Health care and four letter words

[Whitlock]

What are they thinking? The Goverment will have one hell of a time collecting fines! Will we all going to jail if we don't pay? Note this is from 9-8-09




http://news.yahoo.com/s/ap/20090908/ap_on_go_pr_wh/us_health_care_overhaul

[ScottA]

Did you notice the fine is roughly the same as the price of insurance? This is a tax on life no more no less. Atleast with the car insurance tax you can avoid it by not owning a car. There is no escape from this one. Combine this with the carbon taxes and you won't be able to get out of bed without government say so.

[MountainDon]

Well, to further open this can of worms, I have always had some questions...


If someone chooses to be uninsured, should their illness or injury treatment be paid for out of the public purse? If so, why? Why not leave them on their own to come up with the cost of treatment?  If you are hit by a car and injured, should we leave you in the gutter at the side of the road if you do not have insurance? If not, then why should my tax dollars pay for your treatment when you have made no effort to be financially responsible about your own welfare?


Also, why is it that private businesses are expected to be the major providers of heath care insurance to the bulk of the people? As a business co-owner we started up to provide ourselves with an income and to provide the service of early childhood education. I've also been an employee of large national companies and the recipient of great low cost to me, health insurance. That was great for us, but I ask the question why. Why should the business be expected to help pay for that? Why should that not be available to every citizen and legal resident?  


Even though I am quite a libertarian, those questions just won't go away. It does cause me conflict.  

[ScottA]

You make some good points Don. First off why is it assumed that just because you don't have insurance that the bill must be paid by the public? I have not had insurance for several years and when we go the doctor we pay cash or use a credit card. Secondly how can they justify the rates that are charged by doctors and hospitals? They are a rip off period. I say return it to a free market and you'll see the cost of health care go down. This in turn will lower the cost of insuance to a point where more people can afford it. I do belive there is a segment of society that will need to be subsidised regardless. But this is no different than feeding them.

[Squirl]

I have been avoiding the off topic section because I was ranting to much but this one has really struck me.  I call this the hold your head up high and blow your brains out Tax.  If Obama signs this it would be the largest promise broken of his campaign.  The largest disagreement in his primary battle between him and Clinton was the federal mandate on insurance.  He swore up and down against it.  Welcome to the insurance company take over of health care reform.  This proposal has no public option and would require people to buy health insurance from private insurers.  This would be a multi Trillion dollar boon to the health insurance industry.  The article is a little vague though.  It says that this was a proposal by only one Senator Baucus.  It does not state that this was supported by any other senator or the white house.  It also does not state that this is an actual bill brought to the floor.

[MountainDon]

Well, Scott why do you assume you will be able to pay for anything that comes along and strikes you or your family? I do not mean going to the doctor for a couple of stitches, and a tetanus shot. I'm talking about the bigger stuff. The cost of medical care is another topic.

Stuff like I get hit by a drunk or inattentive driver coming home from the mountains and somehow survive the combined 110 mph head on crash. Months in the hospital plus months of rehab.

Or a child born with serious problems that require years or perhaps a lifetime of special care.

Or I get diagnosed with colon cancer. But I'm lucky. It's caught early and chemotherapy kills the cancer. But it comes back in three years. More chemo. A few years later it's found to be recurring....

All those things are expensive to treat and if one is uninsured, who pays? You, I and everybody else in the country who pays the tax man. The government either directly pays for it with taxpayer dollars. Or it's "paid" because the hospital is a publicly funded state or university hospital and, once again the dollars come from the taxpayers money.

I would wager that there are virtually no members of this forum who could self pay for the treatment of any of the above, without facing financial ruin.


So I ask again, if we treat everyone for these sorts of things, covered by insurance or not, maybe there is something wrong with the system we currently have?

And again, I ask why is it expected that employers should be involved in using business time and money to find the best deal and then pay for part of their employee health insurance costs? Yes, it's a "benefit", but why?

