Psychology and the US Healthcare Debate

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thewesternsky

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I noticed another thread moving in this direction, and decided to create a new one rather than making that one get too off-topic.

Anyone have thoughts about American health care reform and psychology as a profession? Will this be good for us? Bad for us?

Personally, while admitting I'm not too familiar with Obama's plan, I think it will have little effect. I'm basing this on assumptions which may or may not be warranted, so if others have information that contradicts this-- Let me know.

I'm a Canadian citizen. We've had universal health care here since the 1960's (longer in some provinces). Many, but not all, of our health care services are provided, free of charge to us, by our government plans. Services that are NOT included in these plans, which must be either paid for out-of-pocket or be covered by private insurance through work (which approximately 65% of Canadians have), include: most dental care, optometry, most mental health care, and things like chiropractic and massage therapy. There are some exceptions to this, however-- I know hospital in-patients (post-TBI, etc) receive neuropsychological assessments free-of-charge, and I believe that some therapy *may* be covered if you have a referral from your primary-care physician (not 100% sure on this one).

Under the Canadian plan, then, the majority of psychological services are *not* covered under universal health care. I'm assuming that the US plan is going to be similar, but I really have no idea.

Thoughts? :)
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Great idea for a thread! It's interesting to hear the point of view of someone who lives in a country with socialized health care. I'm not too familiar with Obama's plan either, but I would venture that there are many directions the field of psychology can go if and when his plan is implemented.
 
I'm Canadian too. Although I live in the States now I'm not following the health care debate--I don't intend on staying in the US when I'm done.

One thing I will say is that all the stuff American hear about Canada's health care system on US news are either absurd exaggerations or outright lies. We do not leave grandmothers to die in the street, and neither I nor anyone I know has ever waited a significant amount of time for any kind of health care. The most I ever waited was one time when I waited a day for a (free) non-essential CAT scan.

Anyone know where to get income figures for Canadian psychologists? I swear I saw figures for academic US vs. Canadian psychologists on the apa salary survey, but I couldn't find it when I looked yesterday.
 
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As typical for politics, its quite difficult to parse out the valid points (for or against) from the stupidity that pervades nearly every national political issue.

I'm not convinced the current proposal is the optimal solution, but I do know our healthcare system is laughably broken in nearly every way so something needs to be done. I may not trust the government to do it right, but I'm also not convinced they'd be any worse than the insurance companies.

As for the effects on psychology - I suspect it may depend what area you are in. Much of health psychology is, in essence, preventive care, and could see a significant boost if there actually is a real shift towards prevention (which may or may not happen, but is the part of this debate I feel most strongly SHOULD happen). My area pretty much defines preventive care though, so I'm rather biased. As for the effects on more traditional areas I'm unsure.
 
Ollie123 said:
As typical for politics, its quite difficult to parse out the valid points (for or against) from the stupidity that pervades nearly every national political issue.

I'm not convinced the current proposal is the optimal solution, but I do know our healthcare system is laughably broken in nearly every way so something needs to be done. I may not trust the government to do it right, but I'm also not convinced they'd be any worse than the insurance companies.

As for the effects on psychology - I suspect it may depend what area you are in. Much of health psychology is, in essence, preventive care, and could see a significant boost if there actually is a real shift towards prevention (which may or may not happen, but is the part of this debate I feel most strongly SHOULD happen). My area pretty much defines preventive care though, so I'm rather biased. As for the effects on more traditional areas I'm unsure.
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:thumbup:

A someone with a pre-existing condition who has been rejected for coverage on things like medication by "death panels" within our current health insurance industry, I am all for some sort of reform. I grow incredibly tired of how dichotomous the debate is. It's either what we have now or universal, socialized, doom. There's nothing in between.

I'm in health psychology and bill under medical diagnosis using health and behavior codes. Reimbursement is generally better than traditional psychotherapy billing with a lot less red tape. I'm curious how this will change.
 
