May I rekindle the US healthcare discussion?

[Brainfade]

Dhondy and others (including yours truly) had weighed in a few months ago, but the thread died. I posted links to dispute some of Doc's claims made regarding gov't-sponsored-universal healthcare (including a somewhat critical review of the Harvard prof's paper), but was either ignored or met with snide comments with no supporting information. I have been trying to read up a bit on this topic, and have found one politician whose views made most sense to me - Dr. Ron Paul. He's perceived as a "kook," and will never become President, but he's a medical doctor-turned-Congressman, who has some refreshing ideas on how to fix healthcare. He articulates them much better than I can (and obviously has more credibility in this field), so here are a couple of links: http://www.ronpaul2008.com/articles/261/diagnosing-our-health-care-woes/ http://www.ronpaul2008.com/articles/217/patients-bill-of-rights-or-federal-takeover-of-medicine/ Since Dr. Paul has done all the work, I will just use his writings to support my current views - I just want to hear any arguments against his views.

[kumble_rocks]

The biggest problem I have with republicans is the fact that other than Romney , none of these gits have come up with any plan which will cover pre-existing conditions. I asked gator this question on the other thread which he chose to ignore.. .. let's say I have been working my butt out for 15 years and have been highly productive in society . And god forbade I lose my job and have developed some serious illness like Cancer or Kidney problems etc , COBRA will cover me for 18 months only in part thanks to Bill Clinton's efforts. But after the lapse of 18 months , if I am stilll unemployed , then I am basically screwed because none of the Insurance companies will cover pre-existing conditions like cancer , kidney dialysis etc . Get the drift mate, we need UNIVERSAL HEALTH CARE . That's why I support Hillary ...

[Brainfade]

The biggest problem I have with republicans is the fact that other than Romney ' date=' none of these gits have come up with any plan which will cover pre-existing conditions. I asked gator this question on the other thread which he chose to ignore.. .. let's say I have been working my butt out for 15 years and have been highly productive in society . And god forbade I lose my job and have developed some serious illness like Cancer or Kidney problems etc , COBRA will cover me for 18 months only in part thanks to Bill Clinton's efforts. But after the lapse of 18 months , if I am stilll unemployed , then I am basically screwed because none of the Insurance companies will cover pre-existing conditions like cancer , kidney dialysis etc . Get the drift mate, we need UNIVERSAL HEALTH CARE . That's why I support Hillary ...[/quote'] Two questions: (1) What are the specifics of Hillary's solution? (2) How come the US has higher rates of survival from catastrophic illnesses than do countries with Universal HC? What Ron Paul is arguing is this: Take the govt out of healthcare completely, because govt regulations have driven costs up (HMOs were mandated by liberal politicians). Doctors spend more time and money filling out Medicare paperwork and insurance billing, and complying with idiotic HMO rules. The costs then get passed on to you and me. One facet of Ron Paul's solution is to get rid of managed care (either privately managed or gov't managed). Pay out-of-pocket for primary care, and have tax-exempt heath savings accounts and insurance policies for catastrophic care. Make it a personal responsibility, not a government responsibility. The free-market will bring the rates down and make them affordable in due course.

[kumble_rocks]

Two questions: (1) What are the specifics of Hillary's solution? (2) How come the US has higher rates of survival from catastrophic illnesses than do countries with Universal HC? What Ron Paul is arguing is this: Take the govt out of healthcare completely, because govt regulations have driven costs up (HMOs were mandated by liberal politicians). Doctors spend more time and money filling out Medicare paperwork and insurance billing, and complying with idiotic HMO rules. The costs then get passed on to you and me. One facet of Ron Paul's solution is to get rid of managed care (either privately managed or gov't managed). Pay out-of-pocket for primary care, and have tax-exempt heath savings accounts and insurance policies for catastrophic care. Make it a personal responsibility, not a government responsibility. The free-market will bring the rates down and make them affordable in due course.

