Patterico's Pontifications

2/10/2010

The Health Care Summit

Filed under: Health Care,Obama,Politics — DRJ @ 7:20 pm



[Guest post by DRJ]

In the interest of transparency, President Obama has invited Democratic and Republican Congressional leaders to attend a bipartisan televised half-day health care summit on February 25. The parties disagree on the agenda for the summit — Republicans want to start over while Obama and Democratic leaders want to tinker with the existing legislation.

Hugh Hewitt suggests three areas Republicans attending the summit should focus on:

  • Tort reform.
  • Interstate health care policies.
  • Economic vitality without massive debt: “Therefore we will use our last presentation to acquaint you and your colleagues with the details of Congressman Paul Ryan’s “Roadmap,” which we believe could be enacted in parallel with comprehensive health care reform thus setting our domestic policy house in order.”
  • These are good ideas, but I’d like to see something more comprehensive — like the 8-point proposal offered by Whole Foods’ CEO John Mackey last August. Mackey’s list includes the first two on Hewitt’s list and six more that I think are worthy of discussion:

    1. “Remove the legal obstacles that slow the creation of high-deductible health insurance plans and health savings accounts (HSAs). The combination of high-deductible health insurance and HSAs is one solution that could solve many of our health-care problems.”

    2. “Equalize the tax laws so that employer-provided health insurance and individually owned health insurance have the same tax benefits. Now employer health insurance benefits are fully tax deductible, but individual health insurance is not. This is unfair.”

    3. “Repeal all state laws which prevent insurance companies from competing across state lines. We should all have the legal right to purchase health insurance from any insurance company in any state and we should be able use that insurance wherever we live. Health insurance should be portable.”

    4. “Repeal government mandates regarding what insurance companies must cover. These mandates have increased the cost of health insurance by billions of dollars. What is insured and what is not insured should be determined by individual customer preferences and not through special-interest lobbying.”

    5. “Enact tort reform to end the ruinous lawsuits that force doctors to pay insurance costs of hundreds of thousands of dollars per year. These costs are passed back to us through much higher prices for health care.”

    6. “Make costs transparent so that consumers understand what health-care treatments cost. How many people know the total cost of their last doctor’s visit and how that total breaks down? What other goods or services do we buy without knowing how much they will cost us?”

    7. “Enact Medicare reform. We need to face up to the actuarial fact that Medicare is heading towards bankruptcy and enact reforms that create greater patient empowerment, choice and responsibility.”

    8. “Finally, revise tax forms to make it easier for individuals to make a voluntary, tax-deductible donation to help the millions of people who have no insurance and aren’t covered by Medicare, Medicaid or the State Children’s Health Insurance Program.”

    There are several benefits to Mackey’s proposal. It speaks to most of the problems people have with existing health care policies and addresses the uninsured. It includes a way to achieve transparency not only in how our leaders talk about health care but also in the information patients get about their health care costs.

    In addition, it can be enacted in stages and deals with both current and future problems, especially Medicare. Medicare is already paying out more than it collects and will be “officially” bankrupt by 2017 at the latest. Dealing with Medicare is important from a financial standpoint but it also gives Republicans a way to be proactive rather than reactive, and thereby counter Democratic claims that it is the Party of No.

    — DRJ

    69 Responses to “The Health Care Summit”

    1. Those 8 pts are a road to disaster and are tacitly creating a federal standards board and federal health department that will eliminate state and local health departments

      Tort reform and malpractice insurance reform along with protection to pharm companies is all that is needed

      John MacKay has a failing company that does not provide health benefits to most of its workers as they are mainly part time or contract.

      EricPWJohnson (45e7d9)

    2. #4 is the most important. It is the mandates that force policies to cover politically connected treatment methods. There should be insurance products that allow the doctor to charge more than the insurance payment for example. That would restore the market and prevent the dropping out of primary care docs that is gathering speed. You might be interested in the consequences of the “new ethics”, for example.

      Here is more on the new ethics. It’s called “parsimonious care.” Social Justice, don’t you know.

