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A Reasonable Argument for Health Care as Right and the Health Care Mandate

washunut

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What more facts need be provided? Your thread, "A Short History on Health Care," (see post #11) provides many of the answers you seak. The additional linked articles within the OP discussing issues related to Medicaid/Medicare cost, state budgets where both of these social services/health care programs are concerned, rising health care costs within the private sector and the added cost to the insured that is attributed to emergency room care for those who can't afford health insurance should be all the counter-argument you need.

Nonetheless, my argument isn't merely about cost. It's about fair and equal access to health care. How do you provide health care to all without further infringing on the rights of others? As long as health care is viewed as personal entitlement - something that only those who can afford to obtain it are the only one's who can have it - health care will never be equally accessible or fairly administered. Dr. Johnson, for example, states firmly that only the rich can afford "the best quality health care money can buy" while everyone else is typically left with...whatever's available?

If you are employed by a major corporation, state or federal/civil service, chances are you have decent health care coverage. If you were fortunately enough to retire or are elderly, chances are you're on Medicare or COBRA. If you're poor, you likely receive Medicaid or some form of SSI-suppliment. You'd think that these options would cover all Americans. Unfortunately, there are many who fall through the cracks. What option do they have when they or a loved one gets sick or injured?

The irony here is those who, like myself, are employed and do receive health care coverage via their employer aren't the people I hear complaining the loudest against the health care mandate. It's people who can afford "the best quality health care money can buy", i.e., promiment political figures, some on talk radio, corporate CEOs, renouned figures in entertainment, etc. The health care mandate shouldn't trouble us because we have health care coverage. And should my employer drops health care coverage as an employee benefit in 2014, I can still go to my state's HIE to acquire coverage...assuming my state doesn't opt out. But what if it does? Now, where do I go?

I could pay out of pocket directly doing as CWpill suggests and buy into a health savings account which personally I think is a good idea. But even this doesn't solve the problem for those who are unemployeed or even if they are, such as young adults, whose income may not be enough to allow them to buy into such a health savings plan yet they, too, fall through the cracks. What happens to them? Many now are (or soon will be) allowed to remain on their parent's insurance until age 26. Not a bad compromise. But these are people - college students mainly - who would still be on their parent's nickle anyway because many are still in post-secondary education. Still, raising this age limit was the right thing to do. But what about the others?

What do you do to ensure everyone has access to affordable health care and that such coverage is fair and equal to all? As unfair and unconstitutional as many people believe the health care mandate to be - and to an extent I agree that it shouldn't be the government who makes this decision - until a better way is established to ensure all Americans have fair and equal access to health care, I believe the health care reform law was the best compromise we could hope to achieve...

...until a better way is implimented.

The question becomes, "What way is better?"

(BTW, you're welcome...:) )

It was a lousy compromise. True liberals should probably be more upset with the trash legislation that was passed than conservatives. The reason I say that is when people still find health care unaffordable, and that costs rise even faster than today what is to be done then. Obama and the dems in congress will be preening about passing transitional legislation which they know it is not. Just a couple of examples as it is getting late:

- We have never been given a breakdown of who these 30 million are. We know that some are young workers that do not feel it is worth paying the company charge. The fine of less than $700 is materially less than they would pay for insurance.

- Insurance companies will not be able to refuse people with pre-existing conditions. However this lame congress placed no limit on what a company can charge for this type of policy. So sure if you have a chronic disease theoretically you can get insurance but at what cost.

- If the numbers of uninsured are correct, this would add about 10% more demand for certain services. There is little or no provision to increase the supply of health care providers. So will there really be medical facilities for all these newly insured.

- When Bush put his medicare drug provision in their was rightful howling from the left about not making sure we competed on price. This bill for some reason failed to fix that.

If there was going to be a real health care bill that true progressives want it is a one payer system.

It is sad that progressives have to appaude something they know is junk.
 

cpwill

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Oh for ****'s sake, the founders didn't have any picture at all about health care, because health care in their time is not worthy of the name.

the Founding Fathers certainly would have had little to comment on about radiation treatment for cancer (for example); but they had plenty to comment on about Government.
 

winston53660

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the Founding Fathers certainly would have had little to comment on about radiation treatment for cancer (for example); but they had plenty to comment on about Government.

They might even enact an act “For the Relief of Sick and Disabled Seamen,”

Our Founders realized that a healthy work force was essential to our economic health and growth. It was for this reason that, in July of 1798, Congress passed, and President John Adams signed into law an act “For the Relief of Sick and Disabled Seamen,” establishing the Marine Hospital Service.
This Federal government socialized healthcare insurance was funded by a tax that was withheld from the sailor’s pay, and then turned over to the government by the ship’s owner. This first payroll tax amounted to slightly over 1% of the sailor’s wages. An injured or sick sailor would make a claim, his record of payments would be confirmed, and he would be given a “chit” for admission to the local hospital. Some of these healthcare facilities were private, but in the larger ports Federal maritime hospitals were built.

