The health care debate rages on
Since soaring costs in the health care system are overburdening the U.S. economy, the system will likely be transformed with new reforms and price caps within the next decade, if not by December.
The ultimate debate surrounding President Obama’s health care plan is not whether the system should be reformed. Rather, the debate is on whether such reforms to provide services to the millions uninsured is financially sustainable without having to raise taxes. Considering that a $767 billion stimulus plan was passed only recently, the public is rightfully concerned. Recent poll numbers show that a little more than 50% of Americans do not approve of the President’s health care initiative.
There is substantial financial data supporting both sides: that such a system will add to the deficit and that it will not. As the President declared in his weekly address, good information is not easy to come by. Since the President is the driving force behind such reforms, the burden must be carried on the shoulders of the President to explain, with detail, how his plan will not be an inefficient government program that will only add to the country’s deep deficit. Obama should and will probably continue town hall meetings and interviews with journalists to try to dispel our concerns.
As of right now, the President has not done a sufficient job explaining how his reforms can be afforded. Any health care plan, from my personal observation, has been discussed by the President in broad strokes: if we invest in preventive treatment and require health care of everyone, then costs will come down. The million dollar questions, even among conservative Democrats, remain: where will we find the money in the nation’s budget to start a universal health care program? How much will it affect pre-existing health care? And will it negatively affect the private insurance companies to our detriment? His critics have compared his speeches on health care to campaign-like rhetoric, since the details in the various Congressional proposals have not yet been hashed out and the President has not endorsed any one of the plans.
In the end, political capital is still on the President’s side. So long as the conservative Democrats are appeased, if a health care bill is put before the Senate, it would likely be approved with 60 Democratic Senators. In an interview with New York Times’ John Harwood, Chuck Schumer, Senator from New York, said that a health care plan may be forced through the Senate, even without the support of any Republicans. Currently six moderate Republicans are working with Democrats on the bill.
By December, we should find out whether a spirit of bipartisanship can truly be achieved, especially over such a controversial issue like health care.
It depends what you mean by health care reform what does that exactly entail??? How specific or general would proposed legislation be. With several different committees and sub-committees on Health and Human Services Committees. My best guess to draft legislation, have debate, filled with pety bickering on both sides, have legislation be passed in both chambers would take longer than December. Too much “leg work” to complete massive government spending project before years end.
You cannot reform a system if you do not know the cause of the problems you’re trying to solve.
The biggest cost inflater in US health care is litigious patients. Medical malpractice cases directly cause only about 1% of health costs, but the defensive tactics employed to avoid those cases cost a huge amount more. Unnecessary procedures raise the total cost of care, therefore raise health insurance premiums, raise provider costs, and overburden the system. Meanwhile, in some regional markets, the cost of malpractice insurance drives doctors out of the market, and sometimes out of business. The solution is tort reform, which is not even being considered in the President’s plans.
The second biggest cost inflater is price manipulation by the government. Medicare and Medicaid pay roughly half of all medical dollars in the US, and they do it on payment schedules set by bureaucrats without regard to real market prices. They invariably pay doctors below market, and sometimes they pay below cost. Few doctors can afford to pass up half their market (either economically or socially) so they absorb the losses from Medicare/Medicaid, and make them up by overcharging other patients. In effect, private health care and private insurance are subsidizing the government’s programs. The solution is to abolish Medicare and Medicaid, and replace them (for the poorest patients) with treatment vouchers to obtain care from the patient’s provider of choice on the free market.
The third biggest inflater is over-insurance. Thanks to government incentives, most employer-paid health insurance policies cover practically every dime of treatment costs. This drives up insurance prices dramatically. It also severs the economic relationship between doctor and patient and removes all beneficial incentives — doctors don’t need to satisfy patients, they serve the insurer instead, because the insurer pays. This was created by Nixon’s wage and price controls in the 70s, but continues to be subsidized by the government, which does not tax employer-paid benefits. The solution is to tax benefits as income, but give back the tax in the form of a deduction for private health insurance. Employers will revert to paying salaries over benefits, while employees will purchase private insurance that covers catastrophic incidents (the REAL aim of health insurance) and pay for other care directly.
Three major problems, three solutions — and none of these are in the President’s plan. The Obama plan is not about solving real health insurance problems, it is about obtaining control over the nation by smug busybody Progressives, who intend to solve all the problems of the world by dictating how we live our lives.
