President Obama's health care--

[justplugit]

The President wants to have a health care program in place and
passed before the end of the year That leaves 6 months, excluding
congressional vacation over the summer to come up with an equitable, cost
efficient program estimated to cost ANOTHER Trillion dollars!!

He said today, he was asking for public input, but what are the specifics and when will we get them. Like you want to be thinking about health care over the summer when you finally have sometime not to think of the economic mess we are in.
Emergency, Emergency.

Common sense says an undertaking like that should be formulated gradually over a period of years, and in imho shouldn't even be considered until the
economy is sound and completely back on it's feet.

Another trillion $$$$. I bet you 3/4 of congress still doesn't even know what's
in the stimulus package, except for maybe the 640 Billion he stuck in there for health care that had nothing to do with stimulus.

[fishbones]

What comes after a trillion?

[Cool Beans]

Originally Posted by fishbones

What comes after a trillion?

I'm sure by the end of Obama's 1st term, whatever that number is, it will be common knowledge.
"the national debt is now 4 Gazillion, Bazillion dollars"

[spence]

Originally Posted by justplugit

Common sense says an undertaking like that should be formulated gradually over a period of years, and in imho shouldn't even be considered until the economy is sound and completely back on it's feet.

We haven't seen a plan so it may be too early to say how rapid they will propose to enact change. That being said, a large system of 300+ Million people can only change so quickly. I'd be surprised if this wasn't a multi-year proposal.

As for the part about the economy, that doesn't make a lot of sense. The looming health care problem is bigger in $$$ terms than any pressing issue we face, and I'm not sure there is a free market solution. Waiting 2-5 years for the economy to recover could very well put the solution out of reach, if it isn't already.

I was a bit surprised Obama flipped on taxing health benefits after making it a campaign issue. While this would look to be a progressive tax, it's certainly going to get some serious opposition and is a looser from a PR perspective.

-spence

[justplugit]

[QUOTE=spence;69295

Waiting 2-5 years for the economy to recover could very well put the solution out of reach, if it isn't already.
-spence[/QUOTE]



Then so be it, if we can't afford it now then it's not the time to do it.
It's this credit card mentality that has been a big part of getting us into this financial mess in the first place.

[spence]

Originally Posted by justplugit

Then so be it, if we can't afford it now then it's not the time to do it.
It's this credit card mentality that has been a big part of getting us into this financial mess in the first place.

The problem isn't even really about affordability, it is about priority and solution.

We can't afford not to address this issue. It's like a leak eroding the foundation of your house.

-spence

[Cool Beans]

One thing that makes me nervous, too many liberals think this

Originally Posted by spence

I'm not sure there is a free market solution.
-spence

What do you propose? Complete government control? I'm curious on your response, if Capitalism (free market) can't fix it, do you honestly believe that Socialism (government control) can fix it?

[JohnnyD]

Originally Posted by Cool Beans

What do you propose? Complete government control? I'm curious on your response, if Capitalism (free market) can't fix it, do you honestly believe that Socialism (government control) can fix it?

While at the moment I don't know nearly enough about any proposed health care reform, I don't believe a capitalistic approach can resolve all situations.

Can a government controlled solution work? A quick look at Social Security and Welfare can answer that question.

A purely capitalistic approach is what has brought us to the insane costs of health care that currently exist. Capitalism is what brought the banks down - it is certainly not the supreme method of resolving financial issues. Some? yes... all? no.

I would be curious though at how effective the Canadian and UK health care systems are.

[fishbones]

Originally Posted by JohnnyD

A purely capitalistic approach is what has brought us to the insane costs of health care that currently exist.

I would be curious though at how effective the Canadian and UK health care systems are.

Johhny,
A huge part of the crazy cost of healthcare is malpractice insurance for doctors. These costs have to be passed on to patients by doctors and hospitals. I know you work or worked in the medical field, so you must have some knowledge about this. Many of the best doctors coming out of medical schools now go into research because it's almost financially impossible to go into private practice and make a living while paying off student loans. That's why you see so many doctors trained outside of the US practicing medicine here.

I'm not sure about Europe, but many Canadians who need major surgeries come to the US because the Canadian healthcare system is not on par with what we have here. Also, the waits in emergency rooms in Canada make the emergency room waits in the US seem like they go by in the blink of an eye.