Our Founding Father's Socialized Healthcare System - Paul J. O'Rourke - Open Salon
 

cpwill

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They might even enact an act “For the Relief of Sick and Disabled Seamen,”

Our Founders realized that a healthy work force was essential to our economic health and growth. It was for this reason that, in July of 1798, Congress passed, and President John Adams signed into law an act “For the Relief of Sick and Disabled Seamen,” establishing the Marine Hospital Service.
This Federal government socialized healthcare insurance was funded by a tax that was withheld from the sailor’s pay, and then turned over to the government by the ship’s owner. This first payroll tax amounted to slightly over 1% of the sailor’s wages. An injured or sick sailor would make a claim, his record of payments would be confirmed, and he would be given a “chit” for admission to the local hospital. Some of these healthcare facilities were private, but in the larger ports Federal maritime hospitals were built.

Our Founding Father's Socialized Healthcare System - Paul J. O'Rourke - Open Salon

:lol:

the founding fathers also had the government provide soldiers rations.

Thomas Jefferson supported nationalizing food like the Soviet Union!!!

:roll:
 

Objective Voice

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Let's forget what the Founding Fathers knew and did not know, did or did not do concerning health care for the time being. I found this white paper entitled, "Covering the Uninsured in the U.S.," by J. Gruber, National Bureau of Economic Research. It's a detailed study of our nation's health care system. I think many people will find it interesting especially those who take offense to their tax dollars/income going to pay the cost of socialized health care or paying for someone else's health care. If more Americans realized how much of their insurance premiums were going towards paying emergency room treatment for the uninsured and recognized the cost affects on the government to subsidize this expense, they'd rethink their position on the insurance mandate.

Read the research paper and draw your own conclusion. All I can say is, "Good luck, GOP, for repealing health care." If you think the current health care reform bill is a costly burdern to taxpayers and businesses large and small, you owe it to yourselves to read this paper white. I'm still reading it, but it's very informative.

From page 15 under "Implicit Insurance through Uncompensated Care:

Even at actuarially fair price, individuals may not be willing to purchase insurance if their medical risks are primarily catastrophic, due to the implicit insurance provided through hospital uncompensated care. Under federal law, any hospital that accepts reimbursement from Medicare must treat individuals who arrive in an emergency state, regardless of their ability to pay. Hospitals can try to collect the costs of such care from uninsured patients, but they can be avoided (in the limit through personal bankruptcy), becoming "uncompensated care" costs to the hospital. Such uncompensated care amounts to roughtly $30 billion for hospitals (in 2005).

There's a lot more to this issue than most people know. Read the paper. Get informed.

From a 2009 Times Magazine article (online):

(As the U.S. Congress debates health-care reform,) American families are already picking up the tab for universal health coverage. That's the finding of a new report released March 24 by the Center for American Progress (CAP), a Washington-based liberal think tank.

It's a long-established practice for medical providers such as hospitals and physicians to charge uninsured patients higher prices than patients with health coverage for the same care. (Insurers can negotiate cheaper prices through contracts and because of volume.) What the new study suggests, though, is that providers often pass along the cost of treating the uninsured to their insured patients. Its analysis found that families pay, on average, as much as $1,100 extra and individuals $410 extra in health-care premiums each year in order to cover the cost of treatment to uninsured patients who cannot afford to pay their bills. That amounts to as much as 8% higher premiums due to the lack of universal health care in the U.S. "So many Americans think that universal coverage is for the uninsured," says Senator Sheldon Whitehouse, a Rhode Island Democrat who has been a vocal advocate of health-care reform. "This is the hidden tax we all pay for our failure to insure all Americans."

Moreover, the new report bases its projections on 2005 census data. That means, amid the current economic downturn, that as the number of uninsured Americans rapidly grows, this so-called hidden tax could be much higher than the findings suggest. In December and January alone, as many as 14,000 people per day lost their insurance coverage, the CAP study shows. A second report, released earlier this month by the nonprofit Families USA, found that about 87 million people — roughly 1 in 3 Americans — went without health insurance for some period between 2007 and 2008. "The huge number of people without health coverage is worse than an epidemic," says Ron Pollack, executive director of Families USA. "Almost everyone in the country has had a family member, neighbor or friend who was uninsured."

Read more: http://www.time.com/time/health/article/0,8599,1887489,00.html#ixzz14M1WN9yM
 
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Objective Voice

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Also, according to a mid-October 2010 poll (which we all know are like a-holes, but...), more Americans want to "fix" the health care bill than repeal it.

A mid-October AP-GfK poll asked respondents what they would prefer Congress to do about the new health care law. Contrary to the conservative story line, 57 percent wanted to either leave the law as is (18 percent) or change it so it does more to change the health care system (39 percent). On the other side, 41 percent wanted the law changed so that it does less to change the health care system (9 percent) or completely repealed (32 percent).

So, again, good luck, GOP! You're gonna need it to repeal the legislation.
 

Marilyn Monroe

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An emotional plea is the proper justification for ensuring everyone has fair and equal access to health care. It's about life and looking out for one another. There's no greater cause than that.

You've got too many lazee's in this country. Medicaid takes care of the truly poor. The rest, I presume, need to work more. I'm not going to feel sorry for somebody who has too many kids. Mostly, people do need to take care of themselves. You start giving to everybody, and pretty soon nobody has anything. I seriously doubt you'd be so willing to give if you yourself were going to lose all the niceties you have because of it.

