What the Health Care Debate Is Really All About

[Areopagitican]

The answer is simple: Politicians are incapable of building what amounts to a government-administered "preferred provider network." They simply can't pick one hospital over another, or one physician practice over another, because that implies that some physicians or hospitals in their district are inferior. And that's just not something an elected official ever wants to do.

What the Health-Care Debate Is Really All About Public Discourse

I thought the article was very informative. I never thought of Healthcare in the light they provided. Any thoughts? Comments?

 

[Conservative]

What the Health-Care Debate Is Really All About Public Discourse

I thought the article was very informative. I never thought of Healthcare in the light they provided. Any thoughts? Comments?

I believe the article is basically fair and balanced and offers some good insight into the problems the country is facing with regard to healthcare costs but more importantly quality health care.

IMO, there is no way healthcare costs can be addressed without defining all costs and there is now way that the Federal Govt. can administer a healthcare program for 309 million Americans without adding to the current bloated federal bureaucracy.

Quality healthcare IMO has to be a state issue not a Federal Issue and should be left to the states to solve especially since states control who sells policies in their state. The one size fits all Federal program solves nothing but does create a bigger problem.

I live in TX and TX doesn't have the same problems as other states. It is a pro business state that allows for competition in the healthcare industry. It implemented tort reform and other measures in the mid 90's and again in 2003 that generated more doctors and more insurance companies coming into TX.

I have very good healthcare and a choice. My costs however continue to rise but that is do mostly to the illegal immigration problem we have in TX. That is where the govt. should focus its efforts and what the Constitution requires, provide for the common defense. it is estimated that over 500,000,000 is being spent on treating illegals in this state and who pays for that?

Good quality healthcare requires a united effort, not a one size fits all effort that only promotes special interest groups. Take a look at the TX model and see if it fits in your state but most importantly address all the costs associated with healthcare before implementing any Federal controlled system

 

[NiteGuy]

I live in TX and TX doesn't have the same problems as other states. It is a pro business state that allows for competition in the healthcare industry. It implemented tort reform and other measures in the mid 90's and again in 2003 that generated more doctors and more insurance companies coming into TX.

I have very good healthcare and a choice. My costs however continue to rise but that is do mostly to the illegal immigration problem we have in TX. That is where the govt. should focus its efforts and what the Constitution requires, provide for the common defense. it is estimated that over 500,000,000 is being spent on treating illegals in this state and who pays for that?[/QUOTE]
That's not exactly true, Conservative. Yes, you've had doctors move back into the state - you're back up to what, 42nd in terms of doctor per-patient ratio now, instead of 48th? It's an improvement, but....

Now, add in the following:

Texas is ranked 49th in total Medicare beneficiaries per capita by state, and yet is ranked 4th in total Medicare spending. Which means that Texas has far fewer Medicare patients per capita than almost any other state, and yet spends more on Medicare patients than all but three states. And you can't pin that on illegal immigrants, because they aren't eligible for Medicare.

In short, in healthcare spending unrelated to your illegal immigrant scenario, Texas is still one of the highest cost places to get healthcare in the country. Put another way, Texans are getting a whole lot of healthcare - but are they getting the healthcare they need, or are they just paying more for it?

The numbers argue that it's the latter, and not the former, since outcomes for things like diabetes treatment, coronary bypass surgery, etc., aren't any better in Texaas Medicare patients, than in states where they spend a whole lot less per patient in their Medicare programs.

 

[Conservative]

I have very good healthcare and a choice. My costs however continue to rise but that is do mostly to the illegal immigration problem we have in TX. That is where the govt. should focus its efforts and what the Constitution requires, provide for the common defense. it is estimated that over 500,000,000 is being spent on treating illegals in this state and who pays for that?

That's not exactly true, Conservative. Yes, you've had doctors move back into the state - you're back up to what, 42nd in terms of doctor per-patient ratio now, instead of 48th? It's an improvement, but....

Texas has the fastest growing population in the nation and is one of the very few that continues to grow jobs. Keep ignoring the content of the post, health insurance is a state reponsibility, not a Federal Responsibility.

Now, add in the following:

Texas is ranked 49th in total Medicare beneficiaries per capita by state, and yet is ranked 4th in total Medicare spending. Which means that Texas has far fewer Medicare patients per capita than almost any other state, and yet spends more on Medicare patients than all but three states. And you can't pin that on illegal immigrants, because they aren't eligible for Medicare.

And that is a problem why? Texans do not seem to have the problem that you have with the state which I guess makes you a better expert than the people who live here

In short, in healthcare spending unrelated to your illegal immigrant scenario, Texas is still one of the highest cost places to get healthcare in the country. Put another way, Texans are getting a whole lot of healthcare - but are they getting the healthcare they need, or are they just paying more for it?

So you are an expert on what Texans need? thanks but no thanks.

The numbers argue that it's the latter, and not the former, since outcomes for things like diabetes treatment, coronary bypass surgery, etc., aren't any better in Texaas Medicare patients, than in states where they spend a whole lot less per patient in their Medicare programs.[/QUOTE]

Thank you for your expert analysis of what Texans want and have. Unless you live here you haven't a clue but that doesn't stop you and others from telling us all what we need but like you and others you continue to ignore my main point, this is a state responsibility, not a Federal Responsibility and the people of TX are smart enough to handle their own problems.

I have lived in TX for 18 years now and it was the best move I have ever made. The people of TX seem not to agree with you as they continue to elect Republican Governors and Senators. Guess that isn't something that your statistics do not show.

 

[NiteGuy]

Texas has the fastest growing population in the nation and is one of the very few that continues to grow jobs. Keep ignoring the content of the post, health insurance is a state reponsibility, not a Federal Responsibility.

And what does any of that have to do with healthcare costs in your state? Not a damned thing. You keep ignoring the reality of the situation, in favor of your little fantasy world.

And that is a problem why? Texans do not seem to have the problem that you have with the state which I guess makes you a better expert than the people who live here.

Why is that a problem? You're kidding right? You've got fewer seniors on Medicare than one other state, but you're paying way more than all but four other states, and you don't see that as a problem? Looks like you don't give a damn if the government's being wasteful, as long as it's wasted on you and yours. Hypocrisy much, Conservative?

So you are an expert on what Texans need? thanks but no thanks.

Well, I never claimed to be an expert on Texans, but thanks for the vote of confidence.

Let's try again. You guys have fewer seniors on Medicare than any other state, except one. You also spend more on them in terms of Medicare than all but four other states.

And, to top it all off, the successful outcomes for treatment of various illnesses treated under Medicare in Texas are no better than about half the states, and considerably worse than some states who pay half of what you do for their Medicare patients. Does that sound like you're getting your money's worth? Or does that sound like something in Texas healthcare is seriously flawed?

Thank you for your expert analysis of what Texans want and have. Unless you live here you haven't a clue but that doesn't stop you and others from telling us all what we need but like you and others you continue to ignore my main point, this is a state responsibility, not a Federal Responsibility and the people of TX are smart enough to handle their own problems.

Let's see. More money spent on fewer patients for worse outcomes. Tort reform that brought doctors into the state because the conditions for suing even in valid cases are onerous, but healthcare costs have not dropped at all. Yeah, real smart solutions there, Conservative.

I have lived in TX for 18 years now and it was the best move I have ever made. The people of TX seem not to agree with you as they continue to elect Republican Governors and Senators. Guess that isn't something that your statistics do not show.

