I could live without healthcare reform! How about you?

10,000 US Physicians Appeal Directly to Their Senators

An appeal for action by interested parties, and it sounds like you are one yourself, is not in any way evidence that it will reduce costs. Or that the interested parties even desire that outcome, especially as they tend to be heavily invested in health care securities. That is why we use empirical evidence such as the CBO report which is based on real-world observed cases and results to make rational decisions, not wish lists by interested parties.

Administrative costs...tap, tap, tap.

A friend of mine commented recently that he had some surgery that he felt saved his life. He is a staunch conservative who has never favored national heath care, btw -- until now.  I thought I'd post the exchange between he, I and a guy from NZ -- sorry for the length:

> Jesus ____, I had no idea it was that serious. Do you mind if I ask
> what kind of work you had done?

Hi Ben,

My guts were literally sticking out. I would shove
them back in and they would pop back out. It was
pretty far along. Toward the end, I had to walk
around with my hand holding my guts in. It was
very scary.

When I finally went to see a doctor about it, he had
me see a surgeon right on the spot (he went and got
the surgeon to come to the room I was in, to look at me)
and that surgeon scheduled me for the pre-surgery
screening the following business day and the operation
was a day or two after that.

I had an inguinal hernia that I had ignored for far too
long. The bowel can end up strangulated and that can
kill very quickly if it's not addressed immediately.

Without the surgery, I wouldn't likely be here anymore.
And it was a simple surgery. So my view of the
necessity of accessible medical care has somewhat
changed -- shall we say...

The sad thing is that people die every day from simple
things that are completely preventable with proper care.

The prospect of being in that condition was very humbling
and very frightening. Nobody in my family had ever seen
me look frail or scared. I had lost a ton of weight and I'm
fairly thin to start with. I looked like hell. Most of what I
ate would give me the runs and so I absorbed less and
less nutrition as the problem progressed. It was awful.

I am so thankful to be healthy today.

{guy from NZ}Would you care to tell why it took you so
long to get something done about an OBVIOUS problem. Was it
fear of the cost, given the woeful American health system, and
your personal knowledge of the inner workings of the health
insurance industry or were you in denial, or afraid of doctors??

It was obvious. My wife had a diagnosis for me
many months before it became so serious.


> Was it fear of the cost

Yes. I was very concerned about how much it
might cost and whether or not insurance would
try to label it as pre-existing. We had changed
plans right around the time all of this was going
on. I was horrified that I would end up with the
bill for it all. As it was, the surgery was over
$30K. I don't see why that should have come to
that much money.


> given the woeful American health system, and your
> personal knowledge of the inner workings of the health
> insurance industry

The American healthcare system is excellent for
something like what I had, actually. We're the best
in the world for interventive medicine. And I was in
typical American form, waiting until the problem was
bad enough. That's how we do things here.

A better system would have given me access to care
without such fear of costs and this would have been
dealt with earlier on and probably would have cost a lot
less and been less dangerous. I finally got to a point
where dying was a lot less appealing than a huge bill
that I might get stuck with. As it was, I still had a
significant co-pay but I'm not complaining. It could
have been so much worse.


> or were you in denial, or afraid of doctors??

Well, there was some of that. I don't trust doctors for
the most part. And with good reason. They gave me
drugs that made me very, very sick after my surgery.
I warned them that I don't react well to drugs and that
I'm not used to taking anything artificial. I warned them
that I have very strong reactions to simple things like
caffeine and alcohol. The anesthesia knocked me on
my butt and took a long time to leave my body. The
pain meds they gave me made things really bad. I went
off the pain meds and refused to take them. The pain
was preferable to the side effects of the meds.

So yeah, I have a low opinion of the medical community.
It's a "one size fits all" system and care is delivered on a
conveyor belt. It's easy to have things slip through the
cracks and not get what you need or get something that
might be harmful.

It's a money driven system, not a care driven system.
The two don't mix very well. The system is badly broken.
We manage to deliver what is needed and in my case, it
saved my life. But in retrospect, there was a lot of room
for improvement.

So you tell me... If I'd been a Kiwi, how would things have
gone for me? How much different would my experience
have been? Would I have had to wait? Would I have had
to worry about the cost? Would I have had to worry about
a declination for pre-existing condition?

And think about this... if there were some sort of compliction
from the surgery that required a lot of care, I'd be on the hook
for all of that too. And they could have screwed up, resulting
in my death and my wife would have still been stuck with a
huge bill -- even if they got results that were less than stellar.

