Your Republican Nominee for 2012

[mtnairlover]

I've never met anyone in my 41 years that has left our country for better priced health care. Do you have a long list you routinely update with people you know that leave the U.S.A. for better health care?

Additionally, the American people as a whole already abuse the health care system for every little ailment they get...even when paying for it. You don't think the abuse and backlogs for necessary health care will worsen with the proposed plan? I sure do.

What's the propose plan? Do you know what it is, what it says?

Have you ever lived in SoCal, or Texas, or Arizona? Shall I post up the links that I posted up on another thread that takes you to articles upon articles of how and why people leave this country for better priced health care? Here's one...http://travelojos.com/2009/04/americ...le-healthcare/ This blog links to a study done back in 2008 that highlights how many people would leave our country for affordable health care. American companies are seeing the profitability in tapping the market that is being left behind by our higher prices by building hospitals south of the border, because they can charge a whole lot less for surgery and a hospital stay...http://www.newsweek.com/id/169827?from=rss.

There is a whole lot more out there that shows why Americans are leaving this country to recieve more affordable health care.

[mtnairlover]

I've already posted a closer look, based on the census data, at this 46 million uninsured number and it is quite misleading:

http://www.cosportbikeclub.org/forum...470#post490470

http://www.cosportbikeclub.org/forum...373#post490373

http://www.cosportbikeclub.org/forum...226#post490226

http://www.cosportbikeclub.org/forum...219#post490219

The number who "can't afford it" is nowhere near 46 million.

Dirk

Yes, I know this. So, maybe I should have been a tad more detailed in my answer. By offering affordable health care and insurance to another 46 million customers, you've opened up the market and you will increase your profits...even though the initial cost will be on us, the profit in the long-run has the potential to outweigh that cost. It takes time to make people happy and comfortable enough to go back to spending their money. Start up costs for any company are always scary...but the potential to have something better in years to come is what can outweigh those costs.

[*GSXR~SNAIL*]

What's the propose plan? Do you know what it is, what it says?

Yes, there are several...read below.

Have you ever lived in SoCal, or Texas, or Arizona?

Oh, you mean where the largest majority of illegal immigrants live? According to the US Citzenship and Immigration Services, a branch of the US Department of Homeland Security those three states are 1-3 in order among the 50 states in per capita illegal immigration. By the way, if you look at the proposed House Democratic Bill you will see that covering the "Nearly half the 17 million non-elderly residents who remain uninsured would be illegal immigrants." is included. That's awesome!

Shall I post up the links that I posted up on another thread that takes you to articles upon articles of how and why people leave this country for better priced health care?

No, but thanks for doing so...

Here's one...http://travelojos.com/2009/04/americans-look-to-mexico-for-affordable-healthcare/ This blog links to a study done back in 2008 that highlights how many people would leave our country for affordable health care. American companies are seeing the profitability in tapping the market that is being left behind by our higher prices by building hospitals south of the border, because they can charge a whole lot less for surgery and a hospital stay...http://www.newsweek.com/id/169827?from=rss.

There is a whole lot more out there that shows why Americans are leaving this country to recieve more affordable health care.

A mass exodus, I bet?

Read a detailed comparison of the various health care plans before Congress
ASSOCIATED PRESS • August 13, 2009
The House Energy and Commerce Committee — the last of three panels — completed sweeping health care legislation Friday. A look at that bill in the Democratic-controlled House and legislation in the Senate as President Barack Obama pushes to overhaul the system, cover nearly 50 million uninsured Americans and contain rising costs. Many of the details are still being negotiated and any final health care bill would have to meld proposals from the House and Senate.

The House Democratic bill:
WHO'S COVERED: Around 94 percent of non-elderly residents (those not covered by Medicare, which kicks in at age 65) would be covered — compared with 81 percent today. Nearly half the 17 million non-elderly residents who remain uninsured would be illegal immigrants.

COST: About $1.5 trillion over 10 years.

HOW IT'S PAID FOR: Revenue-raisers include $544 billion over the next decade from new income taxes on single people making more than $280,000 a year and couples making more than $350,000; $37 billion in business tax increases; about $500 billion in cuts to Medicare and Medicaid; sizable penalties paid by individuals and employers who don't obtain coverage.

REQUIREMENTS FOR INDIVIDUALS: Individuals must have insurance, enforced through tax penalty with hardship waivers. The penalty is 2.5 percent of income.
REQUIREMENTS FOR EMPLOYERS: Employers must provide insurance to their employees or pay a penalty of 8 percent of payroll. Companies with payroll under $250,000 annually are exempt. That level could rise to $500,000 under a deal between House leaders and fiscal conservatives.

Employers could apply for a two-year exemption from the mandate if they can prove the requirements would result in job losses that would negatively affect their communities.

SUBSIDIES: Individuals and families with annual income up to 400 percent of poverty level ($88,000 for a family of four) would get sliding-scale subsidies to help them buy coverage. The subsidies would begin in 2013.

HOW YOU CHOOSE YOUR HEALTH INSURANCE: Through a new Health Insurance Exchange open to individuals and, initially, small employers; it could be expanded to large employers over time. States could opt to operate their own exchanges in place of the national exchange if they follow federal rules.

BENEFIT PACKAGE: A committee would recommend an "essential benefits package" including preventive services, mental health services, oral heath and vision for children; out-of pocket costs would be capped. The new benefit package would be the basic benefit package offered in the exchange and over time would become the minimum quality standard for employer plans. Insurers wouldn't be able to deny coverage based on pre-existing conditions.