Cosmo: I agree. I totally believe that our system needs reform, I just don't think universal healthcare is the solution.
 
cara susanna said:
Cosmo: I agree. I totally believe that our system needs reform, I just don't think universal healthcare is the solution.
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Hrm, I'm not sure if you meant to say this. Doesn't universal healthcare just mean making sure that everyone can get healthcare? I think there is nothing wrong with this concept. Personally as a civilized society, we should strive to provide this and hope this is beyond just being liberal or conservative.

What have been understandable concerns are how this is achieved as people may have issues with a government run system. However, I've worked at a VA and a large non-profit HMO and so far those have seem to be very lucrative and stable environments for psychologists. Certainly, that's no gurantee that this new system would be similar.

However, so far no one has suggested having a single system and whatever the final result of the bill, will be many different companies (and possibly the government) competing with each other. It will be up to current and future psychologists to say to each company that we are worth the extra salary to hire. If we can't do that, then we've already lost our ground to the "creep".
 
When I said universal healthcare, I meant "socialized healthcare"
 
It is my completely anecdotal, unscientific observation that those opposed to a "public option", or to "universal healthcare" or what ever it's currently called, are those who either have current, relatively reliable access to a health plan they are able to afford, or those who are young and healthy, with low medical need/cost. I think if everyone were to adopt a healthy dose of "there but for the grace of God", the tenor of the debate would be very very different. Don't kid yourselves: enjoying adequate medical coverage and/or good health is luck and genetics. Seriously. One inattentive texting driver can undo years of "healthy lifestyle choices" - and then what? Or what about that chronic condition known as old age? Everyone gets there eventually. Anyone who plans on tapping Medicare, but opposes any kind of public health option is being a bit hypocritical, don't you think?

It's easy to get lost in a swamp of detail, which is why it's a good idea to have a clear handle on your principles. And then to challenge your own narrow self-interest to make sure that you are actually acting in ways that are consistent with your principles - even if it appears to work against self-interest. My experience: frequently it doesn't. I have never ended up with less because I adopted a more generous attitude when my first impulse was to cling to what I had. Competition is not the only survival strategy, and I find I am...can't find the word....by how self-centered, self-serving, dishonest and downright mean the tone of public debate has become.
 
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Okay, federally-funded healthcare! Whatever term you like. x_x

This new healthcare system would focus on the relatively young and healthy. Critics of it are concerned about where it leaves the elderly, children, and the chronically ill.
 
cara susanna said:
Okay, federally-funded healthcare! Whatever term you like. x_x

This new healthcare system would focus on the relatively young and healthy. Critics of it are concerned about where it leaves the elderly, children, and the chronically ill.
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Where are you getting this? I'm so confused.

For those of you interested in reading the bill, I found it online--
http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=111_cong_bills&docid=f:h3200ih.pdf

The language is a bit tough (which is, among other things, what led to last's week's "seniors will be FORCED into meetings where they will be urged to sign DNRs" mess-- that's patently untrue, by the way).

I'm busy analyzing data this afternoon, but I plan to read through the plan tonight. :) Interesting stuff.
 
cara susanna said:
Okay, federally-funded healthcare! Whatever term you like. x_x

This new healthcare system would focus on the relatively young and healthy. Critics of it are concerned about where it leaves the elderly, children, and the chronically ill.
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Medicare is federally-funded healthcare that focuses entirely on the elderly, and the last time I checked, most elderly people are very protective of their medicare.

We need new healthcare policies to make sure that the elderly, children, and chronically ill have medical care that they can rely on, which they don't. Right now, people with minor pre-existing conditions can't get insurance even when they're willing to pay for it. And for many who are lucky enough to find insurance, it's out of their price range. I've heard of some individuals being asked to pay several thousand dollars a month just for insurance. We can't sustain this current path. California is running out of funding and can't cover many children, who are now going without medical care.