I believe there has to be a big overhaul, a big rebuild, of the system of paying for health care costs. Health insurance companies make tons of money, pay tons of money to executives and routinely deny services to people. I understand they are in business to make money and that is a part of the problem. The only place money should be earned is by the folks providing the patient care.

[ScottA]

I see your point Don. I don't really have an easy solution. I don't think anyone does. But the situation you describe would wipe out a person with insurance just as fast under the current system. There needs to be a limit to what society expects in the way of care or society needs to cover the disaster scenarios. Passing a law that forces people to buy a product from a for profit business doesn't cut it as a solution. Something like that might work if the insurance is really going to cover everything and is priced in such a way that everyone can afford it. And no businesses should not be required to provide insurance to their employees. That's just as bad as forcing the individual to buy it.

Maybe a public option is the best choice. We pay taxes for roads, airports, and stadiums. I don't see this being much different.

[MountainDon]

Maybe a public option is the best choice. We pay taxes for roads, airports, and stadiums. I don't see this being much different.

In some ways it goes against my beliefs of looking out for myself and my family. But in other ways I say that as members of our society should we not ALL have some expectation of being covered by some health care and health payment system that provides us with adequate care at reasonable cost.

We should also be able to seek medical care without fear of the problem becoming a possible future reason for insurance denial. We have faced this ourselves; a simple case of treating a very early stage non threatening form of skin cancer was the basis for a refusal to issue coverage for my wife. Yet, had I continued to slave for the bank she would have had continuing coverage and with the exact same plan we tried to get ourselves. We do have coverage, but it is more expensive with higher premiums and higher co-pays and deductibles. When my COBRA was up I never even went through the motions of applying for my own individual coverage. Not with my history. I went straight to the NM state sponsored insurance. Costly but it does cover me quite well. I actually do get more back in services than I pay out over a years time.

So yes, if we have public roads, airports, parks, schools and universities, police and fire protection, etc. why not a public option health payment system?

[Virginia Gent]

If we're talking about a public option on a Federal Level, the reason we shouldn't have it, besides not being able to afford it, is because it is not one of the enumerated powers granted to Congress under Article I, Section VIII of the U.S. Constitution.

And I'm gonna nip something else in the bud while I'm at it. It's what Liberals love to use to justify all this spending that the Congress has no Constitutional authority to be doing ... the General Welfare Clause. To quote, quite possibly, the two smartest founding fathers:

James Madison: Father of the Constitution
"If Congress can employ money indefinitely to the general welfare, and are the sole and supreme judges of the general welfare, they may take the care of religion into their own hands; they may appoint teachers in every State, county and parish and pay them out of their public treasury; they may take into their own hands the education of children, establishing in like manner schools throughout the Union; they may assume the provision of the poor; they may undertake the regulation of all roads other than post-roads; in short, every thing, from the highest object of state legislation down to the most minute object of police, would be thrown under the power of Congress.... Were the power of Congress to be established in the latitude contended for, it would subvert the very foundations, and transmute the very nature of the limited Government established by the people of America."

"With respect to the words general welfare, I have always regarded them as qualified by the detail of powers connected with them. To take them in a literal and unlimited sense would bea metamorphosis of the Constitution into a character which there is a host of proofs was not contemplated by its creators." -referring to a bill to subsidize cod fisherman introduced in the first year of the new Congress-


Thomas Jefferson: Confidant of Madison during his writing of the Constitution
"To lay taxes to provide for the general welfare of the United States, that is to say, "to lay taxes for the purpose of providing for the general welfare." For the laying of taxes is the power, and the general welfare the purpose for which the power is to be exercised. They are not to lay taxes ad libitum for any purpose they please; but only to pay the debts or provide for the welfare of the Union. In like manner, they are not to do anything they please to provide for the general welfare, but only to lay taxes for that purpose.