I dont know enough about healthcare reform to make an educational statement regarding it. All I can say is people dont mind paying for it if its affordable I never thought it should be a right or privilege I think that everyone should have it. If a single person can pay 50.00 every two weeks and a family 150 dollars a month Im not for universal health care. If it gets to the point where employers keep dropping people from their health care plans and shutting down businesses and there is no other alternative then bring on the universal health care of find a way for the health providers to remain competitive and lower their premiums (which is not going to happen).
The fear regards the ability of politicians to manage efficiently and effectively. One look at the public school systems throughout the country, something with which most Americans are familiar, suggests county, state, and federal political operatives too frequently substitute politically motivated policies and practices for sound principles of education. Given this reality, the fear of inefficient and ineffective health care managed by political operatives is justified. The proof, however, is in the details. What exactly would be provided, at what cost, for whom, etc. The promise of a chicken in every pot offers an appealing attraction for many, particularly those financially unable to purchase their own chicken. The promise of free (affordable) health care for those financially struggling offers similar appeal.
For such folks, even inferior health coverage is preceived as superior to none at all. Conceptually, a healthier work force can improve work place efficiencies by reducing costs for time lost due to illnesses to workers and/or family members.
Inferior health coverage at higher costs for those currently satisfied with the health care they receive, however, would not be quite so well received. Critically important considerations include the QUALITY of care provided, and the COST for such care. The certification of more doctors might be a way to increase competition for provided services, threreby reducing charged fees. One can expect such an idea to be obstructed by vested interests in the medical field. Legally requiring all Senators and Congressmen to give up their current medical coverage in favor of a Universal Health Care package provided to all Americans might help to reduce fears as to the quality of care to be expected. Such a circumstance, idealistic as it may be, seems difficult to me to envision at the present time, however.
If the politicians really want to improve healthcare, they should start by working on the things which drive health care prices up.
First address tort reform - 1) limit what lawyers can charge their client for representation. The Good Lord only asks for 10% why should lawyers collect more. 2) Make lLosers pay court cost and lawyers fees for the winners - this would eliminate a lot of frivolous lawsuits based on the premise that the defendant will find it cheaper to settle out of court. 3) limit the awards to actual costs of medical remedy and lost wages. Any other damages would have a strict cap of $10,000.
When Texas limited medical liability, Drs flocked to Texas because they were able to treat the patient without exorbitant malpractice insurance rates, and they were a lot less likely to get sued.
Change insurance policies so that people like me (a male) are not charged for medical coverage of pregnancy, female reproductive organs problems, and other medical problems that are restricted to the female of the species. Also, make Insurance companies take people with pre-existing conditions, but allow the insurance company a reasonable premium increase for the first year of coverage. After one year the Insurance cost would be reduced to the rate for someone who did not have the pre-existing condition.
Make all medical facilities use the e-verify system to weed out illegal aliens from obtaining treatment under anything less than life threatening conditions.
Make health insurance deductible to the individual at the same rate as to an employer. In this manner it would become portable. Do not penalize a company or individual who elects to not have health coverage. They’ll be penalized enough if they don’t have health coverage and they need it. But each individual makes that decision based on their individual condition.
These few changes would reduce medical costs considerably
Well this is one huge mess. Again we have the ill-informed trying to “fix” healthcare. I too have been in the profession for 35 years. The last time they spoke about this, the whole industry went into a tailspin. Hillary care was the first.
In this country we have hands down, the best healthcare in the world. Why? Because of funding. If you can’t fund it, it’s not going to happen. I laugh at the Michael Moore’s, Jane Fondas, and the rest of loon left. Like X Ray said, they all get their healthcare here. If Michael Moore were in Cuba, he wouldn’t be such a hunk of lard, he is the poster boy of bad health, and the last person in the world to criticize US healthcare. What a hypocrit. I know the healthcare system in Cuba, the one the citizens get, and it ISNT what you saw on Sicko. The hospitals where the citizens go rarely have sheets on the bed, let alone the necessary equipment, and personnel.
Despite what most politicians say about the non-insured. I can tell you that the un-insured get treatment, even the illegals, so the lack of treatment due to lack of insurance, is a bunch of baloney. The care given to the folks that have insurance and those that don’t, doesn’t vary in our system. As health professionals, we take good care of all our patients, this is why the system is as good as it is.