Some lucky people get insurance through their jobs, but what if you get ill and can't work anymore? Not only are you out of income, you're also no longer getting medical care. (This is especially pertinent to chronic conditions.) What about those who are self-employed? Most can only rely on emergency care, which bankrupts the individual and the hospital, thus leading to less emergency care centers in most locations. Also, because of the rising cost of insurance, many companies can't afford it anymore. More and more people will eventually be tossed into this quagmire of frustrating insurance policies and exhorbitant costs.
 
Edit: Yeah, I don't really feel like arguing this. I try to keep politics outside of my professional stuff, and this forum edges too close to professional for me. Sorry, I hope you understand.

But I'm sure markp or Jon Snow or someone else will take up the opposing side, and do a much better job of it than I would. :D
 
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Does anyone have details about what "End-of-life" counseling really consists of?

I've only seen summaries and haven't dug through the actual monster reports, but everything seems to gloss over the details. Some reports imply Obama himself is going to come convince Grandma to OD on Vicodin the moment she gets the sniffles, whereas others seem to think its basically just an in-person brochure about how to set up a living-will. I'm guessing its somewhere in between but does anyone here know for sure?
 
Ollie--From what I have heard, the Dems can't keep the story on the bill straight anyhow, so I'm not sure anyone can give a solid answer.

In the end, I think a Ron Paul-style healthcare system (see here http://en.wikipedia.org/wiki/Political_positions_of_Ron_Paul#Health_policy) is the best for the US. Although I'm from Canada and love our health care system, I actually don't think a federally mandated system would work here, for a few reasons. First, your (essentially one-party) political system is very, very strange and people in future government can muck things up in bad ways, whatever gets set up now. Second, in countries where it does work, essentially 100% of the population is totally behind it, which isn't the case here (witness the staged demonstrations by people who look to be rather in need of the care they're crying not to receive).
 
The elderly are already fully covered by medicare, which is hugely popular (I believe I read that it enjoys a 95% satisfaction level somewhere recently).

This bill will not impact the elderly in any way. Children would be fully protected (many, though not all, are currently covered through S-CHIP and medicaid). The chronically ill would no longer be denied healthcare, as they routinely are by private insurers.

While health care will never be perfect in a country of 300 million, we can do better than we are (i.e. behind such stalwarts as Columbia and Saudi Arabia according to a recent WHO report and, for example, 37th in life span - smack in between Saudi Arabia and Cuba). All of this while we spend 150% of what other industrialized countries spend (and I don't even want to know how much more we spend than Columbia!).

For those not 'in the know' (i.e. those who seldom utilize their critical reasoning skills) - approximately 1/3 of this country is already run by "socialized medicine". Its called Medicare and the VA health system.

I appreciate how supposed 'doctors to be' actually believe the stupidity that has been spread by the health care industry and their cronies (both Republicans and many "Blue Dog" democrats).

Its actually rather frightening. ---

cara susanna said:
Okay, federally-funded healthcare! Whatever term you like. x_x

This new healthcare system would focus on the relatively young and healthy. Critics of it are concerned about where it leaves the elderly, children, and the chronically ill.
Click to expand...
 
Ollie123 said:
Does anyone have details about what "End-of-life" counseling really consists of?

I've only seen summaries and haven't dug through the actual monster reports, but everything seems to gloss over the details. Some reports imply Obama himself is going to come convince Grandma to OD on Vicodin the moment she gets the sniffles, whereas others seem to think its basically just an in-person brochure about how to set up a living-will. I'm guessing its somewhere in between but does anyone here know for sure?
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The end of life counseling is an optional (repeat, optional) service, where people would be able to speak with a health care professional about their options for care in terminal situations. For example, people could learn about the procedures for instituting a DNR order. They could also be counseled on options like a living will and be educated about things like hospice, palliative care, etc.

The most important bit is that this a completely optional service that is covered for those who would like to discuss such matters. It's by no means a mandate on who should live and die.
 
Ollie123 said:
Does anyone have details about what "End-of-life" counseling really consists of?