GOVERNMENT-RUN PLAN: A new public plan available through the insurance exchanges would be set up and run by the secretary of Health and Human Services. Democrats originally designed the plan to pay Medicare rates plus 5 percent to doctors, but under Wednesday's deal with the fiscal conservatives the HHS secretary would instead negotiate rates with providers.

CHANGES TO MEDICAID: The federal-state insurance program for the poor would be expanded starting in 2013 to cover all non-elderly individuals with incomes up to 133 percent of the federal poverty level ($14,404).

DRUGS: Grants 12 years of market protection to high-tech drugs used to combat cancer, Parkinson's and other deadly diseases.
The Senate Health, Education, Labor and Pensions Committee's bill:
WHO'S COVERED: Aims to cover 97 percent of Americans.

COST: About $615 billion over 10 years, but it's only one piece of a larger Senate bill.

HOW IT'S PAID FOR: Another panel — the Senate Finance Committee — is responsible for figuring out how to cover costs.

REQUIREMENTS FOR INDIVIDUALS: Individuals will have to have insurance, enforced through tax penalty with hardship waivers.

REQUIREMENTS FOR EMPLOYERS: Employers who don't offer coverage will pay a penalty of $750 a year for each full-time worker. Businesses with 25 or fewer workers are exempt.

SUBSIDIES: Available up to 400 percent poverty level, or $88,000 for a family of four.

BENEFITS PACKAGE: Health plans must offer a package of essential benefits recommended by a new Medical Advisory Council. No denial of coverage based on pre-existing conditions.

GOVERNMENT-RUN PLAN: A robust new public plan to compete with private insurers. The plan would be run by the government but would pay doctors and hospitals based on what private insurers now pay.

HOW YOU CHOOSE YOUR HEALTH INSURANCE: Individuals and small businesses could purchase insurance through state-based purchasing pools called American Health Benefit Gateways.

OTHER PROVISIONS: Creates a new voluntary insurance program that would provide a modest daily cash benefit to help disabled people stay in their own homes instead of going into nursing homes.
A plan under discussion by a bipartisan group of six senators on the Finance Committee:
WHO'S COVERED: Around 97 percent of Americans. Illegal immigrants would not receive coverage.

COST: Around $1 trillion over 10 years.

HOW'S IT PAID FOR: Possible sources include cuts to Medicare and Medicaid; a tax as high as 35 percent on very high cost health insurance policies; a requirement for employers to pay into the Treasury for their employees who get their insurance through public programs or receive government subsidies to help pay premiums. Looking to raise $90 billion by taxing health insurance companies as much as 35 percent on policies valued at $25,000 or more.

REQUIREMENTS FOR INDIVIDUALS: Expected to include a requirement for individuals to get coverage.

REQUIREMENTS FOR EMPLOYERS: In lieu of requiring employers to provide coverage, lawmakers are considering a "free rider" penalty based on how much the government ends up paying for workers' coverage.

SUBSIDIES: No higher than 300 percent of the federal poverty level ($66,150 for a family of four).

BENEFIT PACKAGE: The government doesn't mandate benefits but sets four benefit categories — ranging from coverage of around 65 percent of medical costs to about 90 percent — and insurers would be required to offer coverage in at least two categories. No denial of coverage based on pre-existing conditions.

GOVERNMENT-RUN PLAN: Unlike the other proposals the Finance Committee's will likely be bipartisan. With Republicans opposed to a government-run plan, the committee is looking at a compromise that would instead create nonprofit member-owned co-ops to compete with private insurers.

HOW YOU CHOOSE YOUR HEALTH INSURANCE: State-based exchanges.

CHANGES TO MEDICAID: Everyone at 100 percent of poverty would be eligible. Between 100 and 133 percent, states or individuals have the choice between coverage under Medicaid or a 100 percent subsidy in the exchange. The expansion would be delayed until 2013, a late change to save money — the start date had been 2011.
The House Republican proposal:
WHO'S COVERED: The House GOP's plan, in outline form for now, says it aims to make insurance affordable and accessible to all. There aren't estimates about how many additional people would be covered.

COST: Unknown.

HOW'S IT PAID FOR: No new taxes are proposed, but Republicans say they want to reduce Medicare and Medicaid fraud.

REQUIREMENTS FOR INDIVIDUALS: No mandates.

REQUIREMENTS FOR EMPLOYERS: No mandates; small business tax credits are offered. Employers are encouraged to move to "opt-out" rather than "opt-in" rules for offering health coverage.

SUBSIDIES: Tax credits are offered to "low- and modest-income" Americans. People who aren't covered through their employers but buy their own insurance are allowed to take a tax deduction. Low-income retirees younger than 65 (the eligibility age for Medicare) would be offered assistance.

BENEFIT PACKAGE: Insurers would have to allow children to stay on their parents' plan through age 25.

GOVERNMENT-RUN PLAN: No public plan.

HOW YOU CHOOSE YOUR HEALTH INSURANCE: No new purchasing exchange or marketplace is proposed. Health savings accounts and flexible spending plans would be strengthened.

CHANGES TO MEDICAID: People eligible for Medicaid would be allowed to use the value of their benefit to purchase a private plan.
Obama's campaign proposal:
WHO'S COVERED: All children and many now-uninsured adults.

COST: Estimates as high as $1.6 trillion over 10 years.

HOW'S IT PAID FOR: Obama proposed cuts within the health care system and raising taxes on households making more than $250,000 annually.

REQUIREMENTS FOR INDIVIDUALS: Unlike his Democratic primary opponent Hillary Rodham Clinton, Obama did not propose an "individual mandate." Instead he would have required all children to be insured, making it the parents' responsibility.

REQUIREMENTS FOR EMPLOYERS: Large employers would have been required to cover their employees or contribute to the costs of a new government-run plan.