[scottw]

For anyone that doesn't understand how rationed healthcare works, here is a 1-minute demonstration.

The da Vinci system is a robotic system used for MIS, minimally invasive surgery. It is cutting-edge medicine for such surgeries as prostate surgery.

Use the Surgery Finder (linked at source URL) as follows:

1. Go to the URL. Click on the radio button that says "Hospitals".

2. From the "International" drop down list, select "Canada" and click the blue arrow.

You will notice that there are 9 hospitals that have the da Vinci system; with Canada's population of 33 million, that means that the ratio is 1 system per 3.67 million population.

Back up, and instead of choosing "Canada" choose your state - in my case, I live in PA. Get the results again.

In the state of PA, there are 30; but since one is a VA Hospital, let's say there are 29 hospitals with the da Vinci system.

That means that there is 1 system for every 420,000 people in the state.

Los Angeles County has more Da Vincis than all of Canada.




The best argument against canadacare would be the fact that a Canadian MP, Belinda Caroline Stronach, went to California for cancer treatment.



For Prostatectomies, there are 2 surgeons listed in Canada. There are 6 in UTAH.


There are more MRI machines in Philadelphia than in Canada.



All Americans need to know is that every British and Canadian politician who runs for office claims, "I will reduce hospital and medical wait times".
Having to wait 18 months for surgery (If it's allowed by the National Service) will be quite a shock for Americans.


Anyone who thinks Canada is a good model for healthcare needs to visit a hospital in a border state.
You don't even need to go in....just cruise the parking lot, counting Canadian license plates. 'Nuff said.

But Obama will figure it out...HE's AN EXPERT! or maybe he'll dish it to his wife who has the all hospital experience....diversity coordinator???...$300,000...no wonder medical care is so expensive with high paying no-show useless jobs like that!


I like this one..."Capitalism is what brought the banks down"

[justplugit]

Originally Posted by spence

We can't afford not to address this issue. It's like a leak eroding the foundation of your house.

-spence

I agree it has to be addressed but a quick patch of sand to fix the foundation
will just lead to more problems. I worked in the medical field for 34 years
and have seen the problems develop.

Like FB said, a large part is due to high malpractice insurance $$$ but also new technology.
Twenty years ago if you went to the Doc with a stomach ache he would RX some Mylanta and send you home. Now because he is afraid of malpractice
he'll order an ultrasound, maybe an upper GI or CAT scan or whatever. $$$$$$$

First, before anything ,we need strict TORT reform. Won't happen though, as 90% of Congress is made up of lawyers.

Government could help with some regulations, but if it takes over health care it will be a disaster making medicare and social security look like a well oiled machine.
A quick fix, emergency, emergency as played out in Obama's first 5 months is not what we need. Haste makes waste.

[Raven]

i have decided that my ability to feel what's going on
inside my own Body is a better assessment of my health
than a Doctors 5 minute opinion and corresponding
pill recommendation.

[PaulS]

FB is right on the malpractice and also the costs of Drs. ordering many unnessary tests to protect themselves from suits.


Check out this link for a long article in the New Yorker for another reason.

http://www.newyorker.com/reporting/2...printable=true

[JohnnyD]

Originally Posted by fishbones

Johhny,
A huge part of the crazy cost of healthcare is malpractice insurance for doctors. These costs have to be passed on to patients by doctors and hospitals. I know you work or worked in the medical field, so you must have some knowledge about this. Many of the best doctors coming out of medical schools now go into research because it's almost financially impossible to go into private practice and make a living while paying off student loans. That's why you see so many doctors trained outside of the US practicing medicine here.

On the other hand, an entire industry has been created helping American patient's travel to other countries for medical operations because the costs in the US are too high.

You are absolutely right that malpractice suits and the cost of insurance are a huge issue for doctors. Another part is the ridiculous price of pharmaceuticals.

Limitations need to be put into place with regards to malpractice suits and doctor liability. The slightest mistake and the doctors are found guilty and ordered to pay insane fines, where as only gross negligence should make them liable for amounts over $125k.

[justplugit]

Originally Posted by JohnnyD

You are absolutely right that malpractice suits and the cost of insurance are a huge issue for doctors. Another part is the ridiculous price of pharmaceuticals.