I've only seen summaries and haven't dug through the actual monster reports, but everything seems to gloss over the details. Some reports imply Obama himself is going to come convince Grandma to OD on Vicodin the moment she gets the sniffles, whereas others seem to think its basically just an in-person brochure about how to set up a living-will. I'm guessing its somewhere in between but does anyone here know for sure?
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I've actually read through the relevant sections of beaurocracy, and my understanding is this. The new plan includes an addendum to the current Social Security Act (which governs Medicare, Medicaid, etc). This addendum adds an "Advance Care Planning Consultation" to the list of services that are covered. This list of things that are covered, by the way, includes X-rays, various cancer screening tests, cardiac rehab, and special shoes for patients with diabetes who have circulation problems.

The Advance Care Planning Consultation, which is covered once every five years (i.e., you can't have one more often than that and expect Medicaid to pay for it unless you've recently had a significant change in your health status) entails a discussion with a doctor, NP, or PA. In this discussion, the patient can, if they so choose:

1) learn about available services like hospices
2) learn why it's important for patients to appoint a surrogate decision maker
3) formulate an order regarding life-sustaining treatment (which "may range from an indication for full treatment to an indication to limit some or all or specified interventions.")

That's it. That's what all the hoopla was about. Basically, if a person nearing the end of their life WANTS to make an appointment with their doctor to learn about services and talk about whether they want to stay at home or go to the hospital, whether they want to be resuscitated, and/or who they want as a decision-making proxy-- Then that appointment would be covered.

That's it.
 
thewesternsky said:
I've actually read through the relevant sections of beaurocracy, and my understanding is this. The new plan includes an addendum to the current Social Security Act (which governs Medicare, Medicaid, etc). This addendum adds an "Advance Care Planning Consultation" to the list of services that are covered. This list of things that are covered, by the way, includes X-rays, various cancer screening tests, cardiac rehab, and special shoes for patients with diabetes who have circulation problems.

The Advance Care Planning Consultation, which is covered once every five years (i.e., you can't have one more often than that and expect Medicaid to pay for it unless you've recently had a significant change in your health status) entails a discussion with a doctor, NP, or PA. In this discussion, the patient can, if they so choose:

1) learn about available services like hospices
2) learn why it's important for patients to appoint a surrogate decision maker
3) formulate an order regarding life-sustaining treatment (which "may range from an indication for full treatment to an indication to limit some or all or specified interventions.")

That's it. That's what all the hoopla was about. Basically, if a person nearing the end of their life WANTS to make an appointment with their doctor to learn about services and talk about whether they want to stay at home or go to the hospital, whether they want to be resuscitated, and/or who they want as a decision-making proxy-- Then that appointment would be covered.

That's it.
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Assuming you are correct (not that I doubt you personally, but its obviously a complicated matter and its easy to miss things amongst a pile of documents that could fill a warehouse), I absolutely do not understand the focus on this.

This is why politics frustrates the crap out of me. I TOTALLY get why people are worried it won't work, about problems it may cause, etc. I share many of those concerns, though again, share at least as many concerns about the current system so I'm not sure it would make things worse. Instead of hearing about those, we get to hear 24-hour a day coverage about this.

Of all the things in the bill, that sounds like it should be a complete non-issue. As in one of the least important, least controversial parts of the bill. What frustrates me is that there is so much that COULD go wrong, and we spend our time discussing this because some ***** throws a hissy fit about something someone on his staff asked someone else on his staff asked someone ELSE on his staff to make their 12 year old kid read and report back. Then he just watched TV and made something up so he wouldn't get in trouble.

I'm just not sure if I should be hating the media or politicians more. Again, assuming you are correct western, this was just picked up on because it could be a sound byte. There is a whole lot that can go horribly horribly wrong with making such a drastic change to the system that isn't flashy because it involves a complicated, tenuous economic formula that <1% of the population could even begin to understand, but might make a difference of billions upon billions of dollars. I really hope that whatever the media is doing, someone is actually attending to the critical issues rather than the crap that makes it onto the mainstage.