SUBSIDIES: Obama proposed giving subsidies to low-income people but didn't detail at what level.

BENEFIT PACKAGE: Insurers participating in a new health exchange would have had to offer packages at least as generous as a new public plan. All insurers would have been prohibited from denying coverage based on pre-existing conditions and would have had to cover children through age 25 on family plans.

GOVERNMENT-RUN PLAN: A new public plan would have offered comprehensive insurance similar to that available to federal employees.

HOW YOU CHOOSE YOUR HEALTH INSURANCE: Through a new National Health Insurance Exchange where individuals could buy the new public plan or qualified private plans.

CHANGES TO MEDICAID: Would have expanded Medicaid eligibility, but didn't specify income levels.

Sources: Associated Press research, Kaiser Family Foundation.

[dirkterrell]

Yes, I know this. So, maybe I should have been a tad more detailed in my answer. By offering affordable health care and insurance to another 46 million customers, you've opened up the market and you will increase your profits...

But nearly 18 million of those are people who make over $50K/year. They can afford it. 170 million of their peers in the same income category do.

Nearly 10 million are not US citizens.

Over 8 million are kids under 18, of which 70% are covered by Medicaid/CHIP (nearly all of which are kids in low-income families). The other 3 million? Yeah, let's find out what's going on and fix it. If it's parents who'd rather buy a new car or motorcycle than an insurance policy, let's fix that. If it's families in genuine need, let's give more to charities that help them.

Now, there is probably some overlap in those groups but I doubt it's a significant number. So, continuing to throw around this "46 million poor people who can't get insurance" is disingenuous.

even though the initial cost will be on us, the profit in the long-run has the potential to outweigh that cost. It takes time to make people happy and comfortable enough to go back to spending their money. Start up costs for any company are always scary...but the potential to have something better in years to come is what can outweigh those costs.

What are the details of this idea? I'd like to know how you transition people from subsidized costs to full cost. People are never willing to pay more when they get used to something cheaper.

Dirk

[Wintermute]

Anyway, back to thread subject, I don't think Palin will ever run for another elected office. It doesn't fit her temperament. She seems much happier campaigning and general rabble-rousing than performing the nitty-gritty of holding office.

We'll see "Palin and Friends" on Fox News or a talk radio show from Palin. This underscores a problem Republicans have with their leaders. The conservative media machine is SO lucrative (Limbaugh's contract is what, 200 mill?) that average mortals can't resist dipping their toes into it instead of boring, low-paying public service positions like Governor of a state. Kind of leaves the party with a leadership vacuum. (See also Thompson, Fred and Huckabee, Mike)

[mtnairlover]

But nearly 18 million of those are people who make over $50K/year. They can afford it. 170 million of their peers in the same income category do.

Really? Here's a little reality from someone who makes just a tad over that. I rent a house that needs updated windows, so my heating bills are high. My landlord is a god-send and I could not thank him enough for never, ever having raised my rent in the 5 years I've been here. 4 years ago, when I made about $10k less, I wanted to apply for free and reduced lunch, cuz even with child support, it was hell trying to make it month-to-month. When I looked at the maximum amount that would qualify me, I realized I made $14 too much per month to qualify. Yeah, jokes on me. I seriously considered dropping my health insurance for me and my kids, cuz it was 450 per month. I had a car payment, a student loan, car insurance, a credit card payment and the rest were necessities, like food, heating, water, oh and clothes were sometimes few and far between for my kids and me, so we'd go to the thrift store in August right before school. And let's not talk about glasses for all 3 and the out of pocket cost for lenses and frames, which also killed me.

Now? I do have a little bit left over at the end of the month and I'm not getting child support. But, how did I get here? After leaving the school district, I withdrew my retirement and paid off a few bills, so that I could make from month-to-month, without child support. My insurance is half what I used to pay, but I just found out, our premiums are going up...oh yay, looks like my honeymoon is over.

And that is what those many other folks making more than 50k are facing. Some may not be as frugle as I, some may not have kids, but lots more credit payments, some may not qualify for insurance because of pre-existing conditions, etc, etc.

Nearly 10 million are not US citizens.

Over 8 million are kids under 18, of which 70% are covered by Medicaid/CHIP (nearly all of which are kids in low-income families). The other 3 million? Yeah, let's find out what's going on and fix it. If it's parents who'd rather buy a new car or motorcycle than an insurance policy, let's fix that. If it's families in genuine need, let's give more to charities that help them.

Now, there is probably some overlap in those groups but I doubt it's a significant number. So, continuing to throw around this "46 million poor people who can't get insurance" is disingenuous.

What are the details of this idea? I'd like to know how you transition people from subsidized costs to full cost. People are never willing to pay more when they get used to something cheaper.

The fact is people are still being denied insurance...no way to figure out their plight. The fact is, this country has attempted and placed other plans into action to offer up those who don't have insurance what they need and those programs are failing. The fact is, the system as it stands fails too many people as it is. The fact is, too many small companies are finding it harder and harder to afford insurance for their employees. And the list goes on...

http://www.msnbc.msn.com/id/3032619/#32408434

http://www.msnbc.msn.com/id/3032619/#32409776

http://www.barackobama.com/pdf/issue...reFullPlan.pdf


Oh and Sarah Palin? I agree wintermute...more sales for the media I guess...meh.

[dirkterrell]

Really?

Yes, really. The data are from the Census Bureau web site you originally linked to. Table 6 of the 2007 health insurance coverage report.

Here's a little reality from someone who makes just a tad over that.

Well, I don't want this to turn too personal because it is too easy for statements to be taken the wrong way in the written word on a public forum. I grew up in a poor family. I was homeless for a while. I know what it's like to work your ass off just to survive. You have clearly gone through a lot. And you have come through it.