The system isn't even driven by results. They would have
charged the same if I'd died on the operating table. It's an
odd system and it's very scary to be in the middle of it at a
time when you're more vulnerable than normal.

Ocean, it's alright man, the system has fixed itself.

Finland, a country with socialized medicine, has agreed to take all those nasty Fat Mexicans out of the United States, thus saving the US healthcare system.

http://www.fatmexican.com/index.php

Finland, a country with socialized medicine, has agreed to take all those nasty Fat Mexicans out of the United States, thus saving the US healthcare system.

Thanks Phil. I needed that.

Seems this very important national debate has been intentionally derailed and has now devolved into nothing more than fabrication and fear mongering.

>Spending on health administration and insurance cost $465 per person in the United States in 2004, which was seven times that of the OECD median

While health spending per capita in the US is $7000/year.   The difference in administrative costs is 6% of the total.  It's not a silver bullet.

>Spending on health administration and insurance cost $465 per person in the United States in 2004, which was seven times that of the OECD median

While health spending per capita in the US is $7000/year.   The difference in administrative costs is 6% of the total.  It's not a silver bullet.

PS, could you elaborate? I didn't understand what you're trying to say.

Ben

Just putting the administrative costs in perspective. 

Here is some more reading material for you guys.

The Inside Story on Healthcare Reform

Q&A with McDermott Will & Emery Healthcare Law Partner Eric Zimmerman

WASHINGTON--(BUSINESS WIRE)--A bevy of legislation is flooding Capitol Hill on healthcare reform. With President Obama’s speech kicking debate on these initiatives into high gear, Eric Zimmerman, a partner in the Health Law Department of leading law firm McDermott Will & Emery, weighs in on the issues:

Q: How will healthcare service providers be impacted by healthcare reform?

A: Healthcare reform legislation will impact healthcare service providers in many ways. In addition to across-the-board blunt-instrument reimbursement reductions, lawmakers are also looking to infuse new incentives into reform to shape service provider behaviors. For example, more emphasis will be placed on healthcare quality, and more federal program reimbursement will be linked to reporting and achieving quality objectives. Those providers that already have sophisticated quality data gathering and reporting mechanisms in place will be at an advantage. Those that have genuine quality improvement programs that utilize nationally recognized measures will be even better off.

Q: What are some of the key reimbursement issues at play?

A: Healthcare reform legislation will necessarily need to be financed at least in part on the backs of healthcare service providers. Congress is not going to be able to come up with astronomical sums to finance this simply by looking to insurers and pharmaceutical manufacturers. Congress will need to reduce payments to hospitals, physicians, labs, home health agencies, skilled nursing facilities, DME suppliers and others. Cuts will be across-the-board cuts as well as more targeted reimbursement reductions.

Q: How should healthcare service providers prepare for reform?

A: Service providers of all types should budget using conservative assumptions, and predicting little to no growth, and maybe even 2 percent to 5 percent reductions in federal program payments. Service providers of all types also should begin dedicating considerable resources to measuring and improving quality using nationally recognized quality measures.

Q: If Congress fails to enact healthcare reform, what becomes of the many expiring Medicare provisions?

A: Congress will need to address many expiring Medicare provisions through some legislative vehicle, if not through health reform. The current conventional wisdom is that Congress will advance a Medicare bill, if consensus evaporates on healthcare reform. However, the timing of the collapse of healthcare reform may make it difficult for Congress to advance Medicare-only legislation in 2009. As such, many of these expiring provisions may actually expire, at least for a little while.

Q: What are the practical implications of advancing reform legislation through a reconciliation process? What is the real effect/meaning of the Byrd rule?

A: There are many political implications to advancing legislation through a reconciliation process, but there also are many practical implications. Current Senate rules prohibit the Senate from advancing revenue neutral provisions in a reconciliation bill, which means all provisions must either spend or save federal dollars. Gone from the bill therefore would be many of the reform proposals, and many of the "goodies" that have encouraged healthcare providers to support reform proposals to this point.

www.mwe.com 

© 2009 McDermott Will & Emery. McDermott Will & Emery conducts its practice through separate legal entities in each of the countries where it has offices. This communication may be considered attorney advertising. Previous results are not a guarantee of future outcome.

This is just my daily reading as we are in the industry, I will look in my sent files for more.
There is no such thing as a free lunch as much as you all want one. If people took care of their bodies, didnt smoke healthcare would be very inexpensive, most people wouldnt use it until they reached medicare ages. We could have any kiind of healthcare you want, private goverment a mix of both and it will be very affordable. but with 2/3rds of the country overweight and 25% smoking we have a very very expensive healthcare system.

