America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies

[unofan]

Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies

Getting rid of mandates; allow more of an a la cart system where you can pick and choose what coverage you want and aren't forced to have coverage for things that will likely never apply to your situation.

Fine in theory. But what happens when one of those unlikely things ends up applying to you and you chose not to cover it? While you should be SOL due to your own poor choice, society doesn't allow that outcome. So the taxpayers end up biting that bullet just as they do now.

Until you solve the "what-if" scenario for people under an a la carte system, you can't have an a la carte system.

 

[moe24]

Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies

Fine in theory. But what happens when one of those unlikely things ends up applying to you and you chose not to cover it? While you should be SOL due to your own poor choice, society doesn't allow that outcome. So the taxpayers end up biting that bullet just as they do now.

Until you solve the "what-if" scenario for people under an a la carte system, you can't have an a la carte system.

I agree. A la carte sounds nice, but it really isn't a viable solution.

 

[Kepler]

Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies

I'd generally agree with you on the GOP taking either chamber in 2010, but people in this country have strong history of voting against people rather than for them. If things worsen, or are perceived to be worse, the Dems could get bloodied in 2010 and 2012.

Agreed. The incumbent is always fighting gravity. That helped the Dems in 2006. In 2008 even though the Dems controlled Congress the sitting administration was GOP and that seems to be trump. The Dems have a sweep now so all the systemic pressures are against them. What they have going for them is the possibility that the economy will recover and the GOP being such a steaming pile of Fail, but the former is probably going to be a bunch of mixed indicators (market up, jobs stagnant) and the latter can be danced around in local races (look for GOP candidates to hide from the national brand the way Dems did in the '80s).

Assuming if for no other reason that the business cycle the economy has clearly recovered by 2012, Obama will win re-election and have some coattails (unlike Clinton, who was in it strictly for himself, Obama seems to practice No Dem Left Behind). The GOP needs big gains in both chambers in 2010 to avoid the Dem sweep extending all the way to the 2014 midterms. Six years of Dem rule with 1 or 2 more SCOTUS appointments and the world not ending is the GOP's worst nightmare. The Millenarianism they've feasted on for so long won't phase anybody who doesn't live on a compound or attend Liberty.

 

[walrus]

Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies

. I don't have time to read comments @ Politico, but I'm sure if I did, there'd be no shortage of traitor - or even Hitler references.

I'll guarantee those comments are being made in Maine

 

[Rover]

Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies

In this whole debate, the Dems have justifiably had their feet held to the fire in terms of cost (something the past admin didn't have to deal with for some reason). For example, the 1.5T House committee bill was too expensive. However, what I'd love to know is how much savings, in specific dollar terms, will these following generally GOP ideas actually generate:

Tort reform
Buying insurance across state lines
Ending mandated coverage
a la carte coverage
ending employer based insurance

 

[amherstblackbear]

Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies

I'll guarantee those comments are being made in Maine

Do I remember right - that Maine has open elections for senate primaries?

If that's the case, Snowe is (even more) invincible. Any attempt by the GOP to support a candidate to her right will get squashed by independents and Dems voting in the Republican primary. This vote plays right into her "independent" shtick. I'm sure a lot of Republicans are mad, but I'm also sure that a lot of people figure -- if she's making both Dems and GOP-ers mad, she's doing something right. My money is on her winning her next primary with 65% support, minimum.

 

[Kepler]

Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies

Do I remember right - that Maine has open elections for senate primaries?

If that's the case, Snowe is (even more) invincible. Any attempt by the GOP to support a candidate to her right will get squashed by independents and Dems voting in the Republican primary. This vote plays right into her "independent" shtick. I'm sure a lot of Republicans are mad, but I'm also sure that a lot of people figure -- if she's making both Dems and GOP-ers mad, she's doing something right. My money is on her winning her next primary with 65% support, minimum.

If she's invincible why doesn't she cut a deal to switch? She's got zero power as a minority member.

 

[amherstblackbear]

Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies

She's got one of the lower party loyalty scores, but she still votes with the GOP 60% of the time in a "bad" year. She may be RINO, but she isn't a Democrat.

She could go IND, but then she still has to decide which party to caucus with. Presumably not the GOP. Not sure what kind of benefit that brings. But there's a clear cost, in that "flipping" could erode the image she's spent her whole career cultivating.

I think it's moot, anyway. She's a Red Senator in a dark blue part of the country, and will be for the foreseeable future. The GOP would be shortsighted fools to chase her.