Here is what we really need to do, to bring costs down:
A. Get rid of the Joint Commission: This is a body of people who make it up as they go along. Every new idea they bring to the table, is nothing buy MORE expense. Their regulations bog the healthcare system down with paperwork, 2 years worth of meetings before the visit, and in spite of all this preparation, mistakes happen. Joint commission has done nothing to improve healthcare, instead they have done everything to complicate it by adding red tape and more UN-Necessary expenses to a hosptial system that is already running on fumes. This endless array of paperwork, red tape, etc. is costing us a fortune, and there is NO VALUE in what they have to offer. Personally, I would get rid of this immediately.
B. Change the current documentation standards in hosptials, instead of documenting everything, just document if something goes wrong. This idea alone would free up about 60% of hospital personnel, so they can attend to the patients.
C. Provide for a standardized medical record software where paper is not used. Standardize medical documentation across the country.
Getting rid of paper, over documentation, and printers would save billions. Add to that the removal of all policies that are pointless and do nothing to improve patient care, and you have some very significant numbers.
D. Capitate medical malpractice lawsuits. Punish those who bring frivolous lawsuits into court, including the attorneys who encourage this type of activity.
E. Outlaw the TV commercials soliciting class action lawsuits against pharmacological companies, asbestos, etc. Watching Fox news during the day is frustrating, every other commercial is some attorney “spokesman” advicing and seeking people to sue different manufacturers, etc.
Just another note: As healthcare workers we have the patient’s best interest in our endeavors. We are always seeking ways to improve the delivery of care, patient safety, as well as patient outcomes. We do not need the government or joint commission to meddle on how we care for our patients.
Hospital inspections should be regulated by the states, and each state should have a group of individuals that do surprise hospital visits to assure that certain guidelines are in place, and to perform safety checks on generator back up systems, fire alarms, etc. That is the extent of what a hospital inspection should be. The rest of the stuff, is political BS.
Here are some questions that I have:
1. How many people die before age 65?
2. How many people die at age 70?
3. How many people pay thousands into the social security system, and never collect a dime or use their medicare because they die before the time comes?
4. What are they doing with the colleced funds of those that die?
Given that we pay all this money over a lifetime of work, we should have the right to will that money to a family member. If we pay for it, we should be able to at least will it, if we die before we can collect.
@Louis…I was hoping our friend who actually works in the industry would comment! Thanks, Louis! I always welcome your insights on this topic.
And we have several great contributions here all around. Now if our politicians would listen to those who know we’d have something!
Regarding the ABC 20/20 video, it is right on target. You want to wait for anything? And get lousy service when you finally get your turn? Let the government serve you! If you think that it’s frustrating to wait in line all day for a license tag, imagine waiting six months for radiation treatment when you’re diagnosed with cancer! That very thing happened to a colleague whose mother died of lung cancer in the UK. Her mother waited more than six months for a desperately needed CT scan, then waited several weeks for treatment to begin. She soon passed away because the cancer had metastasized beyond the ability to treat it. A dramatic example of a patient that may have lost her life anyway? Maybe — but there are many, many documented examples of mundane diseases that go untreated in national health systems due to wait times, lack of access, lack of technology and right on down the line. Conversely, if you need an emergent CT scan anywhere in this country, you will get it in less than one hour of arrival in any emergency room! High diagnostic technology is close to home and available to anyone in the United States — not so elsewhere.
I agree with Jerry McDaniel that the broader issue is constitutionally based, and whether the federal government has the power to govern healthcare. But while broad constitutional concepts are argued in the legislature and courts, all Americans will suffer if this healtcare legislation is passed. The pressing, urgent issue is getting this legislation rejected so that it doesn’t lead to further erosion of our democracy, not to mention poor quality healthcare!
Oh, and I’m not exactly a young Republican and definately not an attorney or law student, but I support all of you who do fit that description. Our future is in your hands, and I’m very proud that there are so many bright, energized young Republicans to carry the torch of democracy and freedom!
Why isn’t it an ethics violation for lawyers to charge a percentage of court settlements?
Why not make it illegal for lawyers to do this and instead limit them to charging hourly and up front fees? That would reduce frivolous litigation and lead to more ethical counsel in the courts.
If lawyers are going to make their living by the law, they can certainly be held to ethics standards under it.
