US House Democrats Unveil a Health Care Plan 925
gollum123 sends in this piece from a political blog in the NY Times. Here is the text of the bill in question (PDF). "House Democrats on Friday answered President Obama's call for a sweeping overhaul of the health care system by putting forward [an] 852-page draft bill that would require all Americans to obtain health insurance, force employers to provide benefits or help pay for them, and create a new public insurance program to compete with private insurers — a move that Republicans will bitterly oppose. ... But the chairmen said they still did not know how much the plan would cost, even as they pledged to pay for it by cutting Medicare spending and imposing new, unspecified taxes. The three chairmen described their bill as a starting point in a weeks-long legislative endeavor that they said would dominate Congress for the summer and ultimately involve the full panorama of stakeholders in the health care industry, which accounts for about one-sixth of the nation's economy. ... House Republicans, who have had no involvement in the development of the health legislation so far, quickly denounced the Democrats' proposal as a thinly disguised plan for an eventual government takeover of the health care system. ... The House Democrats' plan is one of three distinct efforts underway on Capitol Hill to draft the health overhaul legislation. In the Senate, both the Finance Committee and the health committee have separate bills in the works, and in recent days those efforts seem to have stumbled."
Will this bill stop the pre existing condition BS? (Score:5, Interesting)
Will this bill stop the pre existing condition BS? Let you buy any plan that you want? UN tie it from your job?
How about having a Bankruptcy that is just for Health stuff and does not show up on any back round check?
Not let people ask about you medial history before offering your a job?
Make it so you can not be dropped by a insurance provider.
852-page draft bill (Score:2, Interesting)
I suspect congress will look at all the examples of socialized medicine around the world and end up picking the worst elements from each of them.
Re:they did not know how much the plan would cost (Score:5, Interesting)
Short answer: there's no easy fix. Medical costs are rising for several reasons:
* Rising costs and quality of medical care (30 years ago there were no MRIs, hip replacements).
* Corrupt doctors, ordering tests because they are profitable (read the article, it goes into great detail on that point)
* Corrupt insurance agencies (sometimes charging 30% overhead)
* Incompetent government (a point which you outlined)
* Clueless patients wanting every possible test (I can't blame them for this, it's not like we have medical degrees) and not taking care of themselves (Safeway for example managed to reduce health insurance costs by 40% or so by encouraging their employees to take care of themselves)
* Oh yes, and how can any such list be incomplete without including pharmaceutical companies and medical lobbies? Many problems there.
I'm sure I'm missing some. The good news is with all these problems, there is lots of room for improvement. The bad news is that these problems exist, and the path to fixing them isn't entirely clear. I am not sure that I favor this bill, but I think it is good we are having a debate about it. We should have had this debate 10, 20, or 40 years ago.
How about this idea (Score:5, Interesting)
Let's require that whatever bill they propose, that all of the US government, especially congress & house, have to operate under that bill for one year before it can be forced on the rest of us. Whatever plan they currently have is gone. They are not allowed to work outside of their proposed system. They have to use only what their bill contains, and the funding has to come as a deduction (tax) out of their salaries. The money used to provide their health care services must come from whatever they paid in, and if (when) it runs out, nobody gets any more services until more funding is available. Also, any government employee who goes outside the system must declare it on some specified national forum, so we can know about its deficiencies before it takes effect on the rest of us.
This will show us if it is a viable plan, and that it is has enough money coming in so that extra funding is not hidden in additional taxes. Let's see how they like their own plan before we're forced into another stupid plan.
Re:Great quote... (Score:3, Interesting)
Re:Then its not insurance... (Score:1, Interesting)
Why am I not surprised to see a Republican openly proclaming that they'd vote for someone to be killed for not liking Republicans
Uh, its a joke.
Although, you do bring up an interesting point...
Why should you be required to support the life of someone who openly hates your culture and is trying to get rid of it? Should a Jewish person be required to pay taxes and provide health care for someone who is a member of a Neo-Nazi organization? Should a black man be required to pay health insurance for someone who is a member of the Klan? Should a member of PETA be required to pay health insurance for a hunter of baby seals? You open up quite a can of worms, indeed, when you make health care a public issue.
