HC passes Senate

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charrison

Lifer
Oct 13, 1999
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You free market guys just don't get it and I guess you never will. Free market economics will never work with healthcare for one simple reason. A SICK PATIENT HAS NOTHING TO BARGAIN WITH! Price competition means absoluetly nothing when your in jeapordy of dying.

ANd most healthcare transactions are not made in life or death situation. Is it unrealistic for a doc to post his prices in the waiting room? Most patients are well enough to shop around as long as they are not in the ER at the time.

Free market economics is exactly what has ruined insured healthcare in this country, ALL economic forces work against the patient in a free market system. The supply/demand rules that drive free markets just don't work for healthcare.

Try govt intervention which warps markets.

With a normal commodity when the price gets too high people just stop buying it and the price is forced to drop, with healthcare that is not an option, so instead of the normal peaks and valleys in price appreciation healthcare cost rise constantly. One of the quiding pricipals of economics is that the price of a commodity will always seek out the percieved value of that commodity. With health care the real and percieved value of ones life is priceless so their is no price that is too high.

And guess what, because of cost people have stopped buying it and they are still covered! THe govt has picked up the tab where consumers stopped paying. There has been no incentive for cost cutting the medical field.
 

Vic

Elite Member
Jun 12, 2001
50,422
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The quality of your response is astounding.
I can see why your post count is so high, I guess you value quantity over quality
Tyrone would be proud

:rolleyes:

Please explain to us, in some kind of coherent detail and without resorting to empty rhetoric, how our existing healthcare system is free market-based.

For example, free markets require negotiation of fees and services prior to completion of the transaction. Yet, when I go to my doctor, he won't tell me what he charges, not even for routine exam. I get to find that out later. But if say I bought a house, the price of the house, everything that comes with it, and the detailed cost of financing would all be disclosed at closing. Because you see, that's how a 'free market' works.

So one could elaborate and say that the insurer is acting as my, the medical consumer's, agent... but they're not. They don't negotiate on my behalf, they negotiate on their behalf. More to the point, I don't even know what they, the insurance company, charges for their services. My employer pays that cost, and they won't tell me because they get special group pricing and tax breaks. And hey, I get tax breaks too, my portion of the premiums are deducted from my paycheck pre-tax. But if I wanted to get my own health insurance, my employer won't give me the actual difference it would cost them to insure me (although they will give me a small pittance of the difference), and I won't be able to buy the same quality health insurance for anywhere near the same price they pay.

And so forth and so on. If that's your idea of a free market, then pal, you obviously don't know what a free market is.
 
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blackangst1

Lifer
Feb 23, 2005
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You know there is large difference between the cost of an MRI when billed to insurance versus a consumer paying cash for it no matter the location?

You know when the consumer only has to pay a copay it removes most of the market forces that force prices down.

And single payer would remove that? No. The difference is now the hospital will bill the government what it used to bill insurance companies. Even in the talk of single payer there was nothing talking about the government dictating price. Nothing would change in that regard.
 

blackangst1

Lifer
Feb 23, 2005
22,902
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:rolleyes:

Please explain to us, in some kind of coherent detail and without resorting to empty rhetoric, how our existing healthcare system is free market-based.

For example, free markets require negotiation of fees and services prior to completion of the transaction. Yet, when I go to my doctor, he won't tell me what he charges, not even for routine exam.

Mine does...anecdotal perhaps? And what does that have to do with anything? OK, so providers give you a PDF file with all their charges before they treat you. And then?
 

charrison

Lifer
Oct 13, 1999
17,033
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And single payer would remove that? No. The difference is now the hospital will bill the government what it used to bill insurance companies. Even in the talk of single payer there was nothing talking about the government dictating price. Nothing would change in that regard.

As I stated in a previous post, as long as a 3rd party is paying the bills, costs are going to continue to rise as consumers are going to demand more "cheap" healthcare. Untilt he consumer starts directly paying a larger share of the bill, costs are going to continue rise as they are now.
 

Lemon law

Lifer
Nov 6, 2005
20,984
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One big reason for rising costs is private health care insurers who have a built in dis-incentive to see prices drop. Because the higher the bill is for a given service, the more money sticks to the hands of the private insurance company as their part of the take.
 

charrison

Lifer
Oct 13, 1999
17,033
1
81
One big reason for rising costs is private health care insurers who have a built in dis-incentive to see prices drop. Because the higher the bill is for a given service, the more money sticks to the hands of the private insurance company as their part of the take.