It's very likely that in 40 years if we go universal health care we'll all lose our high standard of living. This high standard hasn't been around that long. I remember when the middle class was pretty small. I think many people fail to realize this because they've never known it.
 

cpwill

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Also, according to a mid-October 2010 poll (which we all know are like a-holes, but...), more Americans want to "fix" the health care bill than repeal it.

lol, so you add in those who want to drastically change the current health care system (which includes obamacare) with those who want to keep obamacare.


in other news, 100% of americans who voted either voted for Democrats or didn't not vote for someone else :roll:
 

Objective Voice

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You've got too many lazee's in this country. Medicaid takes care of the truly poor. The rest, I presume, need to work more. I'm not going to feel sorry for somebody who has too many kids. Mostly, people do need to take care of themselves. You start giving to everybody, and pretty soon nobody has anything. I seriously doubt you'd be so willing to give if you yourself were going to lose all the niceties you have because of it.

It's very likely that in 40 years if we go universal health care we'll all lose our high standard of living. This high standard hasn't been around that long. I remember when the middle class was pretty small. I think many people fail to realize this because they've never known it.

I don't disagree there there are a lot of lazy people in this country who don't take responsibility for themselves, but you can't lump everyone who doesn't have health care in that same basket. Read the white paper I linked to and then perhaps some of the underlying issues with our nation's health care system and why some peope don't acquire health care will begin to make sense to you. But don't judge based off your own prejudices or pre-conceived notions. If I may say so, from the sound of your post you've only received a small part of the overall picture. Get truly informed and then make an informed decision.

lol, so you add in those who want to drastically change the current health care system (which includes obamacare) with those who want to keep obamacare.

In other news, 100% of americans who voted either voted for Democrats or didn't not vote for someone else :roll:

I fail to see where one's personal voting record had anything to do with the issue at hand. It's about what the GOP says the People want. So, if nearly half of those polled (a representation of how the People think on the matter which is all polling data is) say they'd rather fix the legislation than trash it and start over, then I'd think the GOP needs to do exactly as they say is the primary reason they've been re-elected into power - listen to the American people and just fix those aspects of the health care reform bill that are broken.
 
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Saboteur

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Hey I just want the same healthcare that saved Dick Cheney's life. How many times now? 4? Why should I pay for him and not you too?

Also I agree that healthcare shouldn't be a business, but we shouldn't call it a right either. It just needs to be another government service. By government I mean "We the People". Remember? You and I are the government and our elected officials are our servants right?


Lately it seems to be the other way around and made even worse by that Supremem Court ruling that gave even more power to corporations. What was that Musolini said?
 
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cpwill

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as i recall, it was something about making sure everything was contained within and provided by the State.
 

Objective Voice

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Not everything can be "contained" as you say by the States. In this case, health care issuance can be but like public health guidelines, the fed has to set the standard. Do I believe they overstepped their bounds? With the health care mandate, yes. All else, no.

Could the health care legislation been better? Yes, absolutely! But here again, had more bipartisan support were rendered I believe the People would have been better served. That said, we live in a capitalistic society with some aspects of socialism, but the overriding market system is capitalism. As such, you must view health care first and foremost as a commercial entity because that's what it is! As such, the government has the authority to regulate it up to a point. That point is setting minium fair standards for all the nation's citizens. The mandate...that's a different story. Still, if the People could be convinced that we'd get a better, more cost effective and efficient health care system via the government using the income tax code to finance it, I'd be all for it. But...

That will never happen...not in my lifetime anyway. Nonetheless, for what it's worth I think the best compromise (short of cost containments which I don't think could have been done in a free-market system) was reached. Some may disagree, but once you look beyond "ME, ME, ME" and really study the private health care system and you read the health care bill for yourself, I think most people will agree the Dems came away with a very decent compromise.
 
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cpwill

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Not everything can be "contained" as you say by the States.

the State, not the states; Mussolini was hardly a devolutionist. everything inside the state, nothing outside the state, nothing against the state, was i believe, how it went.

In this case, health care issuance can be but like public health guidelines, the fed has to set the standard. Do I believe they overstepped their bounds? With the health care mandate, yes. All else, no.

Could the health care legislation been better? Yes, absolutely! But here again, had more bipartisan support were rendered I believe the People would have been better served.

:lamo

Republican ideas were publicly asked for and then discarded out of hand. the Democrats had a fillibuster-proof majority, and were uninterested in moderation or bipartisanship. it would have been so easy for them to throw in one or two minor Republican ideas and peel off Olympia Snowe or one or two like-minded Rep's; and they just plain weren't interested. heck, this bill was so horrible, so left wing, such a steaming putrid pile that they had to fight and claw and twist arms and virtually threaten people's lives in order to get Democrats to vote for it.
 

Objective Voice

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cpwill,

I'm curious...did you take time to review any of the other health care proposals prior to what ultimately was passed? Because if you had, you'd know that many of the proposals made by Republicans were, in fact, incorporated in the final health care bill. For instance, increasing the poverty limit on Medicaid, running the health insurance exchanges through the States (yes, plural), enacting high risk pools, and allowing community health co-ops for the self-employed were Republican ideas. So, every time I hear this claim that the Dems didn't try to work w/Republicans I discount that out of hand because most people who make such a claim most likely have NOT reviewed any other proposals but, instead are just reciting false rhetoric.

