A friend of mine who is pretty knowledgeable about health care writes:
Saw your B-J post on public option. I’m so cynical that I don’t even want to follow the debate because I just know the bill will be such a hash. Congress just can’t legislate.
But, since you’re a bit more sunny on it, think about this: In most cases, Medicaid (that’s not a typo, I don’t mean Medicare) is better insurance than private insurance. I think the perception is otherwise, but it’s false.
Two concrete examples:
1. In my wife’s therapy practice, Medicaid patients can have care essentially indefinitely. Case renewals sail through. Almost all private insurance is terribly limited, and care has to be shaped for the half-dozen or dozen sessions that are alloted. It is true that many private therapists don’t take Medicaid because of low reimbursement, but a single-payer plan would probably change that — therapists would have to suck it up and be paid a little less.
2. For my kid’s new anti-seizure medication, the current improvement isn’t the drug, it’s the release mechanism. These “XR” (extended release) versions allow fewer doses per day, and since kids tend to forget to take the meds, or are in school, it is far more than a convenience. The XR versions tend to be non-generic. Of course, private insurance only pays for generic, non-XR versions (and I have some of the best private insurance available). Since a XR version of my kid’s med was just released, luckily I don’t have to pay $100/month for her meds. However, Medicaid pays for a non-generic XR version of the same med, so every kid who has seizures and medicaid is probably on the XR med.
These two anecdotal points don’t even touch denial of benefits and crushing costs.
It may be true that the poor have worse care and worse outcomes, but I don’t think that it can be chalked up to Medicaid. Things like lack of transportation, lack of education to navigate the system, and all of the other issues that surround poverty have to be factored in. If you had Medicaid, good transportation and enough education and life skill to navigate the sometimes complex medical system, you’d be in better shape than the average insured American. This is not the typical American’s assumption, and certainly not the media’s.
Update. Since Medicaid is administered by states, I should point out that this is New York State. Though famously politically dysfunctional, the Empire State is generally pretty good — or generous, at least — with things like this. So take that into account.
WereBear
Which is why Republicans fear the Public Option. It would mess up their rhetoric.
They’re always willing to let people die in a good cause.
Julia Grey
Wait, wait, wait…
Medicaid funds are administered by the separate states, which can elect to supplement the amount that the feds give them…or not. Given that Mark Sangfroid, er, Sanford, is our governor, I’m sure that you can guess whether SC adds anything worthwhile to the minimums the feds give out.
Therefore Medicaid in South Carolina is much more limited in scope and eligibility and especially restrictive in terms of mental health care compared to most other states. The Medicaid-is-better situation outlined by WereBear does not obtain here.
Which only goes to show that we have to have NATIONAL standards for health care reform, and we know that will never happen.
Sigh.
geg6
What I don’t get is why the astounding and arrogant testimony by the health insurers isn’t getting more media attention. No one I know is even aware of their flat out statement that they will continue to deny paying customers for treatment regardless of what Congress says or does. They are all astounded when I direct them to the video and how Congress is running awa y from apublic plan as fast as they can. Only the public is serious about health care reform and apparently, we don’t count.
El Cid
The BBC’s NewsHour / World “Have Your Say” just had an extensive 20 minute feature on U.S. health care reform, beginning with the increased use of free clinics, and then focusing around a discussion with 3 guests, the NYT’s health correspondent & analyst Reed Abelson, Dr. David Cutler who’s in charge of the White House’s reform efforts, and a St. Petersburg, FL libertarian doctor (Dr. David McCailin? McCaleb?) who uses terms like “government takeover” and “collectivist”.
It was overall a good discussion except for McCailin or whatever sounding like a [crazy sh*t-bag] when it was time to crazily bash soc_ialism.
[Note: Via the World Have Your Say blog, I see that it’s Dr. David McKalip of the “Campaign for Liberty“.
This is how much of a crazy sh*t-bag McKalip is:
On Thursday I marched with lovers of liberty against the greatest threat to American patients in the history of our country: the rise of Medical Fascism. Some may wonder – what happened to socialized medicine, isn’t that the great threat? While it is true that there are attempts to soc_ialize medical care, the fact is that the power players in Washington are ready to set the rules and then hand the keys of health care spending over to large health insurance companies. This is the definition of fascism: the state decides what corporations will do and the corporations do their bidding while making a profit. As it turns out the very corporations making the profit also control the government. That is why I marched with members of the 912 project in Tampa today to spread the message that the government and large corporations should not control your health care dollar: you should.
Thanks, BBC, thanks for having him on without mentioning that.]
El Cid
Oh, well, as Apollo said, All things in moderation.
Xenos
Did they ever clean up Empire Blue Cross after the last round of scandals? I am going onto a high deductible plan with them in a couple weeks, but I can’t even remember how long ago they had trouble with highly paid nepotism, embezzlement, and so on. I am realizing that it may have been quite a while ago.
PeopleAreNoDamnGood
The scheme is being attacked by the paid destroyers of reform, who seek to find whatever faults there are in the proposed policies, and blow them up all out of proportion.
What doesn’t show up in that battle is the fact that any scheme, including the grotesque and lopsided one we operate under now (insurance tied to employment, insurers dictating terms of care, millions without access).
All schemes are imperfect. The responsibility we have right now is to pick the scheme that protects and serves the largest number of people, and delivers value in relation to cost.
The present scheme fails that test. The public option seems to move us in a better direction.
I really distrust anyone who, at this stage of the game, is going around saying we are doomed, that congress can’t do its job, blah blah blah. If the American Experiment has already failed, then maybe the blogosphere needs to be repurposed?
Reform will be a zigzag process of getting where we need to go. Deal with it.
Donna
“Update. Since Medicaid is administered by states, I should point out that this is New York State. Though famously politically dysfunctional, the Empire State is generally pretty good—or generous, at least—with things like this. So take that into account.”
And that’s why, in Texas, I don’t qualify for Medicaid even though my husband and I are below the poverty line. I’m neither pregnant nor have children…
Sucks to be poor, childless and in Texas.
arguingwithsignposts
@geg6:
Because the media folk in Washington DC have health care – likely pretty good, along with the various fat cats and federal employees they interact with on a daily basis. If it were their health that was at risk, they’d write about it more.
Just like, if weak-kneed, compromised congressfolk didn’t have gold-plated health-care they’d be much more inclined to pursue a public option or – god forbid – single payer.
F them all.
Jackie
It varies by state but in Illinois reimbursement is at a break even point usually, which is inadequate. I participate with a limited number of patients because I feel a duty to help care for the poor. So I work for free but at least they cover the overhead. Everytime the state budget is a mess they just hold payments. There have been times there is a 9 month backlog. There is a serious lack of access to specialsts who won’t participate but if I intercede in special circumstatces,for office care ,a few will agree to see them gratis.
I want a public option but you will not overcome my more conservative profession by telling us medicaid is wonderful. That is what they are afraid of and a growing number won’t take medicare because, while better, they still feel their work is undervalued. They will fight to the death over medicaid.
kay
@Julia Grey:
I’m going to disagree with you, Julia. Parity in funding for mental health care is an easy sell.
We did it here, and it was genuinely bipartisan. Everyone knows someone who needs (and has been denied) mental health care, and people really do get the idea that mental health care is comparable to physical healthcare. I heard the diabetes is like depression comparison over and over, and from people I never expected to make that connection. I think we’ve reached some critical mass on that issue.
Do it at the state level. It’s faster. You’ll succeed.
HRA
Sucks to be injured at work in NYS, too. I am responding to the statement about therapy in regards to WC.
Therapy was great for my never ever to leave me pain. Makes one wonder why someone who works gets zilch while those on Medicare get it forever.
El Cid
Sorry for the repeat, but it’s hiding out in moderation thanks to soci_alism:
*****************************
The BBC’s NewsHour / World “Have Your Say” just had an extensive 20 minute feature on U.S. health care reform, beginning with the increased use of free clinics, and then focusing around a discussion with 3 guests, the NYT’s health correspondent & analyst Reed Abelson, Dr. David Cutler who’s in charge of the White House’s reform efforts, and a St. Petersburg, FL libertarian doctor (Dr. David McKalip) who uses terms like “government takeover” and “collectivist”.
It was overall a good discussion except for McKalip sounding like a [crazy sh*t-bag] when it was time to crazily bash soc_ialism.
[Note: Via the World Have Your Say blog, I see that it’s Dr. David McKalip of the “Campaign for Liberty“.
This is how much of a crazy sh*t-bag McKalip is:
“On Thursday I marched with lovers of liberty against the greatest threat to American patients in the history of our country: the rise of Medical Fascism. Some may wonder – what happened to socialized medicine, isn’t that the great threat? While it is true that there are attempts to soc_ialize medical care, the fact is that the power players in Washington are ready to set the rules and then hand the keys of health care spending over to large health insurance companies. This is the definition of fascism: the state decides what corporations will do and the corporations do their bidding while making a profit. As it turns out the very corporations making the profit also control the government. That is why I marched with members of the 912 project in Tampa today to spread the message that the government and large corporations should not control your health care dollar: you should.”
Thanks, BBC, thanks for having him on without mentioning that.]
“Medical fascism.” Brilliant, just fucking brilliant. This is a shit-bag who deserves an international audience.
Wait, why not improve it? “Medi-fascism?” “Healthitarianism?” “Marxism-Obgynism?”
Thanks doc.
PeopleAreNoDamnGood
Please stop criticizing the “best healthcare system the world has ever known.”
mr. whipple
When my dad’s Parkinson’s got really bad, we went to see an attny that told us the same thing: that unlike the public perception, medicaid was the gold standard.
El Cid
@PeopleAreNoDamnGood: Unlike we lefty surrendercrats, Confederate Senator Richard Shelby (R-Alabama based foreign manufacturers) will stand up against the invasion of the Medical Fascists.
ronin122
@PeopleAreNoDamnGood: Well that pretty much means a fifth of all lefty bloggers and 80% of those who comment at such places.