No, which party gets elected would not be part of the statistics on healthcare. But considering what the statistics reveal, I'd have to say I'm not surprised. I could have looked at the those numbers, and pretty much told you who was being elected in the state, had I not already known.

You can tell me what you know all day long. I'd rather get my information from reliable sources, like the US and Texas HHS, studies by Kaiser-Pemanente and Blue cross/Blue Shield, and the Texas Department of Insurance. Your anecdotal evidence doesn't mean crap next to professional, often independent sources.

I do enjoy the comedy value, however.

 

[Conservative]

And what does any of that have to do with healthcare costs in your state? Not a damned thing. You keep ignoring the reality of the situation, in favor of your little fantasy world.

Seems to me that you ignore the reality of the situation in this state so the question is why do you care? Obviously the people of TX don't or do we need people like you here telling us what is best for us?

Why is that a problem? You're kidding right? You've got fewer seniors on Medicare than one other state, but you're paying way more than all but four other states, and you don't see that as a problem? Looks like you don't give a damn if the government's being wasteful, as long as it's wasted on you and yours. Hypocrisy much, Conservative?

Why do you care what the people of TX pay for health insurance? Health insurance is a personal responsibility and if it becomes a problem for those people then the people will do what they always do take that up with State Govt

No, don't see it as a problem at all nor do the Seniors in this state apparently. Tell me why it is a problem for you?

Well, I never claimed to be an expert on Texans, but thanks for the vote of confidence.

Let's try again. You guys have fewer seniors on Medicare than any other state, except one. You also spend more on them in terms of Medicare than all but four other states.

And, to top it all off, the successful outcomes for treatment of various illnesses treated under Medicare in Texas are no better than about half the states, and considerably worse than some states who pay half of what you do for their Medicare patients. Does that sound like you're getting your money's worth? Or does that sound like something in Texas healthcare is seriously flawed?

Damn, those stupid people of TX taking personal responsibilty for their own problems. How can that be?

Let's see. More money spent on fewer patients for worse outcomes. Tort reform that brought doctors into the state because the conditions for suing even in valid cases are onerous, but healthcare costs have not dropped at all. Yeah, real smart solutions there, Conservative.

Hey, what can I say, apparently this state is screwed up and needs people like you to straighten it out, no state income taxes, a budget surplus, and continued economic growth in a recession.

No, which party gets elected would not be part of the statistics on healthcare. But considering what the statistics reveal, I'd have to say I'm not surprised. I could have looked at the those numbers, and pretty much told you who was being elected in the state, had I not already known.


You can tell me what you know all day long. I'd rather get my information from reliable sources, like the US and Texas HHS, studies by Kaiser-Pemanente and Blue cross/Blue Shield, and the Texas Department of Insurance. Your anecdotal evidence doesn't mean crap next to professional, often independent sources.

I do enjoy the comedy value, however

Regardless of where you get your information it doesn't present the feelings of the people of TX. The people of TX seem to get it whereas you and others do not. Healthcare is a personal responsibility and many in TX CHOOSE not to participate and if they did they don't expect you or the residents of any other state to pay for their healthcare.

Now you can post whatever information you want but that information doesn't mean crap. Texans understand personal responsibility as well as state responsibility. The people here do not need you or anyone else to tell Texans what to do.

 

[NiteGuy]

Why do you care what the people of TX pay for health insurance? Health insurance is a personal responsibility and if it becomes a problem for those people then the people will do what they always do take that up with State Govt

I don't give a damn about what you pay for private health insurance. I do, however, give a damn when you guys insist on using two to three times in Medicare what any other state does, with fewer seniors and worse medical outcomes. If you want to waste your own money fine. Quit wasting mine as well.

No, don't see it as a problem at all nor do the Seniors in this state apparently. Tell me why it is a problem for you?

Of course the seniors in your state don't see a problem with it. They're getting all kinds of "healthcare" out of it. The problem is, they are not getting more effective healthcare.

And why is it a problem for me? Because you're wasting money for Medicare that could be going to somplace that needs it more.

Damn, those stupid people of TX taking personal responsibilty for their own problems. How can that be?

Take your fingers out of your ears, Conservative. You all aren't taking personal responsibility, you're ripping off the rest of the country. How does it feel to be a state of thieves?

Hey, what can I say, apparently this state is screwed up and needs people like you to straighten it out, no state income taxes, a budget surplus, and continued economic growth in a recession.

None of which has anything to do with healthcare. Quit dodging and ducking, and deal with the issue at hand, which is healthcare costs. Sheesh...

Regardless of where you get your information it doesn't present the feelings of the people of TX. The people of TX seem to get it whereas you and others do not. Healthcare is a personal responsibility and many in TX CHOOSE not to participate and if they did they don't expect you or the residents of any other state to pay for their healthcare.

Denial isn't just a river in Egypt, Conservative. It's alive and well in your posts.

That's the problem with folks like you - they don't want to be confused by the facts, their minds are already made up. The residents of other states are paying for your healthcare, at least where Medicare and Medicaid are concerned. You really want to do the rest of us a favor? Tell Perry to seceed before he gets voted out of office. That way the rest of us won't have to pay your sorry-assed exorbitant Medicare and Medicaid charges. That alone ought to bring both programs a lot closer to being solvent again.

Now you can post whatever information you want but that information doesn't mean crap. Texans understand personal responsibility as well as state responsibility. The people here do not need you or anyone else to tell Texans what to do.

I've already shown that to be a bald-faced lie, Conservative. And unlike you I've done it with cold, hard numbers over the "feelings" of you and like-minded Texans.

I'm sorry that the facts don't comport with your little fantasy world, but them's the breaks. Refute the numbers with some of your own, if you can. Or, you can just continue to blather on, and show yourself to be uninformed and irrelevent to this conversation.

By the way, you seem to have been here a fair amount of time, judging by your post count. When are you going to take some personal responsibility, and learn how to properly use the "quote" system here? Or is that too much for a poor liberal like me to ask of a smart, know-it-all Texan like yourself? :2razz:

 

[Conservative]

I don't give a damn about what you pay for private health insurance. I do, however, give a damn when you guys insist on using two to three times in Medicare what any other state does, with fewer seniors and worse medical outcomes. If you want to waste your own money fine. Quit wasting mine as well.

Figure out where the money that goes to Medicare comes from and get back to me.

Of course the seniors in your state don't see a problem with it. They're getting all kinds of "healthcare" out of it. The problem is, they are not getting more effective healthcare.

How do you know they aren't getting effective healthcare out of it?

And why is it a problem for me? Because you're wasting money for Medicare that could be going to somplace that needs it more.

Medicare is wasting money, just like every other govt. run program but that is ok since you want the govt. to take over and run healthcare. That will solve the problem

Take your fingers out of your ears, Conservative. You all aren't taking personal responsibility, you're ripping off the rest of the country. How does it feel to be a state of thieves?

Great, I love it in TX. I love the growth here, no state income taxes, and an unemployment rate 2 percent under the national average. You do realize that employed people pay into Medicare and SS?

None of which has anything to do with healthcare. Quit dodging and ducking, and deal with the issue at hand, which is healthcare costs. Sheesh...