Sorry, I'm done now. This is why I went into science. The devil is in the details, and I want to rout him out.
 
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aagman01 said:
For those not 'in the know' (i.e. those who seldom utilize their critical reasoning skills) - approximately 1/3 of this country is already run by "socialized medicine". Its called Medicare and the VA health system.

I appreciate how supposed 'doctors to be' actually believe the stupidity that has been spread by the health care industry and their cronies (both Republicans and many "Blue Dog" democrats).

Its actually rather frightening. ---
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Is it really necessary to insult people just for disagreeing with you? Many of us oppose this healthcare system because it goes against our core beliefs of the role of government and what our rights are. I don't support national healthcare, but that doesn't mean I'll call those who do idiots.

By the way, 94% of surveyed doctors--"real" doctors, not just students--opposed this plan.
 
The system is so broken already, we NEED change. I agree that there are a lot of ways that a new plan can go wrong. Even if this does not work completely, hopefully it will help some and we'll learn from it to improve it further. We cannot just sit and let everything stay the way it is. Even the insurance companies agree that we need change.

It's really sad that we've only heard about "killing your grandma" and "socialism" scare tactics in the media. I'd like to hear about real concerns and we should try to make this reform as effective as we can make it. So far, I have not heard anything that would indicate that this reform will be a total failure. The Republicans have focused mostly on outrageous concerns. Hopefully, that's a good sign that so far it's a sound plan with no obvious holes.
 
Giving the government an unprecedented amount of power in healthcare isn't reason enough to oppose it, for someone who is entirely against big government?

Remember, not everyone has the same political ideals.

I said I wouldn't get into this, btw, but there's nothing in the bill that says the meetings are optional. If they're optional, I have no complaints.
 
DVel said:
It's really sad that we've only heard about "killing your grandma" and "socialism" scare tactics in the media. I'd like to hear about real concerns and we should try to make this reform as effective as we can make it.
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So far, the only real concern I have run across is the cost of starting such a program. The issue of who is going to pay is a difficult one. Should taxes be raised across the board so that everyone pays for the public plan? If so, will that mean that too many people will switch to public HC and thus overburden the system? Should the money be borrowed from somewhere else and/or come from other programs?

I'm for health care reform because I think the system is clearly broken and needs to be fixed. Nevertheless, I do think this is a legitimate concern.
 
cara susanna said:
Giving the government an unprecedented amount of power in healthcare isn't reason enough to oppose it, for someone who is entirely against big government?

Remember, not everyone has the same political ideals.

I said I wouldn't get into this, btw, but there's nothing in the bill that says the meetings are optional. If they're optional, I have no complaints.
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Well, the SF Chronicle is one of many publications that cite that the meetings are optional. http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2009/08/17/MNT4198FQ4.DTL&type=politics

Heck, even Fox affiliates acknowledge that it is. http://www.fox4kc.com/lifestyle/health/wdaf-end-of-life-health-care-reform-081709,0,1753435.story

As for the issue of big government, I don't see why government would be any more corrupt or inclined to indecent practices than private insurance corporations, HMOs, etc. Why shouldn't they be allowed to compete by providing a plan for those who choose it or who can't afford private insurance?
 
Because if the government has the power to give it, they have the power to take away. The problem with insurance companies is that they don't have the patient's best interest at heart. Well, neither will the government.

But costs are my biggest concern, now that you mentioned them.
 
Ollie123 said:
Sorry, I'm done now. This is why I went into science. The devil is in the details, and I want to rout him out.
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Agree completely. This is why I love the internet, and why I do things like read entire sections of 1000+-page bills. The media is often contradictory and, while the truth generally comes out eventually (many newspapers are now reporting exactly what KD and I mentioned), I like to go back to the source as much as possible.

The amount of misinformation and general anarchy out there is astounding, though.