Seriously though, I have to fully agree: big changes (like well pretty much EVERYTHING we need to do in this country at this point from healthcare and climate change to LGBT issues to foreign policy, name it and it’s there) take time. You need the support (some things popular, the rest from our dumbass congress), need to make something that works (not the easiest task), need to run head-on against the inertia of all changes, and to do so against the backlash of anyone who doesn’t want it. Not to make the comparison to the Civil Rights movement but does anyone think that the acts passed did so easily and quickly? No. So anyone who thinks this will be over in a month is naive.
Frankly I am not holding my breath for any concrete health care bill to be drafted until November IF lucky, likely closer to sometime early next year. So we got the time (too bad not the patience). However, now’s the time to stop this looking-over-their-shoulder-to-see-if-they-can-backtrack dead in the tracks now, or else what we get will be expensive and solve nothing.
Oh and about time for every Democrat to cut this bipartisanship fetish: not going to happen with the current GOP, and people elected them to get results DESPITE them, not non-results alongside them.
latts
It was nine years ago (so a much better economy/funding), but I was generally pleased with my mom’s Medicaid coverage in Mississippi, of all places… for example, they covered Procrit for her treatment-induced anemia, where most private insurers wouldn’t. Some of the limitations were a bit annoying– a limit of 4 prescriptions a month that made us pick the most expensive ones & pay out of pocket for the others, there was no local anesthesiology group that accepted Medicaid– but the best thing was that once she qualified (I won’t lie; there was a lot of paperwork), there were really no hassles, no disputes, no surprise denials. When a person has terminal cancer, that in itself is an amazing relief.
Edit: That said, I’m not in favor of state governments administering healthcare in general, despite the positive prior experience. In the South and pretty much any conservative states except maybe Utah, anything that state lawmakers provide for the previously uninsured will be designed to maximize profits and fail to benefit consumers.
Nylund
Is it really too much to ask that the American public should also be able to get the same insurance as the people we vote into office?
How could any politician get away with arguing that that the public does not deserve that?
I have zero faith that any meaningful healthcare reform will happen.
PeopleAreNoDamnGood
@ronin122:
Amen.
mistermix
Another irony of Medicaid: some very red states get some of the best reimbursement. In the 90’s and continuing through the Bush years, a number of “rural exemptions” were pushed through to save rural hospitals that couldn’t survive on Medicaid/care reimbursements. In the Dakotas, for instance, where there’s been a pretty consistent pattern of Democratic representation at the federal level, despite Republican legislatures and governors, a lot of little 20 bed community hospitals are prospering with a population that is overwhelmingly on Medicaid or Medicare.
That’s why it was such a damn shame when Daschle didn’t get the health care job. The way he fixed Medicaid/care for rural hospitals was one of the keys to him staying in office, and he had a track record of pushing some pretty controversial measures through Congress.
tc125231
@WereBear:
Julia Grey
Do it at the state level. It’s faster. You’ll succeed.
I don’t think you understand the political climate in South Carolina. It’s ridiculously ignorant and backward. But most importantly, it’s racist.
The main reason we are unlikely to improve ANYTHING that requires the government to offer additional assistance to the non-suburban, non-middle class is because the white majority, even the poor whites, deeply believe that anything having to do with aiding the poor is just a way to help shiftless n****rs get by without working for a living.
That particular variety of racism is underground now, but it remains virulent and widespread. It’s the main reason we keep electing dickwads like Mark Coldblood. The white majority believes people like Sanford will protect their pocketbooks from the dirty black welfare queens. It’s the REAL reason beneath all the extreme tax paranoia (read: crazy talk) I hear all around me at suburban parties. It’s acceptable to get vehement about taxes being theft, even if it isn’t acceptable any more to talk out loud about how taxes are being wasted supporting the the worthless darkies and their legions of snot-nosed pickaninnies.
Interrobang
My friend from Baltimore is on the public system, and it’s really a mess there. He can get routine maintenance care (which is good, since he is diabetic and has fibromyalgia), but not emergency care, and even the routine basic stuff doesn’t cover everything. He recently needed a bunch of bloodwork done, but that wasn’t covered by the clinic that he goes to, so he had to go to the ER. It took the better part of 24h for him to be seen. (!)
(When I need bloodwork done, which is relatively often, I get the form from my doctor and trot down to the other end of the building and have it done right there, and since I’m one of these Commie Canadians, I never see a bill…)
Martin
I’m going to talk to my mom about it tomorrow. She worked in health insurance for years but is now retired and volunteers at the local hospital to help the patients deal with their health insurance. When Med-D came down, she was swamped helping the patients sort out their options. She has a pretty good sense now of what insurers are decent and what are just fuckers (CA Blue Cross leads her list, IIRC – I think they were the ones that denied coverage for treatment for a heart attack for a patient who was traveling out of state something like 4 times, with a different excuse each time. I think it took my mom 2 months to sort that out and get them to cover the woman, including a call to a board member to intervene).
Interestingly, her husband is a C-level exec at a large regional non-profit insurer. I talked to them a lot throughout the campaign and since Obama was elected and they’re concerned (but not alarmed) about Obama’s vision. I’d say 5 years ago, they had bought into the ‘socialized medicine == teh evil’ mindset and would have been alarmed, but through my mom’s experiences, they realize that private insurers can be far worse. Because he’s at a non-profit, he’s not too worried about their ability to compete if this is set up well, but a public option would require a complete reboot of the company. He expects that most of the for-profit insurers would go under, with the better ones remaining as sort of a boutique industry. The non-profits would be a mixed bag – some are much better run than others, and the shitty ones would vanish fairly quickly while the well run ones should be okay. Once policyholders start running from an insurer, it’s very, very difficult to keep it alive. Cash flow is like blood, and a public option presents a threat to *all* private insurers in that regard. Anyone in denial about their ability to compete with a public option will die – quickly. The HMOs are the wildcard – they actually could do pretty well because they have relatively few external costs (drugs and equipment, mainly). The big ones basically have their own supply chains.
His more immediate worry is that Medicare is reasonably fucked up and that should get fixed first, and if that can’t happen, then nobody should expect a public option to be any less fucked up.
But the potential good news not being presented in a public plan comes on the billing side. If the government can get a massively improved billing system working out of the public plan, then they’ll quickly get good doctors flock to them, and maybe lure some of the better ones out of the HMOs. We’ve had some incredibly good doctors in our HMO and we always ask them why they work there, and their answer is all the same – they want to see patients, not deal with insurance companies. They make less working for the HMO, but they have fewer headaches, their income is more reliable, and they get to spend far more time doing what they went to medical school to do. That’s the goal of the public plan.
tc125231
@Nylund: We’ll get health care, and meaningful taxes on the corporations and the wealthy, when Americans show the kind of determination and nerve Iranians have been showing.
I’m not holding my breath, but I’ll show if you will.
oh really
Medicaid is run by states. In Washington State single adults are not eligible. With a sex change operation and an adopted child a (former) male might have a chance. Otherwise, singles have to apply for Basic Health, which not only isn’t accepting new applicants, it’s cutting 40% of its recipients from the rolls.
That’s the great thing about the American “safety net.” It disappears when it’s needed most.
tc125231
@PeopleAreNoDamnGood:
Brian J
Wasn’t it earlier this week when we learned that Obama planned to push himself into this debate more forcefully? I remember reading something to that effect.
If that’s the case, then it’s probably because he realizes that this call all easily fall apart, killing his one big chance to get some major done. And to some extent, I think he’s right. Of course, even small steps in the right direction are better than nothing, but something pretty gigantic would be nice. I think the public is open to something drastic, as long as a few points are emphasized:
1. Public options aren’t perfect, but they could be better than private ones for some people.
2. If you don’t like the public option and have a private one you want to stay with, the administration is going to ensure that’s what you can do. It’s entirely a matter of choice.
3. Some minor tax increases can make life better for a lot of people.
4. Of course, if we reform the system to institute cost controls, we can both make existing care better and expand coverage to more people. Hence, we could possibly pay less in taxes for a new system than we otherwise would. And more than anything, cost controls will help ease a massive strain on the federal budget.
5. The other side has no plan, so while we have lots of options, we realize that nothing is perfect and will gladly be open to suggestions about how to improve any new coverage for people.
That’s not very artfully said, but I think the aforementioned points convey everything the administration wants to get across. And if we can take a page from the Republicans and repeat the same points over and over and then over some more, like they do with tax cuts, we can beat back any propaganda from the special interests.
PattyP
I can certainly vouch for the difference between XR versions of a medication and the generic, non-XR ones. They are absolutely not the same. For someone with a brain that isn’t firing on all thrusters, it makes a world of difference to have an easy-to-remember-to-take medication. I take an anti-anxiety/depressant med that used to cost $110 for a 3-month supply (through insurance), whereas the non-XR generic was only around $40. My mail-order pharmacy kept pushing the generic on me for a while as “equivalent.” They also suggested completely different meds that were cheaper than what I was taking. Anyone who uses anxiety, depression, or ADD meds knows how differently each one affects different people, and how long it takes to find the right med or balance of meds as well as dosages. I went through two years of psych evals and different meds before I found the right one for me. Interestingly, shortly after my HR department switched to this plan, they sent a survey to employees asking for their opinions of it. I wrote much the same thing I did above, and a few months later, the price of my meds dropped to $60. I have no idea if my survey response had any effect, but I pretend it did so I can feel important. ;-)
tc125231
@Interrobang:
Scott H
There is something very, very impressive about a government that can convince its citizens that said citizens shouldn’t have the same level and kind of health care that the members of the government provide for themselves at the citizens’ expense.
That’s some kind of super voodoo mind control mojo at work.
PattyP
D’oh! My comment went to moderation but I can’t figure out what word flagged it.
geg6
Anyone who thinks we’d do better to try for health care reform through our state legislatures has never lived in nor has any familiarity whatsoever with the PA legislature. We’d all be dying in the streets while they got tax-payer funded tummy tucks if it was up to them.