Yes. If insurance was about nothing more than hedging bets on property, and we were primarily concerned with the health of the insurance industry, then this would be the move to take. However, since health insurance deals with human lives, and the people most likely to have the poorest coverage are those least likely to be able to absorb the costs of health care that is uncovered,
But here's the thing, if health care is so important, why can't people pay for it themselves? Do you not see the problem that we actually have? We have health care that is beyond the ability of anyone to afford it, and so foolishly people look at insurers as if they can magically make it affordable. They can't, and replacing them with government won't make it affordable either.
What's going to happen, really, in this health care reform, and why insurers are on board, is that the Administration is going to lower what it pays to doctors and will treat less diseases with less skill than was done before simply because it is too much. Private insurers will thus be able to point their fingers at government, and, if they want to offer premium insurance that covers more, they will be able to, dropping those that cannot afford it, knowing that the Feds have a plan for everyone else.
Re:give me a break (Score:1, Interesting)
Re:Stupid... (Score:4, Interesting)
They get government jobs denying or delaying medical procedures they deem unnecessary or low priority.
Re:Great quote... (Score:5, Interesting)
Bad news: your 15% figure is out of date. We're now spending 17% of our GDP on health care, and if the trend of the 2000s continues, we'll be at 30% by 2020.
Unfortunately, the Republicans will oppose any type of health care legislation, because the truth is that they don't think anything's wrong. Most won't admit it, or will make the wholly unsubstantiated claim that malpractice insurance is the only thing wrong with our system. This is despite the fact that all estimates put tort at least than 0.5% of our health spending. Of course, while the effects of 'defensive medicine' are tougher to estimate, there's fortunately empirical proof showing that it makes no difference. Texas has the strictest malpractice tort limits in the country (you can get at most $250k, even in cases of gross negligence causing permanent disability or death), causing malpractice claims to plummet, yet their health spending increases have continued to outpace the rest of the country in the six years since it was passed. So much, in fact, that Texas now spends more than any other state for decidedly mediocre results. Essentially, it's a microcosm of the U.S. as a whole.
There was a great article [newyorker.com] in the New Yorker a few weeks ago wherein a reporter visited McAllen, Texas, home of the largest health care spending in the world. What he found was a perfect example of what we see across the country: when doctors treat their practice as a revenue generator, costs go way up, and quality actually suffers. The doctors think that they're doing their best for their patients, but they subconsciously make more referrals when it brings in money. It's long, but it's definitely worth the read.
Re:Great quote... (Score:5, Interesting)
Wrong. When German Railways (Deutsche Bahn) was still state owned, the trains were always on time, there were many more connections, the fares were lower and easier to understand and the trains and tracks were better in shape.
Now Deutsche Bahn is a private company. Trains run notoriously late (often because the trains are damaged or the tracks are in the sore need of repair), many connections are inoperative, the prices soar.
I never have seen a high speed train being evacuated in the middle of nowhere because of some motor damage in the early nineties. I had to live through it twice last year.
Pedal Extremity Excision by Handheld Ordnance (Score:2, Interesting)
Just an aside to the editors: this is not science.
The health care industry is presently 1/6th of the US economy. Without significant changes it will double in 30 years to 1/3 of the economy. Its size is due to the involvement of the government sanctioned Ponzi schemes and cash flow tidal pools known as insurance companies. Contrary to the report generated by the government that is being used as the rationale for the "improvements" in the health care industry, forcing the insurance companies to take on even more will result in more and faster growth. By 2040 health care would be around half of the US economy.
A government run operation that competes with the commercial enterprises won't improve things. We already have that in Medicare/Medicaid. The mandated low payments and customary federal employees' gross mismanagement only result in more costs passed to patients and insurance companies as well as denial of services as more providers opt out of accepting these. The growth of these programs has resulted in increases in taxation without concominant increases in service. With growth unchecked, and with the demographic bubble of baby boomers draining it outnumbering the younger work force, by 2040 it will require the younger people to have 2 full time jobs just to pay the taxes that keep those programs afloat.
The US pays more now for health care than most others, without better results or satisfaction. This will only get worse as the present system grows, and will get worse still if it is forced to grow even faster. The only rational solution is to remove the middleman carcinoma from the health care industry. That is, get rid of insurance and mandate reduction in the artificially inflated medical care costs that they promote.