Now, I won't deny there weren't backdoor deals or that the reconciliation process didn't come across as a "Senate backdoor procedure" just to get the reform bill passed, but it's not like Senate Republicans hadn't used the same procedure themselves to get bills through Congress they wanted when they had the majority. It's the nature of politics. But, Dems did "promised" to conduct themselves in more honorable ways. Still, when Republicans claim cooperation yet still say "NO" even when the Democrats changed many things Republicans didn't like, such as removing the public option from the bill, I can't blame the Democrats for moving forward without them in any way they saw fit that didn't violate Senate rules.

Bottom Line: You can get off that "they didn't cooperate/backdoor politics" kick.

Now, congressional procedures and standard polics aside, have you read the researched paper or ANY of the other linked articles on the subject matter at hand? If not, we really don't have anything more to talk about if all you're going to do is divert from the thread topic.
 
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washunut

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cpwill,

I'm curious...did you take time to review any of the other health care proposals prior to what ultimately was passed? Because if you had, you'd know that many of the proposals made by Republicans were, in fact, incorporated in the final health care bill. For instance, increasing the poverty limit on Medicaid, running the health insurance exchanges through the States (yes, plural), enacting high risk pools, and allowing community health co-ops for the self-employed were Republican ideas. So, every time I hear this claim that the Dems didn't try to work w/Republicans I discount that out of hand because most people who make such a claim most likely have NOT reviewed any other proposals but, instead are just reciting false rhetoric.

Now, I won't deny there weren't backdoor deals or that the reconciliation process didn't come across as a "Senate backdoor procedure" just to get the reform bill passed, but it's not like Senate Republicans hadn't used the same procedure themselves to get bills through Congress they wanted when they had the majority. It's the nature of politics. But, Dems did "promised" to conduct themselves in more honorable ways. Still, when Republicans claim cooperation yet still say "NO" even when the Democrats changed many things Republicans didn't like, such as removing the public option from the bill, I can't blame the Democrats for moving forward without them in any way they saw fit that didn't violate Senate rules.

Bottom Line: You can get off that "they didn't cooperate/backdoor politics" kick.

Now, congressional procedures and standard polics aside, have you read the researched paper or ANY of the other linked articles on the subject matter at hand? If not, we really don't have anything more to talk about if all you're going to do is divert from the thread topic.

If Obama,Pelosi and Reid were honest they would tell you there were no negotiations because they had the votes and did not want to share any of the supposed glory of passing this bill with Republicans. So the democrats were left with the 60 senators needing all of their votes.

One of the more ironic aspects of this lousy legislation. Democrats for years decried the drug for seniors bill passed by republicans. The outrage was that the bill did not allow for the government to negotiate prices with big Pharma. So of course the cry was Bush in bed with big business. Fast forward to this huge Health care overhaul and lo and behold they do not fix this glaring problem. Still can't understand why not. Just as I can't understand why we did not have real HC reform under a single payor system. If the mandates go down in the courts this bill is dead no matter which party is in office.
 

Objective Voice

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I'm inclined to believe there were some aspects of "take the glory for myself" on the part of the Dems and even w/Pres. Obama in passing health care reform legislation, but I'm also of the opinion that there were compromises w/Reps on passing the legislation. As I reminded my spouse and co-workers, the public option was removed, the language to ensure illegal alients was clarified, the non-use of federal funds to pay for abortions was strengthened and broad powers were given to the States to decide for themselves whether to form HIEs under federal guidelines or op-out and form their own state governed HIE.

As I read, study and learn more about our nation's health care system, I'm discovering that there are MANY moving parts: doctors (private clinics), hospitals, pharmasueticals, insurance companies, employers - large, small and self-employed - co-ops, Medicare, VA and Medicaid. There are so many aspects to our nation's health care system it is nearly impossible to wrap your arms around all of it and not negatively impact one or more sides of it while also trying to find the middle-ground to sustain all of it. And clearly, not everyone will be pleased with whatever changes eventually come forth. But here again I say that what eventually was passed was a good compromise. I linked to this article from the NYBook Review in another thread entitled, "Health Care: The Disquieting Truth". In it, the auther confirms your primary complaint, that cost controls were not part of the reforms. But the author goes on to fully explain why that remains a problem. I urge you to read it if you haven't already done so.

From the aforementioned white paper (page 34; see post #30 for link):

Policies designed to reduce the number of uninsured come in four (non mutually-exclusive) varieties: policies that expand entitlement to free (or very low-cost) public insurance; polities that expand access to private pooling mechanisms for purchasing insurance; policies that subsidize the purchase of private insurance; and policies that mandate insurance coverage.

From the standpoint of health care reform legislation trying to broaden the reach of health care coverage, the legislation does cover all four methodologies. However, three things are absolutely clear where current health care reforms are concerned:

1. Employers will not drop insurance coverage for their employees because as the white paper makes clear (and apparently very few people know), most (large) employers receive subsidies for the health insurance they provide.