Ripley
As others have noted, Medicaid is state-administered, although often with a second-layer, conventional insurance company administrative entity in place as well. As nightmarish as that sounds in terms of bureaucracy, here in New Mexico (hardly the squeakiest-cleanest state government among the fifty…), it’s extremely efficient, broad in scope of care, pays adequately/quickly on both sides of the desk (i.e. patients and providers), and generally fair in terms of eligibility (as things stand now – this element, of course, needs serious tweaking toward inclusiveness). Hell, NM state government even fired Value Options (a recent mid-level Medicaid administrative tier) for mismanagement, and not after decades of slop-job admin from VO – after less than three years.
So, yeah, to some degree the standard. Half my patient case-load are people using Medicaid, and I’m more than content with the arrangement. On the other hand, Medicare in NM? A well-and-true fookin’ nightmare; I’m on my third attempt at becoming a provider (after being a Medicare provider in PA for 8 years…). The administrative body has shot down my applications for things like, I shit you not, misplaced punctuation, a transposed number, and so on. The rub: the administrative body is a for-profit corporation in (wait for it, Donna @ 7)… Texas.
Lee
The guy I carpool with has a daughter that qualifies for some sort of Medicaid (extremely severe epilepsy). It picks up whatever his private insurance does not cover.
He is extremely happy with the way it is administered and this is in Texas of all places.
Martin
No, it’s that 97% of the public has no idea what the health care plan of Congress looks like. Anyone pushing for a public plan would go far by cutting an ad outlining the benefits of Congress’ coverage and then pointing out that it’s a public plan. 97% of the people assume that because Congress has a great plan, that it’s a private plan, because the message has always been that private plans are better.
For extra credit, 4 Congressmen (or leaders in the party, such as Howard Dean) of varying backgrounds who support a public plan (elderly, pre-existing condition, young with family, single) should go and get quotes from well-known insurers for what that coverage would cost and put that in the ad.
kay
@Julia Grey:
Thanks. I live in Ohio and we have lots of racists here, so I know what you mean. Many of them are Democrats. I live in a rural white area, and we have lots and lots of poor people, too. They’re all on Medicaid. We had success in the wingnut state legislature with a parity bill. Poor whites backed it.
I’m going to buck the trend here and say Obama shouldn’t lead this. I think it has to be led by Congress.
I know, I know.
Congress is broken, they’re bought and paid for, they’re weak and messy, but goddamnit that’s our system and there’s something really wrong with one man in the executive branch calling all the shots.
Congress has to step up. Obama cannot and should not lead every charge. It’s not even a sound political strategy. The public will balk at the President Obama One-Man show at some point. That point is approaching.
I did not vote for a unitary executive.
Congressional Democrats have to do their job. They have to be dragged, kicking and screaming, and forced to write a decent bill.
If we can’t do it the way it should be done, then we should admit our system of government is broken, and try something else.
El Cid
Speaking of health matters:
After a SINGLE dose of Ipilimumab (a monoclonal antibody) on two patients with seemingly incurable and terminal prostate cancer:
kay
@geg6:
Get it through a legislature. I don’t care if it’s state or federal.
I think the “help us, President Obama!” strategy on every single issue is fundamentally flawed.
I have no earthly idea why Robert Reich is writing letters to Barack Obama. The letter goes to Pelosi and Reid. I hate them too, but they’re Congress, and we’re stuck with them.
Handling health care like the stimulus is a bad strategy. It’s too big for the President to ram through. The President shouldn’t ram it through. Congress has to do it.
jcricket
What’s funny is that the medical insurance they have (the media folks) sucks 1000% more than they know. Karen Tumulty recently found out, after 15 years of covering health care as a journalist, that having insurance is no guarantee of being able to use it, or avoid bankruptcy.
We’ve got 50 million people outright uninsured. 50 million more with insurance so crappy it’s not worth the premiums they’re paying. And I bet another 50 million (you and me) whose insurance is pretty good until we get really sick, or fail to fill out some form properly, etc.
The whole system is f’ed up, and while I’m not surprised the industry is defending their profit machine, I’m shocked Democrats aren’t point out the flaws in the system more. We’re already paying a ton through taxes (extra for ERs, S-CHIP, Medicaid, Medicare, VA, etc.) and lost productivity – and getting the shitty outcome I mention.
We could pay less, cover everyone, virtually eliminate medical-cost-related bankruptcies with a solid public plan (or better yet, single payer).
If we don’t move in that direction now, we’re just increasing the cost and trauma to the system down the road. There’s no way around it. Failure to act right now to build a public/private hybrid will virtually guarantee a nationalization of the system down the road – of course by that point we’ll all be too sick or dead to care.
Kirk Spencer
As a number of people have noted it’s run by states. However, most of those noting so aren’t making a clear counterpoint.
Medicaid is very good in every state. Notice the restrictions above – they’re not what is provided, they’re restricting who gets access.
IF you can get on, Medicaid in either of the Carolinas (or Georgia, where the income for a family of three cannot be higher than 950 per month – sigh) is excellent.
Frankly, I’d be overjoyed to see a surprisingly simple thing like: Medicaid is available to all. If you are above the “free” level, you will make a monthy payment adjusted to your income to a maximum of ($$$ – and that’s the tricky part).
We have a good structure. We have TWO good structures – medicaid and VA. All the tapdancing is sleight of hand.
Yutsano
We actually have four: Tri-Care (the military/dependent health care plan) and Medicare (despite all the handwringing about reimbursements and Part A being in fiscal trouble, it’s still a very efficient health care delivery system). I guess you could throw SCHIP in there as well although I don’t have children so I have no idea for sure how well that works. It was my understanding SCHIP was simply an extension of Medicaid anyway, so that could already be in there. The point is we already have systems in place. We should not be going about making a new system out of whole cloth when we could just as easily expand what already exists and fund it decently.
Orac
Whenever I see someone say doctors will just have to be “paid a little less,” I see a lack of understanding, at least to some extent. The problem with Medicaid reimbursement for many surgical procedures and diagnostic tests is that it often doesn’t even cover the costs of providing the service or, at best, barely meets costs. This is certainly true of mammography; indeed most radiologists lose money on routine mammography but make it up on the additional views done on diagnostic mammographies needed to define abnormalities and on biopsies that need to be done on abnormalities found on mammograms. As for general surgeons, a fair number no longer do a bread-and-butter operation, inguinal hernia repair, because the reimbursement doesn’t even cover their expenses for doing the operation.
monkeyboy
If a ‘public option’ is passed then we can probably assume that it will be so crippled that it is undesirable to anybody that has any other option. Any thing else would be unfair competition with the insurance industry.
Then again I could see the insurance industry rooting for an available public option as a place to dump less than peak-of-health clients – say a provider for a business says it doesn’t have to insure all employees because there is always the public option.
Mary
The CBO estimates the Democrats plan will add up to $1.6 trillion or more to the deficit over the next 10 years and only cover 13 to 14 million of the 50 million without insurance. The plan would subsidize these people to the tune of $6000 per person by 2019. Where is this money going to come from? Answer, You and me with the Democrats openly proposing big cuts to Medicare and Medicaid, higher taxes and sky rocketing deficits that will lead to inflation that will hurt the elderly on fixed incomes the most.
The U.S. debt currently with Medicaid and Medicare is $57 trillion, $11 trillion in Social Security, $11+ trillion in the current budget. That is about $80 trillion in the hole and growing by the day. Moreover, state like Ca and NY are going bankrupt due to the enormous costs associated with Medicaid, which sounds a lot like the “public option” the Democrats are proposing.
A government takeover of the health care will inevitably lead to higher (costs, deficits and taxes) and lower quality of care. Than to solve the “problem” (that government created in the first place), politicians will impose even higher taxes and rationing of health care.
The goal of the Democrats health care take over is to suck as much money out of our pockets as possible so the government has control of our money and how it is spent. The ugly truth is that the poor and elderly on Medicaid and Medicare will be forced to bear the brunt of this with Medicare premiums going up and services being cut in order to help pay for the health care costs of the uninsured. Think about it. The money has to come from somewhere.
Given the government’s mismanagement of Social Security and Medicare (that are going bankrupt) how is it that anyone can trust the government not to make an even bigger mess of health care is beyond me. I guess if you like sky rocketing deficits, higher taxes, run away inflation and some bureaucrat making life and death decisions on who gets what health care if any, a government take over of health care as proposed by the Democrats is for you.
A better way to bring down the costs of health care and cover more people is to get government out of the way of the free market. Give the health insurance industry the option of providing a wide range of insurance coverage based on people’s needs and ability to pay. Another way to lower costs is to reign in the ambulance chasers with tort reform laws that will lower the cost of malpractice insurance. Medicaid and Medicare are going bankrupt and instead of cutting their costs by reducing the amount of reimbursement the government pays for services just get rid of them and replace them with tax credits and some form of government subsidies for people with low incomes to help them pay for their choice of insurance. That alone would save trillions of dollars
Comrade Stuck
@Mary:
This has been a public dis-service announcement from the Grand Ole Party of Lies, Distortions, and Sexual Perversion.
Delia
@Mary:
And which insurance company do you work for?
iluvsummr
@Martin: Has anyone seen ads for a public plan? I haven’t. Certainly would help, but who’d pay for it?
kay
@Mary:
Mary: It’s what you said in 1993. How’s it working out?
We tried the GOP approach. Big flop.
kay
@iluvsummr:
I don’t think they need ads. S-CHIP and Medicare and Medicaid are popular. S-CHIP is wildly popular. Parents love it.
What we need are the Democrats in Congress to promote the plans we already have.
They could start by pointing out that the GOP idea of offering private plans to compete with Medicare was a massive fail. The private plans cost more, and they’re draining the Medicare system. It was a spectacular failure, and no one talks about it.
kay
This is for Mary:
34 states have enacted tort reform since 1986.