You posted an article from the New Yorker regarding healthcare costs in McAllen, TX one of the most liberal cities in TX. The article didn't come to any conclusions but that doesn't reflect the costs in the rest of the state. TX has a growing population and is the largest geographically in the nation. With size comes problems with doctor/patient ratios yet Texans seem to be pretty happy.

Denial isn't just a river in Egypt, Conservative. It's alive and well in your posts.

Stop trying to save the world and save yourself first.

That's the problem with folks like you - they don't want to be confused by the facts, their minds are already made up. The residents of other states are paying for your healthcare, at least where Medicare and Medicaid are concerned. You really want to do the rest of us a favor? Tell Perry to seceed before he gets voted out of office. That way the rest of us won't have to pay your sorry-assed exorbitant Medicare and Medicaid charges. That alone ought to bring both programs a lot closer to being solvent again.

You have provided no proof that Medicare is being wasted in TX as using statemaster doesn't provide anything but pure data, nothing about population, geography, private insurance participates, business growth or anything else that really matters.

I've already shown that to be a bald-faced lie, Conservative. And unlike you I've done it with cold, hard numbers over the "feelings" of you and like-minded Texans.

I'm sorry that the facts don't comport with your little fantasy world, but them's the breaks. Refute the numbers with some of your own, if you can. Or, you can just continue to blather on, and show yourself to be uninformed and irrelevent to this conversation.

Numbers matter only if in context and you haven't provided any. Regarding tort reform here is an interesting article for you.

Texas-style health care reform is bigger and better | San Francisco Examiner

By the way, you seem to have been here a fair amount of time, judging by your post count. When are you going to take some personal responsibility, and learn how to properly use the "quote" system here? Or is that too much for a poor liberal like me to ask of a smart, know-it-all Texan like yourself? :2razz

Oh, I may bet around to it one of these days. Anything I can do to upset is is good enough for me

 

[NiteGuy]

Figure out where the money that goes to Medicare comes from and get back to me.

Typical. A smarmy, no-response response. Just what I expected.

How do you know they aren't getting effective healthcare out of it?

Maybe because as I showed earlier, the outcomes for Medicare patients in Texas are worse than they are anywhere else?

I don't know about you, but whenever I see that something costs me a whole lot more than someplace else, but I get a worse product and/or worse results, I tend to think I'm not getting very effective use out of my money.

Medicare is wasting money, just like every other govt. run program but that is ok since you want the govt. to take over and run healthcare. That will solve the problem

I don't believe you've ever heard me say that I want the government to take over and run healthcare. You are either mistaking me for someone else, or you're just pulling crap out of your ass again. Which is it?

Great, I love it in TX. I love the growth here, no state income taxes, and an unemployment rate 2 percent under the national average. You do realize that employed people pay into Medicare and SS?

Great. I couldn't be happier for you. Umm, you do know that what your getting for Medicare is paltry, compared to what your fellow Texans are putting in, right? You're being subsidized, in large part, by the rest of us, Conservative. How do you like being a leech on the rest of the country?

You posted an article from the New Yorker regarding healthcare costs in McAllen, TX one of the most liberal cities in TX. The article didn't come to any conclusions but that doesn't reflect the costs in the rest of the state. TX has a growing population and is the largest geographically in the nation. With size comes problems with doctor/patient ratios yet Texans seem to be pretty happy.

Once again, you really need to read for comprehension, Conservative. The article came to a number of conclusions about what's causing the high cost of healthcare in McAllen, as well as some solutions that would work for them, along with most other places in the country.

Now, I never claimed that McAllen was representative of the rest of the state. I did, however post numbers that did come from the rest of the state. Face it, while McAllen is the worst place in the country for healthcare, Texas as a whole is no great shakes. I'm going to keep saying it until you get it:

There are 41 states with a higher per-capita doctor/patient ratio, even after all of your supposed gains in physicians since 2003.

In terms of the number of patients on Medicare/Medicaid, you have fewer than all but 1 other state.

In terms of healthcare costs through Medicare and Medicaid, you spend up to 3 times more than all but 4 other states.

And yet for all of the spending you do for that small number of people, they aren't any healthier than those in states that spend far less, with far more patients. In fact, in many cases, you have worse outcomes.

Do you get it yet? You spend more "government money" for all your talk about the vaunted Texas independence, and you do a crappier job of keeping your people healthy, with more money to throw at the problem, courtesy of your leeching off the rest of the country.

But continue to wallow in ignorance.

Stop trying to save the world and save yourself first.

Gosh, what a snappy comeback, Conservative. Of course, as usual, it has nothing to do with what we are talking about.

You have provided no proof that Medicare is being wasted in TX as using statemaster doesn't provide anything but pure data, nothing about population, geography, private insurance participates, business growth or anything else that really matters.

Umm, if you spend more money, but get less good outcomes, I'd call that wasted money, Conservative. And so would you if you were being at all honest in this discussion.

Numbers matter only if in context and you haven't provided any.
Bull****. I've provided plenty of context. You just refuse to admit it.

By the way, you seem to have been here a fair amount of time, judging by your post count. When are you going to take some personal responsibility, and learn how to properly use the "quote" system here? Or is that too much for a poor liberal like me to ask of a smart, know-it-all Texan like yourself?

Oh, I may bet around to it one of these days. Anything I can do to upset is is good enough for me

Damn. Not just uninformed, but lazy and vindictive too. Nice to know.

 

[Conservative]

Typical. A smarmy, no-response response. Just what I expected.


Maybe because as I showed earlier, the outcomes for Medicare patients in Texas are worse than they are anywhere else?

What you showed were results from statemaster with no context. Run, little man.

I don't know about you, but whenever I see that something costs me a whole lot more than someplace else, but I get a worse product and/or worse results, I tend to think I'm not getting very effective use out of my money.

Anytime the govt. gets involved it costs more money. So what are you proposing?

I don't believe you've ever heard me say that I want the government to take over and run healthcare. You are either mistaking me for someone else, or you're just pulling crap out of your ass again. Which is it?

does it really matter? Do you have a solution?

Great. I couldn't be happier for you. Umm, you do know that what your getting for Medicare is paltry, compared to what your fellow Texans are putting in, right? You're being subsidized, in large part, by the rest of us, Conservative. How do you like being a leech on the rest of the country?

I have private insurance and haven't reached 65 yet. thanks for your concern. I would be more than happy to get my "contribution and my company's" for both SS and Medicare. then I wouldn't be a leach on anyone because it is my money I am getting back

Once again, you really need to read for comprehension, Conservative. The article came to a number of conclusions about what's causing the high cost of healthcare in McAllen, as well as some solutions that would work for them, along with most other places in the country.

McAllen doesn't represent the rest of TX so quite frankly the report means nothing

Now, I never claimed that McAllen was representative of the rest of the state. I did, however post numbers that did come from the rest of the state. Face it, while McAllen is the worst place in the country for healthcare, Texas as a whole is no great shakes. I'm going to keep saying it until you get it:

Guess we need liberals to take over here and turn it into that liberal utopia that everyone is talking about. Where would that be?

There are 41 states with a higher per-capita doctor/patient ratio, even after all of your supposed gains in physicians since 2003.

Notice high population states have low per capita doctor/patient rations. Where is California on the list and why is that list important to you? Have you ever been to TX? It is 900 miles from Beaumont to El Paso.

In terms of the number of patients on Medicare/Medicaid, you have fewer than all but 1 other state.

