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

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

What exactly are you outraged about? That a state which has committed itself to covering all its residents worked a deal so that it could continue to insure legal immigrants with refugee status (a.k.a. equal protection)? That the state had the nerve to negotiate with a new private insurance company to provide that coverage when the existing players wouldn't meet the price the government was looking for (a.k.a. a free market)?

Seems like a non-story to me.
Except in order to provide coverage, the amount of coverage is less and the author reports that the insurance companies will not be making any money on the policies.
But it comes at a price, for both patients and the providers of care - and it was greeted with an amalgam of relief and concern from advocates for immigrants, and with skepticism from competitors of the insurer selected to cover this group. The new plan will no longer cover dental, vision, hospice, or skilled nursing services, and, in some cases, it will boost medication and treatment co-payments for patients. And the insurer, a subsidiary of a Missouri company, will probably lose money on the deal.

Flip this to nationwide and if the insurance companies start losing copious quantities of money, they'll bail and who will be left holding the bag? The government (taxpayers).
 
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Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

Flip this to nationwide and if the insurance companies start losing copious quantities of money, they'll bail and who will be left holding the bag? The government (taxpayers).
I'm trying to follow here, but I'm still missing the correlation. If you're using this as a predictive model, please flesh it out a bit. I wouldn't mind seeing where you're going with this, but this quote above comes a bit short of connecting the dots.
 
Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

I'm trying to follow here, but I'm still missing the correlation. If you're using this as a predictive model, please flesh it out a bit. I wouldn't mind seeing where you're going with this, but this quote above comes a bit short of connecting the dots.
Let me see if my feeble brain can do this.... :)

You mandate health insurance (which Mass does). You have a large group that does not make enough or is employed in a business that does not have its own health insurance (independent contractors). They have to join the government's plan but the government needs an underwriter.

The underwriter looks at the potential income and what is mandated (I don't know what Commonwealth mandates) by the government and has to provide a bear bones plan that they still can't make a profit on. After a few years how can they stay in business unless they can attract healthier, higher paying people.

But, these people are usually in jobs where the employee has its own health insurance plan, so why would they join the government's plan? The government's underwrtier eventually will need to pull out OR the government mandates that you go to their plan.

Admittedly this is simplified and probalby skips a few steps. But, lunch is coming to an end and I have to spend your dollars wisely.

One closing thought. The Federal Government is charged with "promoting the general welfare". I like lots of promotion, and not a heck of a lot of involvement.
 
Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

Let me see if my feeble brain can do this.... :)

You mandate health insurance (which Mass does). You have a large group that does not make enough or is employed in a business that does not have its own health insurance (independent contractors). They have to join the government's plan but the government needs an underwriter.

The underwriter looks at the potential income and what is mandated (I don't know what Commonwealth mandates) by the government and has to provide a bear bones plan that they still can't make a profit on. After a few years how can they stay in business unless they can attract healthier, higher paying people.

But, these people are usually in jobs where the employee has its own health insurance plan, so why would they join the government's plan? The government's underwrtier eventually will need to pull out OR the government mandates that you go to their plan.

Admittedly this is simplified and probalby skips a few steps. But, lunch is coming to an end and I have to spend your dollars wisely.

One closing thought. The Federal Government is charged with "promoting the general welfare". I like lots of promotion, and not a heck of a lot of involvement.
A few more clarifying questions, hopefully you'll be able to get to them later...

First, I believe you're assuming that the final Federal legislation may include both a mandate and a public option... correct?

Secondly, it also looks like you're assuming that, like Massachusetts, the Federal Government will need to administer their plan through an existing insurance company? If so, this is the first time I've heard that suggested. My assumption was that, in any public option, the Feds would underwrite their own policies like they do for Medicare. The issue of ensuring a profit becomes irrelevant if that's the case.

The third point assumes that the second point is true. If the insurance company administering the public plan is operating at a loss, you're assuming that the Federal Government would pass further legislation to mandate every citizen goes to the Federal plan... thus becoming a single payer system like Canada?

The fourth point assumes the first, second, and third points are true. You're assuming that the Canadian system is currently worse than the American system?

Did I follow that correctly?
 
Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

Except in order to provide coverage, the amount of coverage is less and the author reports that the insurance companies will not be making any money on the policies.