 

[walrus]

Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies

. My money is on her winning her next primary with 65% support, minimum.

She could commit murder and get reelected, no repub will run against her and a Dem will get squashed. She a freakin lifer just like all the rest. Is it any wonder their are no new ideas in DC

 

[Kepler]

Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies

The GOP would be shortsighted fools to chase her.

Um...

 

[Bill]

Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies

In this whole debate, the Dems have justifiably had their feet held to the fire in terms of cost (something the past admin didn't have to deal with for some reason). For example, the 1.5T House committee bill was too expensive. However, what I'd love to know is how much savings, in specific dollar terms, will these following generally GOP ideas actually generate:

Tort reform
Buying insurance across state lines
Ending mandated coverage
a la carte coverage
ending employer based insurance

I haven't seen figures for the others, but the CBO estimates that Tort reform would save 41 billion over 10 years:

http://cnsnews.com/news/article/55262

 

[mookie1995]

Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies

I thought that was the case right now for most employee health plans and I think it is with mine..

they are.

that is a big thing to consider (employee contribution) before taking a job. i left a company that paid 90% of the total cost (after the first four years there picking up 100%) and was offered a job by two other companies. i ended up taking the job that cost me less for my contribution (same plans) with the salary offers being equal.

 

[leswp1]

Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies

Things like:

Getting rid of mandates; allow more of an a la cart system where you can pick and choose what coverage you want and aren't forced to have coverage for things that will likely never apply to your situation.

We need a much better electronic record keeping system. It shouldn't be "that" difficult in the computer age.

Allow purchase of health insurance across state lines.

Tax credits to make insurance more affordable to low income families/ individuals.

Tort reform.

Regulations to get the drug companies out of bed with Congress. Same for the insurance companies to a lesser extent.

Incentives for encouraging more people to go into the physician and nursing professions.

Exempt health insurance premiums from taxation. i.e. Subtract them from your gross income prior to application of income taxes.

Thank you very much for answering without ranting !

I like everything on your list except the A la carte.

Unlike Rover I see no problem with Tort reform. I do think it would fair better if separated out.

I would love the insurance to cross lines but until there is a MASSIVE overhall of regulations this would be impossible d/t all the state regs. In order for this to work you would need to nationalize stuff which seems to scare the heck out of people. The logistics boggle the mind. Right now we have a ridiculous time just managing the plans from this state!

EMR is extremely complex. Technology is one thing but computers like to fit everything into logical little boxes and humans don't fit into boxes well when medical conditions are involved. In order for this to work efficiently there would need to be a national system- something that a lot of people would be against. Without a standardized system all hell is breaking loose as we speak in the medical system d/t these records not interfacing, multiple ways systems work. The potential for error is dam scary and it unfortunately is pretty frequent. Too many places things can be entered and then 'disappear' unless you know to look for them. Eventually this might work but I can't see it happening soon. We should be talking to France which has made it work (but they have a national system and standardized care).

The only thing that I think is not OK is the a la carte system for the reasons others have stated. If there was a way to let folks die if they didn't have the correct coverage then OK(which obviously isn't going to happen). If not there is no penalty for those who roll the dice. In fact if you are smart you would roll the dice because the hospital can't refuse you treatment if you have a catastrophy. If it isn't something like a car wreck and is something like cancer then they still treat you and you, your relatives (after you die) would be in the hole for hundreds of thousands of $. The relatives may not hqave made the decision but they pay for it. This seems to be a no win situation. No one wants to be forced to buy healthcare yet those that don't force society to pay for their selfishness.

And is anyone else amused by the last ditch 180 by the insurance companies (the 'study' that suddenly pops up saying costs would increase) now that their underground effort to scuttle reform is failing? (I am not cynical or anything)

 

[Rover]

Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies

les,

You need to read a little closer. I'm not against tort reform, and already said it should be handled separately. However, its not going to save a lot of money from anything I've seen, certainly not anything like the current effort is trying to do.

 

[Bill]

Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies

The only thing that I think is not OK is the a la carte system for the reasons others have stated. If there was a way to let folks die if they didn't have the correct coverage then OK(which obviously isn't going to happen). If not there is no penalty for those who roll the dice. In fact if you are smart you would roll the dice because the hospital can't refuse you treatment if you have a catastrophy. If it isn't something like a car wreck and is something like cancer then they still treat you and you, your relatives (after you die) would be in the hole for hundreds of thousands of $. The relatives may not hqave made the decision but they pay for it. This seems to be a no win situation. No one wants to be forced to buy healthcare yet those that don't force society to pay for their selfishness.