Sounds to me like people of TX haven't signed up for either. Should make people like you happy as Texans aren't using what is available to them, but then that contradicts your previous claim about Texans using more Medicare than they pay in. Which is it?

In terms of healthcare costs through Medicare and Medicaid, you spend up to 3 times more than all but 4 other states.

Seems to me you are quite confused. How can we spend more and not have people on the program?

And yet for all of the spending you do for that small number of people, they aren't any healthier than those in states that spend far less, with far more patients. In fact, in many cases, you have worse outcomes.

My bet is that Texans are really going to be concerned when they find out that you know their health better than they do. All that "book learnin" you have, Can you get a refund?

Do you get it yet? You spend more "government money" for all your talk about the vaunted Texas independence, and you do a crappier job of keeping your people healthy, with more money to throw at the problem, courtesy of your leeching off the rest of the country.

You do realize that Medicare and Medicaid are paid for by individuals' right? Didn't think so. It isn't the Government's money, it is the taxpayer's money.

But continue to wallow in ignorance.

Yeah, I am pretty ignorant. I bow to your superior wisdom and now know you are a legend in your own mind.

:2wave:

 

[NiteGuy]

What you showed were results from statemaster with no context. Run, little man.

Try again, little boy. I've also posted numbers from HHS, Kaiser Permanente, and the Texas Department of Insurance. But go ahead and pretend it didn't happen. Everyone else can see you for what you are.

Anytime the govt. gets involved it costs more money. So what are you proposing?

Actually it doesn't. The Medicare Part D prescription coverage is actually quite a bit under budget at this point. Far more than anyone would have predicted.

As for my proposal, I doubt you'd like it much. It doesn't include "tort" reform.

does it really matter? Do you have a solution?

Of course it matters. If you can't even admit you're mistaken on this, what's the point? You're wrong. Just say it and get it over with already.

I have private insurance and haven't reached 65 yet. thanks for your concern. I would be more than happy to get my "contribution and my company's" for both SS and Medicare. then I wouldn't be a leach on anyone because it is my money I am getting back

Yeah, and men in jail want out. Let's try to stay on topic shall we? I was talking about "you" as the whole of your state. Since Texas spends more than $16,000 per year on average, for Medicare enrollees, it's a fact that Texas isn't paying it's own way. But then, you already knew that. You just wanted find a way to deflect.

Guess we need liberals to take over here and turn it into that liberal utopia that everyone is talking about. Where would that be?

Hardly. You do however need somebody with some brains to quit spouting talking points that are directly contradictory to the facts. Most of your state legislators and the Governor at present aren't it. There are some real smart, engaged conservatives across the country. I've yet to see one in Texas during the last decade, however.

Notice high population states have low per capita doctor/patient rations. Where is California on the list and why is that list important to you? Have you ever been to TX? It is 900 miles from Beaumont to El Paso.

Actually, that's not true, either. Not that I'm surprised that you'd just pull something out of your ass again. It seems to be your modus operandi.
Higher population states usually have a larger physician to population ratio, not a lower one. The national average is something like 273 doctors per 100,000 in population.

States like Nevada, Idaho, Wyoming, etc., have less than a 200 docs-to-pop ratio, putting them at the bottom of the survey. Texas has a ratio of 219 per 100,000 putting them in a tie with Georgia for 39th place. Georgia, for Pete's sake! California takes the 26th spot with 261 doctors per 100,000.

But Illinois hits #14 at 284 per 100,00, and New York is only 3rd, with 401 physicians per 100,000 population.
See the pattern yet, Conservative? Small population states, low doc-to-pop ratio. High population states, and a higher ratio? Well, except in Texas.

Sounds to me like people of TX haven't signed up for either. Should make people like you happy as Texans aren't using what is available to them, but then that contradicts your previous claim about Texans using more Medicare than they pay in. Which is it?

Nice spin there, Conservative, but you keep drilling yourself right into the bull**** you keep trying to throw.
Having fewer people on Medicare than most other states, and yet spending a much, much more more per patient than most other states is not contradictory at all.

Seems to me you are quite confused. How can we spend more and not have people on the program?

No, Conservative, the only one confused here is you. Then again, I imagine that Sesame Street confuses you as well.

My bet is that Texans are really going to be concerned when they find out that you know their health better than they do. All that "book learnin" you have, Can you get a refund?

Don't need a refund, thanks. And I'd worry a whole lot more about your own education than mine at this point. It seems to be sorely lacking.

You do realize that Medicare and Medicaid are paid for by individuals' right? Didn't think so. It isn't the Government's money, it is the taxpayer's money.

There you go, trying to think again, Conservative. You really ought not to do that. You're liable to hurt yourself.

Of course I understand that it's the taxpayers money. I also understand that our parents, grandparents, whomever, through their elected representatives, made a compact with the government to collect that tax money from all of them, so that it could be used to insure that seniors and the less advantaged would be able to get a basic level of healthcare, if nothing else, when the need arose.

You want a new contract? One that lets you keep all of your money, and kick the old folks and poor people out of the hospital and into the street? Vote in some new politicians.

Bear in mind that the old folks and poor people get to vote too, though. Oh, and some of us with money and a conscience get to vote as well. It's a real bitch, I know, but what are you gonna do?

Yeah, I am pretty ignorant. I bow to your superior wisdom and now know you are a legend in your own mind.

At least I have a mind.
(Come on, you walked right into that one.)

 

[Conservative]

Try again, little boy. I've also posted numbers from HHS, Kaiser Permanente, and the Texas Department of Insurance. But go ahead and pretend it didn't happen. Everyone else can see you for what you are.

Then provide the link and the year that study was made?

Actually it doesn't. The Medicare Part D prescription coverage is actually quite a bit under budget at this point. Far more than anyone would have predicted.

Yes, and do you know why? Competition and incentive to cut costs. What a novel idea. Where is that incentive to cut costs in the Obamacare plan?

As for my proposal, I doubt you'd like it much. It doesn't include "tort" reform.

Of course not, because tort reform is a cost of healthcare and we can't be cutting anything that adds to the costs.

Of course it matters. If you can't even admit you're mistaken on this, what's the point? You're wrong. Just say it and get it over with already.

I have yet to be proven wrong and you don't even understand the numbers you posted

Yeah, and men in jail want out. Let's try to stay on topic shall we? I was talking about "you" as the whole of your state. Since Texas spends more than $16,000 per year on average, for Medicare enrollees, it's a fact that Texas isn't paying it's own way. But then, you already knew that. You just wanted find a way to deflect.

That is your opinion not backed by anything factual or even if it is it contradicts your position on TX having the fewest number of participants. Further you ignore that Medicare is funded by FICA which is your payroll taxes at work. All working Texans put their money into Medicare and if fewer people are participating then TX has a greater pool of money that isn't being used

Hardly. You do however need somebody with some brains to quit spouting talking points that are directly contradictory to the facts. Most of your state legislators and the Governor at present aren't it. There are some real smart, engaged conservatives across the country. I've yet to see one in Texas during the last decade, however.

Keep looking stupid with your condescending remarks. Your posts speak for themselves, ignorant. It really is a shame that TX doesn't share in the misery of your state wherever that is

Actually, that's not true, either. Not that I'm surprised that you'd just pull something out of your ass again. It seems to be your modus operandi.
Higher population states usually have a larger physician to population ratio, not a lower one. The national average is something like 273 doctors per 100,000 in population.

Obviously you have never been to TX. You really ought to get out more.