My advice is to drop any insurance and keep the money. If you need care, either get the same rate from a provider they offer to insurance, or if they refuse, get care and don't pay. Become medically indigent. That will help cause the present system to collapse, the sooner the better, the later the greater damage to the rest of the economy. That advice came to me from the professor and hospital administrator teaching history and systems of the health care industry for my master's in health care administration. He also told us that by the time we got our degrees that we may not have jobs, and even if we do, we probably won't retire from the same industry, since the present system is not sustainable. For me this became academic, because by the time I graduated I realized I had too much conscience to be able to hold peoples' health hostage with a protection racket.
On a more recent note, if you think insurance companies are the sort of responsible entities to be tasked with self-oversight and watching out for your best interests, look back a week or so in the news and find out how many of those companies have invested how many millions of dollars in tobacco companies. That only looks like conflict of interest. Their real interest is in handling your money when you get sick, so they'd just as soon you get sicker sooner, so in this instance they are being entirely responsible to those to who they exist to be most responsible to -- their shareholders.
Trying to fix this problem by requiring those responsible for the problem to take an even greater role is simply shooting the economy in the foot. I have to drive 70 miles one way to get medical treatment at the closest Veterans Administration facility, and do so several time a month. And I'm glad to, so that I don't have to participate in the travesty called the health care "industry". God love the care givers, they deserve all respect, but God damn the "industry" that helps create the problems it makes money from supposedly solving.
Re:I'll go ahead and say it (Score:4, Interesting)
The Great Chain of Being (Score:2, Interesting)
It has nothing to do with 'hating' dimwit. It has to do with The Great Chain of Being. Still very much believed in to this very day by the right wing.
http://en.wikipedia.org/wiki/Great_Chain_of_Being [wikipedia.org]
'Socialized' medicine is a direct assault on The Great Chain of Being. It means nothing that other countries have universal coverage with massively cheaper costs and better care. Flattening the hierarchy so that those at the very bottom have the same access to quality health care as those on the top is a direct assault on The Great Chain of Being.
Re:Great quote... (Score:4, Interesting)
As someone who knows many doctors, I will tell you flat out that if that figure includes malpractice insurance it's either a flat out lie, or product of ridiculously bad methodology.
Or maybe you shouldn't rely on the anecdotal testimony of a small group of people who make up only one part of the sizable cost structure of the whole health care system? Even if there was something wrong with the study (which you only stated, but did not demonstrate), how do you attribute the negative correlation between malpractice caps and health spending?
Re:... no matter how many lives it takes (Score:3, Interesting)
maybe it is because they are poor ? (Score:4, Interesting)
and your medieval healthcare system practically KILLS poor by neglect, or treatment that arrives somehow too late ?
Re:I'll go ahead and say it (Score:3, Interesting)
Re:give me a break (Score:3, Interesting)
Re:Great quote... (Score:4, Interesting)
The US has the highest cancer survival rates in the world, and by a pretty large margin. That has to be worth something in your metrics of "better".
Well, duh! That's where the money is.
The overwhelming majority of health care expense in the USA is in the last 6 months of life, often after there is little question that no matter what is done, the patient is gonna die. Patients are typically guided into increasingly expensive treatments without any meaningful discussion about the quality of life of those final few months. It is not as bad as all the doctors consulting with each other over how to wring a few dollars more out extending Joe Smoker's life another 3 weeks. But it is much closer to that extreme than telling Joe "Hey you don't have much longer, and in 3 months your going to feel really bad no matter what we do, so now is your last good opportunity to take that Summer-long fishing vacation you've been promising yourself the last thirty years. When you get back, we'll see what we can do to make the last few weeks as comfortable as we can."
No, USA health professionals don't know how to have that conversation with a patient as a general rule. The general attitude is that it is much better for the patient to keep him hopeful that this treatment or the next can keep him going for a good long time. That this is also more lucrative for the doctors and the health care institutions is purely a side effect (according to the doctors and the health care institutions, and they do say we should trust them about this kind of thing).
Re:The irony, of course... (Score:4, Interesting)
You can cut down a lot of timewasting if it's in your interest to prevent waste of resources rather than maximise profits.
e.g. I know "antibiotics don't work on colds or flu" as I heard it on an NHS "commercial" on TV.