The docs are just as guilty, they try to soak the 3rd party as well.
 

Vic

Elite Member
Jun 12, 2001
50,422
14,337
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Mine does...anecdotal perhaps? And what does that have to do with anything? OK, so providers give you a PDF file with all their charges before they treat you. And then?

Anecdotal? Hardly. There are countless providers in my area and not one of them while disclose costs and fees upfront.
As for 'and then,' well and then I can negotiate charges and/or choose between various providers for the best cost/benefit. You see, the key component of markets that makes them markets is that little thing known as 'shopping.' Without the ability to shop, there is no market, much less a free one.
 

ProfJohn

Lifer
Jul 28, 2006
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Maybe we need to view overall health care as a cost the American people owe to the American people. As as overall health care costs were inflating at double digit rates year after year, health care costs are now a greater slice of GDP than Government itself.

What is being rejiggered is who pays for what in terms of our overall net National health care costs. And some had been paying more than their fair share and others were getting a free ride. And our existing health care system was in danger of collapse because those entities paying for far more than their fair share were opting out.

As Eskimospy noted, we could have gotten significant overall efficiencies by enacting a single payer system, which could have reduced overall health care costs. Another area where we could get overall cost reductions is in doing more in the area of preventive medicine.

But if this bill can reduce our net national health care costs while providing a more equitable sharing of expenses, there will be far more winners in this bill than losers.
1. You are wrong about healthcare and the government. Healthcare is around 15% of GDP our government is around 20%.

2. You are wrong about the problem being related to who pays into the system. The problem is related to people who take more out than they pay in.

3. A single payer system may provide some efficiencies, but it would create a HUGE increase in the demand for healthcare and thus would result in huge increases in the amount of money that we would spend on healthcare. Once people are told that healthcare is 'free' they will rush to see doctors and the costs will skyrocket. The only way to contain costs at that point would be to ration care, like every other country that uses single payer does.

4. This bill does NOTHING to reduce our overall healthcare spending. In fact it should result in MORE healthcare spending as all the people who have no insurance or coverage now will be forced to get coverage and with then turn around and start using services as well.

I personally do not have healthcare insurance and have not had it for years at the same time I have not used any healthcare services for years. But if I am forced to pay for healthcare due to some government mandated then you can be assured that I will start using some of those services to recoup my 'investment'
 

blackangst1

Lifer
Feb 23, 2005
22,902
2,359
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As I stated in a previous post, as long as a 3rd party is paying the bills, costs are going to continue to rise as consumers are going to demand more "cheap" healthcare. Untilt he consumer starts directly paying a larger share of the bill, costs are going to continue rise as they are now.

Well, SOMEONE has to pay the bill. The problem isnt who pays it.
 

blackangst1

Lifer
Feb 23, 2005
22,902
2,359
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Anecdotal? Hardly. There are countless providers in my area and not one of them while disclose costs and fees upfront.
As for 'and then,' well and then I can negotiate charges and/or choose between various providers for the best cost/benefit. You see, the key component of markets that makes them markets is that little thing known as 'shopping.' Without the ability to shop, there is no market, much less a free one.

So youre telling me you cant call 10 random doctors and ask how much the cash price for a general check up is, and they wont tell you? PM me your zip. I'll find out for you on Monday.
 

Zstream

Diamond Member
Oct 24, 2005
3,395
277
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So youre telling me you cant call 10 random doctors and ask how much the cash price for a general check up is, and they wont tell you? PM me your zip. I'll find out for you on Monday.

He is full of it, I called around to at least four medical offices in my area to find the lowest cost of a MRI scan on my knee. Each office was within 50-10$ of each other so it did not matter to me in the end.
 

Pliablemoose

Lifer
Oct 11, 1999
25,195
0
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But it is exactly what you asked for. No, not what you wanted, but you asked for it.
Life sucks, eh? :p

You are a health care provider. You've seen just what headaches Medicaid and other programs are. Why would you expect something better than what they have had for half a century. They are unable or unwilling to fix the most basic problem and you're suprised it's a cluster? I thought I taught you better than that.
:p

This bill is pointless without the public option, they need to scrap the whole damn thing. That Obama wasted his political capital on this bill is an embarrassment.
 

