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ducknwork
03-19-2010, 11:17 AM
Here it is:

http://i2.cdn.turner.com/cnn/2010/images/03/18/health.care.pdf

And if you don't want to read 153 pages, here is a summary:

http://i2.cdn.turner.com/cnn/2010/images/03/18/section.analysis.pdf

And here's the money:

http://i.cdn.turner.com/cnn/2010/images/03/18/hr4872.pdf


There are some things in there that I REALLY don't like. Unfortunately, I think we have no choice at this point, so grab your vaseline and bend over.

dnf777
03-19-2010, 11:38 AM
There are some things in there that I REALLY don't like. Unfortunately, I think we have no choice at this point, so grab your vaseline and bend over.

Ironic you put it that way....
While I don't entirely disagree (there are things I don't like either) I have seen a significant drop in people coming in for age-50 screening colonoscopies. I've had two people (with good insurance) tell me they're afraid to go to the doctor for anything that might qualify them as having "pre-existing conditions", and losing their coverage. I guess it's better to forgo preventive and screening measures, and save your insurance for when you get a preventable disease! You may be sicker, but at least you can afford it. :(

YardleyLabs
03-19-2010, 11:46 AM
Ironic you put it that way....
While I don't entirely disagree (there are things I don't like either) I have seen a significant drop in people coming in for age-50 screening colonoscopies. I've had two people (with good insurance) tell me they're afraid to go to the doctor for anything that might qualify them as having "pre-existing conditions", and losing their coverage. I guess it's better to forgo preventive and screening measures, and save your insurance for when you get a preventable disease! You may be sicker, but at least you can afford it. :(
My last colonoscopy cost more than $1000 because the anesthesiologist and the lab evaluating the tissue samples were "out of network". So much for that $9000/year per person premium plan.

road kill
03-19-2010, 11:48 AM
What affect will this have on well-care or preventative care?
I think it will make it even more difficult to get.




rk

M&K's Retrievers
03-19-2010, 11:59 AM
QUOTE=YardleyLabs;586030]My last colonoscopy cost more than $1000 because the anesthesiologist and the lab evaluating the tissue samples were "out of network". So much for that $9000/year per person premium plan.[/QUOTE]

Get used to "colonscopy". We're all gonna get 'em on a regular basis without any lubrication.:mad::(:mad:

Sabireley
03-19-2010, 06:49 PM
There are some things in there that I REALLY don't like. Unfortunately, I think we have no choice at this point, so grab your vaseline and bend over.

I suspect you will like it less as they strike deals to secure additional votes. We probably won't get to see the final version before the vote if they can strong arm or bribe enough people between now and Sunday. If there is no vote on Sunday, we might get to see the final version before they pass it.

dnf777
03-19-2010, 07:27 PM
What affect will this have on well-care or preventative care?
I think it will make it even more difficult to get.




rk

We'll only know after its been implemented. I *should* have the opposite effect. If eliminating "pre-existing" cancellations and denials, people should be less afraid of preventive care. We're operating under the status quo, and I've seen a decrease in preventive care at my practice, and two folks as much as said so.

I have doubts as to how a law can accomplish all this. Its forcing a business to engage in risky business. If everyone was obliged to join, it may even out, but as it seems to be, I have my doubts. To accomplish the stated goals, a public option seems the way to go, and then it has a host of other issues.

Health care isn't cheap. People with cancer are living longer, and dying less from their disease than ever before. As Jeff pointed out, colonoscopies can cost over $1000. In cost effective analyses however, they are by far one of the most cost-effective modes of prolonging life. (approx $20,000 per life-year saved) By comparison, mammograms are around 80k per life year. If we are only concerned about saving money, and ensuring the profits and business health of insurance companies, we should drop all such tests and just take our chances. Not a good option, in my book.

I suspect insurance companies have many more cards to show. Don't be surprised if costly procedures all the sudden get really long processing times, for no reason.

Buzz
03-19-2010, 07:54 PM
As Jeff pointed out, colonoscopies can cost over $1000.


I was under the impression that this is what Jeff paid out of pocket. Ten years ago I had a colonoscopy in Cincinnati and it cost me a little over $800. A couple years ago, I had one along with an EGD. I think it was about $3800 total. A co-worker had a poor policy through her husband's business. Her doc wanted her to have a colonoscopy and she had a $5000 deductible. So she called the hospital to price it. The quoted her $5000. She called her insurance company to see if they had a contract price with the hospital and they said no. So she went without.

YardleyLabs
03-19-2010, 08:00 PM
I was under the impression that this is what Jeff paid out of pocket. Ten years ago I had a colonoscopy in Cincinnati and it cost me a little over $800. A couple years ago, I had one along with an EGD. I think it was about $3800 total. A co-worker had a poor policy through her husband's business. Her doc wanted her to have a colonoscopy and she had a $5000 deductible. So she called the hospital to price it. The quoted her $5000. She called her insurance company to see if they had a contract price with the hospital and they said no. So she went without.
Exactly. The total bill was closer to $4000.

ducknwork
03-19-2010, 09:59 PM
Did you guys notice that Nebraska was still getting a better deal than the rest of the states?

What a buncha BS.

luvmylabs23139
03-20-2010, 09:35 AM
Oh, don't forget the new deal to buy off TN. The CT deal is still in too.
Montana gets a deal as does some bank in ND when they included the takeover of student loans at the last minute.

pat addis
03-20-2010, 04:00 PM
so is anyone happy about all the special deals it is not fair

K G
03-20-2010, 05:15 PM
"Special" deals are what it's going to take to get this POS health care bill passed....

k g

dnf777
03-20-2010, 08:46 PM
I was under the impression that this is what Jeff paid out of pocket. Ten years ago I had a colonoscopy in Cincinnati and it cost me a little over $800. A couple years ago, I had one along with an EGD. I think it was about $3800 total. A co-worker had a poor policy through her husband's business. Her doc wanted her to have a colonoscopy and she had a $5000 deductible. So she called the hospital to price it. The quoted her $5000. She called her insurance company to see if they had a contract price with the hospital and they said no. So she went without.

Wow! That's a lot! I can tell you that my office collects exactly $380 in professional fees for my doing a colonoscopy from medicare, and give or take 10-20% depending on which insurance. That leaves a big difference that's going into somebody's pocket, and it ain't mine!

Its very frustrating when folks come in, some with very strong reasons to get a colonoscopy, and ask how much it will be, as they are paying out of pocket. I honestly cannot answer, as I cannot get answers from the hospital. Straight answers anyway. All I can say is what I collect, and in some cases, are willing to waive my fee. But knocking down a 5k bill by $380 doesn't help much.

I'd like to know where that money goes. BTW, where is Bill Frist in all this health care debate. As a former senate majority leader AND physician, you would think he would have a comment or two......

jbonnot03
03-21-2010, 05:26 AM
I agree that something needs to be done. However, I don't think this bill is the answer. I also realize everyone needs healthcare. What is driving up the costs is the "free" healthcare everyone has access to. All I have to do is walk into the ER and they have to treat me whether I pay or not. If I don't pay, that bill gets paid by someone else. The hospital has to pay their employees no matter if they get paid or not.

Whistler
03-21-2010, 08:25 PM
I don't think the dems, or republicans even what whats in the plan.

HuntsmanTollers
03-22-2010, 09:38 AM
Funny never heard that employer size classifications were being changed. No wonder they are saying this will help small employers. After all there will now be fewer "small" employers.

Buzz
03-22-2010, 10:01 AM
Wow! That's a lot! I can tell you that my office collects exactly $380 in professional fees for my doing a colonoscopy from medicare, and give or take 10-20% depending on which insurance. That leaves a big difference that's going into somebody's pocket, and it ain't mine!


I believe that a lot of that money is going toward facility charges.

Does anyone REALLY understand where the money is going? I know a few physicians, and they all complain about decreasing reimbursements. Yet the charges paid out continue to escalate. Almost 10 years ago I had a colon resection at Cleveland Clinic. They did surgery early Wednesday morning. I was discharged Saturday afternoon. The total bill including the surgeon and the hospital bill was around $17k. Last winter I had a gallbladder removed. Outpatient surgery. I went into surgery around 10 am, they took me to a recovery room with no bed, just a recliner. I was on my way home by 3:30 PM. My bill from the hospital was just a little over $15k. So 9 years ago, 18 inches of my colon and 3 night stay was just a couple grand more than a few hours in the hospital 9 years later.

