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New York, 1:50 PM
Sat Nov 28
12 posts in the last 24 hours
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08/11/09
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08/12/09
And yes, I believe that, with laproscopic surgery, ACTUAL cost of a knee surgery could well be in the ballpark of $584 (which any hospital administrator will tell you is dramatically different than billed cost). It's not Medicare underpayment adding to your bills -- it's the uninsured (many of them middle-class) who have to go to the ER for treatment because a routine sinus infection became pneumonia, or because they need a few stitches which could've been provided by a competent doctor in-office in forty-five minutes, and the well-documented provision of expensive unnecessary care for insured people (costly diagnostic tests to rule out extremely remote possibilities, for instance) just because someone will pay for it. Perhaps the appropriate comparitor for your situation isn't your private insurance vs. Medicare/Medicaid, but rather insured vs. uninsured: what kind of chair do you think your son would've gotten had you had NO health insurance. Are you really saying that some 50M people should go entirely without care so that others can get Cadillac care? And remember: most chronically ill people (me, for instance), are effectively shut out of private insurance, substantially lowering your premium rates. Also, I'm reasonably certain that your son's care costs more than your premiums, so that excess is being passed on to someone else as well. Which, I might add, is the whole point of insurance, public or private.
In a way, it's like the Post Office: everybody complains, but I have yet to meet anyone who sends all or even most of their mail through FedEx or UPS. Why? Because the USPS provides reliable and comparatively speedy service throughout the entire US (and much of the rest of the world) at a vastly lower cost than private industry. Sure, industry is vastly better at providing customer service, but apparently the premium they charge isn't worth it when most people are sending out holiday cards. Would the more expensive care be worth it if you personally were footing the bills? Would it even be possible?
So you (wrongly) called bullshit on me; now it's my turn. While yours and my personal experiences are interesting and not without merit, they do not and cannot tell us the ultimate value that Americans are receiving for our health dollars. In an earlier post, I provided data; I challenge you to do the same. If you need help, start at www.pubmed.com (a government-sponsored program, coincidentally). Tell me what's wrong with Medicare/Medicaid/the VA, and back it up with real data instead of something you heard about someone's brother's experience over lunch one day.
And finally, I wish your son the best, and am happy he got his chair. I know people with CP, and it sucks. God is an asshole sometimes. That doesn't mean you have to be one too.
08/12/09
Something tells me that we will never agree on this topic, and I'm not about flaming each other. We have just had different experiences with Medicaid.
08/12/09
08/11/09
Excuse me, i have to go visit my canadian doctor, with whom i made an appointment, just 15 minutes ago.
08/11/09
Hope you get a clean bill of health, btw.
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08/11/09
Hoorah! ;-)
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(Stumbled across a Jimmy Fallon clip last week and he was doing pretty well with Obama, and Bill Clinton, too. Still not gonna watch his show, though.)
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BUT you can get your freak on, wear your Big Foot Exists! tee shirt and foil hat, and still pull the lever in the voting booth.
And there's the problem.
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*smirk*
Maybe the problem is that the administration and congressional leadership are not doing a good enough job of communicating that these folks can't see for themselves that they're being lied to.
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If it's a given that there aren't enough resources to provide every single person any treatment she wants or needs, somebody ultimately has to evaluate whether a treatment is reasonable given its cost, it's effectiveness, the condition of the patient, etc. I'd MUCH rather have a panel of disinterested government bureaucrats doing the evaluations rather than employees of a company that is actively trying to screw me out of getting the services my overpriced coverage ostensibly bought me.
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08/11/09
So, what you guys are saying is that we shouldn't seek a plan that doesn't ration healthcare, but instead switch the rationing to government controlled rationing? Is that because the government has proven themselves to be so much wiser than private enterprises? I guess there is some merit to that argument in that the government would never do anything as foolish as running up enormous deficits or buying fancy private jets when they are in economic crisis.