Now? I do have a little bit left over at the end of the month and I'm not getting child support.

But you are entitled to that support. Deadbeat parents shouldn't be walking the streets.

My insurance is half what I used to pay, but I just found out, our premiums are going up...oh yay, looks like my honeymoon is over.

See what I mean about your idea of bringing people in on the taxpayers dime and later having it turn a profit?

The fact is people are still being denied insurance...no way to figure out their plight.

Well, we don't know how many of those ~18 million $50K+ people are denied and how many choose not to have insurance.

The fact is, too many small companies are finding it harder and harder to afford insurance for their employees.

Having been a small business owner myself, I understand this. But why not address issues like this directly by coming up with ways to allow small businesses to pool their insured so that they can negotiate better deals rather than a wholesale restructuring of a system that works for 85% of the population?

The point has been rather insultingly made (in this thread and others) that people who are against government-run healthcare are selfish, heartless, stingy, etc. and that there is a moral/ethical responsibility to care for those who truly cannot care for themselves. I happen to agree with bearing that responsibility. But by bringing in the government, you make a moral/ethical responsibility a legal one and that is wrong. Instead of solving problems with the bulldozer of government, why not seek a private charitable solution for the few who truly need help? Those who blindly take my opposition to government run health care as an indicator of stinginess might be quite surprised to find out just how generous I am with private charities. And I am not in any way unusual in that regard. Steal my charity behind the threat of the government spear and I will resist. Ask for it to be given willingly for genuine need and I will do so overwhelmingly.

Dirk

[Pandora-11]

Yes, really. The data are from the Census Bureau web site you originally linked to. Table 6 of the 2007 health insurance coverage report.



Well, I don't want this to turn too personal because it is too easy for statements to be taken the wrong way in the written word on a public forum. I grew up in a poor family. I was homeless for a while. I know what it's like to work your ass off just to survive. You have clearly gone through a lot. And you have come through it.



But you are entitled to that support. Deadbeat parents shouldn't be walking the streets.



See what I mean about your idea of bringing people in on the taxpayers dime and later having it turn a profit?



Well, we don't know how many of those ~18 million $50K+ people are denied and how many choose not to have insurance.



Having been a small business owner myself, I understand this. But why not address issues like this directly by coming up with ways to allow small businesses to pool their insured so that they can negotiate better deals rather than a wholesale restructuring of a system that works for 85% of the population?

The point has been rather insultingly made (in this thread and others) that people who are against government-run healthcare are selfish, heartless, stingy, etc. and that there is a moral/ethical responsibility to care for those who truly cannot care for themselves. I happen to agree with bearing that responsibility. But by bringing in the government, you make a moral/ethical responsibility a legal one and that is wrong. Instead of solving problems with the bulldozer of government, why not seek a private charitable solution for the few who truly need help? Those who blindly take my opposition to government run health care as an indicator of stinginess might be quite surprised to find out just how generous I am with private charities. And I am not in any way unusual in that regard. Steal my charity behind the threat of the government spear and I will resist. Ask for it to be given willingly for genuine need and I will do so overwhelmingly.

Dirk

I also grew up in a poor, struggling family where my dad walked. It was tough. We did without a lot of things. My mother raised six of us without ever having gov't assistance. I respect her more than anyone can know. I also choose to give from the heart. It's what heals my soul on a daily basis. The gov't interjecting where it has no business angers me and steals from me that which feeds my spirit.
Dirk...you are so right!

[mtnairlover]

The point has been rather insultingly made (in this thread and others) that people who are against government-run healthcare are selfish, heartless, stingy, etc. and that there is a moral/ethical responsibility to care for those who truly cannot care for themselves. I happen to agree with bearing that responsibility. But by bringing in the government, you make a moral/ethical responsibility a legal one and that is wrong. Instead of solving problems with the bulldozer of government, why not seek a private charitable solution for the few who truly need help? Those who blindly take my opposition to government run health care as an indicator of stinginess might be quite surprised to find out just how generous I am with private charities. And I am not in any way unusual in that regard. Steal my charity behind the threat of the government spear and I will resist. Ask for it to be given willingly for genuine need and I will do so overwhelmingly.

Dirk

In this debate here and in the rest of America, insults have gone flying. It's ridiculous when that happens, because it completely ignores the issues and nothing gets solved.

My point is that there are so many issues that go way beyond this idea that it's "the right thing to do". That's what I've been trying to point out with going from post to post about the economy, how regulation done right can help to stimulate the economy, how healthy employees become better employees, etc. There's so much more to it.

Remember years ago when that whole idea of having charities cover what the uninsured couldn't? They can't survive in today's economy either. They too, are pushing for health care reform. If you look at today's economy, it makes sense. I am impressed that you put so much toward charities, Dirk. But, the number of people who can do that these days is dwindling. Are you willing to put even more of your money toward charities to cover for those who cannot do that anymore?

Numbers in tables don't tell the whole story, Dirk. You know that as well as I do. We can make assumptions about what they are saying, but unless there is qualitative research to go along with them, then numbers can mean one thing to one person and something completely different to another.

It's not just about individuals and government. It's about a society along with the economy as a whole.

Edit: Something I just found based on qualitative research done in 2003...http://books.nap.edu/openbook.php?re...d=10602&page=1

[dirkterrell]

In this debate here and in the rest of America, insults have gone flying. It's ridiculous when that happens, because it completely ignores the issues and nothing gets solved.

Agreed.

My point is that there are so many issues that go way beyond this idea that it's "the right thing to do". That's what I've been trying to point out with going from post to post about the economy, how regulation done right can help to stimulate the economy, how healthy employees become better employees, etc. There's so much more to it.