Hope I can stay away from the knife for a good long time. Me and pain meds do not get along well, which makes recovery interesting...:rolleyes:

YardleyLabs
03-22-2010, 10:34 AM
I believe that a lot of that money is going toward facility charges.

Does anyone REALLY understand where the money is going? I know a few physicians, and they all complain about decreasing reimbursements. Yet the charges paid out continue to escalate. Almost 10 years ago I had a colon resection at Cleveland Clinic. They did surgery early Wednesday morning. I was discharged Saturday afternoon. The total bill including the surgeon and the hospital bill was around $17k. Last winter I had a gallbladder removed. Outpatient surgery. I went into surgery around 10 am, they took me to a recovery room with no bed, just a recliner. I was on my way home by 3:30 PM. My bill from the hospital was just a little over $15k. So 9 years ago, 18 inches of my colon and 3 night stay was just a couple grand more than a few hours in the hospital 9 years later.

Hope I can stay away from the knife for a good long time. Me and pain meds do not get along well, which makes recovery interesting...:rolleyes:
Three years ago I had a prostate biopsy. It had to be done in a hosptal because of my reaction when I had one done previously. The total hospital bill paid by insurance was $18k. I still ended up in the emergency room the following night because of my reaction -- that added $2k to the bill. They now want to biopsy me again and I have refused.

HuntsmanTollers
03-22-2010, 10:36 AM
I agree that something needs to be done. However, I don't think this bill is the answer. I also realize everyone needs healthcare. What is driving up the costs is the "free" healthcare everyone has access to. All I have to do is walk into the ER and they have to treat me whether I pay or not. If I don't pay, that bill gets paid by someone else. The hospital has to pay their employees no matter if they get paid or not.

While the "free" healthcare some patients received do drive up costs to the others, that isn't going to change with this health care reform. One of the biggest expenses related to providing medical care in the U.S. is administrative costs. For example government mandate for physicians to utilize Electronic Medical Records.

ducknwork
03-22-2010, 10:45 AM
What would happen if someone who opted out of the 'mandatory' insurance gets sick and goes to the ER? Will they be turned away?:confused:

YardleyLabs
03-22-2010, 10:49 AM
What would happen if someone who opted out of the 'mandatory' insurance gets sick and goes to the ER? Will they be turned away?:confused:
If you are betting on receiving ER care for free, you might be surprised. They are only required to provide life saving emergent care. If you show up with a non-emergent condition they may well suggest that you go to your own doctor or make payment arrangements. In NYC and LA, hospitals have been known to pay taxi fares for people to send them to uninsured public hospitals.

ducknwork
03-22-2010, 10:52 AM
So let's say that someone who opted out of coverage needs lif saving care. Who pays for that? Everyone else (kinda like it is now...)?

Clay Rogers
03-22-2010, 11:16 AM
If you are betting on receiving ER care for free, you might be surprised. They are only required to provide life saving emergent care. If you show up with a non-emergent condition they may well suggest that you go to your own doctor or make payment arrangements. In NYC and LA, hospitals have been known to pay taxi fares for people to send them to uninsured public hospitals.


Thats actually against the law. I work in the ER and we can't turn anyone away, no matter how small the problem. We typically see more PMD stuff than we see emergent stuff. As a matter of fact, I am in triage today and I have triaged over 40 people since 0700 this morning and none are emergent.

Losthwy
03-22-2010, 12:16 PM
From what I have heard the U.S. currently spends about double of it's GNP on health care than countries with nationalized health care.
http://www.forbes.com/2009/07/02/health-care-costs-opinions-columnists-reform.html

HuntsmanTollers
03-22-2010, 12:23 PM
From what I have heard the U.S. currently spends about double of it's GNP on health care than countries with nationalized health care.

Do you think that is an apples to apples comparison? What if I told you that in other industrialized countries the delivery of nursing care to the hospitalized was significantly lower than that of the US. What if your family was expected to provide your food and assist you in your Activities of Daily Living (ADLs) such as bathing and eating, like they are in Japan. This is just like the bogus argument that according to the WHO we rank poorly in health care delivery when compared to other industrialized nations. Until the WHO standardizes reporting requirements or everyone starts using our HIGHER standards it is just more clutter to confound the issue. I can tell you from experience in patient movement and in health care the United States is (was) the standard for the rest of the world.

Losthwy
03-22-2010, 12:31 PM
health care the United States is (was) the standard for the rest of the world.

If that is the case why is it Canada has a higher life expectancy than the US. And a lower infant mortality than the US. The US ranks 33rd in infant mortality.

HuntsmanTollers
03-22-2010, 12:33 PM
If that is the case why is it Canada has a higher life expectancy than the US. And a lower infant mortality than the US.

Go back and read my comments regarding WHO statistics.

Losthwy
03-22-2010, 01:01 PM
Go back and read my comments regarding WHO statistics.
You can also look at and choose to ignore the CIA World Factbook as well. Which ranks the US 46th. Not my idea of a standard for the rest of the world to follow.

HuntsmanTollers
03-22-2010, 01:02 PM
Where did the numbers from the Fact Book come from?

HuntsmanTollers
03-22-2010, 01:10 PM
From the factbook: The Factbook staff uses many different sources to publish what we judge are the most reliable and consistent data for any particular category. Space considerations preclude a listing of these various sources.

If you are willing to bet one of those statistics would be country reported live birth and infant death rate. I do not know if Canada reports the same way we do or not.

HuntsmanTollers
03-22-2010, 01:16 PM
Here is another question for you. How do you think our numbers are affected by our immigration rate and the number of illegal aliens? What is the illegal alien percentage in Canada? I get your point, however all of the data you are referencing in based on each country's definition of number of births. Here is another question, do all countries issue death certificates for neonatal deaths? If not how do you think that impacts their life expectancy rates?

Clay Rogers
03-22-2010, 01:19 PM
If that is the case why is it Canada has a higher life expectancy than the US. And a lower infant mortality than the US. The US ranks 33rd in infant mortality.

If that is the case, then why did a Candian politican come to US to have a cardiac related surgery instead of having it up there? Have you ever been to any of these countries that are suppose to rank higher than us? And I don't mean the resorts, I mean where the normal people live and see the conditions in which they live and the conditions of the hospitals that they would utilize? I doubt it, because if you have you would know better. Also riddle me this, if the healthcare system is so much better in Canada and other places, how come I can't turn left or right without hitting a foriegn nurse?

Losthwy
03-22-2010, 01:26 PM
From Wikipedia-
The World Factbook is prepared by the CIA for the use of U.S. government (http://www.retrievertraining.net/wiki/Federal_government_of_the_United_States) officials, and its style, format, coverage, and content are primarily designed to meet their requirements.[4] (http://www.retrievertraining.net/forums/#cite_note-cci-3) However, it is frequently used as a resource for academic research papers.[5] (http://www.retrievertraining.net/forums/#cite_note-press-4) As a work of the U.S. government (http://www.retrievertraining.net/wiki/Work_of_the_United_States_Government), it is in the public domain (http://www.retrievertraining.net/wiki/Public_domain).[6] (http://www.retrievertraining.net/forums/#cite_note-pd-5)
Contents

[hide (javascript:toggleToc())]
<LI class="toclevel-1 tocsection-1">1 Factbook sources (http://www.retrievertraining.net/forums/#Factbook_sources) <LI class="toclevel-1 tocsection-2">2 Copyright (http://www.retrievertraining.net/forums/#Copyright) <LI class="toclevel-1 tocsection-3">3 Frequency of updates and availability (http://www.retrievertraining.net/forums/#Frequency_of_updates_and_availability) <LI class="toclevel-2 tocsection-4">3.1 Government edition of the Factbook (http://www.retrievertraining.net/forums/#Government_edition_of_the_Factbook)
3.2 Reprints and older editions online (http://www.retrievertraining.net/forums/#Reprints_and_older_editions_online)<LI class="toclevel-1 tocsection-6">4 Entities listed (http://www.retrievertraining.net/forums/#Entities_listed) <LI class="toclevel-1 tocsection-7">5 Territorial issues and controversies (http://www.retrievertraining.net/forums/#Territorial_issues_and_controversies) <LI class="toclevel-2 tocsection-8">5.1 Political (http://www.retrievertraining.net/forums/#Political)
5.2 Factual (http://www.retrievertraining.net/forums/#Factual)<LI class="toclevel-1 tocsection-10">6 ISBN numbers (http://www.retrievertraining.net/forums/#ISBN_numbers) <LI class="toclevel-1 tocsection-11">7 See also (http://www.retrievertraining.net/forums/#See_also) <LI class="toclevel-1 tocsection-12">8 Sources (http://www.retrievertraining.net/forums/#Sources)
9 External links (http://www.retrievertraining.net/forums/#External_links)
[edit (http://www.retrievertraining.net/w/index.php?title=The_World_Factbook&action=edit&section=1)] Factbook sources