To consider the latter phrase, not as describing the purpose of the first, but as giving a distinct and independent power to do any act they please, which might be for the good of the Union, would render all the preceding and subsequent enumerations of power completely useless. It would reduce the whole instrument to a single phrase, that of instituting a Congress with power to do whatever would be for the good of the United States; and, as they would be the sole judges of the good or evil, it would be also a power to do whatever evil they please." -part of his speech to Congress in 1791 against the formation of a national bank-

[Squirl]

The "afford" part should be simple.  If it is truly a non profit public option, premiums will match the payouts.  I don't know if you watch the returns on health insurance companies, but they make a pretty penny.  Cut out the profit, cut down the cost.  It shouldn't cost the public almost anything, besides the public pays in the current system through Medicare and Medicaid anyway.  Also it is already being paid for as Don stated in subsidies to Hospitals. At least this way they could collect the premiums.  Also like most HMO's the government would have a better bargaining power than anyone else.  I like the public option.  Again the word option is critical.

[MountainDon]

...the returns on health insurance companies, but they make a pretty penny.  Cut out the profit, cut down the cost.

Yep. And those profits are what they have after the CEO and other top executive wages, bonuses and company paid for perks. The company jets and all that. It simply does not seem right.

I love the capitalist economy, I really do. That's pretty much how my wife and I got to where we are today; not rich but we're alright, better than many of the parents whose kids we care for. But I have to wonder about the high remunerations that are given to CEO's and other upper management. CEO remuneration seem to grow and grow even as the economy stagnates.

One of the largest health insurers in the nation is UnitedHealth Group. Their CEO earned nearly $12 million which was a combination of base salary and bonuses last year. The CEO of Cigna Corporation earned $21 million in 2008. There is not a human on the face of the planet that earns that kind of money.

The constitution is a great document. But as wise as the founders were they could not foresee the future and the changes the future, today's present, has brought. Reconciling everything is a dilemma that does need to be solved. What we have does not work. That's ground zero.

[Virginia Gent]

If it is truely a non-profit option. That there is the kicker. We are relying on Uncle Sam to tell the truth and do what he says he's gonna do. Just like we were told that the Income Tax would only affect the rich and never go higher than 12% back when they first passed it, or just like we were told that Social Security would not become an identifying number, nor would it be required. Try doing almost anything without a S.S. Number now. Ask the Native Americans about all the broken promises from the Federal Government. Even the horses in the other thread in this very forum about how well Big Brother keeps his "Word" on how something is gonna be. And correct me if I'm wrong, but I heard that Medicare/Medicaid was bankrupt, just like Social Security is fixin' to be. Sorry ... the Federal Government has had tons of time to improve it's image and it's failed. It changes the rules whenever it suits them, and always to our detriment at that. It may be non-profit, for now, but that's just like all the other examples I gave above ... it's only "for now".

And if you remove profit incentive from any business, why bother continuing to run or open a business? If I knew that I wouldn't be able to make the kind of living I wanted by opening a business, because the Federal Government says I'm not allowed too, why bother? You'll chase away all business, just like they did almost all our industry, leaving one person to fill the void ... Big Brother. Sorry, but it's starting to sound pretty Communist in here. Punishing a business or industry for being successful? Do you know why those horrible CEO's make so much money? Because they create profit for the company and it's shareholders. And they don't do it by withholding claims, I know that much. It's a hard job that not everyone can do successfully. That is why they make so much. It's basic economics, supply and demand. If every other person on the street was a financial genius that could create tons of money for any company, they wouldn't be getting paid millions on millions of dollars. Has anyone looked at what these evil insurance companies make after they pay their expenses? I'd wager it's a lot like the evil oil industry, not a whole lot when you subtract all their cost from their profit.

Maybe there is another reason why insurance and medical prices are so high? Perhaps it isn't an evil company price gauging it's customers. For example, I heard that only 6, or so, insurance companies are allowed to "compete" in California. There are, what, over 1,400 insurance companies in the country, and only 6ish are allowed to do business in that state? There's a cause for higher prices right there. Tort Reform anyone? Forced Malpractice Insurance? Not a big fan of ABC or 20/20 but I do like John Stossel. Check out his little piece he did called "Sick in America". It might help add some insight as to some of the high cost in our health care industry and add a solution or two on how to bring it down some.

