US Healthcare Reform

[jennyc]

That's what i was trying to say earlier, why was letterman basically calling Obama a commi becuase of his health plan. 22 Million people without health cover.... that is the whole Australian population. If you were one of those 22 mill who couldnt afford health cover would you think it was fair?

Forget your own situation, we can always deal with ourselves. What if you couldn't afford health cover and your work didn't provide it, you weren't eligable for medicare and your CHILD got sick, what if they got chronically sick. How would you cope, would you still think the system was fair if your child was one of those 9%. I'm not American but i have a fair enough of an idea to udnerstand that you use the medical system and you have to pay for it (unless you can acess a 'free clinic').

Don't forget your situation can change in a heartbeat. You can go from being top dog to underfoot in a matter of moments, wouldn't you like to know you were going to be cared for in any event? Out here we pay a medicare levy in our taxes, we pay around 100-200 per month for family private health cover. If you don't have health cover and you are above a certain threshold then you incur a surcharge on your tax.

[BigSky]

BigSky aren't you guilty of doing a similar thing in citing the Constitution as a means to oppose health reform?

The notion that one social act of government is going to push the nation into an obliarchy is hysterical rubbish and you know it. It just answers the question I raised in my last post.

Not at all.

Our government was founded as a Constitutional Republic and as such its not playing politics demanding they stay within the confines of that Constitutional Republic especially when this bill goes far past health care reform.

I never said anything about one social act.   You should feel ashamed and embarrassed for trying to take it out of context.

Leaving aside the appalling and inhumane suggestion that illegal immigrants should be denied health care (presumably be left to die on the streets er Hello! they are still Human Beings!) in the UK National Insurance is deducted from wages at source by the employer in the same way as income tax and those who are unemployed get their insurance paid by welfare benefit. If this is the system your government proposes then the problem of the ones who can afford to pay but don't is solved.

It's appalling and inhumane?  Really.......then you can start sending $1200 a month to the US to take care of these illegals.  What not going to send it?   Whoops not so appalling and inhumane now is it if you are the one being asked to be stuck with the bill.

Illegals are not citizens of this country, but are in fact criminals. Illegals cannot work here legally, so they are not paying taxes.  In order for them to work and have taxes deducted from wages they had to commit identity theft and use someone SS number.

It maybe different in your country, but in the US it goes that criminals are not suppose to benefit from their crimes.

Oh so that's OK is it. 22 million people treated as second class citizens in health care just because they can't afford to pay.

Ohh but is so bright to think we should add 100 million more to those ranks.

In the final analysis it's not about the constitution or an obliarchic state is it. Its about about maintaining the status quo so that you and millions of others keep your priviliged payed for place in the pecking order at the expense of others less fortunate. God forbid that you should have to join  the 112 million of the hoi perloi in the line for health care.

The only way to get that analysis is if you lack the understanding of our founding system of government and how it operates today.

This liberal idea of yours that since the system isnt perfect for everyone, so we should really f*** it up for everyone is asinine at best.

Our Constitution can be changed.  It clearly outlines the process to change it.  Instead we have a government ignoring its limitations of operation

The whole basis of your argument is as dishonest as it is fatuous and is just an attempt to hide your hidden selfish and shameful agenda.

Ahh breaking out the  ad hominem  attacks.

Typical of a liberal.


Funny how you think we should take on your busted ass system that isnt fairing any better in treatment or coverage for the people.



Sure most agree there needs to be reform and that everyone should have coverage.

But really now.... is it too much to ask that the government does it within the confines of its powers as by the Constitution.   Is that really too much to ask?

[BigSky]

Why is "socialism" used when describing a single-payer health system when it is not used for our public run schools, police, fire protection and other public services offered by the government (state and/or federal).   

Just wondering...............................

States have more rights to operate than the Federal government does.  IE the 10 th Amendment.

[Ken Shelmerdine]

Sorry can a moderator please delete this post. Lost it when sending Thanks I will redo it tonight

[kristina]

The UK NHS is not perfect and there are problems where the resources spent for various treatments can vary depending on which NHS trust serves your area but at least if your finances are limited you will get the same quality treatment and care as anyone else using it and be none the poorer for it.

Not true. If you are unlucky enough to suffer from a very rare genetically inherited disease
(Lupus/SLE/MCTD with very rare genetically inherited components in my case)
and if this disease causes you ESRF, you might not be able
to find any NHS-GP/specialist/rheumatologist/nephrologist to medically treat you
and you might find youself in the same situation as I find myself:
no NHS-medical care at all, no NHS-doctor to go to for medical help.