In researching the Factbook, the CIA uses the sources listed below. Other public and private sources are also consulted.[4] (http://www.retrievertraining.net/forums/#cite_note-cci-3)

Antarctic Information Program (National Science Foundation (http://www.retrievertraining.net/wiki/National_Science_Foundation))
Armed Forces Medical Intelligence Center (http://www.retrievertraining.net/wiki/Armed_Forces_Medical_Intelligence_Center) (Department of Defense (http://www.retrievertraining.net/wiki/United_States_Department_of_Defense))
Bureau of the Census (http://www.retrievertraining.net/wiki/United_States_Census_Bureau) (Department of Commerce (http://www.retrievertraining.net/wiki/United_States_Department_of_Commerce))
Bureau of Labor Statistics (http://www.retrievertraining.net/wiki/Bureau_of_Labor_Statistics) (Department of Labor (http://www.retrievertraining.net/wiki/United_States_Department_of_Labor))
Council of Managers of National Antarctic Programs
Defense Intelligence Agency (http://www.retrievertraining.net/wiki/Defense_Intelligence_Agency) (Department of Defense)
Department of Energy (http://www.retrievertraining.net/wiki/United_States_Department_of_Energy)
Department of State (http://www.retrievertraining.net/wiki/United_States_Department_of_State)
Fish and Wildlife Service (http://www.retrievertraining.net/wiki/United_States_Fish_and_Wildlife_Service) (Department of the Interior (http://www.retrievertraining.net/wiki/United_States_Department_of_the_Interior))
Maritime Administration (http://www.retrievertraining.net/wiki/United_States_Maritime_Administration) (Department of Transportation (http://www.retrievertraining.net/wiki/United_States_Department_of_Transportation))
National Geospatial-Intelligence Agency (http://www.retrievertraining.net/wiki/National_Geospatial-Intelligence_Agency) (Department of Defense)
Naval Facilities Engineering Command (http://www.retrievertraining.net/wiki/Naval_Facilities_Engineering_Command) (Department of Defense)
Office of Insular Affairs (http://www.retrievertraining.net/wiki/Office_of_Insular_Affairs) (Department of the Interior)
Office of Naval Intelligence (http://www.retrievertraining.net/wiki/Office_of_Naval_Intelligence) (Department of Defense)
US Board on Geographic Names (http://www.retrievertraining.net/wiki/United_States_Board_on_Geographic_Names) (Department of the Interior)
US Transportation Command (http://www.retrievertraining.net/wiki/United_States_Transportation_Command) (Department of Defense)
Oil & Gas Journal (http://www.retrievertraining.net/wiki/Oil,_Gas_%26_Energy_Law_Intelligence)

Koolaid
03-22-2010, 01:34 PM
If that is the case, then why did a Candian politican come to US to have a cardiac related surgery instead of having it up there? Have you ever been to any of these countries that are suppose to rank higher than us? And I don't mean the resorts, I mean where the normal people live and see the conditions in which they live and the conditions of the hospitals that they would utilize? I doubt it, because if you have you would know better. Also riddle me this, if the healthcare system is so much better in Canada and other places, how come I can't turn left or right without hitting a foriegn nurse?

I can't say much about the reporting of statistics, but there is a lot more to the story of Danny Williams than just deciding to come to the US. I think my favourite part is how he applied after wards to our government to be reimbursed for his surgery...and full well had the right too.

Secondly this was not an emergency surgery. He was in no remote danger of dying or even close to it being a necessity.

Thirdly he lived in what is the most remote of all the provinces. Admittedly in Newfoundland there isn't a plethora of heart specialists.

Fourthly? I know that a person story isn't really a statistic, but I'm gonna use it anyways because it was an identical procedure. A buddy of mine went in to see his family doctor, had some blood work done and within a week of the blood work coming back he was sent to see a specialist about 45 mins away. A month later he had the surgery. Today is back to 100%. His surgery was a necessity. Danny Williams said "My heart, my choice..." No hurry for the surgery...wanted to pay to get it done without being put on a waiting list. That list would have probably been in the range of about a year, but for non-emergency surgery that's how it goes. I'm totally fine with that. Others may not be.

In general I don't think it's a very good example because one can always say something about the number of Americans (admittedly I don't really care about taking the time to find an estimate) that go to places like China or India to have health procedures preformed.


On a slightly comedic note....do we really stand out enough that you could point us out as foreigners? =P

HuntsmanTollers
03-22-2010, 01:38 PM
Again you are not answering my question. You provided a partial list of references that the CIA Factbook utilizes. I already provided that information. What I am still asking you is how that data is determined. I am willing to bet that the health care statistics specifically Life Span and infant death rate are based on the nation's self reporting, if nothing else death certificates. If an infant dies and doesn't get a death certificate how does it count against life span?

HuntsmanTollers
03-22-2010, 01:44 PM
From my experiences dealing with medical facilities around the world, I will tell you that that Queen Elizabeth hospital in Nova Scotia is a World Class facility. I am not stating that there are not good hospitals in countries around the world of course there are. However, I still believe the overall quality of health care being delivered in the US is the standard.

Koolaid
03-22-2010, 01:51 PM
Yes the QEII is a top class facility. I'd dare say that the fact that it is in the Maritimes would lend it to not even being in the top 10 in Canada for standard of care. Not arguing your point, just saying that some people have been led to believe that we have a 3rd world health care system up here. It's not perfect, but for a population of 30 million spread as thinly as we are, it does a fairly good job. Certainly not perfect, and because of our similar aging population problem that the states is heading into, not sustainable into the distant future. Thankfully I think the current situation in the states may bring this more to the forefront of discussion up here.

Buzz
03-22-2010, 01:57 PM
If that is the case, then why did a Candian politican come to US to have a cardiac related surgery instead of having it up there? Have you ever been to any of these countries that are suppose to rank higher than us? And I don't mean the resorts, I mean where the normal people live and see the conditions in which they live and the conditions of the hospitals that they would utilize? I doubt it, because if you have you would know better. Also riddle me this, if the healthcare system is so much better in Canada and other places, how come I can't turn left or right without hitting a foriegn nurse?

Do you guys ever do any research on these examples you put forward? Each Province in Canada has their own health system. There are Provinces in Canada that have very small populations and no large cities. The guy in your story was from Newfoundland and Labrador, see the map below. There are just over 500,000 people in the whole province. The biggest city is under 200,000 people. How many huge university hospitals do you think they have access to there? How many world class surgeons do you think live there? Is it because of their healthcare system, or is it because they live in a place with one of the lowest population densities that you'd find anywhere? Their population density is 3.5/square mile. South Dakota has a population density of 10.5/square mile, Wyoming has one of 5.4/square mile, Alaska has one of 1.03/square mile. Where he went for surgery was Miami Florida. Florida has a population density of 338.4/square mile. Do you think the healthcare there could have ANYTHING to do with that???

You are comparing apples and rocks.

I had surgery around 10 years ago. I lived in Cincinnati at the time. I went to Cleveland and had the surgery at Cleveland Clinic. Did I go there because there were no good surgeons in Cincinnati? No, I went there because one of the best surgeons at the surgery I was having was in Cleveland. That's a choice that the majority of people can't make because they don't have the resources.

http://upload.wikimedia.org/wikipedia/commons/thumb/3/3c/Newfoundland_and_Labrador%2C_Canada.svg/250px-Newfoundland_and_Labrador%2C_Canada.svg.png

Eric Johnson
03-22-2010, 03:14 PM
I had surgery around 10 years ago. I lived in Cincinnati at the time. I went to Cleveland and had the surgery at Cleveland Clinic. Did I go there because there were no good surgeons in Cincinnati? No, I went there because one of the best surgeons at the surgery I was having was in Cleveland. That's a choice that the majority of people can't make because they don't have the resources.