      Mike K (2cf494)

    3. Good post, except for the first five words.

      Brother Bradley J. Fikes, C.O.R. (9eb641)

    4. By electing to focus on insurance Obama chose an easy target, but not one likely to result in significant reductions in costs since it is priced off the estimated cost of providing care. Eliminating mandates, making them optional, and providing pricing transparency and giving consumers the choice of high deductible policies instead of one size fits all under ObamaCare is great, but it does nothing to address the underlying cost of delivering medical care in this country. Obama fundamentally picked the wrong target.

      daleyrocks (718861)

    5. Begin by having the Federal government pay the employer share of the COBRA health care benefits of those who become unemployed, so that the unemployed only have to continue paying the share they paid while they were employed. Extend COBRA to 18 months past the end of unemployment benefits, rather than 18 months past the end of employment. Allow states to pay some or all of the former employee’s share of that cost.

      htom (80c7d9)

    6. The “summit” is a trap. Nancy Pelosi’s minions are talking about how they’ll ram the current bill through, passing the senate version in the house and using reconciliation in the senate…

      sam (5ef311)

    7. Good 8-point proposal. The key is removing the government from the health care market. This will be difficult, if not impossible, because politicians never give up control over monied interests without being forced to.

      Will the Dems go for it? I think Obama is a true believer, so I don’t think so.

      Patricia (e1047e)

    8. Tort reform is certainly something which should be done, but I haven’t seen any solid studies suggesting that it’s a prime driver of high costs. Louisiana has pretty strong tort-reform laws (cap on all damages other than past and future medical expenses at $500,000 and procedural hurdles to get through before you can file suit), and we still have plenty of folks without insurance and our healthcare costs are not noticeably lower than any other state’s.

      PatHMV (003aa1)

    9. “Tort reform is certainly something which should be done, but I haven’t seen any solid studies suggesting that it’s a prime driver of high costs.”

      PatHMV – I believe the CBO estimated that a mild form of tort reform would save $54 billion over 10 years last year.

      daleyrocks (718861)

    10. Why would the R’s participate in a summit designed to foist this travesty on all of us?

      JD (b78ff7)

    11. Nothing would stop the 2010 Democrat Bloodbath faster than the GOP compromising on any kind of healthcare reform that Pelosi, Reid, and Obama will approve of.

      They would just poison pill all the conservative parts (to be killed in court) anyway.

      Too many bad faith attempts. It’s time to wait for the voters to have their say. Reform can wait.

      Dustin (b54cdc)

    12. I like Mackey’s list, with the exception of the eighth point. There’s no need to have government involvement with charity efforts.

      His list doesn’t address, however, the availability problem for high-risk individuals with pre-existing conditions, and in particular the disparity between the very broad protections federal law now provides for those group insurance members who get their insurance through large employers and those who have lost, or never had the opportunity to obtain, that same sort of coverage. The disparity is an artifact of the historic tax deductability of employer-provided coverage — which is to say, it’s a problem that government created, and that now, as a practical matter, probably can’t be solved without further government involvement. Simply mandating coverage — forbidding denials on the basis of preexisting coverage — would also cause huge cost increases unless it’s coupled with a mandate that forces more young and healthy consumers into the risk pool, though, and there’s the rub. There’s the same problem with eliminating lifetime caps as a result of government mandate — another idea that attracts broad bipartisan support, but that can only make economic sense (even outside a single-payer system) if you find a way to effectively compel more healthy people to subsidize the few biggest cash sinks.

      The resultant cost problems from such mandates is the main reason why one can’t just take the quote-unquote “good parts” of the Dems’ various plans, on which there is now considerable bipartisan agreement, and implement them by themselves. Mackey’s plan, then, won’t satisfy even the so-called moderate Dems, or the most liberal Republicans.

      And being merely “good” — but less than “perfect” — Mackey’s suggestions are unlikely to actually be enacted, I’m sad to predict.

      The New Yorker ran an interesting profile of Mackey in January, who is as unconventional a hippie as he is an unconventional CEO, in January. Among the topics covered was the backlash from the Hard Left against him and Whole Foods as a result of his WSJ article.

      Beldar (119f1b)

    13. I’d also like changes to deal with people who have pre-existing conditions.

      DRJ (84a0c3)

    14. Pre existing conditions are the big wide ever changing standard in the insurance industry

      Making health care more affordable by tax incentives for medical companies and the entire industry could be a start.