Let me know when tort reform starts paying dividends. How long do you think it might take?
Insurance companies took the savings and pocketed it.
They forgot to pass the savings along to the consumer.
No one could have predicted that.
Jackie
@Kirk Spencer: I’d agree from a patients perspective if you get medicaid and IF you can find a good doctor who will take you as a patient it is very good coverage.
I like my job but I expect to collect a salary. If your state pays doctors as mine does I see you for free. The state payment covers my overhead. In a major metro area my costs are not low. Ask any small business owner what happens when their accounts receivable is 90 plus days. I can only afford to take a few new patients. Anyone who is already a patient “grandfathers in” if bad luck lands them on medicaid. Every year we sit down and see how many new medicaid patients we can afford. Everyone we see gets treated just like all the other patients, they are generally grateful that we see them and we do it but many scramble to find an office and many settle for a situation where they don’t feel well cared for because they have few options. Specialty care is even harder to access.
Trust me, I am used to the you greedy doctors routine in this. We have our share of the venal. But primary care doctors are not the ones with alot of “fat” that can be trimmed. There is near universal agreement by the experts that we are underpaid and overburdened. If lots more people end up with a buy in to medicaid you may have great insurance and no doctor. It’s not a recipe for good care.
latts
@Comrade Stuck:
I was going to break down and confess that our true healthcare objective for these many years was to tax all hardworking white Christians into slavery indentured servitude and force them to watch as the fruits of their labor are squandered on monthly diagnostic MRIs for all single mothers, semi-annual tooth whitening for underachieving schoolchildren, and three free abortions per year (only one of them just before birth; we do have our limits) for all females over the age of nine (with a breast-implant flex option if they prefer contraception instead).
Yutsano
To expand on that, seniors when told that Medicare is a government program don’t believe it. They sincerely believe it to be a private entity because it works so well and so efficiently and they’ve been told for the last 30 years that nothing good comes from the government. Speaking as someone who is on Medicare due to disability, my personal experience with it is I love it. I’ve never had a bill not paid, my responsibilities are laid out, and I don’t take advantage of the system just because I have it.
Kirk Spencer
Wow, Mary. Let’s take those in turn, shall we?
The CBO study specifically stated it was not including two major funding elements the bill under consideration would include. It didn’t do so as they were finalized. In addition it failed to analyze savings to individuals and businesses. In other words it’s a study of one of the bills based solely on expenses. Of COURSE it’s bad.
Inevitably? I submit Medicaid as proof you’re wrong.
FUD. There is no single objective statement in that at all.
Nowhere have I see that in any bill. It’s tied to the previous bit of an analysis done without considering any revenue alternatives. This particular FUD fails to note there are several alternatives under consideration such as VAT and another tier of income tax.
This one is a lie. Social Security is not going bankrupt. In fact it’s doing well enough it’s STILL being looted to pay for other issues. As to Medicare, yes – and that happens to be part of the reason we need health care reform. A major driver for the money problem is that medical costs have sky-rocketed. Pull that back in – with, among other things, large volume cost controls such as found from a national health care program – and much of the problem will go away. As to mismanaged – Reagan lied when he made the government a scare word. In general government offices do a lot on surprisingly little money. There is waste and fraud, with one of the worst departments being the department of defense. On the other hand, there’s a great deal of waste and fraud in private industry as well – except they tend to be unregulated.
That’s what we’ve been doing. It’s why we’re in the fix we’re in.
Real simple rule – if you’re in a hole, stop digging. The process you describe throughout your final paragraph works under the belief that maximizing profit maximizes benefit. It doesn’t. Maximum profit is done by cutting out significant expenses – and in the health insurance industry that’s most typically done with two terms: Rescission; and “prior conditions”.
That was very well written FUD, but it was FUD.
kay
@Yutsano:
It is, it’s hysterical. Someone needs to tell them it’s, um, THE PUBLIC OPTION.
My clients say “I have the Buckeye”. They’re talking about S-CHIP. That’s the name of the S-CHIP program.
I say “so, you’re on Medicare?” They say,”no, Kay, the kids are on the Buckeye”.
kay
@Kirk Spencer:
Thank God, a patient person. To rebut Mary’s talking point opus.
Comrade Stuck
@kay:
I would’ve, but was afraid my message would have been lost in a hail of 4 letter words.
Yeoman’s effort Mr. Spencer.
Yutsano
I agree. There is no way this system will work without a better imbursement schedule for both primary and specialist doctors. I personally would have zero issue with my primary doc making $150 a visit every time I see him or getting paid a decent salary in the $90-110K range as long as the care he provides stays at the quality I get from him (and he’s excellent BTW). This may be the huge flaw in the fee-for-service model we have now. The question is how do we determine a better more equitable model to replace it?
Yutsano
How in Hades did I get moderated???
Delia
I don’t think Mary’s still here. I think she was a hit and run. Meanwhile, here’s Bill Maher’s AMA commercial.
Kirk Spencer
@Jackie: I hear this argument a lot. There is a degree of accuracy within it. On the other hand…
According to the 2008 annual survey of the American Medical Association, the worst paying field for a starting physician is Family Medicine. In that field the starting physician can expect to earn only $130,000 per year (in 2007). After time it gets a bit better – the median for the worst field (geriatrics) is $187,000 per year. Most fields are earning significantly higher. (AMA says these do not include benefits.)
According to the Office of Occupational Statistics, physicians have one of the top three median incomes – their competitors are “Chief Executives” and airline pilots. The OOS says the physician median income is around $280,000 per year.
So here’s the deal. When you’re on top of the heap and you tell someone who makes a fraction of what you do that you deserve to be paid more, expect no sympathy. (Comparison based on a national median household income of ~50,000.)
Comrade Stuck
@Delia:
I was a little disappointed she didn’t weave Freddie Mac, Fannie Mae, and Chappaquiddick into her little scree. Or at least Barney Frank.
kay
@Comrade Stuck:
I think we have to stop pretending that uninsured people aren’t receiving medical care. That’s what every conservative rant is premised on: that people will begin receiving medical care, adding massive costs.
Uninsured people receive medical care. It’s spotty, and it sucks, but we do treat them, after a fashion. We don’t (yet) leave people to expire in the street.
They get medical care, and we all pay for it. The only question is how to allocate the cost.
Do conservatives believe that the emergency care that uninsured people are currently receiving is free?
Yutsano
Nate Silver weighs in on the public option debate:
http://www.fivethirtyeight.com/2009/06/public-support-for-public-option.html
Taking out the Ras numbers (which being Ras were pretty much guaranteed to be ass anyway) it seems clear that this is definitely a majority opinion for at least the OPTION of having a public health plan. So what’s your excuses now Congresscritters? (I really should say Senate because the House plan has a public option in there as of right now.)
Mary
Kirk Spencer, Sorry you did not address the issues in my post above in any factual way other than name calling by calling the post “FUD”. So here are my REPLIES:
1) “The CBO study specifically stated it was not including two major funding elements the bill under consideration would include. It didn’t do so as they were finalized. In addition it failed to analyze savings to individuals and businesses. In other words it’s a study of one of the bills based solely on expenses. Of COURSE it’s bad.”
REPLY:
—Where do you think the other “two major funding elements” will come from? There are only two sources for the government to get “additional funding” Higher Taxes and More debt that will make the deficit go even higher which ultimately leads to inflation.
— As to savings for business, if you think FORCING businesses to pay for the health care of their employees will be a “savings to business” I have a bridge in Brooklyn I would like to sell you.
— As to savings to individuals, if you think higher taxes and higher Medicare premiums will be a “savings to individuals” well I have another Bridge in Brooklyn I would like to sell you.
2) A government takeover of the health care will inevitably lead to higher (costs, deficits and taxes) and lower quality of care.
“Inevitably? I submit Medicaid as proof you’re wrong.”
REPY: Hello,
— New York and California are going bankrupt in large part due to the high costs of Medicaid which proves I am right.
—The CBO has already put a price tag of 1.6 TRILLION dollars on the Democratic Finance government health care plan.
—Both the House and the Senate are openly talking about raising all sorts of taxes like a soft drink tax, a value added (aka national sales tax), a tax on current employer benefits, etc. etc. etc.
—As to quality of care, cutting over $400 billion from Medicare and Medicaid will result in lower quality of care for the poor and elderly as their services will be cut in order to help pay for the cost of providing insurance to the uninsured.
3) The goal of the Democrats health care take over is to suck as much money out of our pockets as possible so the government has control of our money and how it is spent.
FUD. There is no single objective statement in that at all.
REPLY: The Democrats health care take over WILL result in higher taxes ergo more money being taking out of our pockets which the government will control, not us. Those are the OBJECTIVE facts.
4) The ugly truth is that the poor and elderly on Medicaid and Medicare will be forced to bear the brunt of this with Medicare premiums going up and services being cut in order to help pay for the health care costs of the uninsured.
“Nowhere have I see that in any bill. It’s tied to the previous bit of an analysis done without considering any revenue alternatives. This particular FUD fails to note there are several alternatives under consideration such as VAT and another tier of income tax.”
REPLY:
Here is the source for that:
To pay for health care overhaul, President Obama proposes $313B cuts in Medicaid, Medicaire spending
By Celeste Katz
DAILY NEWS POLITICAL CORRESPONDENT
http://www.nydailynews.com/news/politics/2009/06/13/2009-06-13_to_pay_for_health_care_overhaul_president_obama_proposes_313b_cuts_in_medicaid_m.html#ixzz0J4j3sxOE&D
5) Given the government’s mismanagement of Social Security and Medicare (that are going bankrupt) how is it that anyone can trust the government not to make an even bigger mess of health care is beyond me.