Specifics of Hilary's solution can be broken down as follows - 1) Affordable: Unlike the current health system where insurance premiums send people into bankruptcy, the plan provides tax credits for working families to help them cover their costs. The tax credits will ensure that working families never have to pay more than a limited percentage of their income for health care. 2) Available: No discrimination. The insurance companies can't deny you coverage if you have a pre-existing condition. This is one of the most important aspect of her plan. I am willing to pay , but none of the insurance will cover me under Mccain's plan. So the republican spin of socialized medicine needs to be exposed here. But , got to hand it to Romney here . He did have a mandate for insurance companies to cover pre-existing conditions in his home state of Mass. 3) Reliable: It's portable all ways. If you change or lose your job, you keep your health care. Again , this will ensure that you don't have to change doctors. This is particularly helpful if you suffer from chronic ill ness like Hypertension and would want to see the same doctor. This will ensure that you will always be in network. Would agree with Ron Paul in principle about minimum govt regulations. But have a problem with Republicans in general who talk about free market economy. Here's the irony , time and again the Republican congress blocked any bill which would allow consumers to buy medicines from overseas like Cananda , Mexico etc wherein the same medicines costs 1/5 th the price of what it costs in USA. For example, the purple pill Nexium for acid reflux disease will cost you 2 dollars a pill with insurance The same drug , I can buy from Canada or Germany for 1/5 th the price. And I can get 1 strip ( 10 tablets )from India for Rs 45. Then , the question begs , why shouldn't I be allowed to buy medicines from these countries . The concept of Global economy is lost upon the republicans when it comes to pandering to big drug companies. They use the wily subterfuge of FDA approval to counter that these medicines are not of the same quality. But the truth of the matter is, their is hardly any difference between Nexium of Germany or Canada with one in USA. And I don't buy the "research" ruse which these drug companies and republicans use to justify ridiculously high prices . Ron paul does not address this issue , I believe although he may not insist on FDA approval for these drugs at the Federal level.

[Brainfade]

Specifics of Hilary's solution can be broken down as follows - 1) Affordable: Unlike the current health system where insurance premiums send people into bankruptcy, the plan provides tax credits for working families to help them cover their costs. The tax credits will ensure that working families never have to pay more than a limited percentage of their income for health care. 2) Available: No discrimination. The insurance companies can't deny you coverage if you have a pre-existing condition. This is one of the most important aspect of her plan. I am willing to pay , but none of the insurance will cover me under Mccain's plan. So the republican spin of socialized medicine needs to be exposed here. But , got to hand it to Romney . He did cover mandate insurance companies to cover pre-existing conditions in his home state of Mass. 3) Reliable: It's portable all ways. If you change or lose your job, you keep your health care. Again , this will ensure that you don't have to change doctors. This is particularly helpful if you suffer from chronic ill ness like Hypertension and would want to see the same doctor. This will ensure that you will always be in network. Would agree with Ron Paul in principle govt regulations. But have a problem with Republicans in general who talk about free market economy. Here's the irony , time and again the Republican congress blocked any bill which would allow consumers to buy medicines from overseas like Cananda , Mexico etc wherein the same medicines costs 1/5 th the price of what it costs in USA. For example, the purple pill Nexium for acid reflux disease will cost you 2 dollars a pill with insurance The same drug , I can buy from Canada or Germany for 1/5 th the price. And I can get 1 strip ( 10 tablets )from India for Rs 45. Then , the question begs , why shouldn't I be allowed to buy medicines from these countries . The concept of Global economy is lost upon the republicans when it comes to pandering to big drug companies. They use the wily subterfuge of FDA approval to counter that these medicines are not of the same quality. But the truth of the matter is, their is hardly any difference between Nexium of Germany or Canada with one in USA. And I don't buy the "research" ruse which these drug companies and republicans use to justify ridiculously high prices . Ron paul does not address this issue , I believe although he may not insist on FDA approval for these drugs at the Federal level.