States like Nevada, Idaho, Wyoming, etc., have less than a 200 docs-to-pop ratio, putting them at the bottom of the survey. Texas has a ratio of 219 per 100,000 putting them in a tie with Georgia for 39th place. Georgia, for Pete's sake! California takes the 26th spot with 261 doctors per 100,000.

And that is a problem for you why? You seem to believe that spending more per capita and having more doctors per capita equates to better care and better results. Since the debt now is over 12.4 trillion dollars we should be in great shape with all that spending, right?

But Illinois hits #14 at 284 per 100,00, and New York is only 3rd, with 401 physicians per 100,000 population.
See the pattern yet, Conservative? Small population states, low doc-to-pop ratio. High population states, and a higher ratio? Well, except in Texas.

Yep, see the problem quite well, TX isn't like Illinois, New York, or California. Wow, shouldn't we be? Sure is working out well for those states. What is the debt in those states right now?

Nice spin there, Conservative, but you keep drilling yourself right into the bull**** you keep trying to throw.
Having fewer people on Medicare than most other states, and yet spending a much, much more more per patient than most other states is not contradictory at all.

Medicare is a federal run program so who is spending the money, Texans or the Federal govt?

No, Conservative, the only one confused here is you. Then again, I imagine that Sesame Street confuses you as well.

Sesame Street analysis adds greatly to the discussion

Don't need a refund, thanks. And I'd worry a whole lot more about your own education than mine at this point. It seems to be sorely lacking.

I know that your education exceeds mine because you tell me that in about every post. Where did you go to school? Maybe you should be seeking a refund

There you go, trying to think again, Conservative. You really ought not to do that. You're liable to hurt yourself.

Of course I understand that it's the taxpayers money. I also understand that our parents, grandparents, whomever, through their elected representatives, made a compact with the government to collect that tax money from all of them, so that it could be used to insure that seniors and the less advantaged would be able to get a basic level of healthcare, if nothing else, when the need arose.

Then you ought to check out where that SS money actually went. SS has been put on budget for decades now and spent as part of the budget process, not the retirement process thus the shortfall in SS.

You want a new contract? One that lets you keep all of your money, and kick the old folks and poor people out of the hospital and into the street? Vote in some new politicians.

Right, I want to starve kids, kill seniors, and pollute the air. That is what a heartless conservative wants as professed by liberals.

Bear in mind that the old folks and poor people get to vote too, though. Oh, and some of us with money and a conscience get to vote as well. It's a real bitch, I know, but what are you gonna do?

LOL, please don't cut off my welfare, please!!

At least I have a mind.
(Come on, you walked right into that one.)

Could have fooled me as I see far too many as book smart, street stupid individuals

 

[winston53660]

Conservative your posting style is well backwards.

 

[Conservative]

Conservative your posting style is well backwards.

But my points are right on.

 

[winston53660]

But my points are right on.

What ever floats your boat.

 

[Conservative]

What ever floats your boat.

Facts, logic, and common sense float mine, what floats yours?

 

[NiteGuy]

Then provide the link and the year that study was made?

Since I've already posted this information on either this thread, or one of the many others in this topic, you go look it up. I'm not going to do your homework for you.

Yes, and do you know why? Competition and incentive to cut costs. What a novel idea. Where is that incentive to cut costs in the Obamacare plan?

The point was, you claimed that nothing the government did cost less than projected. I just proved you wrong. Nice attempt to move the goalposts though.

Of course not, because tort reform is a cost of healthcare and we can't be cutting anything that adds to the costs.

No, it's because "tort reform" for the most part has been a dismal failure at lowering the cost of anything associated with healthcare. If we eliminated all malpractice lawsuits tomorrow, we would at best, eliminate a whole 2% of the total cost of healthcare. With insurance premiums rising at an annual average rate of 9%, and healthcare cost rising overall at about 12% per year, we'd barely slow down the rate of increase, never mind actually cut costs.

I have yet to be proven wrong and you don't even understand the numbers you posted

Except that we weren't talking numbers here, Conservative. We were talking about your claim that I want the government to take over healthcare. I was an obvious mistake on your part, because I've never said such a thing. Now, you can either apologize for being mistaken or not. I don't really care, one way or the other, but it's you who's going to keep looking foolish, not me.

That is your opinion not backed by anything factual or even if it is it contradicts your position on TX having the fewest number of participants. Further you ignore that Medicare is funded by FICA which is your payroll taxes at work. All working Texans put their money into Medicare and if fewer people are participating then TX has a greater pool of money that isn't being used

You really do need to take a basic statistics and economics course, Conservative. If you already have, then you need to stop acting as if you haven't, and stop feigning ignorance.

Texas has the fewest number of Medicare enrollees per capita than all but on other state. But being a high population state, that doesn't mean that they only have a few participants. They actually have 2.8 million medicare beneficiaries in the state. But that's still only 11% of their total population, as opposed to say someplace like Californina at 12% (4.5 million) of population on Medicare, Illinois with 14% (1.7 million), or Florida at 17% (3.2million).

And yet they spend as much per person, on average as California, and more per person, than any of the other states listed. And those are just the higher expense states for Medicare. Some places have a 15% to 19% per capita Medicare enrollee rate, and yet get by on anywhere from one-quarter to one-half of what is spent in Texas or California.

Keep looking stupid with your condescending remarks. Your posts speak for themselves, ignorant. It really is a shame that TX doesn't share in the misery of your state wherever that is

The only one looking stupid here is you. I've posted facts and hard numbers. What you've posted is: "I don't need no facts! I'm from Texas!"

Obviously you have never been to TX. You really ought to get out more.

Great retort, Conservative. Too bad it does nothing to invaliate the fact that you were, once again, wrong. Higher population states have a higher doctor to population ratio, not a lower one, which was your contention.

And that is a problem for you why? You seem to believe that spending more per capita and having more doctors per capita equates to better care and better results. Since the debt now is over 12.4 trillion dollars we should be in great shape with all that spending, right?

No, actually I don't believe that. Well, not entirely. Yes, more doctors per capita would help healthcare spending, because an increase in doctors would mean an increase in competition, and would lower their rates. More spending, however, as I have been trying to get through to you, would not.

As I've already pointed out, Texas spends more per Medicare enrollee than just about anyone else. And yet, they get no better care, and in many cases, fare far worse, than places that spend a whole lot less. Here's more from the New Yorker article written by physician Atul Gawande:

In a 2003 study, another Dartmouth team, led by the internist Elliott Fisher, examined the treatment received by a million elderly Americans diagnosed with colon or rectal cancer, a hip fracture, or a heart attack. They found that patients in higher-spending regions received sixty per cent more care than elsewhere. They got more frequent tests and procedures, more visits with specialists, and more frequent admission to hospitals. Yet they did no better than other patients, whether this was measured in terms of survival, their ability to function, or satisfaction with the care they received. If anything, they seemed to do worse.

That’s because nothing in medicine is without risks. Complications can arise from hospital stays, medications, procedures, and tests, and when these things are of marginal value the harm can be greater than the benefits. In recent years, we doctors have markedly increased the number of operations we do, for instance. In 2006, doctors performed at least sixty million surgical procedures, one for every five Americans. No other country does anything like as many operations on its citizens. Are we better off for it? No one knows for sure, but it seems highly unlikely. After all, some hundred thousand people die each year from complications of surgery—far more than die in car crashes.