I would note that despite all the hoopla, the majority of people still won't be able to make that choice. As noted elsewhere, there's a difference between coverage and care. This bill provides coverage. The ability to choose a specific source of care is likely to be very limited. Heck, in 5-6 years, the dollars may be in such short supply and the physician resource dwindled (NEJofMed last fall published a report that said as many as 46% of physicians were thinking of quitting!) to the point that other than primary care, only the rich will survive.

Eric

Losthwy
03-22-2010, 04:38 PM
Again you are not answering my question. You provided a partial list of references that the CIA Factbook utilizes. I already provided that information.
Did you now, you provided that info? Then you have already answer your question.

Franco
03-22-2010, 06:38 PM
Ten years ago I had a colonoscopy in Cincinnati and it cost me a little over $800.



I've had a few medical procedures over the last few years. My Colonscopy three years ago cost me $20. plus a bottle of Fleet ennama and two rolls of tissue paper.

I've had EKG's, MRI's, Nuclear Stress Test that have cost me $20. each.
When I had one stint put in on a Sunday Night, it cost me $2,800.

My percription cost are high but, that's my fault since I'm too lazy to join a Percription plan.

Leddyman
03-22-2010, 06:56 PM
If that is the case why is it Canada has a higher life expectancy than the US. And a lower infant mortality than the US. The US ranks 33rd in infant mortality.

The infant mortality is significantly higher than that. You are looking on the wrong side of the uterus.

torg
03-22-2010, 07:57 PM
We have a lot of Canadians on this forum. So Canada what do you think of your government run Health Care? We live on the Minnesota/Canadian border and know several Canadians who told us they prefer their system over ours. Tell us about the good and the bad.

Clay Rogers
03-22-2010, 07:58 PM
Do you guys ever do any research on these examples you put forward? Each Province in Canada has their own health system. There are Provinces in Canada that have very small populations and no large cities. The guy in your story was from Newfoundland and Labrador, see the map below. There are just over 500,000 people in the whole province. The biggest city is under 200,000 people. How many huge university hospitals do you think they have access to there? How many world class surgeons do you think live there? Is it because of their healthcare system, or is it because they live in a place with one of the lowest population densities that you'd find anywhere? Their population density is 3.5/square mile. South Dakota has a population density of 10.5/square mile, Wyoming has one of 5.4/square mile, Alaska has one of 1.03/square mile. Where he went for surgery was Miami Florida. Florida has a population density of 338.4/square mile. Do you think the healthcare there could have ANYTHING to do with that???

You are comparing apples and rocks.

I had surgery around 10 years ago. I lived in Cincinnati at the time. I went to Cleveland and had the surgery at Cleveland Clinic. Did I go there because there were no good surgeons in Cincinnati? No, I went there because one of the best surgeons at the surgery I was having was in Cleveland. That's a choice that the majority of people can't make because they don't have the resources.

http://upload.wikimedia.org/wikipedia/commons/thumb/3/3c/Newfoundland_and_Labrador%2C_Canada.svg/250px-Newfoundland_and_Labrador%2C_Canada.svg.png



So let me get this straight, you are saying we do have the best healthcare here in the USA. Thanks for agreeing.

Buzz
03-22-2010, 08:30 PM
So let me get this straight, you are saying we do have the best healthcare here in the USA. Thanks for agreeing.


I'm saying that "some people" have access to the best healthcare in the world here.

HuntsmanTollers
03-22-2010, 10:45 PM
I'm saying that "some people" have access to the best healthcare in the world here.

And what is wrong with that? Do I think that everyone should have access to basic health care? Yes, under the old system everyone in the US had access to some type of health care. I do not think everyone is entitled to the same level of health care. If you want an elective procedure, great you pay for it. Here is a question for you, in Florida who pays for prisoners to receive elective procedures?

Gerry Clinchy
03-22-2010, 10:49 PM
Buzz, why couldn't the Canadian "governor" find an equally competent practitioner in Canada? Ottowa, the capital, should have good health care, and it's a lot closer to Newfoundland than Miami.

As I recall, at least part of the issue for the "governor" was that he might be accused of "cutting ahead in line" of his countrymen to get the care he needed.

I really do believe we will never make health care access equal to all. As long as people who have the $ to do so, they will seek out and get the best care available. Others will get the best care that is covered by the health insurance plan they can afford.

The question becomes whether many in the middle who have decent health coverage now will have the cost of those plans increase (could push at least some of those plans into the "luxury" category subject to tax).

I do think that if this legislation remains in place (is not rescinded), then ultimately it will become a matter of a govt-run, single-payer health care system. I believe that is what many people really do want. They believe that it will solve all the problems of unaffordable care. Probably will be the very same people who complain first if they have to stand in line for the care they need.

Of course, the legislators who enacted the whole thing won't be subject to those indignities. Evidently, in Canada the legislators are subject to the same plan that everybody else gets. What a novel idea :-)

JDogger
03-22-2010, 11:20 PM
And what is wrong with that? Do I think that everyone should have access to basic health care? Yes, under the old system everyone in the US had access to some type of health care. I do not think everyone is entitled to the same level of health care. If you want an elective procedure, great you pay for it. Here is a question for you, in Florida who pays for prisoners to receive elective procedures?

There you have it folks. Orwellian prognastications come true. We're all equal, but some are more equal than others.
To reiterate a commonly cited phrase here, "I think I just threw up in my mouth a little bit".
Thank you for making it crystal clear...JD

Animal Farm regards,

JD

Koolaid
03-23-2010, 05:38 AM
Buzz, why couldn't the Canadian "governor" find an equally competent practitioner in Canada? Ottowa, the capital, should have good health care, and it's a lot closer to Newfoundland than Miami.


I already explained this

ducknwork
03-23-2010, 06:13 AM
There you have it folks. Orwellian prognastications come true. We're all equal, but some are more equal than others.
To reiterate a commonly cited phrase here, "I think I just threw up in my mouth a little bit".
Thank you for making it crystal clear...JD

Animal Farm regards,

JD

Ahhh yes. Because everyone is entitled to the same rewards, regardless of whether you sit on your ass and collect govt checks all week or go to work and bust your ass for 80 hours a week or work hard and sacrifice through school so you can get a good job like our resident sawbones.

Why don't they just start issuing waterfront property and big screen tvs to everyone as well...it's only fair. In fact, if we are all entitled to the same stuff, why am I at work today? I think I'll go back home and spend the rest of my 'working' life fishing with my kids and sleeping in the hammock. That seems much more profitable.

JDogger
03-23-2010, 07:25 AM
Ahhh yes. Because everyone is entitled to the same rewards, regardless of whether you sit on your ass and collect govt checks all week or go to work and bust your ass for 80 hours a week or work hard and sacrifice through school so you can get a good job like our resident sawbones.

Why don't they just start issuing waterfront property and big screen tvs to everyone as well...it's only fair. In fact, if we are all entitled to the same stuff, why am I at work today? I think I'll go back home and spend the rest of my 'working' life fishing with my kids and sleeping in the hammock. That seems much more profitable.

Talking about healthcare here dnw, not welfare. Tell me you do understand the difference? Unbelievable!

HuntsmanTollers
03-23-2010, 09:52 AM
Talking about healthcare here dnw, not welfare. Tell me you do understand the difference? Unbelievable!

Do you understand the difference? I agreed with you that everyone deserves the same basic health care services. Further I will even agree that it should cover items that are deemed medical necessity. However, no elective procedure is medically necessary. If you want plastic surgery, pay for it. If you want the elective gall bladder removal because you couldn't control your diet, great pay for it. Contrary to your beliefs, I believe that personal responsibility is a factor in health care. Why should I be penalized for your bad choices or for that matter why should you be penalized for mine? If there is no personal responsibility then it is WELFARE.