Ron Paul supports reining in the pharma companies and supports lifting the ban on reimportation of drugs: http://www.ronpaul2008.com/articles/215/drug-reimportation-increases-medical-freedom/ Relevant quote: "The ban on reimportation is unconscionable, and most Americans know it despite the best efforts of the pharmaceutical companies and their mouthpieces." Hillary's tax solutions are similar to Dr. Paul's. Here are my problems with her solution (if I understand it correctly) - the government puts forth a set of plans that will be administered by insurance companies. In other words - instead of the HMOs and insurance companies making healthcare decisions for you, some government employee will be doing it (just like they do with Medicare). It does not give you your freedom back. It shifts power from HMOs to an even bigger HMO - the US government. You bring up a good point wrt preexisting conditions. HIPAA only covers group-to-group protection. I am not sure how Ron Paul addresses this, but I will see if I can find out! My only concern is this - how does one prevent insurance fraud? Finally - mandatory health insurance. How is she going to enforce that? Do you go to jail if you don't have insurance? Do you pay a fine? Highly impractical. If someone can't afford health insurance, will he/she afford the government fine? Another problem is "insurance pooling." Right now, insurance companies have "discriminatory" premiums - e.g., I pay a higher premium if I smoke or I am a skydiver - perfectly justifiable, of course. With her plan, you'll have to pay for part of my premium. And, with all due respect, Bill Clinton had little to do with COBRA - it was passed in 1986 under Ronald Reagan.

[kumble_rocks]

Ron Paul supports reining in the pharma companies and supports lifting the ban on reimportation of drugs: http://www.ronpaul2008.com/articles/215/drug-reimportation-increases-medical-freedom/ Relevant quote: "The ban on reimportation is unconscionable, and most Americans know it despite the best efforts of the pharmaceutical companies and their mouthpieces." Hillary's tax solutions are similar to Dr. Paul's. Here are my problems with her solution (if I understand it correctly) - the government puts forth a set of plans that will be administered by insurance companies. In other words - instead of the HMOs and insurance companies making healthcare decisions for you, some government employee will be doing it (just like they do with Medicare). It does not give you your freedom back. It shifts power from HMOs to an even bigger HMO - the US government.

No , I don't think she wants the government to put forth the plan although you can chose to opt for Medicare. According to her , If you have a plan you like, you keep it. If you want to change plans or aren't currently covered, you can choose from dozens of the same plans available to members of Congress Right now the members of Senate and Congress have the best available plan. Her plan will ensure that we all can opt for these plans.

Finally - mandatory health insurance. How is she going to enforce that? Do you go to jail if you don't have insurance? Do you pay a fine? Highly impractical. If someone can't afford health insurance, will he/she afford the government fine?

Yes , we have to pay a fine. Right now, Hillary's model is very close to what Romney had proposed in Massachusettss . I don't know whether you followed the Republicans debates , but Romney was alluding to this point as well on why he ( being a Republican) mandated a mandatory health insurance. It is better that they pay fine upfront rather than ending up at the Hospital on emergency care with no insurance. Anyway the cost is passed on to us by these Hospitals and Insurance companies indirectly , so better fines than extra premium everyone has to shell out because of the uninsured . I don't remember the exact the numbers , but Romney was on record stating that ---- "We're spending a billion dollars giving health care to people who don't have insurance," Romney says. "And my question was: Could we take that billion dollars and help the poor purchase insurance? Let them pay what they can afford. We'll subsidize what they can't."" ----

Another problem is "insurance pooling." Right now, insurance companies have "discriminatory" premiums - e.g., I pay a higher premium if I smoke or I am a skydiver - perfectly justifiable, of course. With her plan, you'll have to pay for part of my premium.

The flip side is at least the Insurance companies won't be able to deny you coverage or drop you because their computer model says you're not worth it. They will have to offer and renew coverage to anyone who applies and pays their premium. And like other things that you buy, they will have to compete for your business based on quality and price. Families will have the security of knowing that if they become ill or lose their jobs, they won't lose their coverage.

[Brainfade]

No ' date=' I don't think she wants the government to put forth the plan although you can chose to opt for Medicare. According to her , If you have a plan you like, you keep it. If you want to change plans or aren't currently covered, you can choose [b']from dozens of the same plans available to members of Congress Right now the members of Senate and Congress have the best available plan. Her plan will ensure that we all can opt for these plans. Yes , we have to pay a fine. Right now, Hillary's model is very close to what Romney had proposed in Massachusettss . I don't know whether you followed the Republicans debates , but Romney was alluding to this point as well on why he ( being a Republican) mandated a mandatory health insurance. It is better that they pay fine upfront rather than ending up at the Hospital on emergency care with no insurance. Anyway the cost is passed on to us by these Hospitals and Insurance companies indirectly , so better fines than extra premium everyone has to shell out because of the uninsured . I don't remember the exact the numbers , but Romney was on record stating that ---- "We're spending a billion dollars giving health care to people who don't have insurance," Romney says. "And my question was: Could we take that billion dollars and help the poor purchase insurance? Let them pay what they can afford. We'll subsidize what they can't."" ---- The flip side is at least the Insurance companies won't be able to deny you coverage or drop you because their computer model says you're not worth it. They will have to offer and renew coverage to anyone who applies and pays their premium. And like other things that you buy, they will have to compete for your business based on quality and price. Families will have the security of knowing that if they become ill or lose their jobs, they won't lose their coverage.