To make matters worse, Fisher found that patients in high-cost areas were actually less likely to receive low-cost preventive services, such as flu and pneumonia vaccines, faced longer waits at doctor and emergency-room visits, and were less likely to have a primary-care physician. They got more of the stuff that cost more, but not more of what they needed.

McAllen, Texas and the high cost of health care : The New Yorker

It's not about how much is spent in treatment. It's about treating for outcomes, and not treating just because each treatment will get you another payment. One of the things we need to do, in terms of healthcare in general, and Medicare in particular, is to stop paying on a fee-for service basis, and start paying based on successful outcomes. But someone a whole lot smarter than me is going to have to figure out how to actually accomplish that little miracle.

Yep, see the problem quite well, TX isn't like Illinois, New York, or California. Wow, shouldn't we be? Sure is working out well for those states. What is the debt in those states right now?

Once again I see we are confusing two different things. Medicare spending in Texas has nothing whatever to do with the debt management of those particular states.

I know that your education exceeds mine because you tell me that in about every post. Where did you go to school? Maybe you should be seeking a refund

Sorry, but you're confused again. I never claimed to be better educated than you. Smarter maybe, but not better educated. :mrgreen:

Then you ought to check out where that SS money actually went. SS has been put on budget for decades now and spent as part of the budget process, not the retirement process thus the shortfall in SS.

I know where the Social Security money went, thank you. But what does that have to do with healthcare sending?

Right, I want to starve kids, kill seniors, and pollute the air. That is what a heartless conservative wants as professed by liberals.

Actually, it's not conservatives words that I pay as much attention to as much as it is their actions. But their words, in many cases seem heartless enough. I can't tell you the number of times that I've heard conservatives say that we should just do away completely with SS, Medicare, and Medicaid as well as a number of other programs.

If you're not one of these conservatives, my apologies.

Could have fooled me as I see far too many as book smart, street stupid individuals

Then you're definitely not talking about me, Conservative.
Since I'm relatively new here, a bit of background. I went into the Air Force right out of high school. After 8 years, I spent a couple of years with a musical group, touring up and down the east coast. Ended up in Orlando Florida, working for a hotel on the graveyard shift, and worked my way up from there.

Yes, I did go to college - working full time, and going to classes whenever I could fit them in. Got a general business degree, worked as a hotel accountant, then a Front Office Manager, Assistant Manager, and eventually a General Manager, over the course of 6 different properties and 15 years. I currently run a hotel with 200 rooms, full service restaurant, bar, and 10,000 square feet of meeting and banquet space.

Oh, yeah. I also started a computer sales and repair business with a friend. We have two locations now, and are looking at a third.

For the record, I don't discount "book smart" as you call it. I wouldn't have been able to get as far as I did without it. But, if it came to hiring someone with 4 years of solid experience and no degree, and someone fresh out of college, I'll take the experience every time.

What ever floats your boat.

Facts, logic, and common sense float mine, what floats yours?

Since when?

So far, at least in this debate, you've produced no facts, faulty logic, and shown little sense, common or otherwise. But one does need something to aspire to, I suppose...

 

[Conservative]

Since I've already posted this information on either this thread, or one of the many others in this topic, you go look it up. I'm not going to do your homework for you.

You obviously haven't posted it on this thread or others wouldn't have asked for them. A Kaiser link doesn't show what you claim.

The point was, you claimed that nothing the government did cost less than projected. I just proved you wrong. Nice attempt to move the goalposts though.

There is no comparison between Medicare Part D and Obamacare, you know it and I know it. The Prescription Drug Program was layered with competition not govt. mandates.

No, it's because "tort reform" for the most part has been a dismal failure at lowering the cost of anything associated with healthcare. If we eliminated all malpractice lawsuits tomorrow, we would at best, eliminate a whole 2% of the total cost of healthcare. With insurance premiums rising at an annual average rate of 9%, and healthcare cost rising overall at about 12% per year, we'd barely slow down the rate of increase, never mind actually cut costs.

You don't have a lot of credibility when you claim Tort reform was a dismal failure. The number of Doctors and Healthcare choices in TX prove you wrong

Except that we weren't talking numbers here, Conservative. We were talking about your claim that I want the government to take over healthcare. I was an obvious mistake on your part, because I've never said such a thing. Now, you can either apologize for being mistaken or not. I don't really care, one way or the other, but it's you who's going to keep looking foolish, not me.

If you support Obamacare no apology will be forthcoming. You came onto this thread attacking TX as if you are an expert. I live in TX and have for 18 years. Tort reform has made a difference here. Is it THE answer, no but it is AN answer. You cannot address healthcare costs by ignoring the cost of litigation and malpractive.

You really do need to take a basic statistics and economics course, Conservative. If you already have, then you need to stop acting as if you haven't, and stop feigning ignorance.

Little too old to go back to school now, my education came from 35 years in the business world after getting a college degree which apparently doesn't count. Give me your qualifications?

Texas has the fewest number of Medicare enrollees per capita than all but on other state. But being a high population state, that doesn't mean that they only have a few participants. They actually have 2.8 million medicare beneficiaries in the state. But that's still only 11% of their total population, as opposed to say someplace like Californina at 12% (4.5 million) of population on Medicare, Illinois with 14% (1.7 million), or Florida at 17% (3.2million).

And yet they spend as much per person, on average as California, and more per person, than any of the other states listed. And those are just the higher expense states for Medicare. Some places have a 15% to 19% per capita Medicare enrollee rate, and yet get by on anywhere from one-quarter to one-half of what is spent in Texas or California.

You still don't get it, Medicare is a Govt. run program and it is the govt. spending the money. If it costs more to implement here find out why. If people aren't enrolled that doesn't mean they aren't paying into the system. So few people collecting more money doesn't mean that these people are getting benefits from other states. Wny are enrollees in Medicare such an important issue to you instead of finding out why those costs you claim aren't being investigated?

The only one looking stupid here is you. I've posted facts and hard numbers. What you've posted is: "I don't need no facts! I'm from Texas!"

You haven't cited your sources but have bloviated a lot.

Great retort, Conservative. Too bad it does nothing to invaliate the fact that you were, once again, wrong. Higher population states have a higher doctor to population ratio, not a lower one, which was your contention.

Geography plays a major role in doctor/patient ratio but don't let that fact get in the way of your "expert" opinion. Again cite your source.

No, actually I don't believe that. Well, not entirely. Yes, more doctors per capita would help healthcare spending, because an increase in doctors would mean an increase in competition, and would lower their rates. More spending, however, as I have been trying to get through to you, would not.

More doctors did come to TX after Tort reform and there are more insurance companies in TX. The people of TX don't seem to be having the problem you have. Wonder why?

As I've already pointed out, Texas spends more per Medicare enrollee than just about anyone else. And yet, they get no better care, and in many cases, fare far worse, than places that spend a whole lot less. Here's more from the New Yorker article written by physician Atul Gawande:


McAllen, Texas and the high cost of health care : The New Yorker

It's not about how much is spent in treatment. It's about treating for outcomes, and not treating just because each treatment will get you another payment. One of the things we need to do, in terms of healthcare in general, and Medicare in particular, is to stop paying on a fee-for service basis, and start paying based on successful outcomes. But someone a whole lot smarter than me is going to have to figure out how to actually accomplish that little miracle.