“This one is a lie. Social Security is not going bankrupt. In fact it’s doing well enough it’s STILL being looted to pay for other issues. As to Medicare, yes – and that happens to be part of the reason we need health care reform. A major driver for the money problem is that medical costs have sky-rocketed. Pull that back in – with, among other things, large volume cost controls such as found from a national health care program – and much of the problem will go away. As to mismanaged – Reagan lied when he made the government a scare word. In general government offices do a lot on surprisingly little money. There is waste and fraud, with one of the worst departments being the department of defense. On the other hand, there’s a great deal of waste and fraud in private industry as well – except they tend to be unregulated.”
REPLY:
You said it well, Social Security is being “looted” which is a very good reason not to trust the government with more of our money. As to Social Security going bankrupt as a “lie” Sorry, unfortunately Social Security is going bankrupt. Here is the source:
http://www.businessinsider.com/henry-blodget-the-social-security-bomb-2009-4,
“Instead of $703 billion coming in over the next 10 years, the current (overly optimistic) projection calls for only $83 billion. This means at least another $620 billion in fresh borrowing will have to occur.
More importantly, this means that the United States eventual date with bankruptcy has been moved forward by about 8 years or so. It also means that instead of being some future problem, a few administrations down the road, it is a near certainty that the current administration will have to confront some very difficult funding decisions that will be forced by the inability to borrow enough to pay for everything.”
6) A better way to bring down the costs of health care and cover more people is to get government out of the way of the free market. Give the health insurance industry the option of providing a wide range of insurance coverage based on people’s needs and ability to pay.
“That’s what we’ve been doing. It’s why we’re in the fix we’re in.”
REPLY: NOT TRUE, government has put all kinds of mandates on insurance companies for, mental health, alternative medicine, Viagra. etc etc. What I am talking about is letting the insurance companies put together a bunch of alternative plans that exclude the above government mandates. fyi, I don’t want to pay for mental health coverage or any form of alternative medicine. If I had the option to exclude those my costs would go down.
7) “Real simple rule – if you’re in a hole, stop digging. The process you describe throughout your final paragraph works under the belief that maximizing profit maximizes benefit. It doesn’t. Maximum profit is done by cutting out significant expenses – and in the health insurance industry that’s most typically done with two terms: Rescission; and “prior conditions”.
REPLY: “Real simple rule” human nature dictates that without any “skin in the game” aka profit, humans will not break their neck to do something for nothing unless you believe in slavery that is.
.
Jackie
@Kirk Spencer: I wasn’t asking you to host a fund raiser. I”m tellling you that I will not work for zero. What part of the payment only covers overhead and I wait months to get it was unclear? I do charity care and as the insurance companies all cut reimbursement and increase paperwork I can do less.
I am aware that alot of people make less money than any doctor. I am grateful for that hence my willingness to help people. I even see some people who pay nothing and then I am paying to take care of them because I still pay my staff etc.
I thought we were talking about workable solutions If you are going to sing another chorus of greedy bastards be aware that no solution will work if even primary care doctors will not participate. I am on the liberal end of the md spectrum/ I am on the lowest paid end of the md spectrum if you can’t sell me there is going to be no hope of selling the plan. I get that come the revolution you’re heading to your family doctors office to shoot us first. If you believe that your family doctor is making more than everyone but pilots and ceo’s you are delusional. My husband was a mid level manager at a major company and our compensation was similar and he had better hours. Way better hours.
Yutsano
Exactly Kay. I even raised this point with a conservative troll on another blogsite and his only response was to insult me. If an uninsured individual goes to an emergency room, those costs are absorbed by both the taxpayers and the insured already. How? Charity programs through the government and higher expenses pulled from the insurance companies. Even then emergency care operates at a loss at most hospitals. The hospitals get their money in the end, it’s just a matter of whether we want that system to be orderly and even or chaotic and spread out.
Comrade Stuck
@Jackie:
I may be in over my head with this, but I think I see your point and it goes to the huge percentage health care is of our overall economy. 17 percent I think. Everyone agrees that costs have to come down, but if they come down to fast a lot of good docs like you are going to get creamed. Not to mention losses of jobs in other ancillary parts of the health care industry, Ie insurance companies. That is why, though I think single payer is the best way to go for the long run, a sudden change could shock the economy into collapse. It needs to be done slowly, so the effect of contraction can coincide with adjustment in the overall economy.
(Disclaimer) If in left field, please ignore.
Julia Grey
IF you can get on, Medicaid in either of the Carolinas (or Georgia, where the income for a family of three cannot be higher than 950 per month – sigh) is excellent.
I don’t know how you can say that. Do you have personal experience? My sister is on Medicaid in SC. Her mental health coverage (she has a mental condition!) allows her to see a psychiatrist for a maximum of 1/2 hour once a month, solely to “adjust her meds.”
Most other doctors don’t even take Medicaid. The only reason our general practice physician agreed to see her was because she was a member of my family. Otherwise she might not have been able to find a basic health care provider who would take her “excellent coverage.”
Yutsano
Also Comrade, the actual percentage of healthcare dollars going to actual doctor salaries is somewhere in the range of 10% (the actual number escapes me and I can’t find where I read that now) so simply paying doctors less isn’t really going to make a huge impact. But cutting that 30% of massive administrative costs the insurance companies have is going to save money period.
Oh and don’t respond to Mary, she’s so far up Rightwingville ass it’s not worth arguing it out. Remember these folks argue from a position of certitude, their beloved Saint Reagan could NEVER be wrong about ANYTHING!
Kirk Spencer
@Jackie: Please re-read what I said. I said I understood.
What I pointed out was that your complaint was about money – in significant part about your income. And if you frame it like that you’re going to lose a LOT of people, because they’re going to look at how much you make and say, yep, “greedy”. They’re going to see how their local doctor sees ten or so people per hour and collects $120 to $150 each, and they’re not really going to see the insurance or rent or cost of maintaining equipment or any of that. They’re going to see that 50 to 75% of the doctors around (again depending on state) APPEAR to be doing fine with medicaid.
They’re just going to see a rich person whining about money. And as I said, that stance garners no sympathy.
I’m not really certain what argument you can lay that would be effective. In part you can emphasize the late payment – 30 to 110 days late (depending on state) is definitely “not good” regardless. You can possibly emphasize how high YOUR costs are – the insurance, the equipment, and such. But when the focus moves to how it cuts into your income – and that’ll happen whether you talk about it or it’s just “staff wages” and the implication – you’re fighting from a major handicap.
You – not personally, but rather your profession – is rich. You, bankers, and lawyers cannot get sympathy if the discussion in any way encompasses “not getting enough money.” And I’m not sure how to work around that.
kay
@Yutsano:
Clinton brought it up in one of the 10,000 debates and I was cheering her on.
When people file bankruptcy because they can’t pay 40 grand in uninsured meds, they discharge the debt, not the fact that they received medical care, or the expense of the care. The provider has to cover the cost elsewhere.
We’re all paying for that. Conservatives think that expense just went away
Kirk Spencer
@Julia Grey: half an hour once a month?
You are aware, I assume, that a lot of paid insurances won’t cover that much? (Yes, preference for that would be once a week, but my last two insurances would only have paid that for about three months. And I had what I considered GOOD insurance.)
Yes, I’ve some experience. I make too much for my family (see the Georgia remark – unemployment insurance pays too much) but my daughter does get it (thanks to the SCHIP clauses). She has (deep breath) idiopathic CNS hypersomnolence and has to see the specialist on a regular basis as well.
bottom line – yes, I consider medicaid (from the point of view of the patient) to generally be quite good insurance.
Jackie
@Comrade Stuck: It is very complicated. There are alot of reasons that everything is so expensive. The system is broken. I want it fixed. The place where most people interact with the system is their family dr. We have alot of influence if the solution is unacceptable. I don’t bring it up but you’d be suprised at the number of patients who ask if I think whatever solution is proposed would work. If most doctors say no the political will won’t be there to get it passed.
We’re well paid compared to alot of people, but I would argue not out of line with other professionals, accountants lawyers etc.but primary care has had flat or declining reimbursements for several years. As small business owners we have all the costs, including health insurance of any small business. All the cost control measures that get implemented pass the paperwork to us. The folks who analyze the system pretty much all agree we’ve gotten the short end of the stick. Part of controlling costs is getting more of us. Now you can argue that medical students aren’t all that ,in the intellect department, but that is a reason an ever declining number of them pick primary care. If I did work for free it wouldn’t come close to making it affordable for the average person. Take another look at those pie charts and they usually lump all md salary together. and we still are a pretty small slice.
Yutsano
People need to understand that cardiac surgeons make somewhere in the 300K range and do probably no more than forty or fifty surgeries a year. Yes that’s it, A YEAR. They are way overrewarded for the amount of work they do and their training is not necessarily more expensive, just highly specialized.
But I’m going to harp on this point: focusing on doctor pay is the wrong focus. We could actually pay MORE under a single-payer system simply because the administrative costs would be gone. Poof. Going from 30% to 5% is a HUGE savings advantage, which is really what has the private insurers scared. They can’t operate against those margins and still churn out their huge profits for their shareholders. This doesn’t mean that the cardiac surgeon shouldn’t take a haircut. Just get to where the money is really going to be saved and figure it out from there.
Mary
Yutsano, Typical lefty, lots of name calling and no substance. The reason you won’t reply to my points is because you know they are are based on facts, which the left cannot deal with other than name call. So what pray, do what do you disagree with about the Democratic Health Care Proposal?
The Democrat Health Care Reform Proposal will result in:
— Higher Taxes
— Higher Deficits
— Cuts in Medicare and Medicaid
— Government Rationing of Health Care
— Less Freedom of Choice
— Increased Costs to Business
— Increased Cost to Medicare members
— Lower Quality of Care
If you don’t reply, I will assume you know the above is all true but have a fairy tale belief that the government who has mismanaged Social Security and Medicare (that are going bankrupt) can be trusted not to make an even bigger mess of health care. I guess if you like sky rocketing deficits, higher taxes, run away inflation and some bureaucrat making life and death decisions on who gets what health care if any, a government take over of health care as proposed by the Democrats is for you.