I may be coming around to your argument wrt preexisting conditions. I would be OK with a plan where there will be some patient responsibility - if you get into the type of situation you described, you are responsible for the first $10, 000. You'll get a tax exempt on the rest of the expense. In my opinion, with HRC's plan, you are not cutting costs. In fact, it will add $110 billion to the budget - where will that come from? One may argue that the "WOT" costs more, but that is another issue. With Ron Paul's plan, you are cutting costs by eliminating the bureaucracy. With a true free-market, you can be assured that insurance companies will step up and offer competing plans to cover preexisting conditions. Also, I want to reiterate something that I edited in previous post (after your reply). With all due respect, Bill Clinton had nothing to do with COBRA. It was passed in 1986 under Ronald Reagan. And I just found this article about the Canadian health system: http://www.theglobeandmail.com/servlet/story/RTGAM.20080301.wheart01/BNStory/National/home They can give us the medicines, and we can give them the hospital care :)!!

[kumble_rocks]

You are right about COBRA being passed under Reagan . I somehow confused it with FMLA act which Clinton had passed in 1993.

[kumble_rocks]

I may be coming around to your argument wrt preexisting conditions. I would be OK with a plan where there will be some patient responsibility - if you get into the type of situation you described, you are responsible for the first $10, 000. You'll get a tax exempt on the rest of the expense. In my opinion, with HRC's plan, you are not cutting costs. In fact, it will add $110 billion to the budget - where will that come from? One may argue that the "WOT" costs more, but that is another issue. With Ron Paul's plan, you are cutting costs by eliminating the bureaucracy. With a true free-market, you can be assured that insurance companies will step up and offer competing plans to cover preexisting conditions. Also, I want to reiterate something that I edited in previous post (after your reply). With all due respect, Bill Clinton had nothing to do with COBRA. It was passed in 1986 under Ronald Reagan. And I just found this article about the Canadian health system: http://www.theglobeandmail.com/servlet/story/RTGAM.20080301.wheart01/BNStory/National/home They can give us the medicines, and we can give them the hospital care :)!!

I don't know , Mate, No insurance company will want to pick up the tab for a patient undergoing Chemo or Kidney transplant or any of these costly procedures. It makes no business sense for any insurance company to pick up a patient suffering from chronic disease ..let's say somebody on dialysis ... The cost will run into million dollar for such treatment. I think at some point we need socialized treatment .. Also, how will Hillary pay for her plan which easily would cost upwards of 110 million dollars every year ? That's a big question mark. But , if the Bush administration can afford a 1 trillion dollar war , surely this should be a walk in the park !:D

[Lurker]

With a true free-market, you can be assured that insurance companies will step up and offer competing plans to cover preexisting conditions.

Cricaddict. There is a myth about true free-market, that it exists. Fact is no market will ever be truly free. Think of Valentine's Day and how an identity(Hallmark etc) has driven it. Did public start V-Day? No. Did corporate media do it? Yeah. A good example of how free-market wont work is the service provided when your car breaks down. There are a bunch of automative mechanics - from Firestone to Midas to Meineke etc etc. Does that drive the price down? When was the last time a consumer came out with a smile from a mechanic. In my opinion the way to improve Healthcare is to drive down the cost. The way to drive down the cost is to cut the middlemen(read agents/brokers etc). These service "facilitators" dont facilitate anything except add on to the charges. Do away with them and see how the total charge falls.