And is anyone else amused by the last ditch 180 by the insurance companies (the 'study' that suddenly pops up saying costs would increase) now that their underground effort to scuttle reform is failing? (I am not cynical or anything)

Obviously there would be challenges to making a la carte work, but I still would prefer to see it in some form or fashion. It may very well be that some minimum level of coverage would be required for everyone, with various other coverages as the "choices". It might also make sense to package groups of coverage as choices as opposed to itemizing coverages in too much detail. I have to think there are certain types of coverage in the current mandates that just don't need to be there for everyone and for every situation, that contribute to costs, and don't necessarily fall in the catastrophic category.

 

[dropthatpuck]

Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies

les,

You need to read a little closer. I'm not against tort reform, and already said it should be handled separately. However, its not going to save a lot of money from anything I've seen, certainly not anything like the current effort is trying to do.

Enough with the blathering.

What material experience do you have with TORT laws or reformation? Legal, hospital, patient, or other?

Just curious....since you seem to have "seen" something....somewhere.

 

[leswp1]

Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies

Obviously there would be challenges to making a la carte work, but I still would prefer to see it in some form or fashion. It may very well be that some minimum level of coverage would be required for everyone, with various other coverages as the "choices". It might also make sense to package groups of coverage as choices as opposed to itemizing coverages in too much detail. I have to think there are certain types of coverage in the current mandates that just don't need to be there for everyone and for every situation, that contribute to costs, and don't necessarily fall in the catastrophic category.

From what I have seen the requirements are basic medical protocols that are evidence based. Recommendations are based on the (can't remember the name of the working body but they are well respected and can/do back every recommendation with lots of meta-analyses) things that have been proven to be most effective for prevention/treatment. If it is what I think it is, these are actually very conservative. It doesn't seem like there is anything crazy.

The point of prevention is to prevent. 100% of females will not get breast cancer. 95% or more of breast cancer is treatable with great success if caught early enough. Mammos are very cost effective for those who are dx, esp early. A little radiation or chemo beats a lot in cost (medical/ loss of work). In the end you could argue that those who never had CA wasted the money, I suppose, but we don't know who those people would be. That is why we screen.

It is possible that things are so itemized because presently there are so many insurance companies that are putting in exclusions for things that have always been standard in the past. These things are considered standard medical care. We order em and the patient gets slugged with a bill that is unexpected and sometimes hefty. Some states have laws to prevent this but others have nothing.

 

[unofan]

Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies

If it isn't something like a car wreck and is something like cancer then they still treat you and you, your relatives (after you die) would be in the hole for hundreds of thousands of $. The relatives may not hqave made the decision but they pay for it.

Not true. A spouse might be on the hook depending on the financing arrangement, but even that's not guaranteed. And no other friend or relative, including parents and children, will ever be required to pay off a deceased person's debt that they didn't co-sign for in life.

Generally speaking, creditors can go after the debtor's estate when the debtor dies. They can't go after the debtor's family.

 

[Rover]

Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies

Enough with the blathering.

What material experience do you have with TORT laws or reformation? Legal, hospital, patient, or other?

Just curious....since you seem to have "seen" something....somewhere.

I'm not a lawyer, but was involved in some insurance wrangling because of a car accident a while back. Somebody creamed me on the Expressway in Boston, and I had to get them to pay my medical bills (and that's all, I didn't make a profit on the claim).

What I've seen is studies showing far less potential savings from TORT reform than what Bill is suggesting, but these are all estimates. I'm all for savings $10B or whatever the amount ends up being, but in the context of a 900B dollar bill, there's bigger fish to fry.

 

[ScoobyDoo]

Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies

I'm not a lawyer, but was involved in some insurance wrangling because of a car accident a while back. Somebody creamed me on the Expressway in Boston, and I had to get them to pay my medical bills (and that's all, I didn't make a profit on the claim).

What I've seen is studies showing far less potential savings from TORT reform than what Bill is suggesting, but these are all estimates. I'm all for savings $10B or whatever the amount ends up being, but in the context of a 900B dollar bill, there's bigger fish to fry.

And they're going to come right back at you now and say the $10B is bogus because the real cost is in the defensive medicine aspect of it.

And round and round we go.