Sure, it's a complex problem. I don't think anyone with any sense would deny that. The question is how we solve it and a huge fraction of the population thinks it's unwise to bring the government into the mix as a "competitor" to private insurance. That won't be competition in any normal sense of the word. Where the government needs to be involved is in its constitutionally mandate role of ensuring that competition is fair and that the rights of all involved are respected. Frivolous lawsuits drive up costs. Government paperwork drives up costs. Insurance company profits are in no way out of the ordinary. I looked at the percentage profits made by the 5 largest health insurers (UnitedHealth Group, Wellpoint, Aetna, Humana, Cigna) in the 2009 Fortune 500 report and they ranged from 1.5% to 4.5%. Data can be found on the Fortune site.

Remember years ago when that whole idea of having charities cover what the uninsured couldn't? They can't survive in today's economy either. They too, are pushing for health care reform. If you look at today's economy, it makes sense. I am impressed that you put so much toward charities, Dirk. But, the number of people who can do that these days is dwindling.

The drop in charitable giving from the record high in 2007 to 2008 was 2%, hardly what I would call dwindling.

Are you willing to put even more of your money toward charities to cover for those who cannot do that anymore?

I am ready to help those who really need it. For people who get sick or injured and are out of work, I am there. For people who choose to buy a motorcycle instead of getting health insurance and get hurt in a crash, they made a conscious decision to put themselves at risk and should pay the price. With a government plan, I have no choice to whom my money is given. When there is no penalty for bad behavior, its rate will multiply.

Edit: Something I just found based on qualitative research done in 2003...http://books.nap.edu/openbook.php?re...d=10602&page=1

At ~300 pages, it will take me a little while to go through that.

Dirk

[dirkterrell]

Here is an interesting op-ed by the owner of a successful business:

http://online.wsj.com/article/SB1000...072865070.html

Dirk

[mtnairlover]

That's a good read. I was a tad disappointed by some of the statements based on fallacies, though. I did like his ideas for "fixing" what's wrong. My questions though, have to do with how all that gets mandated and who manages all the oversight...how do we know things will happen?

I think that's one of the things that's been plaguing the US for many, many years is too much paperwork and too much administration from way too many sides. The system could use a good streamlining as in one of the suggested fixes for the messed up system.

Oh and Dirk, the only reason I mention anything personal is because I feel like it's necessary to get an idea of what others might be going through. I mean we can talk and talk and talk and then there are those who say, "Prove it!" And so my reasoning is to offer up proof by describing what I've gone through...that's why I also include that I'm no different than anyone else. In my mind, by saying that, it would tend to multiply the situation by millions. Kind of like a real-world example sort of thing, that's all.

And then the other thing I mentioned was the fact that my rates will be increasing. I was planning on starting a savings and eventually starting some sort of investment account...maybe a 401k, but I was gonna wait for that. Because I make enough to get along, but not enough to really do much else, it's a bit defeating when I realize that I won't be able to save quite yet...and I ain't getting any younger. It's just a tad scary, you know. So for me and millions of others like me, it would be wonderful to pay a certain amount for insurance and not have to worry that the increases will surpass our raises, which has been happening now for at least a decade.

If someone could come up with a plan that would streamline the process, so that the cost cuts would not hurt as much and that would also create more revenue down the road, then that's what I would agree with. Now, if that someone happened to be an entity like the government, then yes again, I'd be fine with it.

I know all too well how much some people don't trust the government...but, there are some government-run regulations that do tend to work...and those who do not like the government (kinda speaking to my friend here) remembering that this kind of government is not based on security might make the regulation more palatable.

Other than that, what are some other suggestions? Can those ideas be put into place without causing more paperwork and administration in the long run, which would drive up costs? How can we still be competitive when our high costs drive some Americans out of the country for care? Is it possible with other plans to stave off bankruptcies due to medical bills?

[vort3xr6]

mtnairlover, I like how you finally stepped into the middle and embraced the opposite idea as a possibility. I will therefor do the same.

I am reaching the point in my life where I am going to need healthcare. I was paying out of pocket for an Aetna plan that cost me 120 per month and I finally last month let it lapse and as it stands right now, I have no insurance. The economy forced me jobless for 6 months and now having credit cards at their limits and new bills coming through, I can no longer afford health insurance. The bike is put away in the garage and wont come out until november when my new job can offer me insurance. It would be nice to have an option such as supplied by the government that would allow me to have such insurance. Last year I made 12,000 dollars in income. I got taxed and had to pay 600 dollars to the state and 18 dollars to federal. So the government wants to take my money then turn around and offer me to pay MORE to get health insurance?! I already know I wont see a dime of social security LET ALONE medicare.

The government must prove to me that it can handle a system such as medicare or medicaid before it reforms an entire system. If I could barely adjust my motorcycle chain, why would I undertake a project like rebuilding my motor.

Last but not least, I make sacrifices. I gave up my love of riding during the last months of this great season because I cannot afford health insurance. I am eating healthier and only buying fresh fruits and vegetables. I stopped having any alcohol on weekdays and I walk around my complex for 30 minutes a day when I get home from work. Being healthy will keep me out of hospitals.

You have a car payment, student loans, rent, kids. My parents went bankrupt and gave up a lot so we could stay healthy and safe. It is not noble to think the government should help you and everybody else when you havn't thought about selling your car for a cheaper alternative, trying to refinance student loans and delay payments, and cut costs where costs can be cut. Why should the government help people who cannot help themselves.

Poor people are the most obese demographic in the country. If I make sacrifices and eat fresh vegetables and survive below the poverty level living comfortably, why cant they? Why should the government have to step in and bail them out.