And more



Congressional Research Service: Illegal Aliens Can Receive Benefits Under House Health Care Bill

WASHINGTON, Aug 26, 2009 /PRNewswire - Tuesday, the Congressional Research Service (CRS), the "research arm" for the United States Congress, issued a report validating an analysis by the Federation for American Immigration Reform (FAIR), that illegal aliens would be able to receive benefits under the House health care reform bill, America's Affordable Health Care Act of 2009 (H.R. 3200).

The report, Treatment of Noncitizens in H.R. 3200, states definitively, "H.R. 3200 does not contain any restrictions on noncitizens - whether legally or illegally present, or in the United States temporarily or permanently - participating in the Exchange." H.R. 3200 establishes a Health Insurance Exchange which would provide individuals and small businesses with access to health care plans, including the "public option" to be managed by the government.

CRS also confirms FAIR's assessment that the House bill does not include a mechanism to prevent illegal aliens from receiving "affordability credits" that would subsidize the purchase of private health insurance. CRS specifically noted the absence "of a provision in the bill specifying the verification procedure." Because the language is ambiguous, all CRS could reasonably conclude is that any eligibility determination would be the responsibility of the Health Choices Commissioner.

The CRS analysis comes after weeks of denials by Members of Congress that illegal aliens could receive benefits under the House bill. These denials were echoed by countless media and health care "experts" who dismissed public concerns as myths, or as politically orchestrated attacks.

"Case closed. Illegal aliens will be eligible to participate in the health care program offered by the House bill unless Congress acts to amend the bill," stated Dan Stein, president of FAIR. "The loopholes and omissions in the House bill are not there by accident," continued Stein. "These loopholes were intended to extend benefits to illegal aliens while allowing Members of Congress to deny those facts to the American people."

The House Ways & Means Committee had the opportunity to include language that would have barred illegal aliens from enrolling in the proposed public option or receiving the affordability credits, but chose not to. An amendment offered by Rep. Dean Heller (R-Nev.) would have applied the same eligibility verification procedures for coverage under H.R. 3200 that have been used for years to prove eligibility for Medicaid. That amendment was rejected by a party-line vote.

Based on its own findings and those of CRS, FAIR is calling on Congress to:

-  Adopt clear language that makes illegal aliens (and nonimmigrants) ineligible for enrollment in publicly funded or subsidized health insurance programs.

--  Require electronic eligibility verification for any health care reform proposal through the existing Systematic Alien Verification for Entitlements (SAVE) system.

--  Maintain a five-year eligibility waiting period for legal immigrants to ensure that individuals don't come to the U.S. and immediately tap the system.

"For the past month, irate citizens, concerned that their tax dollars will be used to fund health care for illegal aliens, have been unfairly portrayed as uninformed rabble by their elected representatives and a host of media organizations," said Stein. "It is time for the politicians to close the loopholes, and for the media establishment to acknowledge that they got it wrong."

About FAIR

Founded in 1979, FAIR is the country's largest immigration reform group. With over 250,000 members nationwide, FAIR fights for immigration policies that serve national interests, not special interests. FAIR believes that immigration reform must enhance national security, improve the economy, protect jobs, preserve our environment, and establish a rule of law that is recognized and enforced.

SOURCE FAIR

http://www.fairus.org
 

In my post earlier today about my friend's surgery, he had asked the kiwi how he would have been treated in NZ. Here is his response:

Damn that USA "private socialist" medicine. Your account pretty much
says it all about the USA system of "health" care! Yet even you still
defend it as being the best. But ____, is it REALLY! Do you
really KNOW that the rest of the first worlds health system is not as
good as yours? You nearly DIED due to the USA "health" system being the
best in the world <cough>. Your 30k op, your son's $800 bean {removed from nose},
Ben's wifes $800 sticking plaster/shot. My 25 stitches and months of after
care $3 NZD.

Before you go on about someone else paying for my care, NO, I paid for
it along with every one else in NZ's "socialist" medicine system and ACC
scheme! I pay no more taxes than you & millions of other Americans. So
what do you get for your taxes I don't?? I don't fork out a $1k/mth
extra for "health" denial on top of those taxes.


> So you tell me... If I'd been a Kiwi, how would things have
> gone for me? How much different would my experience
> have been? Would I have had to wait? Would I have had
> to worry about the cost? Would I have had to worry about
> a declination for pre-existing condition?