      Strengthening the standards for medical practioners is also something that needs to be addressed

      People must make changes to their lifestyles rather than expect others – which is what existing conditions really is – adding in 0existing conditions is making 1000 people pay for one.

      This is unamerican to ask an insurer to assume the risk whern there isnt any – the risk as become a reality.

      If we give in on existing conditions then we are using the insurance companies as a form of welfare safety net

      EricPWJohnson (fef99c)

    15. Soory all the keys on my keyboard are acting up again.

      But in short asking or “telling” the insurers to except existing conditions is the same as enacting govt health care, its by one fiat or another.

      Let the insurance industry manage their industry and the government should go back to licensing and monitioring and setting standards for the profession, not regulating, price fixing and restraining trade.

      EricPWJohnson (fef99c)

    16. The only thing I want to see concerning people with pre-existing conditions is a waiting time. “You just passed a kidney stone? You’ll have to be a paying member of the plan for 12-24 months before we pay for any kidney-related health issue.”

      Heh, qualifier already. Full portability is necessary. Change jobs? Keep your health plan. Move across the country? Keep your health plan. But this runs up against the “buy in bulk” health plans corporations provide their worker bees, which is a benefit I’m not sure how to work around.

      I’d much rather have the system in place prior to the business fix of the FDR anti-constitutional wage controls, but that’s never going to happen.

      Oh, and EPWJ is much more readily showing his true colors now by rejecting a portion of the Constitution (interstate commerce).

      John Hitchcock (b67c24)

    17. My 9:14 referenced EPWJ’s 7:23 in passing.

      John Hitchcock (b67c24)

    18. People must make changes to their lifestyles rather than expect others – which is what existing conditions really is – adding in 0existing conditions is making 1000 people pay for one.

      One solution is to allow Insurance companies to charge higher premiums for many (if not all) pre-existing conditions.

      Also, your “People must make” sounds suspiciously like “you will do as you’re told”, which only makes me light up another cigarette.

      Scott Jacobs (d027b8)

    19. Also, I would add a #9…

      9) Untie Insurance Coverage from Employment.

      If I want insurance, I shouldn’t be required to get the plan that the company thinks is best. I should be able to get my own. If we shift the tax-break away from companies and to the individual, we fix that issue. then all we need is the ability to buy across state lines, and we have a reasonable facsimile of car insurance…

      Scott Jacobs (d027b8)

    20. John

      again you are showing your inability to make informed or even intelligent comments.
      You expect a company to be told who it can insure for how much and what they must pay and then somehow expect that company to turn a profit.

      Hmmmm. Compare telling insuance companies how they run their business is any different from the reality of government run healthcare?

      Let the market bear the cost – if people are obese, inactive, smoking, thats their choice.

      If you dont like your insurer – switch – buy supplemental insurance – if you feel you are paying too much or cant afford it – you have to mke decisions

      Asking government – which means you are asking me – to pay for it through “regulations” is not much difference and will erode the quality of healthcare for all

      Life in the United States is not a right. Your quality of life depends upon you and no one else.

      EricPWJohnson (fef99c)

    21. daleyrocks… According to this source, total healthcare spending in 2007 was $2.241 trillion. That’s $2,241 billion. Your CBO cite is about $5.4 billion per year. That’s about 0.24% of total annual healthcare spending in 2007. Hence, not a terribly significant chunk.

      PatHMV (003aa1)

    22. Thanks a lot, Scott. You just made me light up another “cigar” (really it’s a cigarette that avoids cigarette taxes ($1.39 a pack as opposed to $4.75 a pack)) right after finishing my last “cigar.”

      John Hitchcock (b67c24)

    23. The difference between a single payer plan and single government regulation of private companies lies more in semantics than in physical reality.

      When people “start” demanding companies do things where is the water edge? When oil gets to 200 dollars a barrel are more “demands” going to be made?