YardleyLabs
03-23-2010, 10:02 AM
Do you understand the difference? I agreed with you that everyone deserves the same basic health care services. Further I will even agree that it should cover items that are deemed medical necessity. However, no elective procedure is medically necessary. If you want plastic surgery, pay for it. If you want the elective gall bladder removal because you couldn't control your diet, great pay for it. Contrary to your beliefs, I believe that personal responsibility is a factor in health care. Why should I be penalized for your bad choices or for that matter why should you be penalized for mine? If there is no personal responsibility then it is WELFARE.
I think you need to be careful about making cavalier decisions concerning what is elective and what is not. "Punishing" risky behavior is a slippery slope (think "risky" behaviors like hunting, drinking, smoking, overeating, failure to exercise, etc.). However, that said, I would have no problems with a nationally subsidized program that covered all basic and preventative care but provided nothing for "elective" procedures. However, I would then not provide any government support of any kind for spending on insurance or medical procedures that were elective. If it is consumption, it should be treated the same as any other form of consumption from a tax perspective. If an employer decided to provide such insurance as a benefit, the cost of the insurance should be taxed as regular earned income. By the way, isn't child birth elective? It used to be excluded form virtually all insurance plans for exactly that reason.

HuntsmanTollers
03-23-2010, 10:33 AM
See we can agree on something. I am not trying to be cavalier regarding what is elective and what is not. I do know that is a slippery slope but so is expanding benefits without cost containment. Technically yes child birth is elective, but I would be fine with including that with the exception of assisted pregnancy. If you elect to place multiple embryos then you should be responsible for the costs that result from your decision, including the probable NICU stay for multiple preterm infants. I understand that would probably bankrupt most families who elect for assisted pregnancy, but if they understand their responsibilities maybe they would be making better decisions upfront, like how many should be implanted. You are also right that defining risky behaviors is problematic, but it does promote personal responsibility and cost controls.

ducknwork
03-23-2010, 10:40 AM
Talking about healthcare here dnw, not welfare. Tell me you do understand the difference? Unbelievable!

Actually, I do understand. Do you?

Buzz worked hard and made himself some good money. He then chose to spend HIS hard earned money to have his surgery at the location of his choice. He could have had the procedure somewhere else, but because he had the resources available to him he got to choose. Good for him.

Mr. Deadbeat doesn't go to work. He collects a check from the government, as well as govt insurance on Jdog's, Buzz's, and dnw's dimes. He needs to be able to receive the necessary care, not the 'cadillac' (;)) care that Buzz was able to receive.

If everyone is equal, where is the incentive to better yourself? If you can buy T bones and soft shell crabs on food stamps, but your neighbor goes to work everyday and buys hot dogs, why would you want to go to work? Same exact principle. Some people don't have any self pride or work ethic and need to be forced into being productive members of society rather than oxygen thieves.

ducknwork
03-23-2010, 10:41 AM
Hey Jeff and Huntsman, you know what else is elective? ABORTIONS...:D;)

YardleyLabs
03-23-2010, 10:46 AM
Hey Jeff and Huntsman, you know what else is elective? ABORTIONS...:D;)
I would actually be happy to see them both treated the same.

Hoosier
03-23-2010, 10:48 AM
I would actually be happy to see them both treated the same.

Are you talking about mother and baby?

YardleyLabs
03-23-2010, 10:55 AM
Are you talking about mother and baby?
If you are talking about returning to the standard that applied when my first child was born, babies are covered at birth. Moms would be covered for complications, but normal child birth is paid fully without insurance. It was a lt cheaper then, but the bill I paid for my daughter was still almost 10% of my gross income at the time. It was still a pittance compared to later costs, but a bargain at any price. By the way, I am not advocating such a pilicy. I actually feel that insurance should cover both child birth and abortion even though i believe both are elective.

M&K's Retrievers
03-23-2010, 11:13 AM
... I actually feel that insurance should cover both child birth and abortion even though i believe both are elective.

Pregnancy is not an illness nor an injury and therefore normal delivery should not be a covered expense. Normal pregnancy is at best a planned or accidental illness. Complications of pregnancy are an illness and should be covered and I believe in most cases are covered.

ducknwork
03-23-2010, 11:17 AM
Would people who cannot pay be forced to terminate the pregnancy or would they just have to forgo all medical care and give birth in the bath tub?:confused:

Or would everyone else still pick up the bill for them? (kinda like now...)

M&K's Retrievers
03-23-2010, 11:26 AM
Would people who cannot pay be forced to terminate the pregnancy or would they just have to forgo all medical care and give birth in the bath tub?:confused:

Or would everyone else still pick up the bill for them? (kinda like now...)

What do you think?:rolleyes:

Losthwy
03-23-2010, 03:08 PM
Ahhh yes. Because everyone is entitled to the same rewards, regardless of whether you sit on your ass and collect govt checks all week or go to work and bust your ass for 80 hours a week...

That really is rhetoric, old welfare baiting BS.

There are tens of millions who work close to the minimum wage and cannot get heath insurance. Don't they work hard? Don't they need health insurance? Was the current system addressing their needs? Every industrialized nation except this country has address the health needs of ALL it's citizens. Are the only people who work hard the ones who can afford the high cost of insurance?

blind ambition
03-23-2010, 04:20 PM
Quote:
Originally Posted by stumpholehunter http://www.retrievertraining.net/forums/images/buttons/viewpost.gif (http://www.retrievertraining.net/forums/showthread.php?p=587670#post587670)
If that is the case, then why did a Candian politican come to US to have a cardiac related surgery instead of having it up there? Have you ever been to any of these countries that are suppose to rank higher than us? And I don't mean the resorts, I mean where the normal people live and see the conditions in which they live and the conditions of the hospitals that they would utilize? I doubt it, because if you have you would know better. Also riddle me this, if the healthcare system is so much better in Canada and other places, how come I can't turn left or right without hitting a foriegn nurse?



I can't say much about the reporting of statistics, but there is a lot more to the story of Danny Williams than just deciding to come to the US. I think my favourite part is how he applied after wards to our government to be reimbursed for his surgery...and full well had the right too.

Secondly this was not an emergency surgery. He was in no remote danger of dying or even close to it being a necessity.

Thirdly he lived in what is the most remote of all the provinces. Admittedly in Newfoundland there isn't a plethora of heart specialists.

Fourthly? I know that a person story isn't really a statistic, but I'm gonna use it anyways because it was an identical procedure. A buddy of mine went in to see his family doctor, had some blood work done and within a week of the blood work coming back he was sent to see a specialist about 45 mins away. A month later he had the surgery. Today is back to 100%. His surgery was a necessity. Danny Williams said "My heart, my choice..." No hurry for the surgery...wanted to pay to get it done without being put on a waiting list. That list would have probably been in the range of about a year, but for non-emergency surgery that's how it goes. I'm totally fine with that. Others may not be.

In general I don't think it's a very good example because one can always say something about the number of Americans (admittedly I don't really care about taking the time to find an estimate) that go to places like China or India to have health procedures preformed.


On a slightly comedic note....do we really stand out enough that you could point us out as foreigners? =P

Please note: The procedure Premier Williams sought out in Florida is available in Canada. I researched this a few weeks back when Gerry wondered why an influential politician would have to go outside his country for heart surgery. The non invasive heart valve repair is available in Canada in a number of Urban centres and is covered by our health care system....what is not available anywhere in Canada, at least in winter, is the warm sunny climate of Florida.

If Premier Williams is seeking compensation from the Canadian Taxpayer for his US surgery, I hope he will be reimbursed at the same rate as if the Op where done in Quebec or Ontario.

ducknwork
03-24-2010, 06:20 AM
That really is rhetoric, old welfare baiting BS.

There are tens of millions who work close to the minimum wage and cannot get heath insurance. Don't they work hard? Don't they need health insurance? Was the current system addressing their needs? Every industrialized nation except this country has address the health needs of ALL it's citizens. Are the only people who work hard the ones who can afford the high cost of insurance?

First of all, you should quote the enitre post. The rest of the post further explains my postition.

Second, I would really, really, like it if you would please point out where anyone on here, especially me, has said that people who legitimately need help and aren't sitting around on their duff all day shouldn't be helped. I think you might have a difficult time with that, so I won't hold my breath. Let me know if you can't do that...;)

dnf777
03-24-2010, 10:17 AM
Pregnancy is not an illness nor an injury and therefore normal delivery should not be a covered expense. Normal pregnancy is at best a planned or accidental illness. Complications of pregnancy are an illness and should be covered and I believe in most cases are covered.

Hmmm....let me put on my right-wing Christian cap and noodle through this with you. We don't care about the health of the mother, that's been established, but what about the PERSON inside? Is that person not entitled to health care? Preventive medicine? Just as Scott Petersen was charged with double homicide for killing his wife and unborn fetus, wouldn't denying health care to a pregnant woman that results in illness or complication to the fetus be elibigle to be charged with child abuse/neglect, endangering the welfare of a child, or even murder, if the mother miscarries? Just tying to find consistency in the arguments...

M&K's Retrievers
03-24-2010, 01:35 PM
Hmmm....let me put on my right-wing Christian cap and noodle through this with you. We don't care about the health of the mother, that's been established, but what about the PERSON inside? Is that person not entitled to health care? Preventive medicine? Just as Scott Petersen was charged with double homicide for killing his wife and unborn fetus, wouldn't denying health care to a pregnant woman that results in illness or complication to the fetus be elibigle to be charged with child abuse/neglect, endangering the welfare of a child, or even murder, if the mother miscarries? Just tying to find consistency in the arguments...

No where did I say that we shouldn't care about the health of the mother but that the expenses associated with a normal pregnancy are not an illness and should be the responability of the individuals not the insurance company. If there are complications with the pregnancy, they are covered for mom and fetus and children are covered from birth with no prex limitation. Not covering expenses associated with a normal pregnancy is not denying health care but placing the responability for paying for it in the proper place.

Preventative care? Where do I start? Why should that be a covered expense? Major Medical Insurance was never intended to reimburse for routine medical expenses but rather pay for catastrophic expenses associated with illness and injury. Auto insurance doesn't pay for oil changes, tire rotation and other maintaince nor does home owners cover household related maintaince. During the Clinton administration is when state and federal mandates started which have added to the cost of insurance (NOT THE COST OF HEALTH CARE). Add to that COBRA, PPO organizations, mandatory second oppinions, dr. co-pays, drud cards all of which add to the cost of insurance not to the cost of health care.

And, by the way, what does Scott Petersen have to do with this?

Buzz
03-24-2010, 02:18 PM
I think that we should everything in our power to encourage folks to go back to having kids at home.

ducknwork
03-24-2010, 02:20 PM
I think that we should everything in our power to encourage folks to go back to having kids at home.

:shock:

Sure, right after we get done having ours...



Who was it that complained about infant mortality the other day??










(No, I didn't miss the sarcasm...)

dnf777
03-24-2010, 03:44 PM
No where did I say that we shouldn't care about the health of the mother but that the expenses associated with a normal pregnancy are not an illness and should be the responability of the individuals not the insurance company. Didn't mean to point the finger at you, personally. But repeatedly the conservatives have not allowed for abortions EVEN if the life of the mother is at stake. That means they don't care about the health of the mother.If there are complications with the pregnancy, they are covered for mom and fetus and children are covered from birth with no prex limitation. Not covering expenses associated with a normal pregnancy is not denying health care but placing the responability for paying for it in the proper place.

Preventative care? Where do I start? Why should that be a covered expense? Ask many insurance companies that not only offer coverage, but encourage its usage to reduce overall costs. Major Medical Insurance was never intended to reimburse for routine medical expenses but rather pay for catastrophic expenses associated with illness and injury. Auto insurance doesn't pay for oil changes, tire rotation and other maintaince nor does home owners cover household related maintaince. During the Clinton administration is when state and federal mandates started which have added to the cost of insurance (NOT THE COST OF HEALTH CARE). Add to that COBRA, PPO organizations, mandatory second oppinions, dr. co-pays, drud cards all of which add to the cost of insurance not to the cost of health care.

And, by the way, what does Scott Petersen have to do with this?
Drawing the legal comparison of being held legally responsible for causing harm to a fetus. That's all.

Hoosier
03-28-2010, 07:16 PM
Where is the language that exempts staff members from this bill?

Hoosier
03-28-2010, 07:46 PM
Found it, any lawyers on here?



(ii) DEFINITIONS- In this section:

(I) MEMBER OF CONGRESS- The term ‘Member of Congress’ means any member of the House of Representatives or the Senate.

(II) CONGRESSIONAL STAFF- The term ‘congressional staff’ means all full-time and part-time employees employed by the official office of a Member of Congress, whether in Washington, DC or outside of Washington, DC.

(4) NO PENALTY FOR TRANSFERRING TO MINIMUM ESSENTIAL COVERAGE OUTSIDE EXCHANGE- An Exchange, or a qualified health plan offered through an Exchange, shall not impose any penalty or other fee on an individual who cancels enrollment in a plan because the individual becomes eligible for minimum essential coverage (as defined in section 5000A(f) of the Internal Revenue Code of 1986 without regard to paragraph (1)(C) or (D) thereof) or such coverage becomes affordable (within the meaning of section 36B(c)(2)(C) of such Code).

Gerry Clinchy
03-28-2010, 08:05 PM
http://newledger.com/2010/03/exempted-from-obamacare-senior-staff-who-wrote-the-bill/



According to the Congressional Research Service, this definition of staff will only apply to those staffers employed within a member’s “personal office” — meaning that it will absolutely not apply to committee staff members, and may not apply to leadership staff.

This problem was acknowledged earlier in the process — last year, Senator Grassley tried to repair it (http://grassley.senate.gov/news/Article.cfm?customel_dataPageID_1502=24645), but he was rebuffed.


In addition to Senate committee and leadership staff, the amendment Grassley and Coburn filed during the Senate debate would have made the President, the Vice President, top White House staff and cabinet members all get their health insurance through the newly created exchanges. It would not have applied to federal employees in the civil service.

Whistler
03-28-2010, 08:10 PM
There are so many interesting posts on this subject.

The one question I ask myself and everyone is:

Is Health Care a RIGHT or a PRIVELEGE? Until we all can agree on the answer to the above question the problem may never get solved. (of course that is just my opinion)

YardleyLabs
03-28-2010, 08:19 PM
There are so many interesting posts on this subject.

The one question I ask myself and everyone is:

Is Health Care a RIGHT or a PRIVELEGE? Until we all can agree on the answer to the above question the problem may never get solved. (of course that is just my opinion)
I believe government should help everybody or nobody when it comes to health care. Helping nobody means no tax deductibility for health insurance or medical care expenditures, whether paid by an individual or paid by companies for their employees. It means no Medicare, no Medicaid, no VA system, and no health benefits for government employees. It eans no public hospitals or clinics and no legal requirements for free emergency care or subsidies to medical providers for care provided.

Helping everybody means helping everybody. I see no reason for one group to be given preference over any other.

I don't see any reason for a middle ground. Given the choice of these two options, I don't think many would support the help no one option. Unfortunately, those who are being helped now, in part because of direct and indirect government subsidies, want to pull up the ladder and shut the door behind them.

Hoosier
03-28-2010, 10:08 PM
I believe government should help everybody or nobody when it comes to health care. Helping nobody means no tax deductibility for health insurance or medical care expenditures, whether paid by an individual or paid by companies for their employees. It means no Medicare, no Medicaid, no VA system, and no health benefits for government employees. It eans no public hospitals or clinics and no legal requirements for free emergency care or subsidies to medical providers for care provided.

Helping everybody means helping everybody. I see no reason for one group to be given preference over any other.

I don't see any reason for a middle ground. Given the choice of these two options, I don't think many would support the help no one option. Unfortunately, those who are being helped now, in part because of direct and indirect government subsidies, want to pull up the ladder and shut the door behind them.

Jeff, do you think the language in this bill exempts Sr. staff?

M&K's Retrievers
03-28-2010, 10:59 PM
[QUOTE=YardleyLabs;591378]I believe government should help everybody or nobody when it comes to health care. /QUOTE]

What would be wrong with the government helping those that need it and leave the rest of us alone? That concept makes sense to me.

YardleyLabs
03-29-2010, 06:28 AM
Jeff, do you think the language in this bill exempts Sr. staff?