------------------------------------------------------------------------------------


Cost of pharmaceuticals is a 2 edge sword that most don't want to see.

On one hand people look at the price and say "you have to be kidding me" not
realizing the cost effectiveness of keeping them out of the hospital and increasing their quality of life and reducing mortality.

They are expensive and people don't want to pay $5 or $10 a day but are willing to pay $7.50 a day for a pack of cigs or who knows how much for booze or illegal drugs that are killing them.

These drugs are very costly to discover, research, do clinical trials and get FDA approval. Pharm will not be willing to develop new life saving drugs if we go with a government controlled health care program.
Pfizer has already discontinued their cardiovascular research as they see the handwriting on the wall. So the new and best pharmaceuticals in the world will certainly become few and far between.

That leaves generics of existing drugs as a mainstay, which many will be manufactured by companies that do nothing to improve health care or provde the quality drugs made by the large Pharms.

The FDA used to issue The Green Sheet which showed drug recalls each month.
In almost every case the FDA inspections initiated the recalls for the generic companies where as the Pharmaceutical Companies would initiate recalls on their own before inspection. There aren't enough FDA Inspectors in the world to inspect every batch of generic drugs coming off the line.

Government controlled health care will take the best medicine in the world and at the very least make it mediocre.

[scottw]

it already has everywhere but here....so far...we'll get there...soon...

Back in the 1960s, Claude Castonguay chaired a Canadian government committee studying health reform and recommended that his home province of Quebec — then the largest and most affluent in the country — adopt government-administered health care, covering all citizens through tax levies.
Four decades later, as the chairman of a government committee reviewing Quebec health care this year, Castonguay concluded that the system is in "crisis."-
"We thought we could resolve the system's problems by rationing services or injecting massive amounts of new money into it," says Castonguay. But now he prescribes a radical overhaul: "We are proposing to give a greater role to the private sector so that people can exercise freedom of choice." these are extraordinary views, especially coming from Castonguay. It's as if John Maynard Keynes, resting on his British death bed in 1946, had declared that his faith in government interventionism was misplaced. IBD

In 2006, a Canadian court threatened to shut down one private clinic because it was planning to start accepting private payments from patients. According to The New York Times, although privately funded clinics are illegal in Canada, many clinics are opening anyway, because patients don’t like the long waiting lists in the government system.

In a 2007 interview on ABC News, Professor Regina Herzlinger of Harvard Business School said, “Many clinics all across Canada are illegal for-profit… They know they can’t get the health care they need from the legal system, so they’re complicit in creating an illegal system that’ll give them what they need.”


Americans have been conditioned to believe that someone else should provide a magic card that they can flash at any doctor, hospital, dentist, optometrist etc.. and recieve whatever they are in need of...for free...for life...this is insane...

[JohnnyD]

Originally Posted by justplugit

Cost of pharmaceuticals is a 2 edge sword that most don't want to see.

How about the doctors I know personally that have been fired from their jobs because they wouldn't sign off on new drugs because he (and the pharma companies) knew the drugs were unsafe for the public?

Big pharma has more skeletons in the closet than the public will ever know about. The corruption, lobbying and back-alley deals are more than can be discussed here.

Some cancer medications can cost up to $17,000/month.

[scottw]

if you get the chance check out the PBS Documentary "Sick Around the World"

they explore the various alternatives already in practice around the world..the top two they determined were Taiwan and Switzerland....Taiwan was engaged in huge deficit spending to keep theirs afloat because the politicians refused to tell the public they had to pony up more to support the system for fear of being booted from office, my favorite quote regarding Taiwan was when an administrator was asked how they handle people that "overuse " the system..it was explained that they "go to their house or call them in and have a little talk with them"...Switzerland was dealing with a population of only 7 million people...Germany and Japan were also near the top of the list..

[spence]

Most comparisons to other countries appear to be fear mongering for the most part. While you certainly hear the horror stories you rarely hear the positives, and speaking with many people in other countries over the years they're often very satisfied with their health care.

Besides, the US is a unique country and as such any health care reforms will probably not look exactly like a EU or Canadian model.