      After all these reforms seem to all be pocket driven rather than ideologically driven. This is not “give me liberty or give me death” – its give me “subsidised crappy healthcare because of a lack of personal responsibility”. The first slogan looks good on flags and banners the second one is not so inspiring

      EricPWJohnson (fef99c)

    24. No, EPWJ, you’re playing with red herrings and straw men and all sorts of other stuff. In other words, you made false accusations about what I said and twisted your false accusations into all sorts of loops in order for you to fry your fish over a fire of straw.

      John Hitchcock (b67c24)

    25. John

      I think you have the right to smoke to drink to use your body as a chemical amusement park if you wish.

      Asking me to pay for it is another issue.

      EricPWJohnson (fef99c)

    26. Section 8 – Powers of Congress

      The Congress shall have Power…
      To regulate Commerce with foreign Nations, and among the several States, and with the Indian Tribes

      It is very clear that the current situation where all the different states have their own regulations on health insurance and no cross-border purchasing is permitted is in violation of the Constitution.

      John Hitchcock (b67c24)

    27. ““Therefore we will use our last presentation to acquaint you and your colleagues with the details of Congressman Paul Ryan’s “Roadmap,” which we believe could be enacted in parallel with comprehensive health care reform thus setting our domestic policy house in order.””

      Oh I think they should have a whole separate thing just to talk all about Ryan’s ideas and get the whole rest of the GOP on the record of those ideas.

      imdw (de7003)

    28. And you’re still playing with straw men, EPWJ.

      John Hitchcock (b67c24)

    29. “PatHMV – I believe the CBO estimated that a mild form of tort reform would save $54 billion over 10 years last year.”

      Obama pointed to a number like this during his chat with the house GOP. But at this stage of the game, what is more important than what this saves is how many votes it gets.

      “Heh, qualifier already. Full portability is necessary. Change jobs? Keep your health plan. Move across the country? Keep your health plan. But this runs up against the “buy in bulk” health plans corporations provide their worker bees, which is a benefit I’m not sure how to work around.”

      The idea of having a national exchange is aimed at getting portability across locations and employers — moving us away from the employer-connected insurance system.

      imdw (de7003)

    30. “It is very clear that the current situation where all the different states have their own regulations on health insurance and no cross-border purchasing is permitted is in violation of the Constitution.”

      You need to read about the dormant commerce clause. It’s the conclusion you think you’re reaching, but you’ll find out it doesn’t quite work here.

      imdw (50eb29)

    31. imdw… the FAR easier method of doing so would be to equalize the tax treatment, so that health insurance is deductible from your taxes whether your employer pays for it or you do so yourself.

      Note, folks, that imdw’s comment bolsters my point about tort reform. While the Dems resist it because of their trial lawyer friends, they can afford to provide some mild form of it in a bill to buy off a few more votes. We can’t let anybody think that including tort reform will make their terrible plan in any way “bipartisan”. Any change in the bill in this regard is fundamentally an insignificant change. It’s not worth the energy of fighting for it at this point.

      PatHMV (003aa1)

    32. Re: pre-existing conditions.

      I assume it’s true there are far more people with pre-existing conditions that are at least partially caused by their choices, i.e., people who choose to smoke, overeat, not exercise, etc. However, some people are born with medical conditions or develop them at a young age (like juvenile diabetes) and they may never be able to buy health insurance. Those are the ones I think need options — perhaps something like the high-risk drivers’ pool in auto insurance?

      DRJ (84a0c3)

    33. I would say that the President has painted the GOP into a corner.

      Except for a few small points:

      Obama’s credibility may not be waning, but it is waving good-bye with a small handkerchief.

      If Pelosi actually tries what her minions have floated for polling purposes, the Democrats may not be toast in 2010, but they will be in 2012.

      And finally, I’ll go along with the notion that health-care should be reformed but, if it is, the public wants a full accounting of the pros and cons, regardless of the party.

      Everyone knows that the billions and billions spent on TARP and stimulus have been “good” money thrown after bad. And now we’re expected to sit gamely why a whole another government program is going solve not only health care, but the deficit?

      Keynes may have had good ideas, but I don’t think he ever thought in trillions

      Ag80 (f67beb)

    34. “imdw… the FAR easier method of doing so would be to equalize the tax treatment, so that health insurance is deductible from your taxes whether your employer pays for it or you do so yourself.”