PART 1
http://www.youtube.com/watch?v=aEXFUbSbg1I
PART 2
http://www.youtube.com/watch?v=BpsEAVbCkMM&feature=related
PART 3
http://www.youtube.com/watch?v=refrYKq9tZQ&feature=related
PART 4
http://www.youtube.com/watch?v=QzhiG0dcwN8&feature=related
PART 5
http://www.youtube.com/watch?v=Xsp_Jh5EIT0&feature=related
PART 6
http://www.youtube.com/watch?v=E_KCLm9cekU&feature=related

[kenhill]

I sure wrestle wtih this too wondering if a human can really be worth $21 million a year.  Then I start getting concerned that I am a socialist!  A CEO possess a skill set that must be unique.  I have finally evolved to the point that a CEO should be paid well, but it should be for perfromance, not just because he is CEO, President of the Board of Directors...

[muldoon]

if they wanted to offer insurance, why not just take AIG (since they already own them) and I dunno - sell insurance to americans at drastically discounted rates?  They can even call it American Insurance Group - dont even need to change the stationary or anything. 

[MountainDon]

... Do you know why those horrible CEO's make so much money? Because they create profit for the company and it's shareholders.

Creating profits is the goal of any business. That is an absolute. No argument there. I have no problem with a return that relates well to the effort put in. Where I have a problem with the total remuneration to many (most? all?) CEO's, CFO's, etc. of large USA corporations is in the ratio of what they earn to the amount earned by the average rank and file employee who make it possible for the company to make any money at all.



Taken from a report in 2005. Download the PD here.

More interesting comparisons...



I would like to believe that we Americans are smarter than all the others, but I really do not think we are. Is an American company CEO worth that much more than the CEO of firms in other countries? Or are the American CEO's worth that much more than American factory workers?

Another interesting point to note. In the period from 1990 to 2001 if the wage of the average American worker had risen as fast as the CEO's compensation, the average production worker would now make $110,126 per year, instead of the average $32,594. Adjust those figures for what we have sen happen to CEO salaries in the past couple of years.

Anyhow, enough of that compensation rant. I still believe reform is required in the USA health care arena.

And John Stossel is a good man!

[MushCreek]

The first thing they need to address is why health care costs so much. Before you go off about the wealthy doctors, bear in mind that a lot of them don't make all that much money. My wife works in the microbiology lab of a hospital, and her malpractice insurance (paid by the hospital) is more than twice her salary! Why? Outrageous lawsuits. Until they get that under control, health care is going to cost us a ton of money, whether we pay out of our own pocket, or pay it in taxes. Between the insurance companies and lawyers, I'm surprised there's anything left to pay health care professionals with. My routine colonoscopy would normally cost about $4000. For a 20 minute procedure! Doesn't that seem just a little excessive?!

[MountainDon]

You are right mushcreek, most doctors are not real wealthy. But the lawyers are. Reform there is needed as well. Too many lawyers in government though.


Yeah, I've wondered why the 20 minutes spent or a colonoscopy is that expensive. Even with a color video included it's nuts. Gonna get a new one Monday.    OK, too much information. 

[Sassy]

Wasn't gonna get into this   

1st off, it makes me laugh - everyone complaining about how much a CEO makes - I complain just as much, it is outrageous!  But who complains about all the entertainers & athletes making just as much or more?  Just for entertaining? 

I work in the health care setting...  yes it is the VA & it is a Federal entity & yes, it is socialized medicine & actually works surprisingly well, but I think that is because the budget is rather restricted & those it takes care of were given the promise that if they put their lives on the line for their country, they would in turn, if needed, be cared for by that same country - only fair, in my opinion.

Today, I seldom see any new US citizen doctors coming up the line, only foreign docs - why is that?  It doesn't pay anymore - the risk is too great for the rewards.  Everything is so highly regulated that they have to practice "defensive" medicine - that means order every test in the book even though they already know what the diagnosis is through physical assessment of the patient - which is the way medicine was done years ago before all the high tech new fangled diagnostic machines - now the hospital & the docs get sued if they don't do all those myriads of tests and BTW, are people any healthier today?  And another thing - those in control have made mandatory "Clinical guidelines" which means if you have high blood pressure/cholesterol/blood sugar, you automatically are placed on certain medications.  That, in itself is expensive.