Most people have dramatically different views on this subject whether they have insurance or not. I know my father certainly had his eyes opened when his work sponsored retirement health care was cut and he they had to go on Medicare.

I agree that TORT reform is needed, and liked John Kerry's 2004 campaign idea to get malpractice cases into Federal courts. People complain about malpractice but remember the big corporations have used malpractice to snuff out the neighborhood doctor. Join my HMO or else

The simple fact is that living under a system where so many people have insurance (or taxpayer funded insurance) has allowed the system get incredibly expensive, without any incentive to streamline...and we have an aging population that's consuming a disproportionate amount of the services...and the AARP is a very big voting block.

I'm not for single payer systems, but I also recognize there's plenty of money in the system to improve it. The path we're currently on isn't sustainable even for those with good insurance.

-spence

[scottw]

Originally Posted by spence

Most comparisons to other countries appear to be fear mongering for the most part. While you certainly hear the horror stories you rarely hear the positives, and speaking with many people in other countries over the years they're often very satisfied with their health care.
-spence

fear mongering

appear to whom?

WHERE IS YOUR PROOF

how many people Spence? which countries?

...I've talked to many Americans and haven't talked to anyone yet who is unsatisfied with their healthcare...

you can cite occasional horror stories from the American healthcare system but rarely hear the positives....

seems to me we went through an entire presidential campaign and the only stories cited were both bogus...one brought up in a primary debate by Edwards about a denial of care in Cali. that turned up to be a very premature report of the facts and was never heard from again as well as the whopper that Hillary was running with that she supposedly heard and was repeating on the trail that turned out to also be false....this is not about providing healthcare for every American, they already get it if they need it(and the illegals too) this is about the government taking over and controlling a sector that represents 17% of GDP...this is a WHOLESALE CHANGE...not simply tinkering to improve what is the best and most advanced healthcare system in the world and assured to be a disaster on the scale of all the other social programs begun under the same auspices that now have us 65 trillion in the red in unfunded obligations...
it doesn't matter whether the world's citizens say they are satisfied or not...it's all that they know for the most part...who do they complain to, they have no options once govt. takes over? their systems by and large are unsustainable and collapsing and rationing has begun....do some reading Canada, Greece, England, Spain, France and on and on...better yet, look at the US states that began their own little versions of socialized medicine and the strain on their budgets....

two of the best supposedly

The Japanese healthcare system
The issue is to solve the "tragedy of the commons" without making another

The Japanese medical insurance system has a unique combination of characteristics that has led to the overuse of tests and drugs, unconstrained demand from patients, and an explosion of costs. Unless the system of medical insurance and reimbursement of healthcare providers changes, the combination of increasing technological advances, an ageing population, and unconstrained demand will produce a crisis in Japanese health care. Japan is only belatedly waking up to this crisis.

Is the German healthcare system setting the right incentives to provide the best patient care?
Posted by eucomed on 29/05/09

An exclusive roundtable hosted by Johnson & Johnson during this year’s Hauptstadtkongress debated the question whether the current healthcare system in Germany should compromise between the need to standardize treatments due to scarce resources and increasingly informed patients demanding the best treatment possible. Although panelists agreed that Germany may be leading in terms of standards of treatment when compared with similar sized systems across Europe the group felt there was still room for improvement.

Rolf Koschorek, member of the German Parliament, made the point that the uptake of innovations could be faster. This would help ensure patient access to the best treatment possible. Professor Carsten Perka of renowned university hospital Charité made clear that price is currently the decision-making driver in hospitals. Perka believes that price of products is not the main thing that hospitals and healthcare systems should be concerned about. As long as physicians continue to be measured based on cost per patient treatment (and product) other crucial aspects that might ultimately benefit the patient such as physician training will fall short. A shame, really, isn’t it?

[justplugit]

Almost a month now since Obama promised Health Care reform info on plans so
the public could have input.

All that apply for Government Health Care, and are not working, should have the same rules that apply to those seeking Unemployment.
-- Ongoing prove where they are seeking work.

Being many American workers are required to take random drug tests in order to work, and therefore pay taxes,
it should be the same rule for Government Health Care applicants, take random drug tests to get and keep the insurance.

Seems only fair, but it's probably not PC.