      That only applies to people who take deductions, or who would benefit from them. Also it removes the group buying power that employer plans provide, and throws individuals into a market without the sophistication that employers bring to it.

      “We can’t let anybody think that including tort reform will make their terrible plan in any way “bipartisan”. Any change in the bill in this regard is fundamentally an insignificant change. It’s not worth the energy of fighting for it at this point.”

      I think this may just be the result of the summit. That the GOP is not interested in working together, just in throwing their own incomplete ideas. That rather than coming to a compromise with ideas that have already passed both houses, some of which have even gotten GOP votes in the past.

      imdw (688568)

    35. Ag80, Keynes never had a bad idea he didn’t espouse. Hayek was right.

      John Hitchcock (b67c24)

    36. DRJ

      Some people are born poor as well.

      EricPWJohnson (fef99c)

    37. Re Tort Reform and Obama/Reid/Pelosi Care:

      I am somewhat dense around the edges, so please bear with me. I am thinking most, if not all, med mal cases are filed in state courts. If that is correct, would it not also be necessary that federal legislation require all med mal cases to be filed in federal court so such cases have federal caps and rules?

      (ducks and covers)

      cave1616 (710dbc)

    38. DRJ, your “born with” example could be worked around, but the individual would be “stuck” with that plan or that portion of that plan.

      Just as your newborn child instantly becomes part of your insurance plan, so that child instantly has no pre-existing conditions.

      John Hitchcock (b67c24)

    39. DRJ

      And the high risk drivers pool is exactly what wrong with America – driving is a priviledge not a right. Making insurance cover people that are high risk is wrong.

      If someone is a high risk then dont let them drive. Its a simple thing, no one does the simple things anymore.

      EricPWJohnson (fef99c)

    40. PatHMV – My $54 billion recollection from the CBO was correct, but what it represented was the impact on the federal budget deficit over the 10 year period. They estimated that the reforms would reduce health care spending overall by $11 billion (0.5%) in 2009 if they had been enacted.
      http://www.cbo.gov/ftpdocs/106xx/doc10641/10-09-Tort_Reform.pdf

      I was merely reporting what I recalled, not suggesting tort reform is a panacea, but given the lack of other cost saving measures in ObamaCare, doctor flight in some states, increases in costs due to defensive medicine, it’s certainly worth trying IMHO.

      daleyrocks (718861)

    41. I wouldn’t believe so, cave, but I’m not one of the JurisDoctors around here (and I prolly bungled that term all to sheol). Capping award amounts and attorney takes, in my mind, would not supercede state civil courts. With an exception where the state civil courts run contrary with the interstate commerce clause of the Constitution.

      John Hitchcock (b67c24)

    42. then screw you and pass it all on your own….

      reap the whirlwind, fool.

      redc1c4 (fb8750)

    43. sorry: #42 goes to #34

      redc1c4 (fb8750)

    44. On reading that, I definitely was not in any way clear. Putting those caps in place would not pull the cases out of state courts but would only limit the jackpots the state courts could award to the victim and the ambulance chaser.

      John Hitchcock (b67c24)

    45. “That only applies to people who take deductions, or who would benefit from them. Also it removes the group buying power that employer plans provide, and throws individuals into a market without the sophistication that employers bring to it.”

      omdw – These are not insurmountable issues. The tax code can be easily adjusted. If there is indeed competition, individuals should not be overly disadvantaged in the market. Ryan’s plan is intended to promote competition as opposed to the one size fits all, minimum allowable loss ratio ObamaCare version, which provides no basis or incentives for competition.

      daleyrocks (718861)

    46. John

      They did it quite successfully in Texas and doctors and clinics of the highest caliber have flooded the state.

      And Lawyers have fled the state

      EricPWJohnson (fef99c)

    47. Sorry to hit and run, but I have more digging to do in the morning if I want to go to work tomorrow afternoon for the first day this week, so it’s time for me to hit the sack.