The government is an enormous corporation. The citizens are the shareholders. As a shareholder of the US corporation do you really want them embarking on
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08/11/09
Rationed means "To restrict to limited allotments." This means that some people will get a service and others won't. That is what people find scary... how do you qualify for that service? How is it determined who gets that cancer drug, MRI, CAT scan, appointment with doctor, etc..... I suppose you could liken it to the saying, 'better the devil you know, than the devil you don't.
I am for health care reform. I've read the Health care affordability act of 2009. It raises more questions than it answers.
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08/11/09
Whereas under our current system, the only people who get service are the rich who can afford the treatments the insurance companies won't pay for.
You're right, it's not "rationing," it's straight up denying. So, to me, rationing at least sounds like a step in the right direction.
08/11/09
Give me some stats on how many and what type of services insurance companies deny to back up your statements.
08/11/09
@skippywasserman:
1st) He was making a joke.
2nd) The problem is more with the loud shouty crazies who have millionaire backers, not the lack of information.
Contrary to the assertions of lazy people, detailed information is easy to come by. Unfortunately, for the general population, shouty crazy people get more airtime and always seem to have the same ultra rich folks funding them (directly, or indirectly.)
You have a group of people who are literally making things up and it's being disseminated as though it were documented fact. Those in congress who are in favor of health care reform have to deal with try to explain something that is boring, not having a single specific plan to talk about and having to debunk outrageously crazy bullshit.
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On a more serious note: I was around when the whiz kids from Harvard - the best and the brightest - brought us deep into Viet Nam.
I'll go with the wisdom of the crowd no matter how dumb some of them are.
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I had a friend who had to pay an ambulance bill of almost 2k because the health insurance thought the ambulance was "unnecessary."
And on and on and on. health care is ABSOLUTELY rationed right now and just about everyone knows someone with a nightmare health insurance scenario.
AND the only people who say the current health care bill raises more questions than it answers are the ones making up silly, pointless, scary questions.
For fuck's sake.
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08/11/09
You make a good point that the policy limits on your employer sponsored health plan restricts your wife's access mental health care. Although I have read the bill, I don't recall if there would be specific limits on mental health treatments. I suspect there will be, but I cannot point to the part of the document that discusses that at this moment.
What I would be concerned about and be asking your legislators about is there going to be a waiting list for your wife to see her psychiatrist along with policy limits. Perhaps your That would make an already piss poor situation much worse.
I understand your frustration. I have two kids on the spectrum. Our health insurance doesn't pay for any speech, OT, psych or behavioral therapy with an autism diagnosis. My kids at the peak of their therapies were EACH receiving over 20 private hours per week at $100-170 an hour per therapy. CT just changed the law, to establish some coverage in this area.
Our system is broken, clearly. It is clear to me that we need health care reform. I've read the bill and I am not convinced that this bill will solve the situation in the way we all hope.
08/11/09
How about we do this? I fund the parts of government I believe in--universal health care, education, etc--and withhold the part of my taxes that go toward unnecessary defense systems, star wars, foreign bases--basically, anything that's not defense but offense. Conversely, you direct your taxes where they want to go.
I guarantee you my taxes will be lower than yours. And my world will be better.
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I'm going to use this by way of example. This is UNH's key statistics: [finance.yahoo.com]
Their profit margin is 4.24%. The notion that the profits are what is driving up the cost of healthcare is ludicrous. Cigna's was 3.2%. Even if you looked just at their operating margins, which is probably a more fair way to analyze this, you're still talking about 8% and 5% respectively. The profits are not the issue.
I will again cite my example of another government run service that is rationed: legal defense. You have the right to a public defender if you can't afford an attorney. Only your public defender will strong arm you into pleading guilty to a lesser charge even if you're innocent, because the best thing for the government system is to avoid an expensive trial and get you off of their books. If you insist on going to trial, you can count on having your attorney switched several times on you before you ever reach that point and unless it's a high profile case, you are virtually guaranteed to get an inexperienced attorney fresh out of law school. Why? Because the good public defenders go into private practice. Now, does this practice serve society? Does it serve the accused? Or does it serve the budgetary concerns of the government? I hope you never get arrested, but if you do, I hope you don't have to rely on the government to defend you.
08/11/09
I am no cheerleader for the VA, but the system works when it's allowed to work.
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And by the way, the metric of "years of productive life saved" is commonly used by scientists, doctors and yes, insurers, to make decisions about the distribution of care. For instance, I remember when Human Growth Hormone was approved for the treatment of AIDS-related wasting, it provided an average of a few months of crappy, painful, low-quality life at a cost of something like half a million dollars. Would we be better off spending that money on flu vaccines for at-risk people or smoking cessation programs? The latter would undoubtedly save more years of productive life -- in fact, one could well argue that paying for the former at the expense of the latter is far MORE problematic. These lines are drawn, and have to be drawn until we have limitless resources for health care -- in other words, for ever.
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Experimental treatments. May sound perfectly reasonable, but when you have a life-threatening illness with no proven treatment, as I did for a while, that exclusion can be a major problem. I'm not saying I'd necessarily do it differently if I ran the zoo, but it's definitely a type of service that insurance companies ROUTINELY deny.
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Do you want zero defense spending? Cut it in half and you still won't pay for the healthcare of the 20% of Americans who don't already have it.
08/11/09
The other thing is the degree to which the real money for insurance companies is made or lost by mere percentage points in the stock market. Wall Street looks at insurers' bottom lines and, to a large extent, determines how they run their (and most other) businesses; if Wall Street determines bone marrow transplants are hurting CIGNA's bottom line, CIGNA will amend the practice, I have no doubt. No matter what, the incentive to trim costs at the expense of their subscribers' health is undeniable.
I also find myself strangely unmoved by your public defender analogy knowing that you come from an anti-defendent death penalty state where most of the residents believe a penny spent on a criminals' defense is a penny too much.
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With this health care plan, anyone who can afford it can still have their private insurer, and anyone who can't can take the government health care. The way the system is set up now is more like if you can't afford an attorney, you have to defend yourself (which will almost always be worse than a public defender).
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The first amendment protects free speech, not LYING. Why haven't they been called out on this stuff?
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No one EVER said these people where unamerican. Not at all. I dont think they are, I DO think they are wrong.
But last I looked I didnt see Republicans physically attacked or threatened with loaded handguns at events as we have had in the last few weeks. In fact the only physical attack I remember was a shoe thrown by a guy in ANOTHER COUNTRY.
I certainly remember watching kids beaten to a pulp on a college campus near me though for protesting the war in Iraq.
If ANYONE is being faciest, its the Republicans right now. Remember the Nazis where the MINORITY party before they beat and murdered people in the shadows, while appealing to the uneducated masses in public.
08/11/09
What nobody on here has mentioned is that healthcare would HAVE to be rationed. Currently only those who can afford it have healthcare insurace. But when EVERYONE has it for FREE then everyone will try to use it.
Forget the VA, try going to the emergency room in a Military Hospital. When I broke my leg in two places I sat in the emergency room for 4 hours with no pain killer before they brought me an ibuprofen because my wife got fed up. And I was the service member! When a civilian who is married to the service member tries to get care they go to the bottom of the list!
Are members of Congress and B. Obama going to be forced into the new system just like every other american? If so will someone like Teddy Kennedy be denied his cancer treatment next time around because of his age and other factors (like drinking) or will he be given preferential treatment?
Don't look at health insurance companies or hospitals or providers for your profits. Look at the equipment providers who make that CT or MRI machine and see how much it costs as well as if the contract requires a payment per use by the providers. Those situations as well as the drug companies are the driving factor in health costs.
And they get away with it because the Govt requires certain things be covered by Health Insurance companies.
Another example where govt needs to get out of the way. Yes the industry needs to be regulated, but right now you can't even buy healthcare across state lines. WTH?
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