Comrade Stuck
@Mary:
As true as wmd in Iraq.
Jackie
@Kirk Spencer: I think we are talking past each other. Correct me if I misunderstood but I thought you said that letting everyone into medicaid would be a workable solution. As I said I’m used to the greedy bastard argument. I understand that alot of people feel that way and they have no sympathy in the abstract. In reality however pollsters say that people trust our take on the solution. If you are trying to convince the lowest paid members of any profession that the solution is they should get paid less you have a long row to hoe. If you are trying to convince them to work for nothing while one 350.000.000 ceo could pay for175,million of them I see no hope. Most doctor in my area don’t take medicaid at all or do what I do. A huge influx of patients who use that insurance won’t get a doctor. Other states, other areas of this state may differ. Again I’m not in an er, I don’t have to take all comers. You won’t go bankrupt getting your health care in the ER under your system but the system does still go bankrupt and you still get crummy care for chronic conditions.
By the way you’re getting crummy care in a mill if that is what you see. A family doctor who’s practice skews pediatric doesn’t see that many an hour. I manage 4 to 5 and I’m moving as fast as I can. I could charge 3,000 a visit, I get paid what your insurance company decides I get paid.
I’m not asking you to feel sorry for me. We are allies and I am telling you what that plan buys.
Mary
Comrade Stuck, There may have been no WMD’s in Iraq but I can assure you if President Obama and the Democrats get their health care proposal passed it will put WMD’s into our economy big time. In fact, President Obama and the Democrats may do more harm to our economy and way of life than Saddam (maybe even Osama) could ever hope to do.
Comrade Stuck
@Mary:
Your tears taste sweet. But you really should pace yourself. 7 plus years is a lot in blog time.
kay
@Mary:
Mary, we’ve heard all this. It’s in our history. Conservatives said the same thing when Democrats passed Medicare and Medicaid.
That it would be the End of The World.
Go back and look. Same scare tactics, same over the top rhetoric, same stale special interests.
You’ve been singing the same song for 60 years.
gwangung
I put little stock in assurances from someone who’s convinced Social Security is going broke. They’re innumerate and haven’t done any simple, algebraic calculations.
kay
@gwangung:
Mary believes insurance entities are over-regulated. If we just “free them up” they’ll spin money out of paper.
AIG notwithstanding.
Republicans would like to take health insurers out from under review by state regulators.
Because that worked so well when we did it for mortgage loans.
Mary
The people on the left just don’t like to deal with facts. The fact is Social Security and Medicare are going bankrupt and Medicaid is one of the biggest reasons States like New York and California are going bankrupt. Deal with it.
. Here is the source:
http://www.businessinsider.com/henry-blodget-the-social-security-bomb-2009-4,
“Instead of $703 billion coming in over the next 10 years, the current (overly optimistic) projection calls for only $83 billion. This means at least another $620 billion in fresh borrowing will have to occur.
More importantly, this means that the United States eventual date with bankruptcy has been moved forward by about 8 years or so. It also means that instead of being some future problem, a few administrations down the road, it is a near certainty that the current administration will have to confront some very difficult funding decisions that will be forced by the inability to borrow enough to pay for everything.”
Yutsano
Most of your post is simple Republican blather, but let’s deal with just the bullet points.
The Democrat Health Care Reform Proposal will result in:
—- Higher Taxes
Okay, so what? You want services they have to be paid for. Americans are some of the lowest taxed people on the planet. Plus just saying “Higher Taxes” isn’t saying much. How much ARE the taxes going up? and since there is no concrete plan yet, how do you know?
—- Higher Deficits
We’re already there and growing just from the fact that we’re doing nothing. The fact that we need to reform our unsustainable health care system is undeniable. What is your proposed change in course that would keep this from happening?
—- Cuts in Medicare and Medicaid
This one I love. The cuts are to hospitals which use the money to pay for services which cover the uninsured. If you’d paid attention you’d be aware of that fact.
—- Government Rationing of Health Care
Explain to me exactly why rationing by the government is somehow worse than some bureaucrat behind the desk of an insurance company. Your care is rationed now due to claims denials and recission. It’s just done for the bottom line of the insurer. That somehow makes you feel better?
—- Less Freedom of Choice
There isn’t a single universal health care system on this planet where this is true. If anything, a single payer system would EXPAND options since you don’t have to worry about whether your doctor takes your insurance or not. So where exactly does this come from?
—- Increased Costs to Business
Let’s see…having a regular, predictable, amount of money businesses can pay to cover their workers is somehow WORSE for them? Really? You realize if that were true there wouldn’t be a single business that could operate at a profit anywhere in the Western World, including Japan and Taiwan. In fact, businesses in Taiwan reported their expenses going down after their universal health system was enacted.
—- Increased Cost to Medicare members
Costs to Medicare members or payors into the Medicare system? And if it is members, how?
—- Lower Quality of Care
This one is always my favorite. Does a doctor get worse under a single payer system automatically? Does chemotherapy somehow get less effective? All that a single payer system does is poll the risks over a population rather than a smaller paying insurance company pool. It doesn’t change how doctors operate or treatment methodology.
Any more Rush talking points you want to throw out there?
omen
@Mary:
the right has no credible claim to posture as “fiscal conservatives” when bush/republican legacy of medicare part D alone left us burdened with $7 Trillion in unfunded liability.
yes, that’s “T” as in turkey.
Delia
@Mary:
There was a letter much like this in my local paper. I guess they got their talking points from the same place. Except my local letter writer threw in some nonsense that supposed to be scary about the Post Office and FEMA. Since there’s nothing wrong with my local post office and FEMA was fine until Bush dismissed the professionals and loaded it up with his cronies I just laughed. Meanwhile, Mary needs to go back and answer why our wonderful free market insurance companies won’t stop canceling people’s insurance just when they get seriously sick. Until she does that all her talking points are just a bunch of empty bullcrap.
Comrade Stuck
@Mary:
We all agree there are some big problems coming down the road for these programs. But to suggest they are main problem is just Right Wing nonsense. They are efficient and the public loves how they work. The rising cost of healthcare comes from trying to force a vital service into a free market function. By vital service. I mean people don’t have a choice to not seek it when they need it, like they do a TV or Roller Skates. If they put it off or don’t get treated for whatever reason, they die.
This is what the money peoples in healthcare know, that they can sell their product at any price because they know people will find a way to pay, or have the taxpayers pay if they can’t get or afford healthcare.
You come here telling us the market will work if we just throw a little more pixie dust on it and leave the money grubbers alone. and I’m not talking about doctors Jackie. 50 years of doing this has brought us to point of health care collapse. Your way has failed and it’s time to try something else.
Mary
Here is another source: “Entitlements going bankrupt”http://www.jasonpye.com/blog/2008/03/entitlements_going_bankrupt.html
The long term financial woes of Medicare and Social Security are in the news today:
Trustees for the government’s two biggest benefit programs warned Tuesday that Social Security and Medicare are facing “enormous challenges” with the threat to Medicare’s solvency far more severe.
The trustees, issuing a once-a-year analysis of the government’s two biggest benefit programs, said the resources in the Social Security trust fund will be depleted by 2041. The reserves in the Medicare trust fund that pays hospital benefits were projected to be wiped out by 2019.
Both those dates were the same as in last year’s report. But the trustees warned that financial pressures will begin much sooner when the programs begin paying out more in benefits each year than they collect in payroll taxes. For Medicare, that threshhold is projected to be reached this year and for Social Security it is projected to occur in 2017.”
AGAIN, WHY ANYONE IN THEIR RIGHT MIND WOULD WANT THE GOVERNMENT (WHO HAS SO MISMANAGED SOCIAL SECURITY AND MEDICARE) TAKE OVER HEALTH CARE AND GIVE THEM THE GREEN LIGHT TO CAUSE AN EVEN BIGGER MESS IS BEYOND COMPREHENSION. ARE YOU PEOPLE NUTS OR JUST A BUNCH OF KOOL AID DRINKERS. I GIVE UP. BYE BYE.
ree
@Mary:
You’re paying for the 55 million uninsured, Mary, because it isn’t free.
Now. Shall we insure them and try to mitigate that cost, or are you just going to continue to pretend that they don’t get sick and don’t require care? Because that’s silly. Despite best efforts by conservatives and industry lobbyists, we don’t yet let them die in the street.
We can do that. Pretend it doesn’t cost anything. It won’t show up on your balance sheet, but, the fact is, it has to be paid for.
When conservatives start including the COST of our broken health care system, then you’ll be taken seriously.
It’s not all pie in the sky and ponies. It costs to satisfy lobbyists.
latts
Oh, well, now that I know I’ll have to pay additional taxes and the nearly $5K annually in BC/BS premiums (plus deductibles, copays, & 20% in-network) that my employer shells out, of course I’m against healthcare reform. And deficits that actually buy something of public value are abhorrent, unlike deficits that destroy countries, make worldwide enemies, dump thousands of hair-trigger PTSD cases back into our society, and soothe the egos of weak-minded and manipulative men… that kind of deficit’s cool, because That’s What America’s All About. The public sector goes into debt to create misery, and the ungoverned private sector profits from it– wish the Founders had laid that out a bit more clearly.
::eye roll::
Christ on a pogo stick, these people get stupider by the day.
kay
@Mary:
I don’t understand. Are conservatives proposing doing away with Medicare, Medicaid and Social Security?
You better tell my GOP House member. He doesn’t, um, run on that.
kay
@Delia:
Mary wants to get insurance out from under the state regulators who insist they don’t cancel the policy when you get sick.
Because, as you can see, they’re burdened by onerous regulation.
Forcing insurors to comply with the terms of a contract is “unfair”.
kay
I’m glad I read the talking points. The GOP plan is to free insurance companies up, so they can charge people premiums and sell a rip-off product to the peons, and we can all pretend that the uninsured have insurance.