Ben c,
I respect your opinion, as well as your British perspective, but I beg to differ with you. Regarding the World Health Organization statistics, it is well known and documented in the medical community that they are misleading. They use faulty logic, faulty data and statistical manipulation that ends in faulty conclusions about healthcare. This is true not just for their healthcare rankings by country, but also by disease, irrespective of country. Remember, the WHO is an agency of the United Nations, and is inherently political. As such, it has a definitive political agenda and political bias. Here are a couple of interesting articles on the WHO rankings:
http://www.cato.org/pubs/bp/bp101.pdf (technical article)
http://www.healthandsharing.com/21/articledetail (easy read)
Regarding the UK’s National Health System, I have colleagues in six private hospitals in London, and have visited them on two occasions. Most of the providers in these hospitals, including physicians and professional staff, are former associates of the NHS. They left the NHS for the private sector because the private sector provides better patient care, better wages, better technology, and so on. A team of nurses and other professionals visited the Atlanta area a few years ago to learn about quality improvement in healthcare. They traveled more than 4,000 miles and were very impressed with our healthcare system compared to the NHS.
These six private hospitals in London, much like other private hospitals in Britain, cater exclusively to the affluent, and they are located in affluent neighborhoods. If the United States converts to a national healthcare system, the same type of distribution is likely to occur. We will end up with at least two, if not more, levels of healthcare depending on economic class.
Many Americans without healthcare insurance do so by choice. Medicaid/Medicare coverage is available to anyone who demonstrates true financial hardship and meets medical necessity and/or disability standards. In addition, all U.S. hospitals write off huge amounts of revenue to charity and bad debt. The hospital where I work wrote off more than $20,000,000 in bad debt in just the first six months of 2009.
Also, anyone in the United States can walk into any Emergency Room and receive appropriate treatment, regardless of ability to pay. This is already federal law (EMTALA) and provides millions of people emergency medical service on demand. In that sense, we already have universal healthcare in the United States. And I haven’t touched on the thousands of community clinics in the United States that offer free healthcare, financed throughout donations of time and money…
The poll referenced above is from June 21st. It is NOT new and it is extremely dangerous to put information out there without vetting it. Anyone who puts credence in a poll that the NYT has anything to do with: I have a couple of pieces of land I’d like to sell you just off the coast of Nebraska.
YES, the BUSINESS of healthcare needs to be reformed but NOT by the same politicians who have mishandled and misappropriated Social Security, Medicare, Medicaid and Tri Care!
These Bills (yes, I have both House and Senate versions and have read them) are NOT about healthcare for citizens. They are about people who think they know better than the rest of us gaining power and control over our lives and distributing it as they see fit to their favorite projects and pals du jour.
Senator Grassley spoke at an AARP meeting in Iowa & began by mentioning that both he & Senator Harkin, a Democrat, had worked for many years on legislation that affected the entire nation. He went on to say this has always been a bipartisan process in both houses of Congress & in the White House, and he had no reason to believe this legislation would be any different.
HB 3200 was expected to be bloated with provisions squeezed in by lobby firms for clients. The rubber will really hit the road when the Joint Committees begin working the differences out, putting combined draft legislation through 100’s of legal “car washes” until all the lawyers on both sides will be sick of it. David Sloan, VP of Gov Relations for AARP, said on C-Span’s Washington Journal a few days ago that AARP’s lawyers & accountants have yet to finish analyzing the bill. So, as a retired energy lawyer who worked on the massive & complex National Energy Act of 1978, I am quite amused by all the hyperbolic opinions.
I invite you to read why 450,000 physicians support the proposed Health Care Reform Plan on Moms Hugs: Health Care Reform: Part II - Physicians Support Health Care Reform
Older people especially are ill-served by the ”Four Horsemen of the Apocalypse” approach on talk shows or otherwise pressing their panic buttons. Thankfully, cooler heads are beginning to speak up.
I also recommend listening to the President’s weekly address today: http://www.whitehouse.gov/ — or read the transcript (here).
It might help to have a little faith in this President like everyone had to when the Republicans were in power. Try reading about how the Weapons System Acquisition Reforms Act finally got done, which is overhauling a procurement systems bloated with cost overruns. DOD’s procurement is a complex monster that many in both parties had tried to reform for quite some time. Obama promised Senator McCain when they met after the election that he would do everything in his power to get it done & was able to convince Bob Gates to remain as Sec. of DOD to implement the WSARA.
I agree with Senator Grassley, it is way past time for people in both parties to put aside the bitter vitriol for the sake of the whole country.