Vic

Elite Member
Jun 12, 2001
50,422
14,337
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He is full of it, I called around to at least four medical offices in my area to find the lowest cost of a MRI scan on my knee. Each office was within 50-10$ of each other so it did not matter to me in the end.

$50-$100 doesn't matter to you? Hmm, must be nice... and are those costs with or without insurance paying?
 

Vic

Elite Member
Jun 12, 2001
50,422
14,337
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This bill is pointless without the public option, they need to scrap the whole damn thing. That Reid/Pelosi wasted their political capital on this bill is an embarrassment.

Fixed.

As for Obama, he doesn't have the political capital to speak against it, much less veto it.
 

juiio

Golden Member
Feb 28, 2000
1,433
4
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(which, by the way, WHERE is the Constitutional allowance for the government to FORCE you to buy something? Hint, IT ISN'T THERE!)

It will be allowed under the Commerce Clause, thanks to Wickard v. Filburn, one of the worst Supreme Court decisions ever.
 

jadinolf

Lifer
Oct 12, 1999
20,952
3
81
Then it doesn't take effect until Obama is relected so he can run of meme of HC reform before Americans relise what a disaster and expensive way this will effect their lives. Got to hand it Obama - devilishly clever.

Might not be Obama but could be those Chicago gangsters who surround him.
 

eits

Lifer
Jun 4, 2005
25,015
3
81
www.integratedssr.com
things that disappoint me about this whole thing:

- this isn't health care... this is sick care
- if it wasn't for the spiteful bitchass republicans and their mouthpieces, like glenn beck, this bill would never have been created... the public option would have passed and it would have been better
- no one seems to mind that there's no regulation on the insurance companies, who don't have to abide by anti-trust laws
- earmarks for votes (aka politics)
- it's just like taking something that's broken, breaking it more, and saying, "yay! i fixed it!"


i'm extremely disappointed in my party, but not delusional or ignorant enough enough to become a republican

also, for anyone who is gonna bitch and whine about "who's gonna pay for the public option waaah waaah", it's simple... we would, as well we should, you greedy bastards. so your taxes go up just a tiny bit... big goddamn deal. your country will be a much healthier and happier country because of it. it's time you people woke up and started thinking about making the country a better place.
 
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Zebo

Elite Member
Jul 29, 2001
39,398
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I don't know why y'all think a public option or single payer would cost more. All for half price the rest of first world budgets. It's just more bullshit by corporate powers that be. Thousands of excuses why we can't get there which is insulting to anyone's intelligence as the rest of the world does it, no problem, again all for half. And I've been to Germany, France, Sweden, etc and seen their superior HC up close and personal so it's even more insulting. Moore, who i can't stand, touched on it in his movie but he did'nt go into how my relatives get up to a whole month of spa treatment a year. This is normal in Europe along with maternity care and so on. My mom had breast cancer, shes a university professor with great insurance, but guess where she went for her treatment as American HMO's everything was a fight (as you're suffering) back home to Sweden for half a year. Sometime I'll post pictures of facility she stayed in to beat her cancer - place looked like taj mahal not some dry impersonal facility like we have here.
 
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charrison

Lifer
Oct 13, 1999
17,033
1
81
So youre telling me you cant call 10 random doctors and ask how much the cash price for a general check up is, and they wont tell you? PM me your zip. I'll find out for you on Monday.

For the most part when you ask a doc about fee for service you get puzzled looks as damn near everyone pays with insurance. I would assume the situation has improved as HSAs have gained some traction in the past few years. My old dentists however gave me a pretty good discount when we dropped dental insurance and went fee for service.
 

GroundedSailor

Platinum Member
Feb 18, 2001
2,502
0
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It will be allowed under the Commerce Clause, thanks to Wickard v. Filburn, one of the worst Supreme Court decisions ever.

I think Santa Clara County v. Southern Pacific Railroad was one the worst decision of the SC. Which has lead to all the lobbying and special interest groups as well as buying elected representatives. And ironically it was the head note, written by a court reporter who happened to be a former president of a railroad, not the actual opinion itself which has been used to apply the legal principle.
 
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Robor

Elite Member
Oct 9, 1999
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I didn't read/post much in P&N back in 2003 but I wonder how many modern day 'fiscal conservatives' raging against health care reform today were doing the same for Bush's Medicare plan. I suspect they are few and far between.