There's a call centre full of nurses telling people with colds and flu to get some rest and drink lots of water (dial 08 45 46 47 from a UK phone). The same information is online ("NHS Direct").
Then there's things encouraging people to seek help -- e.g. there's an advert on a bus shelter by the college near me, telling teenagers about chlamydia and how they can get a confidential test (and free condoms).
There's also billboards with messages like "a chest pain is your body telling you to call 999" [for an ambulance], and offering help to quit smoking, or diet advice.
Re:I'll go ahead and say it (Score:4, Interesting)
Something else that is popular in Canada is wait insurance. People are signing up by the truck load and most Canadian insurance providers offer wait coverage. In case you don't know what that is, it's where they guarantee the wait for procedures will be under a certain time or they take you to another country if necessary and have the procedure done there.
And yes, this was brought before Canada's high court because Quebec attempted to enforce it's no private insurance laws and the court said it was a fundamental human right to have the coverage because the lack of it would endanger the lives of the people it serves.
Don't sit there and sugar coat government health car as if nothing is ever wrong with it and everyone is satisfied with it's results. Obviously enough people aren't otherwise there wouldn't be a need for wait insurance and there wouldn't be a market so profitable in it that they took it all the way to the highest court in Canada or that every other insurance provider has a plan that covers wait times.
Re:give me a break (Score:3, Interesting)
Drawing the line is indeed tricky. If you're just tuning in, political theorists have been having this discussion since the mid-1800s, while the rest of the world has been pretty much content to sit by and ignore it.
Go read up on John Stuart Mill. He started formulating his ideas around the same time as Marx and Engels, in response to the same socioeconomic crises of the era. However, his core theory of government would be considered libertarian (and surprisingly relevant) by modern ideals:
The sole end for which mankind are warranted, individually or collectively, in interfering with the liberty of action of any of their number, is self-protection. That the only purpose for which power can be rightfully exercised over any member of a civilized community, against his will, is to prevent harm to others. His own good, either physical or moral, is not sufficient warrant. He cannot rightfully be compelled to do or forbear because it will be better for him to do so, because it will make him happier, because, in the opinion of others, to do so would be wise, or even right...The only part of the conduct of anyone, for which he is amenable to society, is that which concerns others. In the part which merely concerns him, his independence is, of right, absolute. Over himself, over his own body and mind, the individual is sovereign.â
In my experience, this model tends to be popular with both modern conservatives and liberals. It doesn't place any explicit limits of the size of the government, but, rather places a more fundamental restriction on a government's purpose or function. In that regard, it actually allows for certain socialist ideals to exist alongside a relatively restricted government.
Healthcare often isn't an individual problem, but rather a societal one. If the state can provide a system of healthcare that serves the vast majority of the population better and more efficiently than a privatized system, the government reserves every right to implement such a system.
Re:What 'Better' Means For Right Wing People (Score:3, Interesting)
It's not that conservatives hate the poor, but, rather that they strive for a society with a rigid class structure.
Effectively, this works out to be a very bad deal for the poor, leaving them in a situation that is literally hopeless.
Also, what about the mayors (usually republican) who round up the homeless, put them on buses, and offload them in other counties?
Re:I'll go ahead and say it (Score:3, Interesting)
Well, no!
And I mean that with all due respect. The problem is that people are holding these other countries up as models as if they are flawless. The very real fact is that they all have their own unique problems that most of us find them just as unacceptable as our own current problems. Some of the problems are inherent in a government running health care instead of regulating it. Most people who are against government health car are so because the US federal government has no constitutional authority to provide medical coverage, it's stretching some authority to regulate it as it is. You can blow that off as a ideological reason but it's a pretty important reason.
This bill here is riddled with problems too. First, it sets a standard lower then current policies provide and mandates that anything extra must be billed and charged separate from it's mandate levels of coverage. Second, it kills any preventative treatments that cost over 5k a year for an individual and 10k a year for family coverage. You can be stuck paying for anything over that. It limits treatments to accepted treatments which mean that drug trials and experimental procedures and off label uses are forbidden and will have to be paid for out of your own pocket. Suppose you have cancer and there is a treatment already in use for genital warts that seems to work well on your cancer in fact, so far it had cured 9 out of 10 patients, you will have to pay out of your pocket for this less expensive treatment or suffer the kemo and so on until the treatment kills you or works. Those are just the few problems I saw before my eyes started hurting from reading the mess. The bill offers less of a quality of care/coverage then current medicaid and medicare program offers and it intends to replace that coverage. This part alone should be enough to raise some fucking flags but you want to tilt at windmills shouting idiolect injustice.