      John Hitchcock (b67c24)

    48. “That the GOP is not interested in working together, just in throwing their own incomplete ideas.”

      imdw – NO. REALLY? Do you mean after being mocked and demonized by the President last year and being shut out of the closed door negotiating sessions on the bills which passed both houses, you suspect they are gun shy about what this opportunity being suddenly offered by Obama is about? So you think there is a lack of sincerity on Obama’s part since Republican ideas were not given any credence last year? Why would they be given any weight now? I suspect pure political theater on his part, myself.

      daleyrocks (718861)

    49. Daley

      It used to be that insurance even back to the 80’s was for catastrophic and long term illnessess. When we started the HMO’s which were mandated, then people took kids to the doctors for thousands of visits because to them they were free.

      When people actually have to pay 100 bucks to see a doctor Whola! doctors can give more quality care to actually sick people than nursemade sprained ankles, booboos, diaper rash, stomach flu ad naseum

      Regulating the insurance companies and the problems in the stock market have “caused” this healthcare crisis – believe it or not the insurance companies dont have to give health insurance and they will stop if they cant make a profit

      Then no one will have anything

      Ask Pennsylvania – you cant find a doctor within a month with an appt – didnt work out to well there and its never recovered from those idiots in the early 90’s

      EricPWJohnson (fef99c)

    50. EricPW – Believe it or not, I’m familiar with how insurance companies operate and are regulated.

      daleyrocks (718861)

    51. Eric:

      If someone is a high risk then dont let them drive. Its a simple thing, no one does the simple things anymore.

      So, using this analogy, you’re saying people born with serious medical conditions should not be able to buy health insurance, right? Or are you saying they should not even get emergency health care?

      DRJ (84a0c3)

    52. DRJ – My interpretation was that EricPW was saying it was wrong for states to force insurers to cover high risk motorists as a condition of doing business in their state.

      daleyrocks (718861)

    53. Drj

      correct, thats correct – its not health insurance its charity – sick people need to pay for their bills –

      If I went into State Farm and told them I plan to load up my van with other people’s kids and rocket down the highway and roll it – oh btw sign me up for the maximum here’s my state mandated 1500 dollars for 4 million in insurance – thats what you are advocating

      Tell me how a company can cover a child with childhood diabetes at a profit?

      Oh saying different is daying that health care is a right a mandated right

      EricPWJohnson (fef99c)

    54. DRJ

      I guess ther definition is this – if a child is born with autism – its a preexisting condition – if they are poisoned and lose a kidney – thats covered – because thats an accident. People who are prone to high blood pressure should be covered – people who destroy their kidneys and livers because of drug and alcohol abuse should not be covered.

      cancer should be covered – but only if you got it while you were covered – dont lose your health insurance – moving to another state even under the same plan is forcing those consumers to take on your burden.

      Its not fair – but then so is life – trying to make it fair is going to lower the qualifty of healthcare and actually increase costs because sick people who could be cured are on a slower curve to get timely medical treatment.

      Its heartrendering to say something about sick children – but thats just it – using children causes well meaning americans to be manipulated into a system that is bad for all involved.

      We should be thanking god that the insurance companies havent given up yet

      really they are the only thing seperating us from Englands Health Care system right now.

      EricPWJohnson (fef99c)

    55. It’s entirely possible to be a believer in individual responsibility, and yet an opponent of nanny-state government-imposed healthcare regulations.

      I think it’s terrific, for example, if — in the exercise of competition — a private insurance company decides to offer lower rates to insureds who don’t smoke. I likewise have no problem with an employer-sponsored health plan that decides that its overweight employees don’t qualify for special discounts or have higher co-pays.

      I would oppose, however, a federal law or regulation that requires healthcare companies to charge non-smokers less and smokers more.

      In general, I don’t want the government to be involved in that kind of line-drawing. It’s another attempt at micro-managing private lives, at legislating good values. The argument that “by smoking [or overeating or failing to take your fish oil capsules or eating beef more than twice a month or having parents with a history of hypertension or depression], you’re imposing costs on society” quickly leads to the rest of the camel being entirely in the tent. And then we all wake up miserable, without liberty, but with lots of fleas.

