gao Bohan » 03 Jul 2012, 07:02

johnny138 wrote:People like you never, ever stop to think of where the money is going to come from to pay for this. Every supporter of Obamacare in this thread incessantly talks of benefits and completely ignores costs.


Actually, the costs of Obamacare have been discussed at length by myself and others. And we're still discussing the costs. Please read the thread before posting.

My father in law is dying of cancer but he was a business owner and worked his ass off his whole life. Because he saved money, we have funds for the treatment but his care causes a burden on our family. Do you think the people who hold up pictures on Facebook are the only ones that get sick? Rather than devote my money to my own family's care, you'd rather me send my money to a woman I don't even know? Not. Going. To. Happen.


I am sorry to hear about your father-in-law. I am also at the point in life where relatives just one generation above me are starting to become seriously ill, and you have my sympathies. But I think you're looking at the issue in terms of absolutes. The choices are not support your family or support a stranger with massive health care bills. The logic of insurance is fairly straightforward. Everybody pays into the system whether or not they draw back, but when they do need funds, their withdrawl is funded by the premiums of the others in the insurance pool. Obamacare simply compels all citizens and legal residents to buy health insurance. It's true that the poor will be subsidized, but the vast majority of Americans will get insurance through work or be forced to buy it on the open market at their own expense. The other side of this coin is that health insurance companies must guarantee issue, cover preexisting conditions, and pay for all preventative treatments. The end goal is for everybody to be insured, and for no one to go bankrupt paying for health care.

Republicans think about it all the time. We try to bring down costs all the time by limiting law suit damage so malpractice insurance costs will come down. We also try hard to get incompetent doctors thrown out of practice. But liberals fight us at every turn on those measures. Liberals aren't serious about bringing down healthcare costs or they would support those measures.


I agree with you that liberals tend to be more focused on expanding coverage than lowering costs. But tort reform is not incompatible with Obamacare. In fact, even before the Affordable Care Act was signed into law, the Obama Administration spent $25 million to test alternatives to the medical liability system. And the Affordable Care Act dedicated another $50 million to expand the state demonstration projects. Democrats are more open to tort reform than is often suggested, but we're not interested in debating the issue until Republicans accept Obamacare as established law and withdraw their vow to repeal it.

Yes, those evil capitalist scumbags that go around creating the jobs for you to earn money and support yourself. They all stole that capital to start businesses, didn't they? No one ever EARNED any money they have, right?


You're railing against strawmen. Nobody has made the arguments you're trying to refute.

What about the business owners that will be forced into bankruptcy trying to pay for this? Isn't the economy struggling already? Aren't business owners already facing tough times? And Obama and his supporters now want to slap another heavy tax on them. Does anyone really believe there won't be economic consequences to that?


The same concerns were raised about RomneyCare (MassCare) and they never came to fruition. Massachussetts is a good predictor of how the US will respond to the full implementation of health care reform. Six years after RomneyCare passed, the states health care costs have risen only 1% above the national average annual increase, and 99% of the state's population now has health insurance. The mass layoffs that conservatives feared didn't happen.

Videos of Obama saying it isn't a tax is irrelevant? Videos explaining where this money comes from is irrelevant? Videos of Pelosi admitting she doesn't have a CLUE what's in the bill she's asking people to pass is irrelevant?


They're about as relevant as videos of Romney championing MassCare as a model for the national health reform, the most recent in the fall of 2009, just months before ObamaCare passed into law. They're interesting for five minutes then you move on. What's truly relevant is the current positions of the national parties and their representatives. There's no question that Romney is now opposed to a system he once advocated and that he would repeal ObamaCare if given the chance. There's also no question that Obama will accept the constitutionality of ObamaCare under the government's taxing power. In reality his position had already changed during the trials; after all, it was the US government who advocated in court that the IRS penalty for not purchasing health insurance is a tax. That was the Government's alternate position, and the one the court accepted.
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Re: American Health Care Reform

Postby Gao Bohan » 03 Jul 2012, 09:29

fred smith wrote:But the FEAR of malpractice costs result in how many unneeded tests and additional paperwork that results in perhaps an additional 5% to 10% in costs? I believe that your figure is for DIRECT costs.


It results in an additional 1%, for a total of 2%. During the health care debate in 2009, Senator Orrin Hatch asked the CBO to update its earlier analysis of his tort reform bill. Their response to the honorable gentleman from Utah included both direct and indirect cost savings.

The Congressional Budget Office, in response to the honorable Senator Orrin Hatch wrote:October 9, 2009
Honorable Orrin G. Hatch
United States Senate
Washington, DC 20510

Dear Senator:
This letter responds to your request for an updated analysis of the effects of proposals to
limit costs related to medical malpractice (“tort reform”). Tort reform could affect costs
for health care both directly and indirectly: directly, by lowering premiums for medical
liability insurance; and indirectly, by reducing the use of diagnostic tests and other health
care services when providers recommend those services principally to reduce their
potential exposure to lawsuits.
Because of mixed evidence about whether tort reform
affects the utilization of health care services, past analyses by the Congressional Budget
Office (CBO) have focused on the impact of tort reform on premiums for malpractice
insurance. However, more recent research has provided additional evidence to suggest
that lowering the cost of medical malpractice tends to reduce the use of health care
services. CBO has updated its estimate of the budgetary effects of proposals for tort
reform to reflect that new information.

[...]

CBO estimates that the direct costs that providers will incur in 2009 for medical
malpractice liability—which consist of malpractice insurance premiums together with
settlements, awards, and administrative costs not covered by insurance—will total
approximately $35 billion, or about 2 percent of total health care expenditures.
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