The issue of coverage of Congressional staff is a little strange. People sa things like, "If this is so good why doesn't Congress buy their insurance through the Exchange?" The fact is that the law does not require anyone to buy insurance through the exchange. If you have insurance now -- through an employer or through a plan that you purchase directly -- you are not required to buy anything through the exchange. If you don't have coverage now, you are free to buy ine from any source that will sell it to you. The differences are that everyone is required to maintain a certain minimum level of coverage in the form of a plan that coveres all major types of health services with no lifetime maximum, a fairly high maximum out of pocket payment, and fairly high deductibles and co-pays. This requirement has been attacked from all directions, often by the same people. On one hand, it is attacked as an affront to the freedom of people who want to purchase no coverage at all or only coverage for major catastrophic illness or injury. Others attack the standard as being too restrictive, saying they couldn't afford to pay the potential patient share of cost under the minimum plan, ignoring the fact that the standard is a minimum requirement and does nothing to prevent purchasing better coverage. When conservatives attack Congress, it is normally with statements that they should be forced to have plans consistent with the minimum standard. The fact is that all Federal employees now receive insurance that is much much better than the minimum standard as do more than two-thirds of those receiving coverage through other employer sponsored plans. I'm not sure that the language quoted has any real effect at all. It appears to say that Congressional staff may buy coverage fro out side the exchanges as long as it meets the requirements for minimum coverage. That is not a special exemption. It simply gives them the same right that everyone else has as well.



I believe government should help everybody or nobody when it comes to health care.

What would be wrong with the government helping those that need it and leave the rest of us alone? That concept makes sense to me.

That is exactly what it does. If you have adequate coverage now, the law does nothing that changes you coverage. The issue is if you have coverage now that is not adequate and want to retain that coverage to avoid paying a higher premium. Realistically, it is impossible to have a functional plan that guarantees everyone access to coverage unless that plan also requires coverage. That point was made by, among many others, Mitt Romney when he signed the bill creating the Massachusetts plan. He called it a personal responsibility plan since the biggest burden on the health care system comes from people with no coverage who end up needing care that they cannot afford.

Hoosier
03-29-2010, 07:50 AM
Does anyone have any idea what kind of taxes will be put on existing plans provided by employers.

Whistler
03-29-2010, 07:59 AM
Jeff has the perfect point to what the Right or Privelege of what health care is all about.

Help all or none.

YardleyLabs
03-29-2010, 08:00 AM
Does anyone have any idea what kind of taxes will be put on existing plans provided by employers.
The "Cadillac" tax, as it is called, goes into effect in 2018 and imposes a tax on plans costing more than $27,500 for families ($10,500 for individuals) excluding costs of any coverage for dental or vision. These limits increase based on the rate of inflation plus 1%. The tax is a 40% excise tax paid by the insurance company on the mount over the cap.

Gerry Clinchy
03-29-2010, 03:15 PM
I was actually pleased to see that the Congress will only be entitled to the same basic program that everyone else gets. I'm not sure what it costs taxpayers now to pay for their "deluxe" plan, but it could be saving quite a lot of money & making legislators more keenly aware of what health care coverage costs in "the real world".

Let's hope that is NOT one of the things that they "fix" as they proceed to "fix" this legislation. If they were to somehow exempt legislators from the luxury plan tax; or provide them with more coverage that could add fuel to the "throw the bums out" movement.

Buzz
03-29-2010, 03:46 PM
I was actually pleased to see that the Congress will only be entitled to the same basic program that everyone else gets. I'm not sure what it costs taxpayers now to pay for their "deluxe" plan, but it could be saving quite a lot of money & making legislators more keenly aware of what health care coverage costs in "the real world".

Let's hope that is NOT one of the things that they "fix" as they proceed to "fix" this legislation. If they were to somehow exempt legislators from the luxury plan tax; or provide them with more coverage that could add fuel to the "throw the bums out" movement.

Legislators get their insurance the same way every other federal worker does. They choose from a menu the same way many do that work for large corporations, and their employer then pays a certain amount, the balance to be made up by the employee.

http://www.usatoday.com/news/washington/2009-06-23-congress-benefits_N.htm


Like millions of employees, lawmakers choose from a range of private insurers. The U.S. Office of Personnel Management does not track how many members of Congress enroll in individual plans, but a Blue Cross Blue Shield preferred provider organization (PPO) is the most popular for all federal employees, according to the agency.

That Blue Cross plan scored well in an analysis by the non-partisan Congressional Research Service. The report found the federal plan had lower deductibles and co-pays than "typical" PPOs but did not rate as well as an average health maintenance organization (HMO). Most people insured through work, 58%, are in PPOs, according to the Kaiser Family Foundation.

Roland McDevitt, director of health care research for consulting firm Watson Wyatt, which performed the analysis in the report, called the federal plan "slightly more generous."

A Kaiser survey found the average PPO premium for individual coverage was $4,802 in 2008. For a family, the premium was $12,937. The federal plan's premiums were higher ($5,386) for individuals but lower ($12,335) for families, according to the Office of Personnel Management.

The government paid 69% of that premium for a family, less than the 73% average.

"These aren't the wonderful, exemplary plans ... that many people think they are," said Jon Gabel of the National Opinion Research Center at the University of Chicago. "They are not the Cadillac plans."

Gerry Clinchy
03-29-2010, 05:29 PM
A Kaiser survey found the average PPO premium for individual coverage was $4,802 in 2008. For a family, the premium was $12,937. The federal plan's premiums were higher ($5,386) for individuals but lower ($12,335) for families,

My plan for one individual paid for 100% by me cost $380/mo. (Highmark Blue Shield). $4560/year. Just increased this year. Last year it was $323/mo. $3876/year. 17.6% increase.

Gerry Clinchy
03-29-2010, 11:32 PM
http://www.mcall.com/news/local/all-news-fraud-032910-cn,0,3718301.story

Looks like having insurance can be just as costly to the general public as not having insurance.

Wonder if the Fed govt will be any better than private industry in ferreting out this kind of thing.

M&K's Retrievers
03-30-2010, 12:47 AM
The "Cadillac" tax, as it is called, goes into effect in 2018 and imposes a tax on plans costing more than $27,500 for families ($10,500 for individuals) excluding costs of any coverage for dental or vision. These limits increase based on the rate of inflation plus 1%. The tax is a 40% excise tax paid by the insurance company on the mount over the cap.

Are you sure the 40% tax is levied on the insurance company? That doesn't make sense. If so, why would Obama be cutting a deal for the Unions? If that's the case, this will be passed on to consumers. I think the tax was levied on the insureds receiving the benefits.

Gerry Clinchy
03-30-2010, 08:56 AM
If so, why would Obama be cutting a deal for the Unions?

The explanation given was that several unions (at least at upper levels) had such deluxe plans that would qualify for this luxury tax, it was some kind of a "hardship". By raising the "luxury plan" dollar-amount definition it allows the union plans to not "qualify" in the luxury category. I'd expect the unions to re-negotiate those contracts and get the $ they might later lose in benefits in some other form of compensation.


If that's the case, this will be passed on to consumers.

Isn't a tax on businesses of any type always passed onto the consumers in one way or another? Taxes on the medical devices and drug companies will also be passed on. If there is still a profit margin, after paying the tax, they will either have to sell a lot more of their products (which is possible if the newly insured need their products; thus increasing the market for products that previously were not purchased due to the cost for an uninsured). Or, if the market doesn't grow enough to absorb more product, the price will have to go up?

So maybe we'll end up getting more of these products manufactured in other countries where production costs are lower?

I keep thinking of the idea of insuring those under age 26 by their parents' plan. I wonder how they computed the cost of this in the CBO scenario. In most health plans that I have been familiar with (and I may be wrong), a "family" coverage didn't charge by the child. Therefore, as stated by a previous poster, their mother's VA plan is the same whether one child or eight. No increase in premium income for the insuror ... but could mean a significant increase in costs to the insuror in providing benefits to that "child". And the most likely to use this option would be those with pre-existing conditions or unemployed. So, while the govt won't have to bear a subsidy for these individuals ...neither will any additional premium be collected for them. If they were NOT covered under the parents' insurance at least some premium might be collected on them, even if they had to be subsidized. Great deal for some going to extended education like law school. What if that "child" is already married? What happens to the spouse? Guess spouse gets covered under his/her parents' coverage? What if these two "children" already have a child (or more) of their own (I had one before I was 26)? Guess those kids go on CHIP? The logic would be if those two under-26 "kids" can't afford their own separate coverage, they couldn't afford coverage for their kids either. So, essentially, those kids (over 21 but under 26) will be receiving "free" health insurance coverage that they didn't have before. OTOH, if the parents are lower income than $88,000 they might even be getting a subsidy for their health insurance to begin with, and the under-26 additions would be even better than "free". Now that's a pretty good way also for a young-healthy, presently uninsured to avoid the penalty for not having insurance; and getting that health coverage "free" to boot. They could reimburse their parents for the amount of the "tax" they would have paid. However, since the tax doesn't go into effect until 2014 (I think), those now-under-26 kids might end up in the taxing position by then.