And you keep saying that people leave the US for healthcare. Yet I have a friend who is a polish citizen who had no health insurance and broke his leg riding a dirt bike. He made below the poverty level and applied for axis insurance. He has not paid a DIME to date for the 3 surgeries or monthly doctor checkups.

When I lived in Arizona, a moving truck overturned with 14 illegal immigrants being trafficed across the border. Every single one of them was airlifted to the nearest hospital and everyone got immediate medical care. Sooo you will have to excuse me when I say I think it is full of shit that people leave this country for healthcare.

[*GSXR~SNAIL*]

When I lived in Arizona, a moving truck overturned with 14 illegal immigrants being trafficed across the border. Every single one of them was airlifted to the nearest hospital and everyone got immediate medical care. Sooo you will have to excuse me when I say I think it is full of shit that people leave this country for healthcare.

Weird...you're saying that illegal immigrants received medical care here in the US? Weird.

• Main Entry: 1il·le·gal
• Pronunciation: \(ˌ)i(l)-ˈlē-gəl\
• Function: adjective
• Etymology: Middle French or Medieval Latin; Middle French illegal, from Medieval Latin illegalis, from Latin in- + legalis legal
• Date: 1538

: not according to or authorized by law : unlawful, illicit; also : not sanctioned by official rules (as of a game)
— il·le·gal·i·ty \ˌi-li-ˈga-lə-tē\ noun
— il·le·gal·ly \(ˌ)i(l)-ˈlē-gə-lē\ adverb

[mtnairlover]

You have a car payment, student loans, rent, kids. My parents went bankrupt and gave up a lot so we could stay healthy and safe. It is not noble to think the government should help you and everybody else when you havn't thought about selling your car for a cheaper alternative, trying to refinance student loans and delay payments, and cut costs where costs can be cut. Why should the government help people who cannot help themselves.

First, thanks for trying. But, please don't assume things with me and what I say. I live 40 miles from work, so I need transportation (but, will be moving soon...hopefully to be only 2.5 miles from work). I bought a used car after my other car had 222,000 miles on it. My payments are low, because it cost me around $6k. I paid off a whole lot of my bills with my retirement. My student loan interest rate is the lowest anyone can imagine without it being 0%...I pay 2.75% in interest. I too, do the best I can living simply and healthy, although I am older and my body tends to hang onto weight more easily than it wants to lose it. I still exercise and don't go out to restaurants, accept when riding. I don't drink, accept maybe once every couple of months, don't smoke. We could go on and on about proving what we are doing to make our lives a little better despite not having a whole lot of anything. I hope that helps though, to prove some sort of point.

Point is, there are a whole lot of people out there who do their damndest to maintain life and health, despite not having a whole lot. The downside to doing that is without extra cash in our pockets, we are not doing a whole lot to maintain community, because we are not spending $$$ in the community. The economy falters because of this. Small business owners don't get frequented by us and have to make tough decisions about firing employees and dropping insurance. More people without jobs and insurance, means more people who possibly need extra assistance from the governmental programs already out there. That also means more $$$ into the system from us because of higher costs in other places.

No matter which way you look at it, eventually we end up paying for the mess we are in. And since things won't change as far as costs continuing to rise, people still going bankrupt, companies going out of business, and health care becoming a bigger and bigger portion of our GDP, something's gotta give.

Let me ask everyone this...If you were a business owner doing business a certain way for years and you watched your clientele, your suppliers and the street outside slowly changing, but you did nothing to improve your business, you still do all your paperwork by hand, you maintain your records of your customers and suppliers in a big ole bookkeepers notebook, you leave your storefront the same, etc. thinking you are saving money, but instead you are losing customers and suppliers can't wait for you to go through your paperwork to pay them, so they go elsewhere...would you do anything at all to change how you do business?

I don't know if health care companies and insurance companies and pharmaceutical companies really care that they are grabbing up a larger and larger portion of the GDP. I don't know if that scares them or not. Eventually, they will lose customers in a big way, because their high costs affect the economy in a very big way. Do they even care? If we do nothing at all to change things up...to change how we do business, more and more people will go bankrupt, lose jobs, and will feed off the government assistance that is already out there...and who ends up paying for that in the long run?

Did you read the information I linked in one of my other posts about health care companies that are building hospitals across the border because it's cheaper and they can attract Americans who cannot afford the high costs hospitals charge in this country? Just thought I'd include that since you didn't seem to believe me.

[dirkterrell]

First, thanks for trying. But, please don't assume things with me and what I say.

This is precisely why I didn't want the discussion to trend towards such a personal level. A healthy discussion degenerates when a statistical issue concerning a population becomes personal. On the issue of personal responsibility both sides need to recognize that there are those who need and deserve our help and there are those who do not. Answers pandering to the extremes lead to destructive situations for our society. Politicians typically do that sort of thing and in recent years it seems to have gotten worse but that might just be my perception of things. What we need is solid, unbiased data on the issue and then we can discuss how to address. That is precisely why I took the time to understand the "46 million" number.

As consumers of health care services, I think we all would like to reduce their costs. That is the nature of consumers in a free market system. Suppliers want to maximize their profits. That is the nature of suppliers in a free market system. The government's role is to ensure that the market operates in an equitable way. If things are equitable for all (e.g. suppliers are not manipulating markets in anti-competitive ways and consumers are not using using the club of government to artificially lower prices), then the market reaches a healthy state. The big question is whether that is happening or not. By looking at data for myself, rather than what politicians are telling me, I am trying to figure it out.

Health care costs are rising. The big question is why? If we don't understand why, then it is silly to try to come up with solutions. I came across an op-ed in the NEJM that I found quite refreshing. Check it out.