2. Private hospitals will never stop accepting patients in their emergency room because they don't want to lose their Medicare subsidy (not to mention that a portion of insurance premiums also go towards defraying the cost of "uncompensated care").

3. No public option/federally run health care system will ever be enacted in this country unless the citizery accepts the idea that we're all connected, that the cost of health care will continue to rise because we've never taken a united stance against cost overrides, and we dread the idea of higher taxes for whatever reason! As such, the only way such a socialized health care system can ever come to be is if we allow for an increase in the income tax in order to pay for it.

Item three is the #1 reason why high-end insurance policies, those employers who choose not to provide health care to their employees, as well as those individuals who choose not to obtain health insurance will be "taxed" accordingly. It is the only way to pay for the individual subsidies and administrative cost under the health care reform legislation. Sure, cuts in Medicare/Medicaid need to take place, but commercial/corporate taxation remain the primary means for generating revenue for health care reform legislation.

People complain about the mandate - a decision which I still contend should have been left to the States - but I also understand that without it and the penalty that ensues our private health care system can not hope to begin to contain the overriding cost associated with "unfunded compensatory care", un-standardized health care treatments, or move towards enacting preventative measures to ensure a healthier elderly society unlike what we have now. I work in the public health and read about the mobidity rates of the young and old every day. I also read about how many of our elderly are forced to choose between buying food versus paying for their next round of expensive prescription medications. So, believe me when I say this is a growing problem that affects not only the elderly, but the young and the disabled. But, here again, I'm with you where cost controls were not properly addressed. However, I also better understand the dilemma associated with trying to contain rising health care costs. It is not an easy fix by any stretch of the imagination. Nonetheless, the best first step towards getting there was the "coverage and access" compromise that ultimate came w/passage of the legislation.

Again, read, study, get informed...learn for yourself! Don't depend on political pundits on either side to tell you how the system operates or "what's in it for (or against) you".
 
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FederalRepublic

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I'm inclined to believe there were some aspects of "take the glory for myself" on the part of the Dems and even w/Pres. Obama in passing health care reform legislation, but I'm also of the opinion that there were compromises w/Reps on passing the legislation. As I reminded my spouse and co-workers, the public option was removed, the language to ensure illegal alients was clarified, the non-use of federal funds to pay for abortions was strengthened and broad powers were given to the States to decide for themselves whether to form HIEs under federal guidelines or op-out and form their own state governed HIE.

As I read, study and learn more about our nation's health care system, I'm discovering that there are MANY moving parts: doctors (private clinics), hospitals, pharmasueticals, insurance companies, employers - large, small and self-employed - co-ops, Medicare, VA and Medicaid. There are so many aspects to our nation's health care system it is nearly impossible to wrap your arms around all of it and not negatively impact one or more sides of it while also trying to find the middle-ground to sustain all of it. And clearly, not everyone will be pleased with whatever changes eventually come forth. But here again I say that what eventually was passed was a good compromise. I linked to this article from the NYBook Review in another thread entitled, "Health Care: The Disquieting Truth". In it, the auther confirms your primary complaint, that cost controls were not part of the reforms. But the author goes on to fully explain why that remains a problem. I urge you to read it if you haven't already done so.

From the aforementioned white paper (page 34; see post #30 for link):



From the standpoint of health care reform legislation trying to broaden the reach of health care coverage, the legislation does cover all four methodologies. However, three things are absolutely clear where current health care reforms are concerned:

1. Employers will not drop insurance coverage for their employees because as the white paper makes clear (and apparently very few people know), most (large) employers receive subsidies for the health insurance they provide.

2. Private hospitals will never stop accepting patients in their emergency room because they don't want to lose their Medicare subsidy (not to mention that a portion of insurance premiums also go towards defraying the cost of "uncompensated care").

3. No public option/federally run health care system will ever be enacted in this country unless the citizery accepts the idea that we're all connected, that the cost of health care will continue to rise because we've never taken a united stance against cost overrides, and we dread the idea of higher taxes for whatever reason! As such, the only way such a socialized health care system can ever come to be is if we allow for an increase in the income tax in order to pay for it.

Item three is the #1 reason why high-end insurance policies, those employers who choose not to provide health care to their employees, as well as those individuals who choose not to obtain health insurance will be "taxed" accordingly. It is the only way to pay for the individual subsidies and administrative cost under the health care reform legislation. Sure, cuts in Medicare/Medicaid need to take place, but commercial/corporate taxation remain the primary means for generating revenue for health care reform legislation.

People complain about the mandate - a decision which I still contend should have been left to the States - but I also understand that without it and the penalty that ensues our private health care system can not hope to begin to contain the overriding cost associated with "unfunded compensatory care", un-standardized health care treatments, or move towards enacting preventative measures to ensure a healthier elderly society unlike what we have now. I work in the public health and read about the mobidity rates of the young and old every day. I also read about how many of our elderly are forced to choose between buying food versus paying for their next round of expensive prescription medications. So, believe me when I say this is a growing problem that affects not only the elderly, but the young and the disabled. But, here again, I'm with you where cost controls were not properly addressed. However, I also better understand the dilemma associated with trying to contain rising health care costs. It is not an easy fix by any stretch of the imagination. Nonetheless, the best first step towards getting there was the "coverage and access" compromise that ultimate came w/passage of the legislation.