In YOUR case, you would have made an appointment with your GP (cost
$16-50 depending on doctor) OR gone directly to the hospital. Your
DOCTOR would have said WTF ______, are you stupid, why have you
waited so long to come see me for the sake of (cost $16-50 depending on
doctor). Your DOCTOR (not the insurance co. denial clerk) would have
immediately rung the local hospital and said this man likely needs
emergency surgery, given you a hospital admittance form, and asked if
you need an ambulance (some cities FREE, others $50) to take you
straight there. From there you would have been seen by a hospital
specialist, likely within an hour, and if deemed urgent, you would have
been on the slab a few hours later.

Cost to you...... free!!!!. Plus any after care and follow up!!

Fck that "socialist" medicine that's trying to kill grandma. Americans
want to wake up and get a clue.

ok let me restate that Goverment medicene works great all over the world until you get seriously ill. Then if you can afford it you come to the US for life saving care.

Holy moly... I can't even wrap my head around that comment. It's just so far from false.. and sorry to say extremely egotistical.

Truth be told most other countries do a much better job than we do IMO. And I'm not talking statistics or some article. I'm talking from experiences in those countries.

Z

Just putting the administrative costs in perspective. 

The point is that the claim that government health care is more expensive is not only baseless, it is also demonstratively false. Even the private insurers don't deny that fact otherwise why would they demand subsidies to compete against Medicare.

And saving will inevitability increase with rising market share and bargaining power.

This is just my daily reading as we are in the industry, I will look in my sent files for more.
There is no such thing as a free lunch as much as you all want one. If people took care of their bodies, didnt smoke healthcare would be very inexpensive, most people wouldnt use it until they reached medicare ages. We could have any kiind of healthcare you want, private goverment a mix of both and it will be very affordable. but with 2/3rds of the country overweight and 25% smoking we have a very very expensive healthcare system.

Posting industry propaganda is neither helpful or informative.

You want everyone to keep in shape. You want to end jury trials. You apparently prefer foreigners to just die if they get in trouble. But the one thing you don't want to happen is anything that slows the giant ATM used by a privileged group of investors and executive skimmers. Hundreds of millions of dollars wasted that should be either going to policy holder’s health care or lower premiums.

It's absurd to think that the problems are all outside of the industry. And it pains me to infrom you of the obvious: Insurers choose who they are willing to cover and how much their premiums cost. Yet you still you think it's somehow the citizens, foreigners and the policy holder's fault that costs are high.

Keep it up; keep pointing those fingers in all directions. Keep divert attention from the real issues. I can’t prove you that you are a paid shill or are intentionally astroturfing this board but I sure know what it smells like.

This is just my daily reading as we are in the industry, I will look in my sent files for more.
There is no such thing as a free lunch as much as you all want one. If people took care of their bodies, didnt smoke healthcare would be very inexpensive, most people wouldnt use it until they reached medicare ages. We could have any kiind of healthcare you want, private goverment a mix of both and it will be very affordable. but with 2/3rds of the country overweight and 25% smoking we have a very very expensive healthcare system.

Posting industry propaganda is neither helpful or informative.


You want everyone to keep in shape. You want to end jury trials. You apparently prefer foreigners to just die if they get in trouble. But the one thing you don't want to happen is anything that slows the giant ATM used by a privileged group of investors and executive skimmers. Hundreds of millions of dollars wasted that should be either going to policy holder’s health care or lower premiums.

It's absurd to think that the problems are all outside of the industry. And it pains me to infrom you of the obvious: Insurers choose who they are willing to cover and how much their premiums cost. Yet you still you think it's somehow the citizens, foreigners and the policy holder's fault that costs are high.

Keep it up; keep pointing those fingers in all directions. Keep divert attention from the real issues. I can’t prove you that you are a paid shill or are intentionally astroturfing this board but I sure know what it smells like.

You know nothing about the health insurance industry. This is the most heavily regualted industry in the country. Each state has a elected insurance commisioner with a big staff whose only job it is is to keep the health insurance industry honest.
The health insurance couldnt be the "evil villians" that Obama is trying to make them out to be even if they wanted to be. The states demand that insurance is completey portable within their state. You dont lose coverage if you get divorced, laid off or fired. All you have to do is pay your premiums and you are covered no matter what happens with your health.
The people with prexisting conditions are the people who have never purchased health insurnace and now want a free ride on the backs of the responsible people, becuase they now have a illiness. In my world we call these people muchers, bums and other such names. They choose to spend their money on beer or Hawaii or a boat or whatever, we chose to pay our premiums.
What happened to people being held responsible for their actions?