      It’s been past government interference that has divorced market incentives and disincentives from citizens’ private lifestyle decisions. Government has been, in other words, actively promoting irresponsible behavior. That needs to stop. Unfortunately, the Dems would accelerate the trend in that direction — by giving everyone crappy, government-rationed health care — and then they would impose nanny-state coercive regulations on top of that system, giving us the worst of all possible worlds.

      Beldar (119f1b)

    56. You know, Beldar, you have a perfectly decent blog, and you write perfectly decent comments / posts. I do not see why you don’t drop by your own blog more often… :)

      As for this, I don’t see what’s wrong with a two-tier (both public health and private health) system. AFAIK, though, in Malaysia, regulations imposed on insurers are only along the lines of any other financial institutions (i.e. no real mandated cover for this that and the other thing). Competition usually forces them to offer pretty similar coverage anyway.

      Oh, and unless you work for a company with a Cadillac health care plan? No such thing as outpatient/routine clinic coverage.

      Gregory (f7735e)

    57. Beldar

      Yes in a risk pool – genetics may play a factor. Life is unfair and unjust. Insurance companies are not denying people based upon genetics but upon medical history.

      Even if that changes it doesnt change the problems we have even conservatives now “feeling” that government is there to give them some health care. when we rid ourselves of this notion completely and without emotion we are actually in the short run helping those who are TRUELY sick. Insurance companies are besieged with people using health care as nanny care. Instead of taking care of a child with a cold they take the child to the doctor to run up the total health care costs and lower the amount of pool money that is truely needed for the very sick.

      going back – allowing insurance companies to offer reasonable premiums that have higher say 5000 dollar deductables will not only make insurance companies have more funds for those 1/2% who need extreme medical care but those people will get it faster

      When we waffle – as you finally did – even an inch that vibration sends shock waves through a companies financial statements.

      Like I said we’d have better start listening to who really runs healthcare in America – the insurance companies or – as the dinosaurs – they will go into other business that they can make a profit at.

      EricPWJohnson (fef99c)

    58. As dinosaurs are now making software, running amusement parks….

      okay lame attempt at humor…

      EricPWJohnson (fef99c)

    59. I agree with most of that but not the fuzzy appeal to tort reform.

      This issue is like the global warming of the right, with some dismay I usually find out what most people know about it is wrong.

      SarahW (af7312)

    60. “So you think there is a lack of sincerity on Obama’s part since Republican ideas were not given any credence last year? Why would they be given any weight now? I suspect pure political theater on his part, myself.”

      I think Obama sincerely wants GOP votes for this bill. Max Baucus tried for a long while — bringing us part of the delay we have — with nothing to show for it but a weakened bill. But the problem is, I don’t think the GOP will approach this in a way of trading votes for provisions. As PatHMV seems to agree. They’re just going to make noise about scrapping it, and not use the opportunity to shape this legislation.

      “cancer should be covered – but only if you got it while you were covered – dont lose your health insurance – moving to another state even under the same plan is forcing those consumers to take on your burden.”

      So if you lose your job or want to start a business or the business you’re in fails, you’re fucked? Yeah I think this is going to be a winner.

      [note: released from moderation. –Stashiu]

      imdw (c70387)

    61. People must make changes to their lifestyles rather than expect others – which is what existing conditions really is

      On behalf of all those cancer patients who led perfectly healthy lifestyles but still contracted the nasty disease, may I just tell you in no uncertain terms to please go f-ck yourself. I had a physical three months before my diagnosis, and was rated in the top 10% for my age group, including all of the relevant indicies. Yet I still contracted cancer, despite my previously healthy lifestyle (regular and strenuous exercise, no smoking, moderate drinking, little to no red meats, etc.) – and no one on either side of my family had ever experienced cancer.

      While I’m perfectly willing to pay a much higher rate for insurance (and I have for many years at this point), to deny someone any insurance while still conducting business in a state is not only an unfair business practice, it’s morally repugnant. You sound as if you have no experience in real life, and treat this as just another intellctual exercise.

      Dmac (799abd)

    62. Wonder of wonders, I actually agree with the previous sentiments!

      Dmac (799abd)

    63. (regular and strenuous exercise, no smoking, moderate drinking, little to no red meats, etc.)