Again, read, study, get informed...learn for yourself! Don't depend on political pundits on either side to tell you how the system operates or "what's in it for (or against) you".

O.V., take this for what it's worth, but I have a really hard time following you. I'm not sure if you're doing it to be irritating, but I'll tell you it is. Here's how I would summarize your argument, stated the way I hear you say it:

"The mandate went too far and I disagree with it, but it was necessary to reduce the costs of the insurance pools that had to be set up to make sure we all have equal access to affordable health care and not have to worry about un-standardized health care or lack of preventative measures that affects not only the elderly but the young and the disabled but I agree we should have cost controls and we don't necessarily have to do destroy an entire industry to have universal health care if enough of the population went along with it it would be a great thing to have a single-payer health care system funded by taxes because it would be more efficient if a bureaucracy took care of us all and I'd be all for it but that would inflict controls upon the people and that's not what free men desire but the system of government our nation falls under is a representative government that functions not to adhere to the will of the people but to provide for the well-being of the people and it would empower people to improve their own standing while also providing ways inwhich those who cannot reach a level of prosperity for which they can be happy with if they attain that prosperity can be able to pay for their health care provided by commercial industry because the overriding market system is capitalism as such the government has the authority to regulate it up to a point in which the only way to truly provide health care to the nation is with UHC through increasing the income tax responsibility (not burden) so we can all look out for each other equally through shared responsibility but until we realize the awesome responsibility we have to pool our resources with the government no UHC system can exist here so the health care bill recently passed is the best compromise."

Can you make sense out of that?
 

gmeyers1944

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I disagree with you. I think healthcare is expensive because we have low-deductible health insurance. I believe that higher deductibles would drastically and positively effect the cost of treatment. If, for example, every citizen were expected to cover the first thousand dollars of their medical care each year, doctors would not be charging $150 for an office visit. People would not be going to the emergency room for nonemergencies. Health insurance itself is the reason healthcare is so expensive.
Don't forget the threat of law suits. A lot of tests are performed only because of the threat of law suits. That raises the cost of treatment and also the cost of malpractice insurance for doctors.
 

Objective Voice

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FedRep,

Actually, I did. Your purposeful lack of punctuation aside, you hit the argument square on the head.

Health care reform is complicated for one reason and one reason only: Because health care IS a business across multiple platforms. As such, it is extremely difficult to adequately address all aspects of our nation's health care system because of the various moving parts. And because our health, and thus by default our medical history, is very personal to us. WE'VE been "trained" to believe that the only "responsible and legitimate" way to obtain adequate health care is through our employer, but the problem with that is our employer is being heavily subsidized to provide us with health care coverage by the very government we're trying to restrain and limit its reach in this area. The truth of the matter is our (large) employers won't be too quick to relinquish providing health care coverage to their employees as long as any threat to tampering with offsetting subsidies are made "part of the solution". These subsidies offset a large portion of their out-of-pocket expenditures. So, why would they forego that? The same argument could be made concerning the States and their shared responsibility w/the federal government concerning Medicaid.

Let's look at this issue from the perspective of those who actually make a living at it - the doctor's themselves. The following are two linked articles from health care professionals, one on the issue of premium increases and the other on the health care mandate. I provide snipets from both articles below.

The rising cost of health insurance premiums:

As employees participate in open enrollment for their company’s health insurance enrollment next year, it’s clear they should make a point of participating in their employer’s enrollment information meetings, not merely pick last year’s coverage. Partly because of the implementation of President Obama’s health care overhaul plan, U.S. workers are expected to pay average premiums of $2,200 in 2011 – an increase of 12.5 percent, the biggest in four years, according to human resources consulting firm Hewitt Associates.

Increases in health care premiums are certain to continue increasing in coming years at double-digit rates, with inflation further exacerbated by the entry of 32 million uninsured Americans into the healthcare system. This will speed the transformation of insurers from underwriters of medical risk to managers of medical risk, a process inevitably accompanied by higher prices.

Annual healthcare inflation -- and hence baseline premiums -- have been rising 8-12 percent annually for two decades, and there is no reason to expect this to change anytime soon.

Why is there on-going runaway healthcare inflation? Unfortunately, the U.S. healthcare system simply can’t seem to get its act together. One reason is that the U.S. essentially has a fee-for-service healthcare system, which means that doctors and other healthcare providers are compensated based on the number of procedures they do, not on the results of their treatment. This contributes to enormous inefficiencies and mistakes. For example, studies have shown that about one in five medications administered at hospital bedsides are done so in error.

Yet another problem is “moral hazard,” or the concept that people insulated from certain risk behave differently than they would if fully exposed to that risk. Have you ever noticed that people are very hesitant to make claims on their automobile and property insurance? Rarely do the costs of minor fender benders result in an insurance claim. Why? Because people fear that claims on their auto policies, for example, will result in either premium increases or the cancellation of their policies. So they pay the cost of minor accidents out of their own pockets.

This isn’t the case at all in the health insurance world. Americans could take much better care of themselves – they could watch what they eat, think twice about smoking or drinking heavily and make a commitment to exercise more. Too many do not, however, which is why a third of our population is obese. Unlike the case with auto insurance, a very high percentage of healthcare expenses become insurance claims because few people lose their health insurance because of high claims.