Most of us here remember when Peternap asked for advise on diabetes...  his doc wanted to put him on insulin injections...  the American Diabetes Assoc still teaches a diet that is totally wrong - high in carbs.  Peternap followed a low carb/high leafy green veggies diet & lost weight, got his sugar under control & totally turned his health around.  I work with a nurse in his 30's - his cholesterol was high so the doc put him on a statin drug (one that lowers cholesterol) it almost destroyed his liver - he still has to monitor it closely - the statins almost killed him rather than helping him.  I'm not saying, "never take medications" but don't just take one without doing your homework...

The hospitals are going bankrupt - yep, they charge exorbitant prices...  but guess what the hospital got paid when I was in there for 6 days?  They charged $92,000 just for the bed & nursing care (doesn't include medications/tests/surgery/doctors etc) - they got paid $19,000 from the insurance co.

Ok, how many people are in the US illegally using all the resources & not paying for them?  So many of our ER's have closed around the nation due to non-payers. To me, that's where some of the biggest health care costs are. 

Kucinich has a "one payer" health insurance plan - haven't read it, guess I should...  something has to be done about the situation...  but I don't see having an IRS type of set-up where it not only includes our finances, but will control our health from birth to death - I don't trust the gumint...  at least not the bunch of criminals who have been in office for the past 20 years...  hey, make that 40 yrs or more like before 1913 when the Federal Reserve Act came into being & the private Federal Reserve took control of our money, therefore control of our nation...  right on the heels of that was the income tax. 

If Bernanke can stand up in front of Congress/Senate & say he doesn't know who the banks were that he gave 1/2 trillion $$$$ to & now, that the bill Ron Paul authored to audit the Feds is getting so much grass roots attention & congress is demanding that Bernanke reveal where a lot of the money has gone, Bernanke is again crying "the economy will be destroyed if we reveal that info" - just like he yelled "we'll have martial law if they don't pass the bailout!"  Baloney! 

So what makes people think that a gov't run ie special interest run national health care plan will be any different?  Until they start making people accountable all I see is more of the same as the nation we once kinda knew slides into oblivion... 

Okay, I'm finished with my rant 

[OkieJohn2]

It's getting to the point you need a jet powered weed-whacker to cut through all the Bull.....uh rhetoric about health care reform.  There are many sides to any issue this important, but with most of our distrust of politicians its hard to understand the truth.  I do strongly agree with the Living Will concept, and am so PO'd when this is called a "Death Panel".  I also feel that Medicare needs to be run smarter,  face it, there are people out there getting rich off of Medicare, and it has nothing to do with the care given.  Look at who is paying for all those expensive anti Health care reform TV ads.

[Squirl]

Well Obama changed his position last night.  He supported the public mandate on buying insurance without a public option.  This will be the largest boon to the insurance industry.

[waggin]

Without campaign finance reform, debating health care reform is about as useful as rearranging the deck chairs on the Titanic.  With all the obstructionist neocons and Blue Cross Democrats (far more than the Blue Dogs & just as obstructionist) they'll talk about it & pretend to be looking for a "solution" forever.  Look at the hundreds of thousands of dollars some of the influential members of each party are receiving in campaign contributions from insurance companies; does anyone really expect them to turn on their "constituents" that keep them in office?  We can expect just as good of a "solution" as Bush & Obama came up with for the economy.

This is ideology neutral; BOTH political parties are the problem!  NEITHER will offer anything materially different from what we have now; in other words, continued giveaways to the insurance industry.

[OkieJohn2]

Back to the huge CEO pay, doesn't that put them in the highest IRS bracket?  Or do they have some other special deductions we don't know about.   Of course, i'm one of those people who is so happy that the Octomom is getting her own show,,,,,,now she doesn't need taxpayer money......or at least I would hope so.