[JohnnyD]

Originally Posted by justplugit

Being many American workers are required to take random drug tests in order to work, and therefore pay taxes,
it should be the same rule for Government Health Care applicants, take random drug tests to get and keep the insurance.

Seems only fair, but it's probably not PC.

West Virgina is working on (or has passed, I can't remember) a law requiring any person taking state assistance to agree to random drug testing.

A policy like that needs to be nation-wide. I'm tired of paying for some sh*tbum to sit at home and smoke crack all day while hard-working people work their tail off in hopes of keeping their job.

Drive down Blue Hills Ave. in Mattapan any day during the week and it's like a Sunday afternoon with all the people sitting on their porches drinking from paperbags or walking around the streets. The same could be said for 90% of people in the City of Springfield.

I can't imagine a policy like that would fly in a hard Left state like MA though.

[justplugit]

Originally Posted by JohnnyD

West Virgina is working on (or has passed, I can't remember) a law requiring any person taking state assistance to agree to random drug testing.

A policy like that needs to be nation-wide. I'm tired of paying for some sh*tbum to sit at home and smoke crack all day while hard-working people work their tail off in hopes of keeping their job.

I can't imagine a policy like that would fly in a hard Left state like MA though.

Being it would be a Federal program, it could become a plan requirement and
should be, illegal drug abuse is a costly health problem.

[JohnnyD]

Originally Posted by justplugit

Being it would be a Federal program, it could become a plan requirement and
should be, illegal drug abuse is a costly health problem.

Exactly. A government that will fine tobacco agencies for public health costs should also protect *my* interests by testing people on public assistance for drugs - because of the public health costs of course. The government has to justify policies like that as them protecting people from themselves.

[striperman36]

We all use drugs, it's the Feds and lobbyist money that decide which are legal

[justplugit]

Pretty interesting, just returned from a Town Hall Meeting with my Congressman on Health-Care.

Main concerns from the people were, afraid company plans will fold and leave it all up to the government plan with no choice, the speed at which this plan is being pushed on us, and where the money is coming from to pay for it in this economy debacle.

A poll was taken on:
Are you willing to have your taxes increased to pay for it?
Are you willing to pay an extra $1000/yr ?
Are you willing to pay an extra $2500/yr ?
Are you willing to pay an extra $4000/yr ?

70% said they were unwilling to have a tax increase to pay for it.

People are starting to wake up to the fact this is going ahead way to fast, questioning what quality of care they will get compared to private plans , and howand where the $$$ are coming from to pay for it.

[Raven]

that our PCP PRIMARY CARE PHYSICIAN

is booked thru the middle of 2010 already
for physicals.

[Joe]

McDonald's, Wendy's, Burger King, KFC - They're profiting off contributing to heart disease and diabetes while not offering health care to most of their employees. This is where many of the 50 million without health care are working. The uninsured eventually get sick and the taxpayers pick up the bill. The profits and the jobs are outweighed by the social liabilities they incur. So F-them - they're one click above tobacco companies.

[fishbones]

Originally Posted by Joe

McDonald's, Wendy's, Burger King, KFC - They're profiting off contributing to heart disease and diabetes while not offering health care to most of their employees. This is where many of the 50 million without health care are working. The uninsured eventually get sick and the taxpayers pick up the bill. The profits and the jobs are outweighed by the social liabilities they incur. So F-them - they're one click above tobacco companies.

I'm not going to defend fast food joints, but what does the employee without health insurance have to do with the customer eating the unhealthy food?

Don't most people who eat a lot of fast food know the health risks associated with it? Smokers know that what they do is most likely going to eventually kill them. The fat guy chowing down on a 6,000 calorie meal at McD's probably realizes that it's not so good for him when he's breaking a sweat while tring to button his pants.

If people took responsibility for their own actions instead of blaming the companies that provide the products, there wouldn't be so many health problems. As a society, we've given people too many excuses and they feel like they can do whatever they want and blame someone else.

[Joe]

Freedom. Choice. Personal Responsibilty. How's all this working out with respect to the healthcare crisis?

What about "Promote The General Welfare?" That is widely interpretted as to work together for the common good.

The fast food industry is contributing to the health crisis on two-fold front: By not insuring employees who in turn become a burden on the health system, while producing a harmful product to society. The fast food industry is clearly detrimental to the common good.