I have read that some NHS-GP's have up to three thousands NHS-patients registered with them in their NHS-Surgery
(they get paid by the Health Authority for every NHS-patient registered with them...)
... and in my experience NHS-GP's do not have the time/are not interested to take on NHS-patients like myself
who are suffering from a chronic rare genetically inherited diseases.

NHS Health Authorities are not interested to assist rare cases like myself either,
because rare cases do not have a voice in the NHS-system.
That is why I am left without any NHS-GP/specialist/nephrologist to go to...
...and privately paid blood tests show (no NHS-blood tests for me), that my kidneys only work 10% now.
Where is the humanity there, I wonder?

[Phraxis]

It does not cost more, it provides at least the equivalent care to those that have healthcare now, and it covers everyone. How can a single payer, Government system not be the better?

I know I said I did not have a position but BigSky made me mad. Don't take me too seriously, I am on allot of presidone, free predisone, but steroids nonetheless.

[BigSky]

It does not cost more, it provides at least the equivalent care to those that have healthcare now, and it covers everyone. How can a single payer, Government system not be the better?

I know I said I did not have a position but BigSky made me mad. Don't take me too seriously, I am on allot of presidone, free predisone, but steroids nonetheless.

Oh please.

If it wasnt going to cost anymore there would be no need to force the 20 million people now who choose not to buy coverage into paying for coverage, not to mention the increased taxes Congress wants to enact to pay for it along with the 500 million obama wants to steal from medicare.
 

[jennyc]

Can there not be a compromise, no one is saying the Canadian way, Aussie way or the UK was is perfect, we are just saying IT WORKS FOR US. Is there not some other way the U.S could take care of its people while still working with in its consitituion/prinicples?

From my understanding the U.S system is the exact opposite to the Australian system. For Aussies healthcare is very affordable and it SUPPORTS the MEDICARE system. For the U.S health insurance is abismally high and MEDICARE supports it where it's cover isn't adequate. Our system is that under our constitution the federal govt controls the money but the states control individual healthcare systems. It isn't perfect but it does work FOR US. We are used to it so it seems quite simple for us. Yeh low population density areas sometimes are under funded or over used but each govt is trying to work out that as well but that isn't to say they are without medical becuase they aren't there are hospital they are very stretched though. Country people often travel to Sydney for treatment. But i'm sure over in the U.S country people have to travel for medical as well. I'm guessing that in the less populated regions of oh say Texas some people have to travel to major cities for treatment becuase the hospital in their area is in adequate/smaller than the larger city hospital. (i used Texas becuase in a country that is almost equal in size to the U.S we only have 6 states and 2 territories plus a few outlying islands so our states have a much larger area to cover with population density being higher at the coastal regions. Once you go over the mountains (on the east coast) population starts to dwindle off as it gets drier and drier).

[ahamner]

From my understanding the U.S system is the exact opposite to the Australian system. For Aussies healthcare is very affordable and it SUPPORTS the MEDICARE system. For the U.S health insurance is abysmally high and MEDICARE supports it where it's cover isn't adequate.

In the US "Medicare" is the existing government run health insurance which is mandatory for people over 65.  The reimbursement rates paid to the physicians and to the hospitals from Medicare are much lower than those of private insurers.  Hence, those who are paying for private insurance are subsidizing the government plan.  In the proposed US Health care reform there is a proposed cut of some $5 to 6 hundred billion dollars in the Medicare budget to pay for the proposed system.  The Medicare system is so poorly funded now that it is projected to bankrupt in less than five years.

If you are covered only by US Medicare there are many doctors who will not take you as a patient.  Therefore to ensure access to health care, one must purchase a "medicare gap" type coverage from a private insurer.  With the additional cuts in Medicare being proposed to pay for the "reforms" in the private system this problem will made worse not better.

So the projections are that the proposed changes will result in higher insurance premiums, higher taxes, and less access to quality health care for 85% of the US citizens.

As far as the US being a "rich" nation, the US government is over $12 trillion in debt with an annual operating deficit exceeding 1.5 trillion in this year alone.  In the next ten years our national debt will likely double because of the huge government operating deficits.  This debt is presently being financed by people around the world in China, India, and other countries.  The US dollar is experiencing a significant decline in value against other currencies and against gold as the US dollar printing press rolls merilly along.

The financial mismanagement of the US, if left unchecked, could bring down the entire world's economy.

[jennyc]

My god is that true, i remember when the Aussie dollar was 60c U.S, now it's floating between 80-90c i think it hit as high as mid 90's last year. Talk about bad governments, before this d**K head PM Rudd we have now we were in the black, the last PM, howard (smart, but not everyone liked him, i'm a liberal all the way so i voted for him, not the jerk in now who flees the country everytime things get hot) anyway, howard had our budget in the black, now it's been what, 12 motnhs and were in billions of debt and Rudd expects us to pay for it. Howard and Costello (his treasurer) also had 64 billion put away in a future fund, guess what Rudd wanted to raid it the moment he came into office, havent heard much about it now, they have been real quiet, he wanted to pull it out and use it to upgrade the internet?? jerk or what?

But there has to be some resolution to the problem, i can understand why people are angry that it will take away from medicare but there has to be a way for the U.S people to come up with something and say enough is enough. People say the U.S is the richest becuase it has the largest trading budget of all countries, the largest tax income etc. the Aussie budget probable wouldn't run New York but even this idiot PM project we'll be out of debt again in 5 years (so long as we the people pay back the stimulus packages through our tax!!!).

But i still don't think that Obama is a commi for trying to fix it, perhaps he isn't going about it the right way but he is trying, and he come across as a very intelligent man so i'm scratching my head, there has to be a better way. It's obvious our way WILL NOT work in the U.S it doens't fit into the principles of your country but you have to admit there is something that could/should be done!

[Jie]

  The Medicare system is so poorly funded now that it is projected to bankrupt in less than five years.

This seems a makeup statement to me. Would you please give out a source to support it.  It does not do any good to debate the healthcare reform when using false statements.


Edited: Fixed quote tag error - okarol/admin

[jennyc]

Thanks for fixing tag

Edited: Fixed quote tag error - okarol/admin[/b]

[ahamner]

Jie,

Try using your search engine before concluding something is true or false.  There are numerous sources available on this topic.  Type in Medicare Trustees Report.

[Jie]

OK. Here is the 2009 Medicare Trustees Report:

http://www.cms.hhs.gov/ReportsTrustFunds/downloads/tr2009.pdf

I copied Table 4 here for Medicare historical numbers and 10-year projection.  It is clear that Medicare has the record asset just ending in 2008, the most recent year.  During the most recent 5 years, Medicare has 102.1 billion dollars of surplus.  It is projected, without any healthcare reform or medicare changes, the taking in money will be less than the expenditures starting in 2009. However, the Medicare is still projected to have US$93.1 billions 10 years in the future.

Table V.E4.—Total Medicare Income, Expenditures, and Trust Fund Assets during Fiscal Years 1970-2018
[In billions]
Fiscal year  Total income Total expenditures  Net change in assets    Assets at end of year   
Historical data:
1970         $7.5             $7.1                     $0.3                          $2.7
1975         16.9            14.8                       2.1                          11.3
1980         35.7            35.0                       0.7                          19.0
1985         75.5            71.4                       4.1                          31.9
1990        125.7           109.7                    16.0                        110.2
1995        173.0           180.1                    −7.1                        143.4
2000        248.9           219.3                    29.6                         214.0
2001        266.3           241.2                    25.2                        239.2
2002        285.5           256.9                    28.6                        267.8
2003        286.0           277.8                    8.2                          275.9
2004        307.6           301.5                    6.1                          282.1
2005        349.4           336.9                    12.5                        294.6
2006        422.3           380.5                    41.8                        336.4
2007        457.1           434.8                    22.2                        358.7
2008        474.6           455.1                    19.5                        378.1
Intermediate estimates:
2009        489.6           499.8                   −10.3                      367.9
2010        512.9           521.3                   −8.4                        359.4
2011        547.8           555.7                    −7.9                       351.5
2012        585.3           567.6                    17.7                        369.2
2013        623.7           622.8                    0.9                         370.1
2014        652.1           691.0                   −38.9                      331.2
2015        680.3           713.9                   −33.6                      297.5
2016        724.8           791.4                   −66.5                      231.0
2017        766.3           836.0                   −69.7                      161.3
2018        814.7           882.9                    −68.2                     93.1
Note: Totals do not necessarily equal the sums of rounded components

Now, please show your source that the medicare is "projected to bankrupt in less than five years".

[ahamner]

Now that you have reviewed the numbers, does there appear to be a "surplus" of $500 billion in Medicare to "cut" to fund the health care reform costs being proposed?

The numbers in the table are based on the assumption of continuing AS IS.  That is, no cuts to funding and a continuation of the underfunded doctor reimbursement rates.  These underfunded rates have been "fixed" by congress on an annual basis since 2003 and is proposed to be fixed for the next ten years in a separate bill from the health care reform bill called the doctor fix.  This fix is projected to cost the Medicare Fund an additional $250 billion over the next ten years.

[BigSky]

The table means nothing because it is combining all assets that Medicare controls.  Part A will be broke and Parts B and D cannot be used to pay for Part A.


Reading the reports own highlight section gives the very grim picture of Medicare.

The HI trust fund is not adequately financed over the next 10 years. At the beginning of 2009 the assets of the HI trust fund were $321 billion and are projected to be exhausted during 2017, under the intermediate assumptions. The HI trust fund does not meet the short-range test of financial adequacy. Although the short-range financial status of the HI trust fund has not been considered satisfactory since 2003, the outlook has further deteriorated as a result of the current economic recession.
The SMI trust fund is adequately financed over the next 10 years and beyond because premium and general revenue income for Parts B and D are reset each year to match expected costs. However, further Congressional overrides of scheduled physician fee reductions, together with an existing “hold harmless” provision restricting premium increases for most beneficiaries, could jeopardize Part B solvency and require unusual measures to avoid asset depletion. Part B costs have been increasing rapidly, having averaged 7.8 percent annual growth over the last 5 years, and are likely to continue doing so. Under current law, an average annual growth rate of 5.5 percent is projected for the next 5 years. This rate is unrealistically constrained due to multiple years of physician fee reductions that would occur under current law, including a scheduled reduction of 21.5 percent for 2010. If Congress continues to override these reductions, as they have for 2003 through 2009, the Part B growth rate would instead average roughly 8.5 to 9.0 percent. For Part D, the average annual increase in expenditures is estimated to be 11.1 percent through 2018. The U.S. economy is projected to grow
by 4.5 percent on average during this period, significantly more slowly than either Part B or Part D.

[Bajanne]

I must confess that I do not know the fine details of this entire US healthcare debate, but I do know that I find it absolutely horrible to think that (a) some people have had to declare bankruptcy or sell their homes, etc., because of hospital bills, (b) people are refused at hospitals, even in an emergency situation,  because they don't have insurance or the ready cash.
Why I can't understand that is because I am from a developing country, and no one has to pay for medical treatment, unless they want to.  I admit that going public does mean longer waits, but at least no one is denied medical treatment because of their financial situation.
Don't you have public education along with private education in the US?  Why not public healthcare along with private healthcare?

[Jie]

It is no doubt that Medicare and Social Security will need to be fixed when the baby boomers retire. Healthcare reform is part of the efforts. More have to be done. One age delay for Medicare and Social Security will save us a few years, or a slightly increase of tax rate will help too. If the "Death Panels" thing can be implemeted effectively, it will save a lot of money too. Just think how much money was wasted for the FL lady!

As the 500 billion dollars saving from Medicare, it is the combination of reductions in Medicare’s payment rates in the fee-for-service sector and reining in the popular Medicare Advantage program. If these cuts work as the way it is planned for, it should not affect the Medicare projection.  Medicare’s Part A Hospital Insurance Trust Fund is projected to be exhausted by 2017 without heathcare reform. With Healthcare reform, the White House projected it to extend for another 7 years. No matter what arguments are used, it is a false statement to say the Medicare is "projected to bankrupt in less than five years". I am sure Medicare will be here 5 years from now and will be here for a much longer time. 

As the Healthcare reform, I can see the pitfalls of arguments of both sides. Dem. forget the minus sides, and Repu. forget the plus sides.  No one can exactly figure out the net effects on private insurance premiums. For example, how much the cut from Medicare would pass to private insurances, how much the removal of pre-existing conditions affects the premiums, how much the reduction of uncollectable debts due to less uninsuranced would help private insurance premiums, how much the competition from the public option or Co-Op would reduce the premiums, and whether the increase of patients would result in lower prices.  This creates a lot of uncertainty.  Many things may need to change over time to make it work and control the cost.  All I know is that the status quo is not sustainable, and something must be done. I wish both parties can work together to make it happen. Unfortuantely, politicians do not operate this way. GOP had its chance during the Bush 8 years and now it is the chance of Dem.

[jennyc]

That's what we have in Australia, Dad got his hip replacement done under the private sector using his health insurance. Rather than wait the 2 years to get it done in the public hospital he went to hills private and had it done as soon as he could afford time off work.

I must confess that I do not know the fine details of this entire US healthcare debate, but I do know that I find it absolutely horrible to think that (a) some people have had to declare bankruptcy or sell their homes, etc., because of hospital bills, (b) people are refused at hospitals, even in an emergency situation,  because they don't have insurance or the ready cash.
Why I can't understand that is because I am from a developing country, and no one has to pay for medical treatment, unless they want to.  I admit that going public does mean longer waits, but at least no one is denied medical treatment because of their financial situation.
Don't you have public education along with private education in the US?  Why not public healthcare along with private healthcare?

[BigSky]

As the 500 billion dollars saving from Medicare, it is the combination of reductions in Medicare’s payment rates in the fee-for-service sector and reining in the popular Medicare Advantage program. If these cuts work as the way it is planned for, it should not affect the Medicare projection.  Medicare’s Part A Hospital Insurance Trust Fund is projected to be exhausted by 2017 without heathcare reform. With Healthcare reform, the White House projected it to extend for another 7 years. No matter what arguments are used, it is a false statement to say the Medicare is "projected to bankrupt in less than five years". I am sure Medicare will be here 5 years from now and will be here for a much longer time. 

That extra 7 years is most likely another fabrication by the WH.  Not going to happen because of these implementations.



Obama uses the figure of 47 million uninsured people and they claim its only going to cost less than a trillion dollars over ten years to insure them.  Other words 100 billion a year  (His number is including illegals, which causes many other political problems)

Compare that to Canada who has less people, with roughly 33 million and spends just over 181 billion this year.

So in ten years Canada with cost increases is looking at most likely nearly 2 trillion dollars for its program.

The US is going to insure nearly 1.5 times the people for half the money? 




Medicare will only be around because Congress will have to pull money from another area to fund it or raise taxes considerably.

Otherwise they run the risk of revolt and worse happening to them as people do not like being taxed for days, months, years, decades and the government then to turn around and say "ahh shucks were not providing you your promised insurance after a lifetime of paying for it".



Jenny

There are many reasons people do not want this bill.

You say yours is affordable.  Which it is from what I have read on the net about it.  The net lists  1.5% of wages.  Then 1% more if one makes over a certain amount.

According to the Congressional Budget Office, the rate in the US will be 17%-20% of pre tax wages.

[Bajanne]

I forgot to add that in my country there is a 1% Health Levy on income.

[jennyc]

We have the madicare levy added to tax plus a loading if your over 30 and don't have health cover.

[paul.karen]

If you have a fire in your kitchen do you tear down the whole house and rebuild or just repair the fire damaged kitchen.

The vast majority of Americans some say as many as 83+% are very happy with there insurance.  So why are we looking to revamp the whole system for 20% of the people?
Of the people that are NOT COVERD many are young people who CHOOSE not to be coverd on there own accord.  So they truly shouldn't even be counted in the stats as uncovered they just dint want to pay the 30/40 dollars a paycheck to recv. insurance.

So the almighty want to spend over a trillion dollars to make the system even slower and longer and on top of it this wont cover everyone like Obamacare is suppose to.

So for about a quarter(likely much less) of what the govt. wants to spend we could insure the people who are uninsured and thus everyone would be insured and the MAJORITY of the people would be and stay happy.

Lets also remember this is America and anything the govt. touches goes WAY OVER in actual costs.  IE.  SS Medicare Post office ect ect.

And just recently a major discovery was made.  breast cancer isn't really that big a deal.  They dint want to check patients as often as we do.  They are now even saying there is no need to teach young ladies how to do a self breast examine.  So rationing has started before the plan has even begun.  And the great wise people who decided breast cancer screening isn't truly needed until certain ages??  Well none of them are cancer specialist.  So we will have panels of people some with NO MEDICAL BACKGROUND AT ALL dictating what people do and dint need.

And maybe just maybe doctors in America wouldn't order so many tests if they couldn't be SUED out of there practice.  Malpractice reform is MUCH needed but the laweys like Obama wont even talk think or consider reform which is one of the biggest reasons for out of control pricing.

I have said over and over as have so many Americans we truly need to revamp the healthcare in America.  But so many of us fear letting Govt. be in total control.  Some people like big govt.  But so many more want govt out of our lives and to do what they are suppose to do. What the constitution states they should do.  But hey the constitution is little more then a piece of paper that gets trampled on on a daily basis.
 

[Stoday]

  But hey the constitution is little more then a piece of paper that gets trampled on on a daily basis.

Don't think you'd be better off with a constitution like the UK's. That's not even a piece of paper; it's not written. 

The US healthcare cost per capita is twice that of the UK, yet only some of the population get the full benefit. For them, it's the best healthcare in the world, but so it should be in view of the cost. I'm sure reform could produce considerable improvements, especially regarding administrative costs. It's unfortunate that the only alternatives being suggested are other countries' systems, non of which are as good as the USA's best. The reform should be aimed at retaining the best quality and extending the benefits to the whole population.

I would like to be able to say to out National Health Service that they should follow the US system, because it's better. Unhappily it's worse (overall) so I have to continue to put up with our NHS.

[BigSky]

If one wants to see US government run health care just look at Indian Health Services.  You will see just how bad it is.