Dirk

[mtnairlover]

"We can only hope that whoever is elected president will move beyond campaign-trail rhetoric and provide the leadership needed for a candid national discussion about health care costs. If not, we will find ourselves on a downward spiral, as more and more resources are used to pay for the health care of fewer and fewer Americans — a potentially intolerable situation."

And that, from a 2004 article.

Good find, Dirk.

Again, my question...how do we get to that point? Who manages and mandates that? And what's going to be very, very hard is telling the big health care companies that...Hey, you gotta lose some of your profit and foothold in the GDP in order to maintain livability here in America. I think that's a whole lot of where the push back is coming from in one way or another.

[dirkterrell]

And what's going to be very, very hard is telling the big health care companies that...Hey, you gotta lose some of your profit and foothold in the GDP in order to maintain livability here in America. I think that's a whole lot of where the push back is coming from in one way or another.

As I pointed out a few posts back, the profits of the 5 largest health care companies ranged from 1.5% to 4.5% in the 2009 Fortune 500 report. That's hardly exhorbitant. The average profit on revenues across all companies is something like 6%. Health care costs are clearly climbing much faster than inflation. We need to understand why. I found this article interesting:

http://www.csmonitor.com/2003/1215/p21s01-coop.html

This jumped out at me:

New technology - from diagnostic devices to surgical techniques - accounts for more than half the rise in total healthcare spending in the past three years, says Andrew Tilton, an economist at Goldman Sachs, an investment bank in New York.

Assuming that number is accurate, that's a place to start looking. In the Fortune 500 list of the 20 most profitable industries (as a percentage of revenues), the medical products and equipment industry ranks 4th at 16.3%. The pharmaceutical industry ranks 3rd at 19.3% but I need to find out what percentage of health care spending is on pharmaceuticals. But clearly more competition in those industries would be beneficial to lowering prices, especially the former since it is responsible for a significant fraction of the rising cost overall.

Dirk

[*GSXR~SNAIL*]

We are by far, the fattest damn country in the world!

http://www.nationmaster.com/graph/he...health-obesity

This is only one source, but I'm sure other sources would reveal similar results.

That pretty much sums it up. If you look at the long list of repercussions/results of being fat or obese than it's no wonder why we as a country have such high health care costs.

From bad immune systems allowing folks to get colds, to diabetes, heart disease, stroke, gallbladder disease, breathing problems, arthritis, and joint and back issues are also results from obesity. The list goes on and on...I think you get the point. This doesn't even to begin to tackle the psychological issues like depression and self-esteem that are treated in our health care systems from being obese. The symptoms both physically and mentally from obesity and the mentality of going in for every runny nose and cough it's no wonder. We abuse our system.

Let me make something very clear, I'm a fat-ass myself. I weigh in at 215-220 lbs. and should be somewhere around 170-180 lbs. I eat lots of stuff I shouldn't and do it when I shouldn't (late night snacking) so don't think I'm being a hypocrite. I'm guilty too. However, I do exercise a lot and don't go to the doctor for anything unless it's major. But when we as a country abuse our bodies and then in turn abuse the health care system we have, what are we to expect?

Let's look at it this way, maybe I'm way off track here. If we were a healthier country and considerably further down on the obesity list and we didn't go in to the doctor for every little thing, could we imagine our health costs being considerably cheaper?

I think they would be.

"We can only hope that whoever is elected president will move beyond campaign-trail rhetoric and provide the leadership needed for a candid national discussion about health care costs. If not, we will find ourselves on a downward spiral, as more and more resources are used to pay for the health care of fewer and fewer Americans — a potentially intolerable situation."

And that, from a 2004 article.

Good find, Dirk.

Again, my question...how do we get to that point? Who manages and mandates that? And what's going to be very, very hard is telling the big health care companies that...Hey, you gotta lose some of your profit and foothold in the GDP in order to maintain livability here in America. I think that's a whole lot of where the push back is coming from in one way or another.

[mtnairlover]

Hey Randy...you're right. We are fat. But, how are you going to get everyone in America healthy, exercising and eating right?

Oh Dirk...I just found this...http://www.kff.org/healthreform/sidebyside.cfm They are side by side comparisons of the various reform proposals floating around. Funny what a person can find with just a simple google search. I haven't actually read any of them, yet...so I couldn't say what's what. But, just thought I'd share.

Because I'm really curious about the numbers you are finding, I wanted to see what it means from the other side. You say 2% isn't bad, but health care companies are getting "fatter", because we are paying more for services...so, I did another search and found an article about insurance companies in California. Below is just a snippet...

Requiring health insurance companies to spend at least 85 percent of their revenue on medical care would ensure that our health care dollars are being spent on health care and could save Californians’ money.

http://www.calpirg.org/home/reports/...alth-care-buck

Another reason for rising costs to the public might also be because insurance companies spend more of their revenue on administration, marketing and profit-making...

Health plans and insurers have an incentive to keep the percentage of revenue they spend on health care low. For example, Great-West Healthcare of California decreased the percentage of revenue it spent on medical costs every year from 2003 to 2007, from 85.8 percent to 69.1 percent. Over the same period of time the company’s profits increased from 0.5 percent to over 10 percent, while the portion spent on administration stayed essentially the same.

Health plans and insurance companies have an incentive to reduce the amount they spend on health care because the stock market favors companies that devote higher portions of their revenue to administration, marketing, and profit-taking.

This really is a complex problem and can't be attacked from just one angle...this problem has spread all over the board.

[dirkterrell]

Hey Randy...you're right. We are fat. But, how are you going to get everyone in America healthy, exercising and eating right?

Give them a financial incentive to do so. If your cost for insurance is much higher for living a riskier lifestyle, you'll have a hell of an incentive to put the ice cream down and go walk or ride a bike.