Flip this to nationwide and if the insurance companies start losing copious quantities of money, they'll bail and who will be left holding the bag? The government (taxpayers).
But the company entered freely into that contract, with the full knowledge of what they would be paid and what their responsibilities would be - believing that the non-monetary benefits (a chance to enter a new market) was worth the cost. Why is it the government's responsibility to ensure that companies only sign contracts with a minimum level of profit? Isn't it a good thing that the government tries to get the best deal it can?

If the government hadn't been able to find a company to underwrite under those terms, then it (the govt) would simply have had to increase what it was willing to pay. Basic supply and demand.
 
Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

10 Health Reforms Docs Want
By Abigail Beckel, and Sara Michael

As part of our 2009 Great American Physician Survey* we asked 1,598 physicians “What healthcare reforms would you like to see?” Predictably, the two most frequent responses zeroed in on changing healthcare’s current payment systems and instituting tort reform. But you had lots of other ideas, too.

Some of you registered your frustration with cheeky responses like “Offer rewards to patients who actually follow my advice,” and “Bring humanity back.” But mostly, you proffered thoughtful ideas on ways to improve the system. Physicians, like other Americans, have widely diverse opinions on what needs to be done — and that diversity is reflected in your suggestions. Below, in no particular order, are 10 of the most-often suggested reforms:

1. Narrow the widening income disparity that exists between primary-care doctors and specialists.

2. Stabilize medical school costs to encourage more people to go into primary care. Increase student loan forgiveness for physicians who serve in needy areas. Give tax credits to doctors who provide care to the indigent, uninsured, and/or in physician-shortage areas.

3. Create tax incentives for citizens who maintain a healthy life by getting yearly physical exams, not smoking, getting immunized, keeping weight down, and getting mammograms, bone density scans, and PSA levels checked.

4. Develop a national electronic health record system that all doctors and hospitals can access. And modify billing systems and coding rules to allow telephone, e-mail, and other virtual patient visits to be billable charges.

5. Cap insurance and pharmaceutical company profits and exorbitant executive salaries, and eliminate the payments drug companies make to physicians who participate in dubious “studies.”

6. Get the government out of medicine entirely.

7. Institute a single-payer system that has universal coverage for both adults and children.

8. Allow patients to choose their care and provider based on quality rather than insurance participation.

9. Do away with or reform medical boards and certifications.

10. Hold payers more responsible for the fair treatment of physicians and fair reimbursement for services performed.

*The Great American Physician Survey results and story will run in the October 2009 issue of Physicians Practice.

Abigail Beckel is managing editor for Physicians Practice. She can be reached at abigail.beckel@cmpmedica.com.

Sara Michael is an associate editor for Physicians Practice. She can be reached at sara.michael@cmpmedica.com.

This article originally appeared in the September 2009 issue of Physicians Practice.
Thought this was interesting. Some of them seem to contradict each other.
 
Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

Thought this was interesting. Some of them seem to contradict each other.

You have a difficult time reading for context, so I won't rip you apart on this one. I'll just point out that this was a list of different things different doctors want, not a "doctors want all of these" list.
 
Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

You have a difficult time reading for context, so I won't rip you apart on this one. I'll just point out that this was a list of different things different doctors want, not a "doctors want all of these" list.

I appreciate the fact that you donated your brain to medical science a few years back, but that magnanimous gesture has resulted in you misunderstanding some pretty basic concepts in your posts. Case in point, your response to leswp1's post. Perhaps you can ask for it back sometime if they're done with it???:D
 
Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

You have a difficult time reading for context, so I won't rip you apart on this one. I'll just point out that this was a list of different things different doctors want, not a "doctors want all of these" list.

I would think that was so obvious that it did not need to be outlined but if you need to provide a roadmap, feel free.
 
Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

I would think that was so obvious that it did not need to be outlined but if you need to provide a roadmap, feel free.

One wonders why you would comment that "some of these seem to contradict each other" if it were so obvious. I mean, you're not one of those Democrats who lump all people in a group (in this case, doctors) into the same basket. You're independent.
 
Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

There have been numerous opinion pieces written that list good, plausible reasons for some sort of expanded government intervention in health insurance, but this ain't one of them.

http://www.nytimes.com/2009/08/30/opinion/30kristof.html

Does it suck if you've worked hard and saved your whole life to build up a nice retirement, or a "nest egg" to leave your children, only to find that unexpected medical or long-term care expenses will eat up most of it? It does.

But should we pass a bill so that "M's" husband's long-term care expenses will be picked up by the rest of us just so "M" can leave a bunch of money to her kids? That I'm not so sure about.
 
Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

One wonders why you would comment that "some of these seem to contradict each other" if it were so obvious. I mean, you're not one of those Democrats who lump all people in a group (in this case, doctors) into the same basket. You're independent.

Again about getting that brain of yours back from whatever jar its in...
 
Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

One wonders why you would comment that "some of these seem to contradict each other" if it were so obvious. I mean, you're not one of those Democrats who lump all people in a group (in this case, doctors) into the same basket. You're independent.

Could it be possible that you have nothing intelligent to add to the conversation? How about commenting on the article instead of playing sissy fight.
 
Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

There have been numerous opinion pieces written that list good, plausible reasons for some sort of expanded government intervention in health insurance, but this ain't one of them.

http://www.nytimes.com/2009/08/30/opinion/30kristof.html

Does it suck if you've worked hard and saved your whole life to build up a nice retirement, or a "nest egg" to leave your children, only to find that unexpected medical or long-term care expenses will eat up most of it? It does.

But should we pass a bill so that "M's" husband's long-term care expenses will be picked up by the rest of us just so "M" can leave a bunch of money to her kids? That I'm not so sure about.

This is a good point. On the other hand aren't these the people who have been paying into the system for years? I have a hard time deciding which way to go with this.
 
Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

There have been numerous opinion pieces written that list good, plausible reasons for some sort of expanded government intervention in health insurance, but this ain't one of them.

http://www.nytimes.com/2009/08/30/opinion/30kristof.html

Does it suck if you've worked hard and saved your whole life to build up a nice retirement, or a "nest egg" to leave your children, only to find that unexpected medical or long-term care expenses will eat up most of it? It does.

But should we pass a bill so that "M's" husband's long-term care expenses will be picked up by the rest of us just so "M" can leave a bunch of money to her kids? That I'm not so sure about.
So I take it you don't have a problem with the Inheritance Tax?
 
Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

Could it be possible that you have nothing intelligent to add to the conversation? How about commenting on the article instead of playing sissy fight.

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

Does anyone have a good link how other countries handle the LT care thing?

I heard a great question the other day- If we are so afraid of rationing health care as we age, how come all the other countries with socialized systems have a longer life expectancy than we do? Now that would be an interesting question to hear the answer to. Is is because their populations are more homogeneous or because their care is different?
 
Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

So I take it you don't have a problem with the Inheritance Tax?

I have a lot of problems with an inheritance tax.

I think we each have a right, and perhaps an obligation to ourselves, to earn and save as much as possible for the time when we can no longer work. If we've saved extra, or fortunately avoided any big medical expenses or long-term care issues late in life, then we should be free to do what we want with the money without government taking a big chunk of it.

I'm just not in favor of the government stepping in and paying those costs if I have a bunch of money already set aside, just because I would prefer to give it to my kids.

If you've exhausted your assets, or had none to begin with, fine. Then the government safety net should kick in. But it should be the bare minimum, and not enough of a net to provide incentive not to save.
 
Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

Does anyone have a good link how other countries handle the LT care thing?

I heard a great question the other day- If we are so afraid of rationing health care as we age, how come all the other countries with socialized systems have a longer life expectancy than we do? Now that would be an interesting question to hear the answer to. Is is because their populations are more homogeneous or because their care is different?

It's because in those countries, there's not a McDonald's on every corner, and if they do want to go to McDonald's, it probably involves walking more than the 20 steps required to get to their garage and then from the parking space to the restaurant. People in countries with socialized medicine may be just as fat as Americans (don't know the stats, but I really doubt it), but even if they are, they still get way more exercise just going about their daily lives. Fat + Exercise is still better than Fat + Lazy.
 
Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

I have a lot of problems with an inheritance tax.

I think we each have a right, and perhaps an obligation to ourselves, to earn and save as much as possible for the time when we can no longer work. If we've saved extra, or fortunately avoided any big medical expenses or long-term care issues late in life, then we should be free to do what we want with the money without government taking a big chunk of it.

I'm just not in favor of the government stepping in and paying those costs if I have a bunch of money already set aside, just because I would prefer to give it to my kids.

If you've exhausted your assets, or had none to begin with, fine. Then the government safety net should kick in. But it should be the bare minimum, and not enough of a net to provide incentive not to save.
So if you don't get sick... keep your money. If you do get sick... say goodbye to your money. Does that pretty much sum up how you feel? If yes, then would you also agree that a cash only system would align with your views and also be extrodinarily less expensive?
 
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