Do you know how big McAllen is in the overall size of TX yet for some reason McAllen is your broad bruch approach to attacking TX. If Medicare costs are they high, why are they that high. Why is McAllen TX so much higher than El Paso. No answer.

Once again I see we are confusing two different things. Medicare spending in Texas has nothing whatever to do with the debt management of those particular states.

Not according to Obama, healthcare costs are driving the Budget deficits which of course we know is a lie.

Sorry, but you're confused again. I never claimed to be better educated than you. Smarter maybe, but not better educated. :mrgreen:

LOL, you are indeed a legend in your own mind.

I know where the Social Security money went, thank you. But what does that have to do with healthcare sending?

Medicare spending is just like SS, it is funded by your "contribution" if you get a paycheck.

Actually, it's not conservatives words that I pay as much attention to as much as it is their actions. But their words, in many cases seem heartless enough. I can't tell you the number of times that I've heard conservatives say that we should just do away completely with SS, Medicare, and Medicaid as well as a number of other programs.

If you're not one of these conservatives, my apologies.

Medicare, SS, and Medicaid are bloated federal and state programs that cost more than intended and require a bloated bureaucracy to run. The return on both are terrible.

Then you're definitely not talking about me, Conservative.
Since I'm relatively new here, a bit of background. I went into the Air Force right out of high school. After 8 years, I spent a couple of years with a musical group, touring up and down the east coast. Ended up in Orlando Florida, working for a hotel on the graveyard shift, and worked my way up from there.

Yes, I did go to college - working full time, and going to classes whenever I could fit them in. Got a general business degree, worked as a hotel accountant, then a Front Office Manager, Assistant Manager, and eventually a General Manager, over the course of 6 different properties and 15 years. I currently run a hotel with 200 rooms, full service restaurant, bar, and 10,000 square feet of meeting and banquet space.

Oh, yeah. I also started a computer sales and repair business with a friend. We have two locations now, and are looking at a third.

For the record, I don't discount "book smart" as you call it. I wouldn't have been able to get as far as I did without it. But, if it came to hiring someone with 4 years of solid experience and no degree, and someone fresh out of college, I'll take the experience every time.

Good for you, you are a street smart individual that comes across as a book smart individual lecturing a resident of TX about how bad things are here. Why is this topic so important to you?

So far, at least in this debate, you've produced no facts, faulty logic, and shown little sense, common or otherwise. But one does need something to aspire to, I suppose...

I have provided sources but you don't like them, doesn't make them wrong. The problem you have is you ignore how many people CHOOSE not to participate in health insurance, you CHOOSE not to acknowledge the waste, fraud, and abuse in Medicare, Medicaid, and SS, and you CHOOSE not to accept that TX has more doctors and more health insurance choices than most other states.

I am still waiting for your proposals to solve the healthcare problems in this country. Attacking TX isn't a solution.

 

[NiteGuy]

Okay, Conservative, I don't have a lot of time for a couple of days, so I'll cut straight to the chase here.

Except that we weren't talking numbers here, Conservative. We were talking about your claim that I want the government to take over healthcare. I was an obvious mistake on your part, because I've never said such a thing. Now, you can either apologize for being mistaken or not. I don't really care, one way or the other, but it's you who's going to keep looking foolish, not me.

If you support Obamacare no apology will be forthcoming.

Good, then let the apologies commence. I don't support ObamaCare. There are a couple of parts I would include in a reform of healthcare, like not excluding for pre-existing conditions, or allowing insurance companies to drop you once you get a serious disease like cancer or MS. There are a few other things I would keep as well, none of them terribly expensive to impliment.

But overall, I think that about 95% of what's been passed in both the House and Senate versions of these bills is unnecessarily bloated, and hugely expensive. Fair enough?

More doctors did come to TX after Tort reform and there are more insurance companies in TX. The people of TX don't seem to be having the problem you have. Wonder why?

I'm not disputing that more doctors came to Texas after tort reform. What I am saying, is that even now, the doctor/population ratio isn't nearly as good in Texas as it is in most other large states. Any increase is a plus, but Texas seems to still be lagging for some reason. I just don't know why.

Do you know how big McAllen is in the overall size of TX yet for some reason McAllen is your broad bruch approach to attacking TX. If Medicare costs are they high, why are they that high. Why is McAllen TX so much higher than El Paso. No answer.

Umm, sorry, but I did answer. Maybe you missed it. It was here:

It's not about how much is spent in treatment. It's about treating for outcomes, and not treating just because each treatment will get you another payment. One of the things we need to do, in terms of healthcare in general, and Medicare in particular, is to stop paying on a fee-for service basis, and start paying based on successful outcomes. But someone a whole lot smarter than me is going to have to figure out how to actually accomplish that little miracle.

As for why McAllen's costs are so much higher, the article answers that pretty well. Since the charges they submit to Medicare and private insurance are valid, most of the doctors, hospitals, home healthcare services, etc. over-schedule, and charge for a lot of unnecessary treatments. Up to six times the number of treatments, x-rays, etc., than what El Paso uses per patient for the same type of illness or injury. What McAllen has done is to turn Medicare and private health insurance into their own personal money printing machine. No fraud necessary, because all of the treatments are performed, all of the charges are valid, and as long as the insurance holds out, or as long as Medicare is willing to pay for 6 or 8 treatments when the national average is say 2 treatments for a particular illness or injury.

And like I said, we should be treating for successful outcomes, not just for payments. But I don't have a clue as to what it would entail to get something like that established in the healthcare system at this point.

Not according to Obama, healthcare costs are driving the Budget deficits which of course we know is a lie.

Not necessarily a lie, but certainly misleading. We are spending more in this country on healthcare, as a portion of GDP, than any other country on the planet. Seventeen percent per year, and rising. Healthcare costs will become unsustainable in a few short years, if we can't find a way to reduce costs. It's costing businesses good employees if they can't afford employer-paid insurance, and it's costing them potential lost employee productivity. It's costing people without insurance to enter into bankruptcy at alarming rates, when they can't afford insurance, and can't afford the medical bills they incur.

Medicare, SS, and Medicaid are bloated federal and state programs that cost more than intended and require a bloated bureaucracy to run. The return on both are terrible.

Well, as I said, I'm not sure how to go about reducing the cost of Medicare. Social Security, however, I could probable fix relatively cheaply, and relatively quickly.

Good for you, you are a street smart individual that comes across as a book smart individual lecturing a resident of TX about how bad things are here. Why is this topic so important to you?

Look, if that's what you thought I've been doing this whole time, just wholesale bashing of Texas, then, my bad. My intent was not to attempt to say that things were so much worse there than anywhere else. In fact, they have done some things that have worked very well.

On the other hand, while I appreciate your enthusiasm for where you live, things are not all sweetness and light. Texas does lag behind in some very important measures of both healthcare costs and metrics for outcomes in patient care. I'll point out a particular in a moment.

The problem you have is you ignore how many people CHOOSE not to participate in health insurance, you CHOOSE not to acknowledge the waste, fraud, and abuse in Medicare, Medicaid, and SS, and you CHOOSE not to accept that TX has more doctors and more health insurance choices than most other states.

And there we go!

I don't ignore those that choose not to purchase health insurance. You do seem to ignore, however that there is a rather large number of people in every state, including Texas, that just plain cannot afford insurance.