M&K's Retrievers
03-30-2010, 09:45 AM
The explanation given was that several unions (at least at upper levels) had such deluxe plans that would qualify for this luxury tax, it was some kind of a "hardship" On who? According to Yardley, the tax is paid by the Insurance Company. I think the tax is on the insured but I could be wrong about that.. By raising the "luxury plan" dollar-amount definition it allows the union plans to not "qualify" in the luxury category. I'd expect the unions to re-negotiate those contracts and get the $ they might later lose in benefits in some other form of compensation.



Isn't a tax on businesses of any type always passed onto the consumers in one way or another? Taxes on the medical devices and drug companies will also be passed on. If there is still a profit margin, after paying the tax, they will either have to sell a lot more of their products (which is possible if the newly insured need their products; thus increasing the market for products that previously were not purchased due to the cost for an uninsured). Or, if the market doesn't grow enough to absorb more product, the price will have to go up?

So maybe we'll end up getting more of these products manufactured in other countries where production costs are lower? That's just what we need. More imports, less jobs.

I keep thinking of the idea of insuring those under age 26 by their parents' plan. I wonder how they computed the cost of this in the CBO scenario. In most health plans that I have been familiar with (and I may be wrong), a "family" coverage didn't charge by the child. That depends on the rating structure. Some have a composite family rate where one rate covers all. Others use try to peg it more accurately charging one rate for a spouse, one for children and another for a family. Therefore, as stated by a previous poster, their mother's VA plan is the same whether one child or eight. No increase in premium income for the insuror ... but could mean a significant increase in costs to the insuror in providing benefits to that "child". And the most likely to use this option would be those with pre-existing conditions or unemployed. So, while the govt won't have to bear a subsidy for these individuals ...neither will any additional premium be collected for them. If they were NOT covered under the parents' insurance at least some premium might be collected on them, even if they had to be subsidized. Great deal for some going to extended education like law school. What if that "child" is already married? What happens to the spouse? Guess spouse gets covered under his/her parents' coverage? What if these two "children" already have a child (or more) of their own (I had one before I was 26)? Guess those kids go on CHIP? The logic would be if those two under-26 "kids" can't afford their own separate coverage, they couldn't afford coverage for their kids either. So, essentially, those kids (over 21 but under 26) will be receiving "free" health insurance coverage that they didn't have before. OTOH, if the parents are lower income than $88,000 they might even be getting a subsidy for their health insurance to begin with, and the under-26 additions would be even better than "free". Now that's a pretty good way also for a young-healthy, presently uninsured to avoid the penalty for not having insurance; and getting that health coverage "free" to boot. They could reimburse their parents for the amount of the "tax" they would have paid. However, since the tax doesn't go into effect until 2014 (I think), those now-under-26 kids might end up in the taxing position by then.

Most if not all states require group plans to cover dependents to age 24 or 25 if they are full time students. That requirement has been around for as long as I can remember.

Gerry Clinchy
04-03-2010, 08:42 AM
http://www.nytimes.com/2010/04/03/health/policy/03health.html?th&emc=th

Was this part of the recent legislation that we "missed" in our previous discussions? Or does this initiative stem from some other source?

Gerry Clinchy
04-03-2010, 08:59 AM
On who? According to Yardley, the tax is paid by the Insurance Company. I think the tax is on the insured but I could be wrong about that..


Yes, the tax would be on the insuror ... but if, as a result, the insuror raises premiums, then that leaves the union less bargaining power in negotiations with the employers. Inevitably, when a business is taxed, the end-consumer pays. In this case, the union may not be able to get a wage increase that might have been possible if there had not been a cost-increase for health benefits for the employer.

Just, how my logic. If the luxury tax is mitigated so that it does not include the unions' plans (raised the trigger point), then the union gets to retain its bargaining position for other benefits.


Most if not all states require group plans to cover dependents to age 24 or 25 if they are full time students. That requirement has been around for as long as I can remember.

It's been a while since I was directly involved in the life/health business, and back then the max age was 21. But I can understand that the age could have been raised to encompass graduate students.

In these cases, how does the insuror treat the spouses/children of these eligible students? If the "child" of 24 is employed, is there any difference? (i.e. is the question of "emancipation" from parents any factor?) Might we correctly assume that a part-time student is not covered under present policies? (but under the new legislation, it would appear that age is the only defining factor)

It is still not clear to me how the spouses/children of these under-26 "children" will be treated? Presumably, the spouse and/or children will have to acquire their health insurance separately from the spouse who can be covered under parents' coverage? I'd guess the bureaucrats will write volumes on this :-) Or it could be handled more simply by stipulating that if such an under-26 child marries, they must acquire their own coverage for their own family? Would it then be beneficial to delay marrying until after 26; and have "partner" & children get their entitled subsidy from the govt?

The insured under-26 "child" could be earning $60,000/year; have an exclusive "partner" & have children with that partner. Partner has lower income, maybe only $20,000 year & with a child, so therefore is eligible for a subsidy? As with welfare laws, would the father of the child have to contribute to support for the child?

This could get complicated?

YardleyLabs
04-03-2010, 09:19 AM
http://www.nytimes.com/2010/04/03/health/policy/03health.html?th&emc=th

Was this part of the recent legislation that we "missed" in our previous discussions? Or does this initiative stem from some other source?


It was part of the original reconciliation bill and a highlighted part of the program for providing immediate help for those excluded based on prior conditions.

M&K's Retrievers
04-03-2010, 10:24 AM
Yes, the tax would be on the insuror ... but if, as a result, the insuror raises premiums, then that leaves the union less bargaining power in negotiations with the employers. Inevitably, when a business is taxed, the end-consumer pays. In this case, the union may not be able to get a wage increase that might have been possible if there had not been a cost-increase for health benefits for the employer.

Just, how my logic. If the luxury tax is mitigated so that it does not include the unions' plans (raised the trigger point), then the union gets to retain its bargaining position for other benefits.



It's been a while since I was directly involved in the life/health business, and back then the max age was 21. But I can understand that the age could have been raised to encompass graduate students.

In these cases, how does the insuror treat the spouses/children of these eligible students? If the "child" of 24 is employed, is there any difference? (i.e. is the question of "emancipation" from parents any factor?) Might we correctly assume that a part-time student is not covered under present policies? (but under the new legislation, it would appear that age is the only defining factor)

It is still not clear to me how the spouses/children of these under-26 "children" will be treated? Presumably, the spouse and/or children will have to acquire their health insurance separately from the spouse who can be covered under parents' coverage? I'd guess the bureaucrats will write volumes on this :-) Or it could be handled more simply by stipulating that if such an under-26 child marries, they must acquire their own coverage for their own family? Would it then be beneficial to delay marrying until after 26; and have "partner" & children get their entitled subsidy from the govt?

The insured under-26 "child" could be earning $60,000/year; have an exclusive "partner" & have children with that partner. Partner has lower income, maybe only $20,000 year & with a child, so therefore is eligible for a subsidy? As with welfare laws, would the father of the child have to contribute to support for the child?

This could get complicated?

Generally, to be eligible from 18-24, the child must be taking 12-15 hours in college(they can skate during the summer) and be claimed as a dependent on the employees tax return. The exact defination/requirement can vary by state. Dependents of dependents are not eligible. Again, by state, dependent eligibility can also include handicapped childern beyond the age of 18.

Other than to be punitive to the insurance companies and those that can afford better plans, I cannot figure out the purpose of the luxury tax. Richer plans equal higher benefits and higher premiums, not higher profits. Also, luxury is defined by premium amount not benefits. Premiums will be higher for reasons other than just benefit levels i.e. male/female makeup, age, location, industry, etc. The 40% will just be passed on to the consumer.