Hat Tip to X-Ray! YES, solving the problems means walking back what we’ve allowed our elected officials to get away with!
It’s as if we took a clean-lined, efficiently run ranch house, added onto it until it became a garish castle and now we’re robbing Peter to pay Paul just to keep on the lights! Dismantling it isn’t going to be easy or pain free but it CAN be done!
Our legislators have mismanaged every single big program they created…WHY would we think they could take on healthcare reform? If we want true reform of ANY kind we need to…
Vote OUT every single career politician of both parties! Seriously, this is NOT age discrimination (I’m 52) but have not McCain, Reid, Kyl, Dodd, Alexander, Frank, Lieberman, Grassley, Byrd, Graham, Harkin, McConnell, Specter, Sessions, Rangel and the gang had plenty of chances to prove themselves and failed? And those are just some of the Senators, without even touching the House. Can we not dig down deep, get off our butts and vote in some new blood next time around?
I don’t care what age, race, gender or party…just please give me some propensity to serve and strong leadership skills.
X-ray’s opinion….
<<“maybe we should terminate the other three socialist programs as well”
That’s alright by me! I would get to shop for my own healthcare, invest my savings as I see fit, and not have to support dysfunctional public schools…>>
Health care, like police and fire protection should NOT be a profit driven plan. The last thing i need to worry about when an ambulance picks me up is that my insurance company will actually pay my bill, or that they will try to weasel out of paying to increase company bottom line.
Given the demonstrated inefficiencies of government run agencies like the VA, Medicare, Medicaid, SEC, etc…countless other agencies…why should Americans believe proposed governemt run agencies will be better managed? Track records of ineffectiveness and inefficiencies speak more clearly than political rhetoric.
H.Paul and others question programs and agencies run by the federal government.
<<why should Americans believe proposed government run agencies will be better managed? >>
So they support the insurance industry, seemingly without any reservations, to provide Americans with health care. I wonder if you guys get a share of that overhead health insurance companies figure in to the costs of the premiums we all pay?
My friends on the right and their heroes in congress are only stoking the flames of fear and offer NO solutions to this problem.
@David W. Walters:
What you say is wholly inaccurate. Conservatives have repeatedly offered a wide variety of options. Unfortunately, the ones that are the most effective, least expensive and most beneficial to the American public happen to be the ones that those who are corrupt on both sides of the aisle want the least.
I have looked over both House and Senate bills. I have read assessments of both by physicians, constitutional lawyers and economists.
Conservatives have given the answers. However, the people in power right now and the complicit media refuse to reveal them to you. Personally, I always vet info myself and never take talking points from anyone whose identity relies on what political party or “group” he/she belongs to.
Very well said David. Our party has offered absolutely nothing into this debate other than fear and slander. I have yet to hear of 1 conservative option which remotely addresses the problem of health care. Our party’s intellect has gone into hiding and we are now represented by the loud and ignorant. Our health care system is broken. Lets offer some alternatives towards change instead of denial to facts. Let us get back to being the party of progress instead of the party of F.I.B.S( Fear, Ignorance, Bigotry, and Smear). Also, Karen, I would love to know where I could read the proposals you had mentioned. Where can I find them? I have looked everywhere and came up blank. Thanks.
@Mike. I’m in a hurry but wanted to get back to you on a start of who has what out there. Dr. Tom Coburn, along with Richard Burr, Paul Ryan & Devin Nunes have a link to their “Patient’s Choice Act” at http://www.coburn.senate.gov. There is a link to Jim DeMint’s “Healthcare Freedom Act” at http://www.demint.senate.gov. There is a link to Newt Gingrich’s plan at http://www.newt.org. And there is a link to the Heritage Foundation’s plan at http://www.heritage.org. If you’d like more just let me know but these are what I grabbed first. All Good Things, Karen
“we are now represented by the loud and the ignorant” because there is a void and they are the only ones willing to fill it. if there are other, more intellectual republicans and/or conservatives, where are they? why aren’t they being heard? what the heck are they saying?
Health care costs will continue to rise as long as medical centers, pharmaceutical companies, and HMOs are run as anticaplitalistic businesses that are allowed to place the burden of their bad business decisions on consumers who have no choice but to use their products and services or die–rather than requiring that their products, services, and employees (including doctors, nurses, and administrators) meet acceptable standards.
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