Theoretically, employer-based health insurance plans could tackle this problem by simply increasing out-of-pocket co-payments. But this opens the door to two conundrums. One is that higher co-payments would prod some people to forgo necessary treatment at the early stage of a disease, such as diabetes, which is much less expensive to treat in its early stages. The other problem is that higher out-of-pocket expenses tend to push the healthiest people out of the insurance pool, and these people are needed to help lower overall costs.

The health insurance mandate:

Private insurers want Congress to nix that $70 billion tax that will be levied against them beginning in 2014. They’d also like lawmakers to permit them to widen the rating bands which cap the amount of money they can charge older enrollees.

Insurers and providers want Congress to add a tort reform rider to the law, preferably one that protects physicians against malpractice lawsuits if they adhere to best practice guidelines. Drug companies want to kill the proposed Independent Payment Advisory Board, whose job it is supposed to be to control the rate of growth in Medicare spending. The Board’s recommendations would, after all, likely include reduced federal spending on prescription drugs which is very bad for their business.

Yet these same groups are worried sick that Republicans might go too far in their zeal to repeal the deal. The baby in the bathwater for these trade groups is the individual mandate: a provision in the law that requires most Americans to carry health insurance.

Many House Republicans detest the mandate, believing it to be an affront to personal liberties or whatever. Of course when providers and insurers look at it, they see an unprecedented revenue bonanza! So they are busy as bees conjuring up alternatives that appease the Boehners and let them cash-in at the same time.

The alternatives they’ve come up with so far include levying higher rates on people that choose not to purchase insurance in the first years after the law goes into effect, and auto-enrolling folks into coverage subsidy programs for which they are eligible. Those woebegone Dems will remind anybody who cares to listen that they considered automatic enrollment before bagging it on account of implementation difficulties and other snafus, but nobody is listening to them right now anyway.

Meanwhile, the folks who penned the Affordable Care Act in the first place are more worried about misguided Republican smart-bomb attacks on selected portions of the law than they are about a full-on repeal.

Those “smart” bombs could destroy the financial underpinnings of their insurance exchanges, for example.

Worse yet would be a situation in which the Feds are left to enforce provisions requiring insurers to cover folks with pre-existing medical conditions even after a “smart” bomb has destroyed the individual mandate. In this nightmare scenario, insurers including Medicare end up with a very sick customer base and no way to spread the costs.

And these are just two very recent articles (or rather blog entries) written by health professionals themselves on the matter. Interestingly enough, their concerns mirror those outlined in the white paper. Still, a better read on the problems within our nation's health care system can be found here from two promoment doctors at John Hopkins Medical Center.

Miller: We try. We are not always together on all the issues. For example, there is the issue of congressional oversight of Medicare reimbursement rates. Some say we need a body outside congressional control that would report to the president and in turn to the secretary of health and human services. I would say that two-thirds of the group are opposed to the concept. I don’t think it’s a bad idea.

My view is that if we don’t get this thing under control at a certain point, we are really going to get in trouble. Medicare is close to insolvency by 2017 by everyone’s calculations, but I think, more importantly, the health of the economy will be severely damaged. We can’t compete with foreign companies if our health care insurance rates are so high that the employer is paying 40 percent of a worker’s health care costs or, if conversely, we have an uninsured workforce.

Just look at a family; they can’t be paying $30,000 a year for health insurance. They just can’t afford that. Wages have been flat for the past five years. So we have to get this under control, and it’s much better to do it in a thoughtful, proactive way than to come to the proverbial edge of the cliff and then just fall off.

What about the danger in doing nothing?

Peterson: I think there is a great danger in doing nothing. I think you will continue with this unsustainable growth rate in the cost of health care, and that burden cannot continue to be borne by employers, so they will continue to engage in cost shifting. We can’t continue to do that. Second, we see evidence every day in our Emergency Department of the danger of doing nothing. A significant amount of people that we are caring for do not have health care insurance, and one of the major problems with that is that they are coming to us sometimes after the disease has progressed much further than need be, and it’s more costly to them and their well-being. And it’s going to be more costly for us and society more broadly.
 
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FederalRepublic

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FedRep,

Actually, I did. Your purposeful lack of punctuation aside...

It was purposeful because that's what it sounds like in my head when I read your writing. It's very annoying.

...you hit the argument square on the head.

What argument? It's an exercise in circular logic that doesn't mean anything.

Health care reform is complicated for one reason and one reason only: Because health care IS a business across multiple platforms. As such, it is extremely difficult to adequately address all aspects of our nation's health care system because of the various moving parts. And because our health, and thus by default our medical history, is very personal to us. WE'VE been "trained" to believe that the only "responsible and legitimate" way to obtain adequate health care is through our employer, but the problem with that is our employer is being heavily subsidized to provide us with health care coverage by the very government we're trying to restrain and limit its reach in this area. The truth of the matter is our (large) employers won't be too quick to relinquish providing health care coverage to their employees as long as any threat to tampering with offsetting subsidies are made "part of the solution". These subsidies offset a large portion of their out-of-pocket expenditures. So, why would they forego that? The same argument could be made concerning the States and their shared responsibility w/the federal government concerning Medicaid.