Republican Deficit Hypocrisy / Bruce Bartlett, 11.20.09, 12:01 AM EST / Remember the Medicare drug benefit?


The human capacity for self-delusion never ceases to amaze me, so it shouldn't surprise me that so many Republicans seem to genuinely believe that they are the party of fiscal responsibility. Perhaps at one time they were, but those days are long gone.

This fact became blindingly obvious to me six years ago this month when a Republican president and a Republican Congress enacted the Medicare drug benefit, which former U.S. Comptroller General David Walker has called "the most fiscally irresponsible piece of legislation since the 1960s."

Recall the situation in 2003. The Bush administration was already projecting the largest deficit in American history--$475 billion in fiscal year 2004, according to the July 2003 mid-session budget review. But a big election was coming up that Bush and his party were desperately fearful of losing. So they decided to win it by buying the votes of America's seniors by giving them an expensive new program to pay for their prescription drugs.

Recall, too, that Medicare was already broke in every meaningful sense of the term. According to the 2003 Medicare trustees report, spending for Medicare was projected to rise much more rapidly than the payroll tax as the baby boomers retired. Consequently, the rational thing for Congress to do would have been to find ways of cutting its costs. Instead, Republicans voted to vastly increase them--and the federal deficit--by $395 billion between 2004 and 2013.

However, the Bush administration knew this figure was not accurate because Medicare's chief actuary, Richard Foster, had concluded, well before passage, that the more likely cost would be $534 billion. Tom Scully, a Republican political appointee at the Department of Health and Human Services, threatened to fire him if he dared to make that information public before the vote. (See this report by the HHS inspector general and this article by Foster.)

It's important to remember that the congressional budget resolution capped the projected cost of the drug benefit at $400 billion over 10 years. If there had been an official estimate from Medicare's chief actuary putting the cost at well more than that, then the legislation could have been killed by a single member in either the House or Senate by raising a point of order. Then-Senate Majority Leader Trent Lott, R-Miss., later said he regretted not doing so.

Even with a deceptively low estimate of the drug benefit's cost, there were still a few Republicans in the House of Representatives who wouldn't roll over and play dead just to buy re-election. Consequently, when the legislation came up for its final vote on Nov. 22, 2003, it was failing by 216 to 218 when the standard 15-minute time allowed for voting came to an end.

What followed was one of the most extraordinary events in congressional history. The vote was kept open for almost three hours while the House Republican leadership brought massive pressure to bear on the handful of principled Republicans who had the nerve to put country ahead of party. The leadership even froze the C-SPAN cameras so that no one outside the House chamber could see what was going on.

Among those congressmen strenuously pressed to change their vote was Nick Smith, R-Mich., who later charged that several members of Congress attempted to virtually bribe him, by promising to ensure that his son got his seat when he retired if he voted for the drug bill. One of those members, House Majority Leader Tom DeLay, R-Texas, was later admonished by the House Ethics Committee for going over the line in his efforts regarding Smith.

Eventually, the arm-twisting got three Republicans to switch their votes from nay to yea: Ernest Istook of Oklahoma, Butch Otter of Idaho and Trent Franks of Arizona. Three Democrats also switched from nay to yea and two Republicans switched from yea to nay, for a final vote of 220 to 215. In the end, only 25 Republicans voted against the budget-busting drug bill. (All but 16 Democrats voted no.)

Otter and Istook are no longer in Congress, but Franks still is, so I checked to see what he has been saying about the health legislation now being debated. Like all Republicans, he has vowed to fight it with every ounce of strength he has, citing the increase in debt as his principal concern. "I would remind my Democratic colleagues that their children, and every generation thereafter, will bear the burden caused by this bill. They will be the ones asked to pay off the incredible debt," Franks declared on Nov. 7.

Just to be clear, the Medicare drug benefit was a pure giveaway with a gross cost greater than either the House or Senate health reform bills how being considered. Together the new bills would cost roughly $900 billion over the next 10 years, while Medicare Part D will cost $1 trillion.

Moreover, there is a critical distinction--the drug benefit had no dedicated financing, no offsets and no revenue-raisers; 100% of the cost simply added to the federal budget deficit, whereas the health reform measures now being debated will be paid for with a combination of spending cuts and tax increases, adding nothing to the deficit over the next 10 years, according to the Congressional Budget Office. (See here for the Senate bill estimate and here for the House bill.)