It’s a lot like their home mortgage plan, where we all pretended home ownership was skyrocketing, until the whole thing went up in flames.
Kirk Spencer
@Jackie: Yeah, we’re talking past each other.
That may be how you took it, but not quite how I meant it. What I meant was it’s a viable, workable model FROM WHICH a decent health care system can be built. From point of view of the patients, it’s good. Does it have problems? Yes – but many of them are from the provider point of view (late and little). And again I’ll note that one of the problems you face is your greedy peers.
Only 4 or 5 an hour? Local survey (I’m near Chattanooga) of family physicians conducted last year said the average here was around 8 per hour. A very unscientific survey in Atlanta gave similar numbers. My (retired, RN) mother did an informal check in Colorado springs – the doctors she checked were doing 7 to 10 per hour (per doctor in multi-doctor offices). I’d be DELIGHTED to have you as my physician based on the extra time you’re stating, but you’re severely under what I’ve checked on at this point.
It’s hard to fight the good fight when you’ve got bastidges stabbing you in the back.
Delia
@kay:
Well, they’d certainly like to. That was what Bush’s big push to “privatize” Social Security was all about, wasn’t it? And those of us who are creeping up on retirement age would certainly have been in a pickle if the goopers had managed to put our Social Security into the stock market just a few short years before they blew that up.
And, oh yes, I’ll grant you that the Bush Administration has mismanaged Social Security, Medicare, and Medicaid, just like they’ve mismanaged everything else. They’ve raided the funds and given them to KBR, Blackwater, and bundled them into those bricks of cash that Bremer was handing out when he was proconsul of our Glorious Imperial Empire in the Middle East. So between that blowing up the stock market they did just great, and there’s a lot to fix. So Mary’s certainly got a point there, albeit, not quite the one she thought she had. Nevertheless, it looks to me like the medical insurance companies belong with the band of robbers and thieves who are making off with all the loot. Now even back in 1993 I never heard of this rescission business. So if these guys have gotten so greedy that they’re now unwilling to perform the business that they originally signed on to perform, well, they are an institution and a species that has become a parasite and a disease upon the body politic. If they refuse to be reformed (and so far they have), they have to be excised.
Yutsano
OH MY GRAVY!
I’m over on 538, scanning through the comments on the public option thread, and what do I find?
http://www.fivethirtyeight.com/2009/06/public-support-for-public-option.html
Look for the comment from Barry4715. EXACT WORD FOR WORD WHAT MARY POSTED!!!
Rush has leashed his trolldogs.
I can haz betr trolls plz?
Mary
Comrade Stuck, That is what the people in the Soviet Union, China, Cuba, North Korea and Viet Nam said and millions of people were slaughtered and sent to labor camps to be reeducated. Not a very good track record, you agree? That is what government has the power to do if you put too much faith in them and hand all power over to them. With the elite in control of government they have the power and the people are their serfs. Decisions on who gets what are based on political favoritism and ones “worth” to the people in power. Sounds a lot like slavery to me.
No system is perfect, but at least in a free market the people have the freedom and opportunity to make their own decisions on how they want to spend the money they have earned with their sweat and tears.
If President Obama and the Democrats get their way, hope you are all happy living in President Obama’s and Democrats vision of a utopian society. As President Obama said. “You can’t drive your SUVs, eat all the food you want and keep your thermostats at 72 degrees all the time. I won’t allow it.”
And that is my final word on this subject. Best of luck to all.
Yutsano
FEAR TEH SOCHULISUM!!!
Delia
@Mary:
Oooh . . . . up the ante, why don’t you? Yes, a spectre is haunting America, the spectre of Communo-fascism or something like that. It will come upon us all if there is a public health plan offered. Worse than North Korea. We may end up like France. I’m sooo scared. I think I’ve got to go hide under my bed now, but first I have to sweep out the dust bunnies.
Yutsano
We’re not asking the real question here Delia. Is Mary a Mary or is she/he a Barry? Or a Marion Barry? Or a marionberry pie? The world may never know…
kay
@Yutsano:
During the 1990’s health care debate, the WSJ printed a flyer that was used by US conservatives to oppose Medicare and Medicaid.
Decades, they’ve been fighting reform. They’re good at it.
slightly_peeved
My government runs my healthcare already.
And I can walk into any general practitioner’s office and they’ll see me. They won’t care what kind of insurance I have – all that will matter is when they next have time free to see me.
And in many cases, I’ll walk out without paying a cent.
Oh, and on almost every metric, the system gets better outcomes than yours. For much cheaper.
Here’s a description, if you’re interested. I don’t believe the US government is uniquely incompetent, so I don’t see why the US can’t have a similar system. The House plan, as well as the Wyden plan, look like pretty good starts.
omen
@Mary:
who got rid of habeas corpus? the right didn’t say boo about it.
Comrade Stuck
@Mary:
Yes Comrade. The democrats plan is just like that. Geesh!
Have you met our Brick Oven Bill. You two would make a lovely couple. You could live on peanut butter and build electric trains.
You know, I felt the same way when George Bush was president. NOLO MAS.
Jackie
@Kirk Spencer: I figured. If you’ll go back I stated if you can qualify and if you can find a doctor it’s a good deal for the patient. I even conceded we have a fair share of the venal. I have no cure for human foibles. Not even most of my own.
I don’t roll in the patients my PA sees into my stats, maybe some docs do. She ends up seeing alot of the quick stuff that might let me see more people. Really I’m especially slow because I don’t even average in paperwork time so if you count total hours at work I see even less. You’d laugh, people complain I talk too fast as it is. i do primary care because I like it, I like to take the time to get to know my patients It makes it less stressful for me. I take the ounce of prevention stuff seriously. Don’t tell my partners I’m a slacker!
Delia
@slightly_peeved:
That’s all well and good, but what kind of re-education camp do you Ozzies get sent to so that you’re happy having a government run health care system that doesn’t cut you loose and leave you out on the street should you have the misfortune to come down with a serious illness? Mary would be very angry at you.
kay
@slightly_peeved:
She left because her casual, off the cuff health care musings turned up on another site, verbatim.
I think of Mary as a volunteer lobbyist for the health care industry.
I don’t know why they don’t insist on payment. Chumps.
gwangung
This kinda insulting to those of us from Russia, China, North Korea or Vietnam (quite a few of us, if you want to know). (Though you did forget about Cambodia).
Try not projecting your own naivete onto others.
Comrade Stuck
@kay:
At first I thought her comment might have been a bot spoof, programmed to go out to liberal blogs. But she turned out to be real, and pure distilled wingnut.
Yutsano
It would not shock me if this whole set-up is their new Harry and Louise. Get out into the blogosphere and spew their nonsense ad nauseum until they get a few doubting Thomases to buy into their spin and kill reform. In other words, after seeing that exact comment in two different places, how do we know they AREN’T being paid?
Delia
@gwangung:
Well, I think you have to look at it as Comrade Stuck suggests, as pure distilled wingnut. Sort of a Pete Hoekstra meme.
“Getting a public option in health care is just like getting sent to a North Korean labor camp.”
Yutsano
I’m sure Laura Ling and Euna Lee would agree.
kay
@Yutsano:
I think they’re volunteers. I stole the line from my friend Ann. She listens to C-SPAN call-in.
She says the “Republican” line is always one or another conservative passionately defending an insurance company or an oil company.
She doesn’t understand why rank and file Republicans think those for-profit entities need an army of volunteers. They have well-paid lobbyists, after all.
Mary should demand minimum wage.
Yutsano
Isn’t that a soshulist concept? ;)
iluvsummr
@Jackie:
I totally understand what Jackie is saying here, but let’s say there are 47 million additional insured with a public option. Do you think the costs & payments would work out differently because we’re no longer passing along the costs of uninsured people who show up in the ER to people with private insurance? With a public option it’s likely that the volume of patients seen goes up and more patients would be seen by primary care physicians (instead of waiting till things are catastrophic healthwise to go to the ER). Do the costs end up working out because of the added volume or would the medicaid reimbursement problem just be magnified?
If the focus for physician payment becomes quality of patient outcomes rather than number of procedures done, I think one thing that will change is more physicians will be willing to go into primary care than seek high-paying specilaties. That isn’t a bad thing in my book – many urban and rural areas of the US don’t have enough primary care physicians, and it doesn’t get talked about as much as it should.
Areas like Crown Heights, Bed-Stuy, Compton, El Monte (CA), Dana Point (CA), East Harlem, Washington Heights, Baltimore are medically underserved and have population to primary care physician ratios ranging from 3000:1 or 3500:1. Since I can’t easily find the ratios for say Beverly Hills, CA or Greenwich, CT, I’ll throw this out: Vancouver, BC’s ratio is 270:1, Nigeria has a population to primary care physician ratio of 3700:1, Cuba’s is 255:1, and studies have shown a correlation between lower population to primary care physician ratios and improved health outcomes. Of course, healthcare reform doesn’t necessarily mean that more doctors will be willing to practice in rural or urban underserved areas but I hope it works out that way.
Yutsano
FWIW it hasn’t necessarily worked out that way in Canada. They have to very heavily incentivize their doctors to work in some of the more remote areas. The tradeoff is they often end up being one of the most respected individuals in the community and treated very well wherever they end up.
Jackie
@iluvsummr: Multiplying by zero doesn’t increase income. My argument pertains to medicaid. Obviously private companies are paying more than thy do or I wouldn’t have an income. My schedule is full, I do not want more patients. I am hoping a public plan with a more realistic payment schedule will appear. If not you will have an insurance plan but many will still be using the ER as their doctors office and it will fail.
There is a reason the profession as a whole is a little leary, A few years ago medicare announced that they were going to cut proceedures and reward primary care. That translated to they got cut and in good years I stay the same. In bad years my cut is just smaller. It isn’t just that we are all greedy rightwing hacks. There has been some bad faith involved .
The savings are in single payer cutting my overhead and taking the money that goes to administrative salaries and giving it to the hospitals, and doctors and therapists who actually take re of people. The savings for the taxpayer is in less catastophic and more routine care. Aside from the OH NO SOc*alist aspect of opposing this doctors fear that all that is going to happen are the tax savings and the government plan will turn into medicaid
This site is doing weird stuff to this post I hope when I t show up it there are actual sentences in it.
Nancy Irving
Your correspondent is absolutely correct.
I am self-employed and had to let my expensive “major-risk pool” individual insurance policy lapse several years ago, when I could no longer afford the increasing premiums.
Since I was diagnosed with breast cancer last year, I immediately qualified for Medicaid in California. (This is a special Medicaid program, the product of political agitation on the part of women’s health advocates. It’s only good for either breast or cervical cancer; if I’d had, say, lung cancer, I would be out of luck, as in California you need to be either disabled or have minor children to qualify for Medicaid, regardless of income.)
I have never had to fill out any forms. I have never had to argue with anyone, or even call anyone, to get anything covered. They sent me a white card which I present to every provider, which covers everything. All arrangements for two surgeries, chemotherapy, radiation, hormone and biological therapy were made for me. All prescriptions have been covered. I pay no co-pays or anything else.
I am being treated at the county hospital, which is an NIH special cancer center. The treatment is terrific. Sixty percent of the doctors who work at the hospital are treated there when they or their family members are ill, as their insurance coverage is handled by the same county program as mine. This is not “poverty care.” My radiation was contracted out to a private hospital, also a top-rated regional cancer treatment center. When I was enrolled in Medicaid, I was given the option to enroll in a Blue Cross PPO, which Medicaid would have paid for, where I would have been treated at a well-known private hospital. Since the treatment I had already received at the county hospital was so superb, I stayed with them. The doctors are all terrific, as are all the supporting personnel. I have never had a bad experience with any provider during a year and a half of treatment.
Last time I saw her, my oncologist told me that she prefers Medicaid patients because, as your correspondent notes, Medicaid covers everything, and they don’t argue, deny charges or play games.
Meanwhile, my best friend, whose husband was a professor who finished his career as a top administrator at Lawrence Livermore Lab and so has some of the best private insurance in America, is now seriously ill. She is constantly battling with her insurers over everything, and is not happy with her doctors at the expensive facilities where she is being treated. It makes me almost ashamed.
Major medical facilities in major population centers are happy to treat Medicaid patients. It’s the uninsured or under-insured middle- and working-class folks who have the most problems getting treatment.
I have nothing but praise for Medicaid. My only worry is that with California’s budget crisis, there will be Medicaid cuts. I am fortunate in that most of my treatment will be over by October. I hope the hospital can treat me through then.
Before this happened to me, I like others thought of Medicaid treatment as sub-par. I know differently now.
The providers who “won’t take Medicaid” are mostly private doctors motivated by greed. Who needs them? The doctors who work at the hospital I’m treated at are not only highly competent, they are dedicated to healing, before making money. Who *wouldn’t* want such treatment?
PaulB
I’m sorry I missed this because I had to work today. It’s rare to meet someone so absolutely clueless in their projection. Her posts were a real hoot, so totally divorced from reality, so wholly ignorant — I do so love mindless partisans and/or dedicated trolls.
Nancy Irving
Well I just spent a couple hours writing a letter to Obama about the public option, with copies to my congressman and two senators.
Stamped and ready to go out Monday morning.
I hope it’s not all over by the time they’re received.
slightly_peeved
Well, there’s all those mandatory weight-training, acting and singing classes we’re forced to go to. They are horrible. We are forced lift heavy weights day-in day-out until our stomachs are ribbed with muscle and our pectorals are rock-hard. Our only comfort is singing songs about breaking free from this cruel existence – songs that are only tolerated by our cruel masters if done in 3-part harmony with precise accompanying choreography.
Rarely does anyone ever escape these relentless classes; there is a legend of a young woman who escaped to the US before having to attend a single acting or singing class. Her name was Nicole Kidman.
Tattoosydney
@slightly_peeved:
Didn’t our Prime Minister, Hugh Jackman, publicly pardon her for her draft dodging, last year some time?
Xenos
@iluvsummr:
Most countries handle this in a straightforward way – medical students pay just a nominal amount for their educations, and accept an obligation to work in underserved areas for part of their careers.
This is actually a pretty important detail that needs to be addressed – the way we educate and train MDs has a lot to do with why they often become part of an insular, resentful elite. Doctors in other countries do not tend to be such narcissistic jerks. The fact that their education is paid for, and that costs for malpractice insurance are handled in a rational way leads to doctors willing to be paid less in return for less insecurity and less harassment from what is essentially a private regulatory scheme. While this means that the doctors make less money in the aggregate, although the main difference is that you get fewer superstar physicians pulling down millions.
Just like the legal profession is distorted by very powerful elite law firms and high powered professional liability practices, the MD profession is run for the sake of the ‘winners’ of that profession. The result is that the public service aspect of the profession declines and is lost.
slightly_peeved
I believe so, though rumor has it that it was opposed by our shadowy chief of police, Russell Crowe. His green-and-red shirted troops maintain order with an iron fist. Many a revolutionary and draft-dodger have endured the worst torture known to man (Russell Crowe’s second album) at their hands.
Tattoosydney
@slightly_peeved:
Crikey! and Strewth!
Do you subscribe to the theory that Russ had Steve Irwin killed for political reasons?
Tattoosydney
@slightly_peeved:
I hear that Bindi is being used to transport secret (and presumably non-twitterable) messages to the resistance.
slightly_peeved
There was a second stingray.
iluvsummr
@Jackie: Yeah the site was acting weird and I had an obvious blockquote fail above. The point I was trying to make is that I understand your concerns but I think that having everyone in the US insured changes things in ways that you are not considering. If everyone in the US is insured under a private or public plan, the cost of treating catastrophic care for the 47 million who are currently uninsured goes away, the focus on preventive care increases (which reduces costs down the line), the pressure to develop a rational approach to handling malpractice increases, the pressure on private insurers to keep those clients who actually get sick goes up (you might have seen the L.A. Times article in which health insurers defended their approach to rescission & vow to continue doing things the same way), etc. The result of reform is not just an expanded pool of medicaid patients that doctors don’t get reimbursed for. This seems to be the line many doctors are repeating without any attempt to see the bigger picture. I find these concerns understandable but it’s still a bit upsetting to me that the bottom line for many doctors I’ve talked to is money, not improved health care.
Many states already reimburse doctors an additional amount if they see medicaid patients in underserved areas. Since we are in the age of the physician as entrepreneur, perhaps the thing to do is to have one practice in your ideal area and another practice with other physicians in an area that receives better medicaid reimbursements. The good doctors of McAllen Texas have figured out how to make a profit off medicaid patients.
@Yutsano: How big is telemedicine in treating patients in rural Canada? HRSA in the US will reimburse many specialists who treat patients in rural or urban underserved areas or in prisons using telemedicine. Works best for screening for diabetic retinopathy, radiology, dermatology.
@Xenos: I totally agree with you here. The average medical resident in the US finishes training with a student loan burden of $150,000. This is part of the problem.
@Tattoosydney: @slightly_peeved: That was funny!
celticdragon
Agreed. The year our family was on Medicaid in North Carolina was the best we ever had for treatment. My son still has Medicaid, thank God.
jacksmith
AMERICA’S NATIONAL HEALTHCARE EMERGENCY!
It’s official. America and the World are now in a GLOBAL PANDEMIC. A World EPIDEMIC with potential catastrophic consequences for ALL of the American people. The first PANDEMIC in 41 years. And WE THE PEOPLE OF THE UNITED STATES will have to face this PANDEMIC with the 37th worst quality of healthcare in the developed World.
STAND READY AMERICA TO SEIZE CONTROL OF YOUR NATIONAL HEALTHCARE SYSTEM.
We spend over twice as much of our GDP on healthcare as any other country in the World. And Individual American spend about ten times as much out of pocket on healthcare as any other people in the World. All because of GREED! And the PRIVATE FOR PROFIT healthcare system in America.
And while all this is going on, some members of congress seem mostly concern about how to protect the corporate PROFITS! of our GREED DRIVEN, PRIVATE FOR PROFIT NATIONAL DISGRACE. A PRIVATE FOR PROFIT DISGRACE that is in fact, totally valueless to the public health. And a detriment to national security, public safety, and the public health.
Progressive democrats and others should stand firm in their demand for a robust public option for all Americans, with all of the minimum requirements progressive democrats demanded. If congress can not pass a robust public option with at least 51 votes and all robust minimum requirements, congress should immediately move to scrap healthcare reform and demand that President Obama declare a state of NATIONAL HEALTHCARE EMERGENCY! Seizing and replacing all PRIVATE FOR PROFIT health insurance plans with the immediate implementation of National Healthcare for all Americans under the provisions of HR676 (A Single-payer National Healthcare Plan For All).
Coverage can begin immediately through our current medicare system. With immediate expansion through recruitment of displaced workers from the canceled private sector insurance industry. Funding can also begin immediately by substitution of payroll deductions for private insurance plans with payroll deductions for the national healthcare plan. This is what the vast majority of the American people want. And this is what all objective experts unanimously agree would be the best, and most cost effective for the American people and our economy.
In Mexico on average people who received medical care for A-H1N1 (Swine Flu) with in 3 days survived. People who did not receive medical care until 7 days or more died. This has been the same results in the US. But 50 million Americans don’t even have any healthcare coverage. And at least 200 million of you with insurance could not get in to see your private insurance plans doctors in 2 or 3 days, even if your life depended on it. WHICH IT DOES!
Contact congress and your representatives NOW! AND SPREAD THE WORD!
God Bless You
Jacksmith – WORKING CLASS