      That’ll learn ya’ 😉

      JD (1500d2)

    64. Dmac

      So you think if you have cancer and are ill you can sign on to my heath insurance plan and expect me to pay for it – is that it? Why not come out and just demand the money from everybody?

      Because if you contract cancer while covered you should be covered – if you declined health insurance and got cancer then that was your choice.

      And yes I’m not talking about paying higher rates – read the body of what I said – I am saying that those who abuse the medical system by going to the doctor for minor first aid problems are actually taking away from the pool of insurance money – funds needed to treat the truely ill.

      Like you were, I’d hate to see money for your treatment spent on sniffles and diaper rash

      And that is what is happening

      EricPWJohnson (fef99c)

    65. Dmac

      And I feverently wish you a speedy and full recovery.

      EricPWJohnson (fef99c)

    66. “So you think if you have cancer and are ill you can sign on to my heath insurance plan and expect me to pay for it – is that it? Why not come out and just demand the money from everybody?”

      This is why the pre-existing condition coverage goes along with the mandate — to increase the risk pools.

      imdw (89ba95)

    67. And this will reduce costs … how?

      JD (1500d2)

    68. One of those eight is not like the others…

      3. “Repeal all state laws which prevent insurance companies from competing across state lines. We should all have the legal right to purchase health insurance from any insurance company in any state and we should be able use that insurance wherever we live. Health insurance should be portable.”

      Note that this is to be done by the States, not the federal government. If you want this, really and for true, you can start that with the State you are in working with other States to regularize ways to offer insurance between the States. You don’t need the federal government to actually do this… in fact it can only help to regularize, not force regularization. This is one of those ‘laboratories of liberty’ concepts, and if States like what other States are doing they can do this very strange thing known as ‘cooperate with each other’ to expand good ideas further. Start NOW, don’t make it part of a wish list: do it now.

      I know its difficult to get the notion through that the federal government isn’t all powerful over the States… but it isn’t amongst the many States.

      I have quibbles on the others as well, but 8 is worth noting that if you really, and for true, want to have people covered then charity is the best place to start as it is immediately accountable to donors. It offers far better accountability structures than government or business. I am less worried about subsidizing charities than I am about subsidizing, say, sugar prices. Or milk prices. Reducing the grubby fingers of government on taxing money going to charity is a good thing: it deprives government of income. I like that. A lot.

      How about treating HSA’s like IRA’s: as investment vehicles. Roll-over and taxfree use for medical needs should be touchstones of such accounts, not having them end every year as you are investing in your future health needs. It is an investment, or so we keep hearing again and again.

      Tort reform a must. Start it in your State if the federal government can’t figure it out.

      As for ‘making costs transparent’, that will also become a line item on the bill – what it costs to hand you the ‘transparent’ cost. I love how the cable and phone companies are passing on taxes that way, and transparency will be yet another cost on the system. I love transparency, but be careful what you wish for…you may get it.

      Medicare reform… hmmmm… it will reform it something worse, no doubt. How about scrapping Medicare, Medicaid and the entire HHS dedicated to that, take the amount of funds for all of this, divide by 2, hand that as block grants to the States apportioned by population and cut the budget with the other half? Let the States figure it out as the federal government has done a Charlie-Foxtrot on costs, accountability and ability to know what its doing. Considering how much is eaten up by bureaucracy, you will actually provide more funds directly to those who need it this way.

      Repeal mandates… hmmm… get the federal government out of it and you are left with State governments. Lobby locally thereafter.

      Yes I am a retired federal bureaucrat.

      If you don’t know how much of your money is wasted in overhead, then you really have no idea of how bad the government really is in using tax dollars. When I say half… in block grants, I mean it. You actually will be increasing deliverable cash via block grants if you get rid of the federal overhead. This is no joke.

      The States and local government can do this better than the federal government… and you can hold them accountable far better, too, just the way it should be.

      ajacksonian (87eccd)

    69. “How many people know the total cost of their last doctor’s visit and how that total breaks down? What other goods or services do we buy without knowing how much they will cost us?”

      Exactly! This video asks the same question in an amusing but pointed way:

      http://www.whatstherealcost.org/45secondstoshare

      ChristineWithRegence (e0f1d6)


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