Time for some mental contortions...
Let's see if I can get this right:

Issue 1. Our health (care) is very personal and private.
Your solution: Make all health records available to the government.
Issue 2. We've been trained to believe the only option to have health care is to have insurance through our employers.
Your solution: Train everybody to believe the only option to have health care is through the government.
Issue 3: The government subsidizes employers to provide health isurance to employees.
Your solution: Have the government pick up the whole tab.
Issue 4: The government subsidizes the states for medicaid.
Your solution: Have the government pick up the whole tab.

There is no solution in your solutions. Frankly, I'm not even sure I understand exactly what you think the problem is. Is that the government doesn't pay for our health care? Because that's the only problem your solution will solve and even then, we'll still have to pay for it.
 

Objective Voice

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It was purposeful because that's what it sounds like in my head when I read your writing. It's very annoying.

Annoying as my writing style may be, you were still able to digest the fine points of my argument.


What argument? It's an exercise in circular logic that doesn't mean anything.

How so? And remember, I've never claimed to approve of the insurance mandate at the federal level, rather at the state level. But regardless of where the mandate comes from, many with the health care industry have stated that the only viable way to (help) reduce the cost of health care is to mandate that every citizen receive health care coverage. Not politicians, health care/insurance professionals themselves have said this. So, how is this a ... "circular argument" ... if the very industry providing the care and/or access to same are echoing the same solution to the problem as the politicians? You could say the insurance industry have the Democrats in their back pockets, but according to recent reports since the midterms, I'd say those contributors have begun to switch allegiences to strengthen the health care law, not to destroy it. Politics as usually....perhaps. But the fact remains that without health care, people aren't seeking the medical attention they need to ensure good health. And without removing many of the disqualifiers that kept some people out of the private health care system, those such individuals had little choice except to either depend on the government for their health care or go without because they just can't afford it.

Time for some mental contortions...

Let's see if I can get this right:

Issue 1. Our health (care) is very personal and private.
Your solution: Make all health records available to the government.

No. I've never advocated that and that's not what the health care law advocates either. Instead, what it attempts to do in promoting the use of electronic health records is minimize the errors and duplication of tests, as well as streamline the distribution of medical information across the health care spectrum. In other words, if you needed blood work done by your primary physician, he or she would run the labs. If after receiving the results it is determined that you should see a specialist, instead of duplicating the lab work, the specialist would then go online to review your results as published in an encrypted file on the Web. If it is then determined that you require surgery or some kind of special regimine, now every doctor, surgeon, specialist involved on your health dilemma has direct and immediate access to your health records. HIPPA laws prohibit this information from being shared with any outside source that is not directly involved in your medical condition or treatment. So, this argument of "everyone seeing your medical records" including the government is a wild, distorted and unfounded accusation.

Issue 2. We've been trained to believe the only option to have health care is to have insurance through our employers.
Your solution: Train everybody to believe the only option to have health care is through the government.

Since their is no "public option" and certainly was never the basis of my argument, I fail to see the logic behind this statement. However, since there are aspects of socialized health care in this country, I can certainly see the paranoia associated with it. But here again, unfounded.

Issue 3: The government subsidizes employers to provide health isurance to employees.
Your solution: Have the government pick up the whole tab.

Again, no public option, no tab to the fed. Individuals would still have to pay some out-of-pocket expense associated w/their health care coverage even with it being subsidized by the fed. What many people forget, however, is these subsidies to individuals would only take place for a limited time. After that, we're all on our own as to how we pay for health care coverage just as many of us are now.

Issue 4: The government subsidizes the states for medicaid.
Your solution: Have the government pick up the whole tab.

Not happening...it's that whole state's rights thingy. Furthermore, all the health care reform law did was expand access to Medicaid by raising the poverty limit. I'm not sure if it expanded coverage. Nonetheless, Medicaid is and shall always be a co-sponsored program between the participating states and the federal government. Even the grants that are being provided to the states to establish their high risk pools are for a limited time (1-year if I recall correctly). So, here again your statement is incorrect.

There is no solution in your solutions. Frankly, I'm not even sure I understand exactly what you think the problem is. Is that the government doesn't pay for our health care? Because that's the only problem your solution will solve and even then, we'll still have to pay for it.

Here again you've made an false assumption. I receive my health care coverage through my employer. But as a 16 yr veteran, yes, at one point the government did pick up most of the tab for mine and my family's health care. But that was 10 yrs ago. I pay for it now and plan to continue paying for it. I'm not looking for handouts, never have. However, my argument has been and continues to be for fair and equal access to health care for everyone. The fairness is providing various ways inwhich individuals can obtain health care. The equal is ensuring that each level of benefits are the same. So, if BC/BS, for example, offers a "bronze-level" health benefits package in AL, that same level package should contain the exact same benefits as it would for a customer in IN who purchases the same package. That doesn't mean that the AL customer and the IN customer would pay the same price for the coverage. The free-market will determine that. But their policies should be identical. That's not necessarily the case across the country today either with the same insurance company or similar plans from different insurance companies.
 
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