I don't fail to acknowledge waste fraud and abuse in Medicare. There has to be a solution, I just personally don't know what it is. By the way, there is little in the way of fraud and abuse of Medicaid, and as I said, I think I do have a couple of solutions for SS.

As for your last statement, Texas may indeed have more health insurance choices than most other states. You may have gained doctors since you instituted tort reform. But please, be realistic. You do not have more doctors than most other states. I've shown that through a couple of different links, in at least a couple of different threads.

I am still waiting for your proposals to solve the healthcare problems in this country. Attacking TX isn't a solution.

No, attacking Texas isn't a solution. I never said it was. Then again, your unabashed, unreserved cheerleading, like your statement about having more doctors than other states, above, simply invites refutation, because it is so obviously false.

As for my proposal for healthcare reform, I'll have to dig it out from another forum I posted on a while back. I'll put it up in a new thread here in a couple of days. Then we can bat it around for awhile if you like.

 

[Conservative]

Okay, Conservative, I don't have a lot of time for a couple of days, so I'll cut straight to the chase here.

Good, then let the apologies commence. I don't support ObamaCare. There are a couple of parts I would include in a reform of healthcare, like not excluding for pre-existing conditions, or allowing insurance companies to drop you once you get a serious disease like cancer or MS. There are a few other things I would keep as well, none of them terribly expensive to impliment.

But overall, I think that about 95% of what's been passed in both the House and Senate versions of these bills is unnecessarily bloated, and hugely expensive. Fair enough?

Rather busy day yesterday so sorry for the last response. We really aren't that far apart and if you are truly against Obamacare then I apologize. There is no way that costs can be contained without identifying all the costs of the current system and then addressing them one by one. The current legislation does little co control costs but does increase the size and scope of the govt.

I'm not disputing that more doctors came to Texas after tort reform. What I am saying, is that even now, the doctor/population ratio isn't nearly as good in Texas as it is in most other large states. Any increase is a plus, but Texas seems to still be lagging for some reason. I just don't know why.

Much of the problem with patient/doctor relationship in TX is due to the rapid growth in population. TX is a popular state to move to because of the tax structure and a pro business economy. When the state passed tort reform the number of doctors and insurance companies move to TX. My bet is the number of doctors moving to the state and getting certified cannot keep up with the population growth.

Umm, sorry, but I did answer. Maybe you missed it. It was here:

As for why McAllen's costs are so much higher, the article answers that pretty well. Since the charges they submit to Medicare and private insurance are valid, most of the doctors, hospitals, home healthcare services, etc. over-schedule, and charge for a lot of unnecessary treatments. Up to six times the number of treatments, x-rays, etc., than what El Paso uses per patient for the same type of illness or injury. What McAllen has done is to turn Medicare and private health insurance into their own personal money printing machine. No fraud necessary, because all of the treatments are performed, all of the charges are valid, and as long as the insurance holds out, or as long as Medicare is willing to pay for 6 or 8 treatments when the national average is say 2 treatments for a particular illness or injury.

This identifies one of the problems with govt. run anything. There is no incentive to reduce costs. The people of McAllen seem to be taking advantage of a bad situation and until you get that problem solved it makes no sense to expand Medicare. I believe McAllen is the exception rather than the rule in TX.

And like I said, we should be treating for successful outcomes, not just for payments. But I don't have a clue as to what it would entail to get something like that established in the healthcare system at this point.

I believe it is going to take a step by step approach by first identify all the costs associated with healthcare as well as any good coming out of the current system. I am happy with my healthcare and I pay a premium each month. I also have a deductible which has to be met before I get 100% payment. Up to that point it is 80/20 and makes sense to me. The problem seems to be that far too many want 100% coverage immediately and want it free.

Not necessarily a lie, but certainly misleading. We are spending more in this country on healthcare, as a portion of GDP, than any other country on the planet. Seventeen percent per year, and rising. Healthcare costs will become unsustainable in a few short years, if we can't find a way to reduce costs. It's costing businesses good employees if they can't afford employer-paid insurance, and it's costing them potential lost employee productivity. It's costing people without insurance to enter into bankruptcy at alarming rates, when they can't afford insurance, and can't afford the medical bills they incur.

We pay a lot because of regulations as well as defensive medicine. As stated it is time to lay out all the costs and then address them one by one.

Look, if that's what you thought I've been doing this whole time, just wholesale bashing of Texas, then, my bad. My intent was not to attempt to say that things were so much worse there than anywhere else. In fact, they have done some things that have worked very well.

On the other hand, while I appreciate your enthusiasm for where you live, things are not all sweetness and light. Texas does lag behind in some very important measures of both healthcare costs and metrics for outcomes in patient care. I'll point out a particular in a moment.

I moved to TX 18 years ago and it was the best move I ever made. I am enthusiastic about TX but realize that all isn't "sweetness and light" and never said it was. There is a reason however that doctors and insurance companies are moving to TX. It would benefit other states to find out why?

I don't ignore those that choose not to purchase health insurance. You do seem to ignore, however that there is a rather large number of people in every state, including Texas, that just plain cannot afford insurance.

The problem is there are millions of people in this country that can afford healthcare but CHOOSE not to and we should not be subsidizing those people. I worked in a company that paid 80% of the healthcare costs of all employees and offered healthcare to even part time employees. the company did not pay minimum wage yet 50% of the employees did not CHOOSE to buy insurance. Most were young thus invinceable in their minds. Those that cannot afford health insurance should receive help but never free insurance IMO.

I don't fail to acknowledge waste fraud and abuse in Medicare. There has to be a solution, I just personally don't know what it is. By the way, there is little in the way of fraud and abuse of Medicaid, and as I said, I think I do have a couple of solutions for SS.

I believe the Prescription Drug program provided that solution, empower people and stimulate competition. All people to keep what they save. Give the people an allowance and if they spend less than that, they keep what they save. I also like billing foreign countries for any healthcare services of a foreign national here and if they do not pay it deduct the amount from their foreign aid.

As for your last statement, Texas may indeed have more health insurance choices than most other states. You may have gained doctors since you instituted tort reform. But please, be realistic. You do not have more doctors than most other states. I've shown that through a couple of different links, in at least a couple of different threads.

Never said we had more doctors just that doctors came to this state after tort reform was implemented.

No, attacking Texas isn't a solution. I never said it was. Then again, your unabashed, unreserved cheerleading, like your statement about having more doctors than other states, above, simply invites refutation, because it is so obviously false.

As for my proposal for healthcare reform, I'll have to dig it out from another forum I posted on a while back. I'll put it up in a new thread here in a couple of days. Then we can bat it around for awhile if you like

My cheerleading of TX is based upon a few facts, a pro business attitude, low corporate tax rate, no state income taxes and a budget surplus.

Your tone changed and I appreciate that change. Thanks for the civil discussion.

 

[phattonez]

All of the proposals seem to ignore the fact that healthcare is expensive because the kind of service that we want is scarce. MRI's are friggin' expensive. CT scans, surgery, this stuff isn't cheap. The way to really get costs down instead of just dilluting the perceived cost through taxes is with more competition, more doctors (medical schools are not growing and so we have many would-be doctors that just can't get into the field), and I'd say getting rid of punitive damages in medical malpractice cases.

And we need to get off of the expectation that everyone needs insurance. Not everyone wants insurance. Besides, insurance isn't all that great of a system. Perceived costs go way down. It's like the problem of having "free" utilities in your lease.