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

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

Rover said:
1) Some people are acting like public insurance doesn't exist at all. In fact it does already exist, for a good deal of the population. I fail to see why adding another limited option will cause the demise of the employer based system.

2) Exactly, and I'd expect this same phenomenon to occur even if a limited public option is enacted. The principle doesn't change.

3) A panel operating much like the base closings panel does work. Recommendations that can only be voted up or down in entirety, not subject to horse trading and other political influence is the way to go IMHO.

In the early 90's while revenue went up, the bottom line is the political leadership at that time resisted the urge to spend it all, be it on programs or tax cuts and instead started paying down the deficit. That kind of discipline will be needed again once the economy turns around.
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1) I certainly don't know enough about it to predict whether a public option would have any effect on private insurers or not. But you have to admit that a public option that competes directly for the business of those who are currently insured (i.e. those who have good jobs) is a completely different beast from Medicaid, which is a safety net for people who aren't currently insured (i.e. don't have good jobs).

2) Again, the difference is that the availability of the public option changes the calculus a little bit. Today, it's nearly* all or nothing - your employer either offers care or he doesn't. With the public option available, it is at least *conceivable* that some employers would feel like they have less pressure to offer a private health plan. Again, I don't know enough of the numbers (nor exactly what the "public option" will entail as far as cost, eligibility, etc) to be able to make a prediction about whether this will materially affect the insurance market. But it is conceivable.

3) No real comment here, but if the independent panel takes as long to make recommendations as the base closings commissions did, then I don't foresee too much savings in the near future!

4) The discussion wasn't about who was or wasn't more fiscally sane (which is like arguing which crow is the blackest!). The discussion is about whether forecasts are accurate - and they often aren't.


*okay, sure, there are some minor differences in the plans companies offer, but it's mostly the difference between shopping at Walmart or Target.
 
Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies

LynahFan said:
3) No real comment here, but if the independent panel takes as long to make recommendations as the base closings commissions did, then I don't foresee too much savings in the near future!
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Not to mention the political arm twisting and meddling once the BRAC made its "final" decisions. Anything but an anonymous panel will be open to the same.
 
Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies

Since most of the Great American Rip-off won't take place until 2013, if the conservatives (note, not GOP) take control of congress and the WH by 2012, can this be reversed before too much damage is done?
 
Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies

joecct said:
Since most of the Great American Rip-off won't take place until 2013, if the conservatives (note, not GOP) take control of congress and the WH by 2012, can this be reversed before too much damage is done?
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How often have you ever heard of an entitlement plan being taken away? Once these things get passed into law they just seem to grow exponentially!
 
Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies

walrus said:
At least he realizes spending is killing us
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Well- we could let everyone die.:rolleyes:

Trouble is we are hitting the babyboomer population bump. No matter what we do cost is going to be up because more people are utilizing things.
 
Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies

walrus said:
I don't believe thats what I said or what he said.
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No, I didn't mean to imply that. It was frustration that no one seems to see that it is impossible short of removing patients to decrease costs. The population of patients needing more services is just destined to increase. Having said that it is pretty embarrassing that we are on the low end of the totem pole for providing care and outcomes but highest on cost.
 
Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies

leswp1 said:
No, I didn't mean to imply that. It was frustration that no one seems to see that it is impossible short of removing patients to decrease costs. The population of patients needing more services is just destined to increase. Having said that it is pretty embarrassing that we are on the low end of the totem pole for providing care and outcomes but highest on cost.
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Do you think the bill passed by the house will fix either problem, money spent and providing care.
 
Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies

walrus said:
Do you think the bill passed by the house will fix either problem, money spent and providing care.
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Nope. I think it makes things move out of stagnation and that it will force change to begin.

Nothing is going to 'fix' a problem this big in one try. Kind of like trying to completely renovate a house in 1 day. No matter how many people you have the various things need time to dry/cure/set etc before you can move to the next step. Tincture of time.
 
Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies

leswp1 said:
Well- we could let everyone die.:rolleyes:
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And with this one quote, you've embodied EXACTLY why there won't ever be any significant reform.

Not ordering additional tests to confirm the primary test to confirm a diagnosis isn't being cost-conscious. It's "letting people die."

Not requiring health insurance to pay for additional specialists opinions isn't being cost-conscious, it's "letting people die."

Not upgrading to the whiz-o-matic MRI 2000 isn't cost-conscious, it's "letting people die."

Not doing an organ transplant to extend an 85-year-old patient's life by a year isn't cost conscious, it's "letting people die."

Refusing to see every overprotective parent who brings in their kid with the sniffles isn't cost conscious, it's "letting people die."

This kind of thinking treats cost as a dependent variable: here's the level of care we're demanding (essentially the best care for every patient all the time - a veritable smorgasboard of health care) and we'll just let the costs fall out where they may at the end. The question being asked by this kind of thinking is, "how do we minimize the costs, given that we're going to maximize the care?"

We simply have to start treating cost as an independent variable: okay, as a country, we're willing to spend, say 15% of GDP on health care. Given that ceiling, now let's design a health care system that provides the best care for the most people, knowing full well that there will be people who won't get the absolute best, most up-to-date treatment. And yes, some people may die sooner than if we did it differently, but if we do it intelligently, we'd be able to maximize the bang (in terms of person-days of life extended) for the buck we are willing to spend. The question being asked by this kind of thinking is, "what's the best care we can provide, given that we can spend this amount?"
 
Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies

LynahFan said:
And with this one quote, you've embodied EXACTLY why there won't ever be any significant reform.

Not ordering additional tests to confirm the primary test to confirm a diagnosis isn't being cost-conscious. It's "letting people die."

Not requiring health insurance to pay for additional specialists opinions isn't being cost-conscious, it's "letting people die."

Not upgrading to the whiz-o-matic MRI 2000 isn't cost-conscious, it's "letting people die."

Not doing an organ transplant to extend an 85-year-old patient's life by a year isn't cost conscious, it's "letting people die."

Refusing to see every overprotective parent who brings in their kid with the sniffles isn't cost conscious, it's "letting people die."

This kind of thinking treats cost as a dependent variable: here's the level of care we're demanding (essentially the best care for every patient all the time - a veritable smorgasboard of health care) and we'll just let the costs fall out where they may at the end. The question being asked by this kind of thinking is, "how do we minimize the costs, given that we're going to maximize the care?"

We simply have to start treating cost as an independent variable: okay, as a country, we're willing to spend, say 15% of GDP on health care. Given that ceiling, now let's design a health care system that provides the best care for the most people, knowing full well that there will be people who won't get the absolute best, most up-to-date treatment. And yes, some people may die sooner than if we did it differently, but if we do it intelligently, we'd be able to maximize the bang (in terms of person-days of life extended) for the buck we are willing to spend. The question being asked by this kind of thinking is, "what's the best care we can provide, given that we can spend this amount?"
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Nice post but what I meant was we have an increasing population utilizing the system so even if we cut costs we would break even.

Why is it other countries manage to handle this and have a longer avg life span than we do? (so they are obviously not killing people off). For profit insurance makes any change difficult. The need to maintain profit supercedes all other priorities.
 
Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies

leswp1 said:
Nice post but what I meant was we have an increasing population utilizing the system so even if we cut costs we would break even.

Why is it other countries manage to handle this and have a longer avg life span than we do? (so they are obviously not killing people off). For profit insurance makes any change difficult. The need to maintain profit supercedes all other priorities.
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These other countries aren't as fat as we are. That's a big part of why they're living longer with smaller medical expenditures.
 
Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies

leswp1 said:
Nice post but what I meant was we have an increasing population utilizing the system so even if we cut costs we would break even.

Why is it other countries manage to handle this and have a longer avg life span than we do? (so they are obviously not killing people off). For profit insurance makes any change difficult. The need to maintain profit supercedes all other priorities.
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I am not sure the medical system alone explains the longer life spans in some developed countries. Genetics certainly plays a role (whether we want to admit it or not) and the fact that countries like Japan have a more homogenious society certainly plays a role(whether we want to admit it or not). Some of the countries with longer average lifespans are made up of a completely different mix than the US which is far more heterogenious. I suspect if Sweden was 15% Hispanic that the life span there would be significantly lowered. Besides, dont we have a higher murder rate in this country that lowers the average life span? I certainly dont like paying a fortune for health care (which we do) but I just dont see this current Bill as a solution-just a way of opening up another Pandora's Box of entitlements that will balloon in cost as every other entitlement has and be impossible to rescind once it is started.
 
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