Maybe Franks isn't the worst hypocrite I've ever come across in Washington, but he's got to be in the top 10 because he apparently thinks the unfunded drug benefit, which added $15.5 trillion (in present value terms) to our nation's indebtedness, according to Medicare's trustees, was worth sacrificing his integrity to enact into law. But legislation expanding health coverage to the uninsured--which is deficit-neutral--somehow or other adds an unacceptable debt burden to future generations. We truly live in a world only George Orwell could comprehend when our elected representatives so easily conflate one with the other.

Of course, there are good reasons conservatives oppose expanding the government, as the pending health legislation would do, even if it adds nothing to the deficit. But anyone who voted for the drug benefit, especially someone who switched his vote to make its enactment possible, has zero credibility. People like Franks ought to have the decency to keep their mouths shut forever when it comes to blaming anyone else for increasing the national debt.

Franks is not alone among Republicans for whom fiscal responsibility never consists of anything other than talk. The worst, undoubtedly, is DeLay, who actually went so far as to attack Sen. John McCain, R-Ariz., last year for his principled vote against the drug benefit, one of only nine Republican senators to do so. (By my count, there are still 24 Republicans in the Senate who voted for the drug benefit, including such alleged conservatives as Jim Bunning and Mitch McConnell of Kentucky, John Cornyn of Texas, Mike Crapo of Idaho, Orrin Hatch of Utah and Jon Kyl of Arizona.)

Amazingly, leading Republicans still defend the drug benefit. Just the other day, former Senate Majority Leader Bill Frist, R-Tenn., celebrated its passage, and at a recent American Enterprise Institute forum, former House Ways and Means Committee Chairman Bill Thomas, R-Calif., berated me for criticizing it. In each case, their main argument was that it ended up costing a little less than originally projected. Somehow, I doubt that Frist or Thomas would feel the same way if their wives thought it was OK to buy a closet full of expensive new shoes just because they were on sale.

I don't mean to suggest that Democrats are any better when it comes to the deficit, although they have a better case for saying so based on the contrasting fiscal records of Bill Clinton and George W. Bush. The national debt belongs to both parties. But at least the Democrats don't go on Fox News day after day proclaiming how fiscally conservative they are, and organize tea parties to rant about deficits, without ever putting forward any plan for reducing them. Nor do they pretend that they have no responsibility whatsoever for projected deficits, at least half of which can be traced directly to Republican policies, according to Office of Management and Budget Director Peter Orszag.

It astonishes me that a party enacting anything like the drug benefit would have the chutzpah to view itself as fiscally responsible in any sense of the term. As far as I am concerned, any Republican who voted for the Medicare drug benefit has no right to criticize anything the Democrats have done in terms of adding to the national debt. Space prohibits listing all their names, but the final Senate vote can be found here and the House vote here.

Bruce Bartlett is a former Treasury Department economist and the author of Reaganomics: Supply-Side Economics in Action and Impostor: How George W. Bush Bankrupted America and Betrayed the Reagan Legacy. Bruce Bartlett's new book is: The New American Economy: The Failure of Reaganomics and a New Way Forward. He writes a weekly column for Forbes.
 

brencat

Platinum Member
Feb 26, 2007
2,170
3
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Just allowing insurance to be sold across state lines would be of significant benefit for most at no cost to the govt.

Exactly. I've been suggesting this to family and friends for years although my father who worked his entire career in the insurance industry says that repealing state control of insurance regulations would be way more cumbersome than people realize.

But it could be done. This and bringing down malpractice insurance costs via caps on ambulance chasing damage awards so more doctors don't quit the profession would be helpful too.
 

brencat

Platinum Member
Feb 26, 2007
2,170
3
76
I didn't read/post much in P&N back in 2003 but I wonder how many modern day 'fiscal conservatives' raging against health care reform today were doing the same for Bush's Medicare plan. I suspect they are few and far between.

Actually I was dead against it (although i was not a member of AT back then!). And Bush was not a true conservative either. He betrayed true conservatism by spending like a drunken sailor (deficits don't matter). Meanwhile gold has risen 500% in 10 years and our dollar is collecting worthless in wheelbarrows.

I hate both parties and my overall cynicism about everything couldn't be higher.