The bottom line is that the bill doesn't need to be complicated nor does it need to reduce the quality of coverage or care for people already with insurance. All they need to do is create a law that very plainly says, If you offer insurance across a state line then you need to offer a plan that has X coverage for with no lifetime max or disqualifications that can't have more then a 20% copay for procedures under $5000 or 10% copay for procedures over $5000 but less then $10,000 and not more then %5 copay for anything over that. Then make the premiums 10% or less of anyone's monthly income (household income for family coverage) for anyone making more less then the median area income and allow citizens to deduct the expenses from their income for tax purposes. You could even allow the insurance company to track any losses over this extra coverage and deduct them from their taxes owed to the government. As for mandating coverage, wait until someone needs medical treatment who is not insured and make them take this minimum coverage out for a minimum of five years from their last use of the insurance for retroactive coverage.
There you have emergency medial coverage for anyone who wants it, those who truly can't afford it will be covered by an existing medicare or medicaid program, and someone who decides to take the risk isn't left hanging but will have to commit when they become a burden. Policies that offer more coverage are covered, and a minimum standard is set.
Re:Great quote... (Score:3, Interesting)
This is only true for management-position and high-level jobs. Most middle class folks use NHS, and while there are problems with some NHS hospitals, in general the health care system is working there. Where it has failed is in dental care, and indeed that is a widely-sought employment benefit; when I lived in England, I traveled to Hungary, of all places, for my dental care.
Re:give me a break (Score:2, Interesting)
Progressive's [sic] simply don't understand economics...
The fact is a free-market economy is the ONLY type of economy on the planet that actually works.
Your ignorance is showing. Here [wikipedia.org]is a nice starting point for you. Start with
then move on to current examples such as
These are still free markets. The difference is who controls the means of production - the people who actually make shit, or others.
Insurance May Even Be To Blame For Costs (Score:3, Interesting)
I think the larger point is that health care is so expensive that we cannot afford to pay for it ourselves, and that, if an insurance company cannot operate profitably, it means probably that health care is too expensive for society as a whole.
I think it's possible that just as rising home prices were driven by rising practice of purchasing on credit, medical care costs may be getting more expensive in no small part because insurance makes them that way. It means that it's possible to charge costs higher than a market without it would bear.
Not that health care is much of a "market" really. It's darn near impossible to find out how much anything beyond an office visit and very simple procedures even cost, much less make comparisons and estimates of quality of service. I'm not sure if this is again a function of insurance, or if it's that the demand for care greatly outstrips supply, but it doesn't seem health care providers actually compete for patients.
I agree completely (Score:3, Interesting)
I also saw several reasons for the lower cost of (superior) care:
Re:I'll go ahead and say it (Score:2, Interesting)
With respect to everything everybody is saying, I'm Canadian, more of a Quebecers, but anyway. Even If sometimes you may have more specialized healthcare available to whom's willing to pay. I assure you, being 30 and have been sick like hell lately, I'm happy I didn't had to pay a Pennie for the millions bucks worth of care I received over the last 2 years. Yes some people may complaint, but most of those who complain are those who because of just a sneeze wants a doctor checking their temperature every minutes because it's free... And if you are worried about those who don't work and aren't willing to pay for them, stop worrying, it's nothing compare to the satisfaction of having nothing to care about if you are ill or not... Even better, BTW, if you score a good job, you will have insurance that will pay for private clinics so you can get your results faster, in 2 days instead of 5, or in 24hrs instead of a day. But the results will be less exhaustive than the free one!!! WOW! And your benefit, I should tell you that there's a bunch of researchers in Canada, that would disagree with you! We design a lot of pills and do a lot of research, and historically I think we have a lot of innovation on our hands, sure it's all American companies, but, It's all Canadian brain into it, yep!