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Topic: Healthcare Debate (was: Quesada apologizes) (Topic Closed Topic Closed) Post ReplyPost New Topic
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Matthew McCallum
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Posted: 26 March 2010 at 4:11pm | IP Logged | 1  

I get the slippery slope angle you're concerned about, but nothing else falls into the specific critera that Health Care does.

Flood insurance.

In 1968 Congress passed the National Flood Insurance Act. The desire was to protect people from catastrophic losses with low-cost flood insurance, at a more reasonable rate compared to what could be bought from the private insurers. In short order, the private insurers could not compete with the low pricing offered by the deep-pocketed Feds and they abandoned the market.

Only two problems: First, the low price on flood insurance made it less risky for municipalities to permit home developers to build into the flood plains and next to aging levees, creating a lot more at-risk flood exposure properties. Next, the low price of flood insurance premiums doesn't begin to cover the losses incurred annually by the Federal program. And despite a constant stream of threatening advertisements to increase the customer base -- "You can be affected by a flood even if you don't live near the water!" -- NFIP remains an upside down program.

In short, our tax dollars essentially subsidize municipalities, developers and home buyers to incur greater flood risk without "paying their fair share" to offset that risk. We are enabling people to be victims of floods.

Not a slippery slope, per se, but I believe a foreshadow of the public option when it emerges in time.

A thought regarding doctor fees. I don't know if you read through the Senate Bill, Mike, but I slogged through it. You may not be aware that $300 billion of the $500 billion in proposed Medicare savings is going to be realized by reductions in fees-for-service paid to doctors seeing Medicare patients. That's not a strawman argument. That's a very real paycut which is now the law of the land.

Medicare fees-for-service are already substantially low, and the cost-benefit analysis for seeing Medicare patients is pretty grim, not only because of the low fees, but for the pain, hassle and slowness of reimbursement by the government. Even with the Health Worker Corps component of the legislation to help meet the demand, it may be increasingly difficult for Medicare patients to find a doctor willing to take them for so little return.



Edited by Matthew McCallum on 26 March 2010 at 4:14pm
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Mike O'Brien
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Posted: 26 March 2010 at 4:24pm | IP Logged | 2  

I've skimmed rather than slough my way through the bill, Matthew - and my understanding is that the Medicare fix was that the Medicare Advantage program - where we let the free market into the Medicare system - is currently being overpaid, and that would end. Perhaps a better system needs to be put in in it's place, but surely, it's better to not waste tax money throwing it at insurance companies over-charging the government?
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Matthew McCallum
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Posted: 26 March 2010 at 4:30pm | IP Logged | 3  

Read that section, Mike. When you skim you miss all the good stuff!

Edited to add: I'm at the office -- taking a Bikeway Plan break -- and I don't have my PDF copy of the bill here, otherwise I'd give you the section. Quick rule of thumb from memory is about $75 billion from better drug pricing, roughly $110 billion less to hospitals, and around $300 billion from efficiencies and payment reductions.

Keep in mind that the 1997 balanced budget law set Medicare reimbursements to physicians so low that they did not cover costs for providing services. Congress has routinely blocked these full cuts from taking effect in the past. It is the enaction of these cuts that are anticipated to account for much of the cost savings to be realized in the Health Care Act.

It remains to be seen if Congress will continue to look out for the doctor fees -- at the risk of Health Care costing too much in the long run -- or if they will allow the reimbursement levels for Medicare patient services to dramatically drop.



Edited by Matthew McCallum on 26 March 2010 at 4:52pm
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Mike Benson
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Posted: 26 March 2010 at 5:02pm | IP Logged | 4  

 we have programs to deal with those who can't scrape together the change to get the cheapest fool - government programs like food stamps or welfare, or local charities like food banks or soup kitchens.

*****

Many similar programs exist for those who cannot afford healthcare. 

 

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Mike O'Brien
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Posted: 26 March 2010 at 5:06pm | IP Logged | 5  

Yes, there are free clinics in some communities, and there was "socialized medicine" already in terms of Medicaid for the poor, but in the end, too many people were still going without because of a payment system that wasn't working.

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Marc M. Woolman
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Posted: 26 March 2010 at 5:06pm | IP Logged | 6  

Some of you Americans are so funny to me. You believe you have a right given to you personally from God to carry guns, but you don't believe that EVERYONE has a right to free, Universal Health care.

A purely capitalist systems favours the wealthy and basically royalty, and last time I checked the overwhelming majority of people don't fall into that category. A mixed economic that system recognizes that some things are are a right and a necessity for all citizens, such as police services, Fire department services, Libraries and basic education; also places Health care in that category. Access to health care regardless of your ability to pay, or the condition of your health, is a basic human right of every person through out the world, and it's a shame some Americans don't see it that way.

I can go anywhere in my country, see any doctor I want, receive necessary health care,and it won't cost me one penny. I won't have to worry about any "pre-existing conditions" whether or not I have a job, and there will be no reason at all that will disqualify me from receiving care. (The word "pre-existing condition" isn't even a part of our medical vocabulary) 
There won't be any deductibles, or co-pays, or a reason for me to bring my wallet. I just need my Government issued health card, and why would any American citizen not want to have that same right?
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Mike O'Brien
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Posted: 26 March 2010 at 5:09pm | IP Logged | 7  

Because we don't like poor people Marc?

To be fair, the reason I hear a lot is that it gives us something to strive for - makes us work harder. But it lacks empathy - just because you can do something doesn't mean that everyone can.

I kind of wish these social darwinists would go find an island somewhere and fight it out to the bitter end and leave the rest of us alone.

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Mike Benson
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Posted: 26 March 2010 at 5:24pm | IP Logged | 8  

Smug Canadians! 

Insert winkie emoticon here. 

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Marc M. Woolman
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Posted: 26 March 2010 at 5:24pm | IP Logged | 9  

The nearest I can tell is that some Americans have the attitude that they don't trust the Government and that anything the Government does a private business could do better. They think this yet have no problem with the U.S. government providing their military services, their law enforcement services, their educational services, etc. etc.

Governments, because of the power of the vote, serve the people. Businesses serve their owners and the bottom line.

(I'm not trying to come across as smug,<I know that was a joke>  but I do get worked up when I think about what Americans have to put up with because of the way their health care system "works".)



Edited by Marc M. Woolman on 26 March 2010 at 5:36pm
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Mike Benson
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Posted: 26 March 2010 at 5:31pm | IP Logged | 10  

Yes, there are free clinics in some communities, and there was "socialized medicine" already in terms of Medicaid for the poor, but in the end, too many people were still going without because of a payment system that wasn't working.

****

Mike, I could list 30 or more programs off the top of my head, including private foundations and drug company initiatives that provide medications free of charge, or at a reduced price, to those that cannot afford them.   As you may have figured out, I am employed in the industry.  So I'm not stating this to impress anyone with my knowledge, such as it is. 

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Mike Benson
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Posted: 26 March 2010 at 5:33pm | IP Logged | 11  

 and that anything the Government does a private business could do better.

****

Unfortunately though, this is the case more times than not. 

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Mike O'Brien
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Posted: 26 March 2010 at 5:35pm | IP Logged | 12  

Mike, as noted in this thread, I am also employed in the industry.

If the agencies you mentioned were providing enough care, then we wouldn't be having this debate.

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