public option health care

 Meh, this thread is going to turn into an argument.

 I heard it passed by 2 votes, not 5. But whatever. A win is a win. WOOT

I got 220-215 -- http://www.youtube.com/watch?v=qwFzis6cRNo

Hopefully not. Probably.

Yup.

We will never have a good universal health care system because the democrats are slaves to corporate interests, as are the republicans.  Remember three years ago Obama stated that he was an avid supporter of a single-payer healthcare system, but first, the democrats had to take back the house, and the senate, and the white house?  Well They've got all three now, and yet Obama has taken single-payer off the table.  What's up with that?  Maybe it has something to do with the millions of dollars in campaign contributions from health insurance and pharmaceutical corporations.  Politicians will never truly represent the interests of the people until we ban corporate contributions to campaign funding. 

And so it begins.

Guys...  please at least skim through the health care bill before celebrating...  more later.

fixed with anticipation of your contribution.

Don't know enough to say this, but it seems to me that while it's a victory to get people covered, the limitations that have been put on this bill (primarily, not being single-payer/not challenging the attached pharmaceutical/other medical industries) aren't really going to fix the cost issues, and that means that we'll be dealing with this again... and probably with less "hope."

Then again, I'd guess that this bill's going to be stopped somewhere along the way anyway...

Another issue that isn't resolved is pay-by-procedure for doctors, which is a large contributor to high costs.

http://www.youtube.com/watch?v=mEJL2Uuv-oQ

All 1990 pages of it?  It weighs twenty pounds and sits over 8" tall on 8-1/2" x 11" paper.  I can skim pretty fast, but that's beginning to push it.  I really pity the solicitors charged with understanding the damn thing.  And I don't know if you've ever read bills coming out of the senate and house, but they are ridiculous in the extreme.  Right now, I'm reading a 64 page bill dealing with must-carry provisions implemented by the FCC on local station retransmission agreements for cable networks, and it's what I imagine chewing on granite is like.  The heath care bill is 31 times larger.  Ouch.

Here's my take on the most serious contributors to cost.

1. High overhead in administrative costs via doctor requirements to service multiple payers
2. Not enough queuing to increase utilization of expensive resources like MRI's
3. Significant advertising for pharmaceuticals and procedurals pushing un-needed consumer driven health care
4. Failure to leverage economies of scale in negoiating payment rates
5. Anti-trust exemtions and artificial barriers to entry in pharmaceuticals combined with a very inelastic demand curve
6. American dietary and exercise habits

More broadly, when discusssing insurance as the system for covering health costs, it's important to remember there are only two options to reduce costs.  Reduce the risk pool by eliminating high-risk individuals (the status quo), or increase the risk pool by adding low-risk individuals.  Without a strong required mandate, similar to what you see in the commonwealth, our risk pool will never be truly successful.

I hadn't heard anything like that. Does this article cover most of what you're talking about?:

www.streetdirectory.com/travel_guide/153256/health/doctors_suggest_cutting_their_own_pay_to_save_healthcare.html

This particular article doesn't seem to make the case very well (can't check the source on "reports released in March," that doesn't seem significant given that about 16 percent of people are uninsured anyway, and the "healthy patient" bonus sounds like a better incentive to gloss over peoples' problems than to take on more of them), though a google search of "pay-by-procedure" didn't give me many results.

Your linked article covers the basic idea, though I'd have to rummage around (far too lazy to do so) for where I read the figures. Off the top of my head, Krauthammer comes to mind, but after that I draw a blank. Sorry I can't be more help on it, healthcare is uninteresting to me. But still, the article you linked has the basic argument-i.e. salaries will drastically reduce costs and reduce incentive to continually tack on procedures.

I was really excited at first too...but I just recieved an e-mail from naral pro-choice, and, apparantly, many insurance policies now include financial support for abortions, and the new bill makes it almost impossible for a woman to get that support from federal OR private means...which is NOT what I want at all...plus, I don't even understand why it happened that way because hardly any republicans voted for it (I believe only one)...

can anyone here name a single country in the world that has a good universal heathcare system. Its because there is not one.

i guess that would depend on what you define as a 'good' system. That probably depends on where you stand in terms of class/identity and politically. There are communities in our country that are not provided health care service due to bigotry (I specifically have the transgendered community in mind, but there are others)

No system is perfect, but countries with these systems have higher life expectancy (correlative, not causal, I know).  Plus, it is more equitable. Personally, I have a problem with a system in which a social parisite like Paris Hilton can recieve better health care (and therefore be represented as more 'valuable' to our society) than a person working two jobs to stay on top and barely covering their health insurance bills.