[CC1981]

(2) How come the US has higher rates of survival from catastrophic illnesses than do countries with Universal HC?

this is a bit like self-fulfilling prophecy, so no credibility can be accounted for these numbers. The reason US has higher rates of survival from catastrophic illnesses is simply because only people with healthcare coverage go to the clinics and hospitals to get treated! Right now, there are over 20 million Americans without healthcare coverage- do you really think they go for further treatment when the doctor tells them they have cancer ? hell no! they can't afford it to begin with! So obviously, this is an artificial stat, given that millions of Americans simply don't go to the doctor if they don't have health coverage!

Take the govt out of healthcare completely, because govt regulations have driven costs up (HMOs were mandated by liberal politicians)

Stupid idea, i am sorry to say. Taking government out of healthcare will make it a profit-driven industry, which makes it an elitist bastion, not one that serves the masses.

Doctors spend more time and money filling out Medicare paperwork and insurance billing, and complying with idiotic HMO rules.

Ron Paul should come up north to Canada and perhaps it will educate him on universal healthcare works. No doctor here spends time filling m medicare paperwork, that is the job of the 15 dollars/hour medical assistant (ie, receptionist).

Pay out-of-pocket for primary care, and have tax-exempt heath savings accounts and insurance policies for catastrophic care. Make it a personal responsibility, not a government responsibility.

Stupidest idea if there ever was one. Tax-exempted healthcare savings account ? Do you have any idea how much (in real money) does it cost for healthcare in the western world ? Without healthcare plan/govt. healthcare, even an X-ray costs you 400-500 dollars per session! Care for cancer, AIDS, coronary heart-desease etc. are in the range of millions of dollars for the average patient. Tax-exempted healthcare savings acct. will do diddly squat for most people in the face of serious illnesses. Seriously, Americans (and Indians too) need to study the Canadian healthcare sysetm, which gives universal healthcare and patient care for life-threatening cases is exemplary. Sure, the system has its flaws ( non-life-threatening procedures can be backlogged for over 18 months in several cases) but it is the most humane, societerial system and the best example of how to run healthcare on this planet.

[fineleg]

By the way, do you folks get visitors insurance (aka medical insurance for visitors to USA), if your folks from India visit you in the US? How expensive are those? What kinda coverage you get?

[kumble_rocks]

Bump for cricaddict - The compassionate conservatives are at it again - Not a single republican supported federal subsidizes for COBRA expansion in the recently approved stimulus package . The House bill would have provide a 65% federal COBRA premium subsidy for individuals who are laid off from Sept. 1, 2008, through Dec. 31, 2009—a provision that has not drawn significant opposition from business groups because it would be only temporary. Beneficiaries' premiums would be subsidized up to 12 months. The Senate got it down to 50 % with approval of only three republicans. The House bill also had a provision which I believe made perfect sense - Under the measure, employees who stop working as young as age 55 could keep COBRA coverage until they were eligible for Medicare at age 65, regardless of the amount of time they worked for the employer. And any employee who worked for an employer for at least 10 years also could keep COBRA until eligible for Medicare instead of the usual 18 months . And COBRA does not come cheap . Average family of four tends to pay 1400 USD per month. But it covers pre-existing conditions . But the business groups backed by these Republicans exerted immense pressure that the Senate bill stripped these expansions and the House was forced to accept the compromise bill minus these federal subsidizes .The cabal of Nancy Pelosi and Harry Reid certainly have their weakness and have proven to be wrong on numerous occasions , but when it comes to COBRA expansion , they got it perfectly right. So , with due humility I ask you , how can one justify this removal of COBRA subsidy from the bill . What we got here is not a scream for socialized medicine , but an urgent need to ractify a grave injustice - One work's their butt out for more than 10 years with a firm , god forbid that individual develops a chronic condition like cancer and lose their job , No Insurance will pick them up after 18 months . Sean Hannity are you listening ?

[Crookbond]

Cricaddict - This one's for you The Crushing Cost of Care http://online.wsj.com/article/SB10001424052702304441404577483050976766184.html

[punjabi_khota]

http://edition.cnn.com/2012/07/10/politics/house-health-care/index.html?hpt=hp_t2 There they go again. Every few months, they get excited about repealing the law. Pass in house -> Fail in senate -> rinse and repeat. :laugh: