America's Affordable Health Choices Act of 2009 - The USCHO debates

[Slap Shot]

Covering people without insurance? yes - less ER visits & better screening for potential problems before they become life threatening.

You're assuming enough would utilize these services to justify the cost. There are millions now that do not elect to utilize their company sponsored plans and out of those that do, I imagine there's a good chunk that aren't responsible enough to go the preventative route.

 

[Rover]

Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

I hate to break it to you, but Scott Rassmussen is a well-known and respected polling expert. I cited his poll only because I believe it helps explain why many Americans are reacting the way they are to health care reform.

In point of fact, just because you don't know anyone happy with their health care doesn't mean that most Americans are ready to embrace the type of change to the system that's being proposed.

Scott Rassmussen leans conservative so I'll take his polls with a large grain of salt. Fivethirtyeight did a piece on this a little while ago. Maybe the guy turns out to be right but I wouldn't be taking his word for it. He seems to have a bias on this one (and before somebody says "he was accurate about xyz", recall Zogby was the most accurate pollster in 04, and the furthest off in 08).

Another poll came out showing that 30+ percent thought they'd benefit, and another 40+ percent thought they wouldn't but others would. It was 77% in total. Which poll do you believe?

All of this is a bit academic until an actual bill gets produced in each chamber. Seems like we've gone into a lull a bit with protests dying down, the Prez on vacation, and nothing but an occasional trail balloon floated up here or there. Probably a good thing, although I'll still argue with knuckledraggers out here when I'm bored.

 

[Rover]

Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

You're assuming enough would utilize these services to justify the cost. There are millions now that do not elect to utilize their company sponsored plans and out of those that do, I imagine there's a good chunk that aren't responsible enough to go the preventative route.

As in they choose not to take insurance or have it but go to the ER anyway?

 

[PCM]

Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

Obama seriously underestimated his oppositions abilities (or overestimated his own) on this battle.

What Obama underestimated the most is the public's satisfaction with what it has in terms of health care. This doesn't mean the system can't be improved or that health care shouldn't be more affordable. It also doesn't mean that we shouldn't find a way to get more people insured. But it does mean that if you're going to propose radical change, you better make sure that people believe it will be change for the better.

 

[Slap Shot]

As in they choose not to take insurance or have it but go to the ER anyway?

As in, "all of the above". Many don't elect to be covered that could be and end up in the ER and many that do elect to be covered still end up in the ER because they don't take precautions. This country is full of lazy and obese people that would drink, smoke and eat McDonalds in the ambulence if they could.

The overall point though is that the, "40 million" figure is far too arbitrary to take seriously given the above rings true for probably a good percentage of that 40 million. If any goverment funded plan is going to be supported we should start with facts and not hypotheticals. Arguing as such is the reason we went into Iraq in case you forgot.

 

[walrus]

Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

In point of fact, just because you don't know anyone happy with their health care doesn't mean that most Americans are ready to embrace the type of change to the system that's being proposed.

I'm happy with mine, why, I don't need any health care . Everyone in my boat should be happy with that. But I'm old so its only a matter of time

 

[The Exiled One]

Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

Call your office, Rover. The talking point is 47 million.

18 million of which are people who can afford insurance but don't want it.
12.6 million of which are illegal immigrants.
9.4 million of which are people between jobs and temporarily uninsured.
8.4 million of which are adults aged 18-25 who are indestructible prefer to spend their income on other things.
8 million of which are children who are covered, but their parents haven't signed them up.
3.5 million of which are people eligible for existing government programs but haven't signed up.

Also, I need some help with a math question. What's 300 - 47?

Here's my take on this...

Insurance, by definition, takes risk from all it's members, adds it up, then divides out the risk in the form of premiums "somewhat" evenly. Those 18 million who can afford insurance but don't want it plus the 8.4 million "invincible" kids are healthier on average than those who are currently covered... part of the reason most of them don't think they need insurance. If they were part of the pool, premiums would go down for everybody. So, healthy Americans with health insurance (like me) are getting a poor deal. That is a situation unique to the United States, and needs to be dealt with somehow. Why? Because if it's not, then more and more healthy Americans will decide to forego the increasing cost of health insurance, thus raising the premiums for everybody else left on insurance and exacerbating the situation.

A solution can come from the right or the left, but there's no doubt it must come.

 

[Red Cloud]

Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

Insurance, by definition, takes risk from all it's members, adds it up, then divides out the risk in the form of premiums "somewhat" evenly. Those 18 million who can afford insurance but don't want it plus the 8.4 million "invincible" kids are healthier on average than those who are currently covered... part of the reason most of them don't think they need insurance. If they were part of the pool, premiums would go down for everybody. So, healthy Americans with health insurance (like me) are getting a poor deal.

So, if I'm reading this correctly, you don't like how much you pay for health insurance, and therefore you want to force all people to have health insurance. If I'm wrong, do let me know, I want to make sure I'm following you correctly.

 

[ScottM]

Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

What Obama underestimated the most is the public's satisfaction with what it has in terms of health care. This doesn't mean the system can't be improved or that health care shouldn't be more affordable. It also doesn't mean that we shouldn't find a way to get more people insured. But it does mean that if you're going to propose radical change, you better make sure that people believe it will be change for the better.

I think part of the issue, and it was IMHO a missed opportunity, was a failure to specifically address those without coverage as the primary goal, as opposed to propose some sweeping overhaul that could undermine the plans many people already have. That, and the O-man's initial outsourcing of the details to Congress has probably contributed to the current misinformation, screaming, recriminations and other needless garbage from all sides.

 

[The Exiled One]

Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

So, if I'm reading this correctly, you don't like how much you pay for health insurance, and therefore you want to force all people to have health insurance. If I'm wrong, do let me know, I want to make sure I'm following you correctly.

It's not too bad now, but ask me again in five years.

What I'm saying is, the private health insurance industry as a whole is self destructing. It won't be long before the premiums are too high for ANYBODY to pay. It'll be cash for preventative services and the ER for all incidentals... not a good situation.

 

[SPIN CONTROL]

Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

Scott Rassmussen leans conservative so I'll take his polls with a large grain of salt. Fivethirtyeight did a piece on this a little while ago.

538? Yeah, No bias there I am sure.

 

[Red Cloud]

Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

538? Yeah, No bias there I am sure.

Nate Silver is to conservatism what Brett Favre is to staying retired.

Rover would like, I suspect, to ignore that Rasmussen was the most accurate polling firm from the last cycle.

 

[PCM]

Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

Scott Rassmussen leans conservative so I'll take his polls with a large grain of salt.

I have no idea which way Rassmussen leans, but I suspect that it would be tough to stay in business as a pollster if you biased your polls to come out a certain way.

How about this new NBC/Wall Strett Journal poll in which 41% of respondents identified themselves as Democrats and 29% identified themselves as Republicans?

Thinking about efforts to reform the health care system, which would concern you more?

Not doing enough to make the health care system better than it is now by lowering costs and covering the uninsured. OR

Going too far and making the health care system worse than it is now in terms of quality of care and choice of doctor.

Not doing enough 41%

Going too far 54%

Not sure 5%

85% of those polled said they have health insurance. Do you think that that if most Americans were dissatisfied with their coverage, they'd be concerned about the government going too far and making the system worse?

 

[leswp1]

Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

I was watching Bill Maher on Friday and he sent Dana Gould (comedian and correspondent) to both the Town Hall meeting and the free medical deal at the Staples Center. It was amazing to see how all the people without insurance were calm and collected just trying to get some essential services they can't afford normally (like glasses, checkups...etc) while the people who have insurance are the ones screaming at the top of their lungs at the Town Hall meeting acting as if somehow life is being unfair to them! They had the vitriol and the anger and for what...no one was taking anything away from them?

It reminded me of the protests we used to always see at Mariucci before Sioux games. There would be 20-30 people holding up signs and screaming to high heaven how wrong it was to demean the Sioux Indians this way and not one of the people protesting was of Sioux background. Lots of White People protesting something they have no stake in.

Hmm, I was noticing the same thing. The people I talk to or read that are rabidly against any plan are the ones least at risk to need it.

These things cut costs?

Prevention can cut costs in some things if it is evidence based and targeted where it will do the most good- ie mammograms can catch a developing cancer and the intervention is significantly less than if we wait until the patient is sx (Just had one of those die today after living 4 yrs (which surprised us all) and using huge amts of healthcare to initially treat her and then provide palliative care). Colonoscopy is another great example. By the time someone is sx with colon CA the survival rate is horrible and the treatments are nasty and expensive.

Today I had a fixed income patient who worked their whole life at a white collar job, did not live outside their means and is now on Medicare. Medicine coverage = 4 meds that are tier 3 at 110$ a month, 3 meds that I can go generic on at 20 a month and an OTC allergy med (that doesn't work) because the insurance will no longer cover prescription. That is 440+60+15=~515 a month on medications. These meds aren't really what would be optimal but I can't switch to meds that would be better because there is no more cash and the pt is not actually affording it at this point. I give samples but that is like a drop in the bucket. The suboptimal meds mean the medical conditions are progressing instead of holding steady. This patient will be hospitalized within the year with stuff that could have been controlled if the medications were available to her. So am I living in a great country or a 3rd world one??

It is sad to read all the partisan hooha in here. Medical coverage is a problem that is sucking $ out of us because the system is cumbersome, broken and profit driven. Insurance is FOR PROFIT. I tell patients this all the time. The system is not driven by what the best medical choice is but by what will be cost effective to keep the profit margin that they can get away with. The medical provider trys to bridge the gap and it is getting harder and harder to do that. Specialists are rewarded but not primary care. etc. If the whole thing is stalled and goes no where then yeah for the insurance companies who have managed again to manipulate things in a way that makes Rove look like an amateur.

Makes me ashamed that in our great country so much we see is about defeating the other side. Where are the people that want to look at what is going on and try and do something about it in a realistic way? Uninsured people end up costing us all big bucks in the end. Under-insured folks first drain their assets and then crash and burn using our assets. The population is aging. The aging are not in good shape. We have huge rates of obesity with resultant other medical conditions, kids with type II diabetes in their teens, increasing rates of heart disease, etc. This is going to bankrupt us if we play ostrich.

OK, so I had another stellar day at work.

 

[Rover]

Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

How about this new NBC/Wall Strett Journal poll in which 41% of respondents identified themselves as Democrats and 29% identified themselves as Republicans?



85% of those polled said they have health insurance. Do you think that that if most Americans were dissatisfied with their coverage, they'd be concerned about the government going too far and making the system worse?

Being concerned about going to far isn't the same as not wanting reform. As has been mentioned, there's a lot of misinformation out there, and who knows what people are concerned about? Polls saying this that or whatever aren't going to answer that until an actual bill is produced. That will dispel what is and isn't becoming law. Check out this poll for an example: http://blogs.wsj.com/washwire/2009/...-health-care-highlighting-doubts-on-overhaul/

Right now in aggregate the public is 50/50 on supporting reform, with a lot of fluidity in those #'s. Not bad after a month of bad press. Once its put on paper, polls will revert back to the 35% of the people who think Obama is the anti-Christ and the 55% or so who support him since myths will be easier to refute.

Red Cloud,

As I already mentioned, Zogby was the top pollster in 04. He was the worst in 08. Past performance obviously doesn't guarantee future results, but I'll put out one more for you. In the same NBC poll sited above, this little nugget is included:

Despite the headwinds Democrats are facing on health care, the NBC poll offers little in the way of good news for their Republican opponents. By a nearly three-to-one margin, 62%-21%, Americans said they disapprove of the way Republicans in Congress are handling health care reform.

How is it that Rasmussen has Republicans favored on every issue, even social security, while this very same poll, which hardly is pro-Dem, has the GOP scorned 3 to 1 by the American public? So, who's right?

However, this is all fluff. Now that Grassley and Kyl have made idiotic statements saying they won't vote for co-ops or even a bill that lowers the deficit, you can easily envision an all Dem + Snowe & Collins bill rammed down their throats come September. No use negotiating any more, as the Repubs aren't negotiating in good faith. I'm guessing you'll get a public option on all but name called co-ops now, and Dems invoking cloture thus giving them a 12 vote cushion (including Maine senators) to get this done.

 

[Red Cloud]

Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

It is sad to read all the partisan hooha in here.

Which you're above, naturally.

Medical coverage is a problem that is sucking $ out of us because the system is cumbersome, broken and profit driven. Insurance is FOR PROFIT.

ZOMGUHWETYIHESGUIEHIUESGSEIGHSEGISYBEG!!!!!!!!!!!!!!

 

[Handyman]

Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

Status quo, maybe or maybe not but I'd bet a majority don't want to blow the system up.

Neither do I but I want some reform put in because the rates are getting out of hand. Jesus my insurance in grad school doesn't even cover blood tests for a basic physical...***!!!

 

[PCM]

Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

Being concerned about going to far isn't the same as not wanting reform.

I know that most Americans want certain parts of health care reformed. There's widespread agreement that something must be done to insure more people and get control of costs. But this doesn't mean that most Americans want a costly government-run health care system. Nor does it mean that most Americans are so dissatisfied with their own health insurance and quality of health care that they will accept anything in the name of reform. That's where Obama and the Democrats miscalculated.

As has been mentioned, there's a lot of misinformation out there, and who knows what people are concerned about?

You can pretend not to know, but it's quite obvious to me: More than two-thirds of voters are satisfied with their health care and they don't want the government to do anything to screw it up.

 

[Handyman]

Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

I hate to break it to you, but Scott Rassmussen is a well-known and respected polling expert. I cited his poll only because I believe it helps explain why many Americans are reacting the way they are to health care reform.


And in 1972, everyone Pauline Kael knew voted for McGovern. He still lost to Nixon in a landslide.

In point of fact, just because you don't know anyone happy with their health care doesn't mean that most Americans are ready to embrace the type of change to the system that's being proposed.

I didnt say they were, I was just saying relying on a Rasmussen Poll to tell you that the majority of Americans are happy is a bit off I can conduct a poll too ya know it isnt super hard. But there is a big difference between saying "The majority likes the status quo" and "the majority dont want the types of change that are in the bill" and you are smart enough to know that

But hey, none of this affects the insured anyways, they can keep their coverage and enjoy their status quo. the whole point of this is to help those that are being bent over a table by the status quo...ya know the ones who aren't calling Obama Hitler and crying Socialism but probably couldn't tell you what Socialism really is.

 

[Bill]

Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

More than two-thirds of voters are satisfied with their health care and they don't want the government to do anything to screw it up.

And the more control the Gov't has of health care, the more it will get screwed up.