Oh Dirk...I just found this...http://www.kff.org/healthreform/sidebyside.cfm

Ok, thanks. I'll take a look at it.

Requiring health insurance companies to spend at least 85 percent of their revenue on medical care would ensure that our health care dollars are being spent on health care and could save Californians’ money.

See, I really worry about approaches like that. I really don't like the idea of the government telling businesses how to spend their money. If an industry is getter "fatter", I first wonder whether it has healthy competition. If it does, inefficient businesses are forced to improve in order to compete. Someone else will offer better services to their customers for their money as long as the government isn't making it impossible for those other businesses to compete or turning a blind eye to antitrust issues. And from my own experience, I know that competition in the health care insurance industry is virtually nonexistent.

Health plans and insurance companies have an incentive to reduce the amount they spend on health care because the stock market favors companies that devote higher portions of their revenue to administration, marketing, and profit-taking.

And in a healthy, competitive market they would have to first do a better job of taking care of their customers. If I don't like what Safeway does for my food dollars, I can go down the street to King Soopers or Wal Mart or Whole Foods or the Boulder County Farmers Market or Vitamin Cottage or others. If we had that kind of competition for health care insurance and health care services, we wouldn't be considering a slash and burn approach to health care and the greatest intrusion of government in our personal lives in my lifetime.

This really is a complex problem and can't be attacked from just one angle...this problem has spread all over the board.

Agreed.

Dirk

[DavidofColorado]

Give them a financial incentive to do so. If your cost for insurance is much higher for living a riskier lifestyle, you'll have a hell of an incentive to put the ice cream down and go walk or ride a bike.

Dirk

Nothing like some forced dieting because the health care that is paid for is so inefficient that you are better off dead.
But with socialism you get to go to gulags (sp) to work off all that body weight and you get a free mass burial at the end.

[mtnairlover]

Give them a financial incentive to do so. If your cost for insurance is much higher for living a riskier lifestyle, you'll have a hell of an incentive to put the ice cream down and go walk or ride a bike.

Bad business. It's like taking away their rights. And insurance companies are already denying coverage to those with pre-existing conditions. What kind of society are we trying to create here? And...more people would drop insurance altogether which would drive up costs even more, because once they get hospitalized and can't afford the bill, guess who eventually gets to pay?

Ok, thanks. I'll take a look at it.

That article describes my quoted info in blue even better. The way I had interpreted it, was that insurance/health companies have a greater incentive to spend their health care dollars on marketing, etc in order to look good in the market, rather than placing those health care dollars back into the system. When you think about it further, that could be another reason why our government is putting more into health care itself, because of all those who cannot afford to pay. When people don't pay, the hospitals, Drs. etc. turn to the government for reimbursement (so-to-speak), instead of spending their own money on taking care of things themselves.

See, I really worry about approaches like that. I really don't like the idea of the government telling businesses how to spend their money. If an industry is getter "fatter", I first wonder whether it has healthy competition. If it does, inefficient businesses are forced to improve in order to compete. Someone else will offer better services to their customers for their money as long as the government isn't making it impossible for those other businesses to compete or turning a blind eye to antitrust issues. And from my own experience, I know that competition in the health care insurance industry is virtually nonexistent.

And in a healthy, competitive market they would have to first do a better job of taking care of their customers. If I don't like what Safeway does for my food dollars, I can go down the street to King Soopers or Wal Mart or Whole Foods or the Boulder County Farmers Market or Vitamin Cottage or others. If we had that kind of competition for health care insurance and health care services, we wouldn't be considering a slash and burn approach to health care and the greatest intrusion of government in our personal lives in my lifetime.

And they aren't taking care of their customers.

Another article I read had to do with how New York had been regulating the health industry for years, but a little more than a decade ago, it decided to de-regulate. Now costs are sky-rocketing and New York is back to talking about regulation, so that people can actually live their lives.
http://www.ins.state.ny.us/press/2009/p0906081.htm

In my view, no matter which way you look at it, the government will have to make some very tough decisions. It isn't taking away rights to keep costs low. It isn't keeping competition from happening either. There can be some of that as well, with better thought out ways to take care of your customers.

[dirkterrell]

Bad business. It's like taking away their rights.

What right is that? You engage in risky behavior, you pay for it. If you have a $2000 pot of money to spend on insurance, preventative care, etc (I'm just making up a number for the sake of argument.) and if you eat right and stay fit, you get to keep $1000 of it at the end of the year. That's an incentive to do the right thing. People are motivated by money.

And...more people would drop insurance altogether which would drive up costs even more, because once they get hospitalized and can't afford the bill, guess who eventually gets to pay?

That's because there is no downside to the risky behavior. If you know someone else is going to foot the bill, why pay it yourself? People are motivated by money.

In my view, no matter which way you look at it, the government will have to make some very tough decisions. It isn't taking away rights to keep costs low.

And refusing to pay the cost of something isn't the same as reducing the cost of that something. As I mentioned before, the majority of the increase in spending for health care in the US is due to new technology development. I saw a story last night about a teenage woman who was kept alive by a new machine after her heart failed until a replacement heart could be found. Yes, costs have been going up but the number of people surviving cancer has been going up too. The mortality rates for cancers have been dropping. In the last decade, deaths from coronary heart disease are down by 1/3. All of this with growing obesity rates as Randy referred us to. It's not hard to think that much of the improvement in our ability to treat diseases has come increased spending on developing new technologies, procedures and drugs.

It isn't keeping competition from happening either. There can be some of that as well, with better thought out ways to take care of your customers.

And in a truly free market, that will happen, just like it does with groceries...

Dirk