Plus, if people are getting preventative health care, as opposed to being treated only when symptoms become unmanageable, there is bound to be less communicable disease. Think of the impact of this even on just STI's...

I could rant more, but I know its not productive in the forum so I'll censor myself here...

Depends on how you define "good".  I'd say that a good universal healthcare system is one where  20,000-40,000 do not die every year due to inability to pay, which is what happens in our system.  For the wealthiest nation in the world overall, and for spending the most money per capita on healthcare, we are among the worst of all industrialized nations with regard to coverage.    

Here come the talking points! 

Singapore.

Universal care available for everyone with private option available to anyone who chooses. A visit to the polyclinic/hospital is S$10 (or about... US$7) flat. Oh and tax rate is roughly -20% of US equivalent for income bracket.

So there you have it. A government that taxes LESS than the US and has good universal healthcare.

That was a the Stupak amendment, which passed just before the bill. It could still be stripped in conference. There were 64 dems who voted for it, none from Washington. So overall happy with the Washington contingent. The amendment basically (If i remember this correctly) tiers coverage for abortions making it expensive for women to have abortions because they need to purchase a separate plan. A bigoted piece of crap in my opinion. But like I said it's not in for good yet.

I've talked with several canadians who are happy with their health care. Not only did they mention the fact that they were happy with it as a whole, but that it brought in a sense of 'community' knowing that you were helping pay for your neighbors coverage and that if he got in a serious accident you were 'there' for them, because you were helping pay for it. Knowing that your money is helping every person you see, knowing that when you look at a hospital and you know that every person in there is helped by your money  (assuming that we divide your money infinitely fractimisally to the point that it would cover everyone), I think that it makes people a little bit better, maybe a little bit prouder.

 The Stupak-Pitts Amendment says the following about it's self:

Which is ridiculous because it is a legal procedure. Heres what the Director of the Women's Health and Rights Program at American Progress has to say: LINK

I urge everyone to watch today's episode of Democracy Now! at democracynow.org.  Dennis Kucinich explains our situation quite well:  the private option will cover from  between 4 and 11 million people, which is not a large enough number to actually compete with the private insurance companies.  Therefore, the public option will do nothing to drive down costs of private health insurance.  The bill just forces most of us to buy private health insurance.

Yes but it also creates the exchange which poorer people get credits on and has standards private companies must follow to be admitted. 

If you think about it we already do pay for our neighbors to go to the doctor. People do who not have health insurance go to the Emergency room because the ER is forced to take them. If they can't pay then the gov't takes care of it while they either 1. do not pay at all or 2. pay the gov't back. So we can 1. continue paying for them to go to the ER which clogs the ER and makes it hard for people who have a real emergency to get in or 2. we pass a public option allowing them to have public health care and they can go to a doctors office, which is cheaper.
The public option sounds pretty darn good to me!!
 

What's all the fuss about the public health option bill winning? Statistics already say they will only have enough coverage for 2% of America. 2%. That sure doesn't sound like a good number to me.

You are just flat out wrong.  *Every* country with Universal health care I've lived in has better care at a lower cost than the United States.  As an American, you wouldn't even have exposure to good health care.  And from a quality of life and reduction in mortality -- two quantifiable methods of comparison -- the United States is way, way behind other developed nations.

^beating a dead troll.

Miborovsky and Locke already dispatched w/ him.

"The Price of Health Reform: Abortion Rights?"

http://www.motherjones.com/politics/2009/11/price-health-reform-abortion...

Stupak Amendment

http://documents.nytimes.com/the-stupak-amendment#p=1

Hopefully, as long as the senate doesn't pass something similar, it will be thrown out in conference. Obama has also officially spoken out against the amendment on the fact that this was a health care bill, not an abortion bill.

Are doctors what ails U.S. healthcare?

www.reuters.com/article/topNews/idUSTRE5A50EB20091106

The gods forbid that doctors actually get fair compensation for the intellect, skill, hardwork and mental anguish their job requires! Curse those heartless monsters for - imagine the sheer gall - wanting a better paying job in a good neighborhood rather than dangerous living in inner city ghettoes or opening abortion clinics in the deep south! It's not like they're normal people like you and me! HOW DARE THEY!

/sarcasm

It's extremely rational when you take into account the inconceivable theory that doctors are people too.

I thought the Baucus Bill was ridiculous.  Pelosi's Plan is impenetrable.  The only way I've found to even begin to digest this mammoth is to find sites which take it point by point then go to the actual page in the bill and look at it myself.   

What are you guys doing to get at the jugular of this thing? 

I could be wrong but isn't part of the source of their wage is their own inexorbinant amount that they have to be paid to be insured themselves?  I think that really the law is what has driven up some of this and the willingness and almost glee that people in this country get from legal cases.  Case in point...the woman who sued McDonald's when she spilt hot coffee in her lap...I'm glad they finally got around to overturning that decision.  If you think about it, everything in America is a business.  I think that that's why the healthcare is so screwed in this country is because we want good healthcare but we don't want to have to pay a lot for it and neither does anyone else.  I'm hoping the bill never passes, it doesn't appear to be the answer we need.

Your argument makes no sense, you refrence cases to support the fact that this county is all about buisness and then go to 'I hope this bill dosn't pass it's not the right answear'. WHY isn't the bill the right answear?

^/agree

Doctors are Public servants and they should be distributed (like goods) where their skills and talents are to be best utilize them. Just like how the govt. moves troops and soldiers around to have good ones where they are needed w/o having all of them in one spot, upon socializing health care govt should move these doctors around.

Yes, they're people, but when their only mindset is making money and began treating people like dollars that need to be earned instead of patients needing care, they lose their right to be 'people'. Doctors should be fairly compensated, that's -fairly- compensated, a lot of doctors, and the one's that Greg is referring to in this article, are over compensated. They're getting paid shittons of dollars for what costs pennys.

An example: My dad's in the army, so my insurance is provided by Tricare. Once upon a time, on a visit to the dentist's office, I had some work done on my braces. For the use of some tool that I don't remember them using, they charged 120ish dollars. Tricare said 'Wait...what?!' and paid them what they believed it was worth, somewhere in the realm of 13 dollars. That's 100+ dollars of overcompensation for dentists to use some tool. Fairly compensated my rear end.

Less money needs to be given to doctors and more to teachers

/elfin

you missed the fact that my comment had more than one point to it

our country is sue-happy, therefore doctors charge a lot for their services due to the large number of and cost of malpractice suits that occur in our country (legitimate or otherwise). insurance companies are out to make money, therefore when you go to the doctor and the insurance decides that they dont want to pay for a certain service the doctor has to give them a good reason for that service, not just "i wanna pull some teeth today", if they have a solid reason the insurance will pay for it, unlike most government provided insurances.

and locke, tricare is like an HMO or DSHS, you dont have to pay for it so they pay for what they wanna pay. all of the government provided insurances are like that, that is one reason that this bill that is going before congress is bad. if you read some of it, it tells you that they can force you to drop your current insurance in favor of their new one and you have no control over it, and they can tell you what theyll pay for just like tricare and dshs and different hmo's do

Doctors are not public servants and they are not soldiers. They do not sign a piece of paper saying that the government has the right to send them to remote corners of the world to die. Should plumbers be relocated by the government to best utilize them? Who decides what the most efficient distribution is? Why do you think a government-mandated distribution would be more efficient?

Most importantly, why would anyone want to be a doctor when the government gets to relocate them at will?

You can safely replace "doctor" with laywer, accountant, business owners, executives, electrician, checkout clerk, in the above paragraph, and your point would be equally invalid. Who decides what is fair compensation? The government? The government can't decide that $4,000 is too much to pay for a toilet bowl, but you think they can fairly decide how much doctors should be compensated, in all 50 states, for hundreds of specialties, while factoring in experience, cost of living, level of training, and reputation? Good luck with that!

So your insurance company reamed your dentist in his tender regions, because nobody dares to deny service to military personnel.

Have you perhaps considered the opportunity cost to your dentist? In the time it took to do your procedure, he could have been doing one that was worth $500. You don't pay your doctor just for him to use some tool. You pay for him to his time and the training he needs to use his tool skillfully. Oh wait, you didn't pay him. Poor dentist.

So let's say your procedure took 15 minutes and was worth $13, eh? So if the dentist's office worked 8 hours a day, that'd be $416 revenue per day for the office if that's all they did all day. This is for the entire practice. They need to pay rent. Water. Electricity. The receptionist. The dentist's assistant. The dentist himself, unless you want him to work for free. No, $416 per day is not enough to keep a practice going.

EDIT: Oh yeah those braces cost money to make too...

Let's just say I'd rather practice medicine in Zimbabwe than your ideal version of the USA.

False dichotomy. Healthcare and educational expenses are not mutually exclusive. And economics is not a zero-sum game.

well said mib

I dont know, I kinda thought that, back in the day, before being a doctor put you in the Upper Class, that people became doctors to help people. Back in the day when Hammurabi's code was law, you certainly didn't become a doctor for money's sake, as the expense of a few patients lives; the death of the patient was the death of you. Considering that there are many doctors in the Armed Forces who, are relocated at will (which certainly doesn't pay as much as a private practice) i'm sure it has more to do with serving your country/community than it does about making money at people's expenses.

And you're right, people don't want to deny military services, why? Because it's a huge source of revenue. If you've never lived in a military community, you can't attest to the fact, but being that I've been in a few I can say that the number of soldiers in the area enormously affects the economy. When the War on Terror broke out and the first waves of soldiers went to Afghanistan, businesses in Clarksville -closed- because of the loss of revenue. There were extreme ups and downs due to the return of soldiers and soldiers leaving.

The total cost of the procedue wasn't 13 dollars, I was referring to specifically the amount they were paying the dentist for the use of a component the procedure. The total cost was much more than that, but it certainly could have been outrageously more.

In terms of economics I disagree with you entirely. I see economics as a zero sum game. When you have X amount of dollars to spend, every dollar you spend on Y is one less dollar you have to spend on Z. When education is receiving less and less funding every year and medical bills are on the rise I certainly see that as an example of the Zero-sum game economics is.

http://en.wikipedia.org/wiki/Public_services

Public servants: People who are funded directly or indirectly by the government. Unless you're a private practice in the realm of health care that receives no outside funds from the government, you are indeed providing a public service. Why do I think government distribution of health care servants is nigh essential? Because when all the doctors are in Los Angelos, New York, and Houston to be 'where the money is' and small towns and cities, even right here in Washington, are having -extreme- shortages of Doctors, to the point that people have to go well out of their way to get essential medical care, call me crazy, but I find it ridiculous. When capitalism begins to become a parasite on the interests of the public, when it becomes a thorn in the public's side that hurts more than it helps, then I believe government regulation is necessary.

I'm not making the connection between "to help people" and "government should be able to order you around like a chattel slave".

Back in the day, medicine consisted of drilling holes in people's heads so their excess humours can get removed.

(Actual Babylonian medicine was more advanced than that, but you get my point.)

I'm sure their decision has nothing to do with zero med school debt, guaranteed internist-placement, and a commissioned officership. Also, these are a minority of all doctors in the country, and unlike most doctors, these guys are actually in the military and have already signed their lives away. Unless you're suggesting that all doctors be conscripted into the military and be given benefits, I fail to see how this is a valid argument.

Not according to your anecdote... With a small business having to survive with $400 revenue per day under the Lockean regime...

Can soldiers buy gas at 90% discount? What about at Wal Mart? Areas near bases get an economic boost because soldiers buy things and services. I'd imagine all the retailers would flee the moment soldiers started demanding a "pay-what-you-want" payment scheme...

So you admit that your insurance company ripped off your dentist, ie. compensated him less than what it cost him to do the procedure. K. Just so we're on the same page.

Then you'll have to argue against 300 years of economic theories.

Quick rebuttal: Fact: Healthy children get better grades.

(Econ majors feel free to chime in.)

1. The healthcare industry is already heavily regulated.
2. I remind you once again that your idea of more government regulation is to chain doctors together and march them to Montana.
3. There already exist federal and state initiatives to encourage rural medicine, that doesn't involve slavery.
4. Any school teacher or cubicle farmer employed by the state is also a public servant. Areas lacking healthcare also lack education and office jobs. Will you also recommend for teachers and office workers to be rounded up and sent to those areas? You can make the exact argument for any service provided in the economy. Will you nationalize them all?

I don't think the two should be mutually exclusive. Becoming a doctor is a lot of work and time invested, and we have regulations to make sure that not just anyone can perform surgery just cuz they say they can... so doctors should be well compensated.

I don't think they had many doctors at all back in Hammurabi's time. So... yeah. I think more people became doctors as we found more reliable ways to perform medical tasks.

What you just described is called opportunity cost. However, when you talk about money, e.g., there are ways to change the amount you have to spend. (Not something you can do with time, for example.) It's not a zero-sum game in that "more healthcare spending" does not always imply "less education spending".

That said, the economic problem is that doctors will have a financial incentive to set up a practice where the price of healthcare (whatever form of healthcare they provide) is higher, but demand for basic care will be in areas where people can't pay.

But the current system, I think everyone mostly agrees, is a twisted piece of crap. Nobody has any concept of what healthcare truly costs any more, what with malpractice, defensive medicine, insurance companies, and everything else tacking on added cost after added cost.

It's bullshit. Single payer healthcare is hands down the best solution and EVERYONE knows it. 67% of Americans support universal healthcare and most people also like Medicare. Why not simply expand medicare to everybody! This would cause an increase in taxes, but we're already paying out our asses to insurance companies and big pharma. Not to mention emergency care! Furthermore 1/3 of all cost is for insurance company paperwork!

Single payer will also stimulate the economy.

Many American companies spend a lot of money to provide health care for their employees. This puts American businesses at a comparative disadvantage over foreign companies (most of the indsustrialized world uses some form of universal care). If this burden was lifted by single payer care, these companies would have more money to invest and could create more jobs which would further help to get us climbing out of this recession.

It is also important to point out that under the most recent healthcare bill that 10% of the population will still be uncovered. This means that 15,000 people will still die every year (granted this is better than the 45,000 that die each year now). This is not OK. Many of these people are working very hard to get by and feed their families (and to stimulate the economy) and they are being denied healthcare coverage. This is so completely dehumanizing, this is creating a massive pool of second class citizens. This is fundamentally wrong especially for it to happen in "the greatest nation on Earth". This is without a doubt an issue of morality and justice.

There is an idea out there that healthcare is a privelege and that just because it is a need that it is not a right. However I would contend, that justice is the highest universal right that every person everywhere should be entitled to, especially in the US. Justice is not a privelege and therefore, healthcare coverage is also a divine right that comes with being human.

Finally, I'm sick of all this public option bullshit. It's a joke, the dems and their supposed "super majority" is the biggest joke I've ever heard. This idea that compromise is the solution is a lie. It's a bold face lie manufactured by lobbyists and corporate money, there's a clear cut right answer and the writing is on the wall. Even a free market solution can't work because of dickheads like Joe Lieberman anyway, so why not fight like Hell for single payer healthcare? No one gives a flying fuck about Waxman-Markey, ending the wars, or election reform. What the Hell else is congress going to do? Nothing. It's always going to be in gridlock mode anyway, so why not just hold it up intentionally until the conservatives finally cave on healthcare? At the very least send the message that healthcare reform is a priority and take a stand for the American people. Fuck the "consequences", the consequences of spinelessness are far higher. If healthcare reform doesn't happen the dems will lose their seats anyway so that's not a risk anyway. If no progress will happen, we should at least make the lack of progress worth a damn by making it purposeful. If this happens there will be no mystery that the conservatives in the legislature are preventing progress.

The Dems should make an ultimatum that no issue will be decided without resolution of healthcare. If this doesn't happen there will never be any worthwhile changes.
 

Moot point: the public option in the form liberals all wanted it is gone, as is the adjacent Medicare-expansion plan.

Democrats Likely to Drop Medicare Expansion

^agreed.

It's pathetic that despite the dems having sixty votes in the senate, it still seems like the republicans are in power.They should seriously just make the best bill, and dare the opposition to fillibuster it. If Joe Lieberman wants to fillibuster, let him stand in front of the senate and read from the phonebook. I'm sure that is exactly the kind of image that will destroy his chances (and the chances of many republicans) at reelection.