Anyway, sections of the bill that are relevant to mental health and psychology-- And I can't guarantee this is all 100% correct, so please take this information as "the results of one person spending her evening going through a very long document that refers to several other very long documents." I did my best, though, and I expect that most of this is reasonably accurate.

1) It seems like they're adding social worker services to the list of services that nursing homes can be reimbursed for providing. (Psychologists used to be the only mental health professionals on this specific list... other than potentially psychiatrists and psychiatric nurses, who would be encompassed by 'physicians' and 'certified nurses').

and, more importantly:

2) Services provided by marriage and family therapists and mental health counsellors can be covered under the plan at least under some circumstances. (Services by psychologists and clinical social workers were already covered in this section, but the addition of MFTs and MHCs is new). I had trouble following exactly which circumstances. Their payment would be equal to that of clinical social workers, and less than that of psychologists.

For those who are curious (I was!), according to the bill a mental health counsellor must: have a Master's or doctoral degree in counseling, have two year post-degree supervised experience, and be licensed in the state where they are practicing.

...And... that's it, as far as I could tell, for changes that are directly relevant to practicing psychologists. For a 1000+ page bill on health care reform, I kind of expected more.

ETA: Oh, I should also mention the good news-- Minimum services to be covered under the plan (or any equivalent private plan that one would choose instead) include: Hospitalization, outpatient hospital and clinic services, physician services, prescription drugs, rehabilitative services, preventative services (including many vaccines), maternity care, care for children under 21, AND... Mental health and substance use disorder services. :)
 
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That's interesting, thanks for posting the info.
 
where exactly did you get that "94%" number? From a panel of doctors put together by Fox News?

Here is a survey just released by Reuters. Reuters is a newswire service.

http://www.reuters.com/article/domesticNews/idUSN3143203520080331

As you can see, a majority of doctors in their poll (over 2000 were polled) support the a health care plan that provides universal coverage.



cara susanna said:
Is it really necessary to insult people just for disagreeing with you? Many of us oppose this healthcare system because it goes against our core beliefs of the role of government and what our rights are. I don't support national healthcare, but that doesn't mean I'll call those who do idiots.

By the way, 94% of surveyed doctors--"real" doctors, not just students--opposed this plan.
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cara susanna said:
Because if the government has the power to give it, they have the power to take away. The problem with insurance companies is that they don't have the patient's best interest at heart. Well, neither will the government.

But costs are my biggest concern, now that you mentioned them.
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But that's the point of a public plan--that people would be guaranteed at least some protection in terms of health care coverage. As it stands now, insurance companies routinely refuse coverage due to pre-existing conditions, or take away coverage if people are laid off from work. Even if the government would have the authority to refuse to cover certain procedures, how is this any different from the way it is now with private insurance?

The government may not always have the individual's best interest at heart--there are a lot of parties to consider. Nevertheless, that doesn't mean they shouldn't be able to offer a plan that will cover those who cannot get privately insured.
 
aagman: I don't watch Fox News. And I know what Reuters is, thanks. It was here: http://www.pharmalive.com/News/index.cfm?articleid=640694&categoryid=22 They surveyed around 9,000 doctors online.

KillerDiller: The problem is I think a lot of people/companies/etc will switch to the government-funded plan, placing a strain on the system. I hate insurance companies, too, which were also created by the government.

IMO what we need to do more than anything is fix the reason the costs of healthcare continue to rise, which is entirely political. I heard the analogy that Obama is trying to fix a watch with a sledgehammer, and I think it fits pretty well.
 
Not to be a jerk, but just because I think it perfectly illustrates my earlier point that "The devil is in the details" I feel the need to point out the wording on the 2 different surveys.

News articles don't exactly have a detailed methods section but it sounds like the reuters one asked a more general question "Would you support a bill to create a national health service plan" whereas the pharmalive one asked about this specific bill. I could easily see how that might result in drastically different responses. I would definitely answer yes to the first one, but waiver back and forth on the second one.

cara makes a great point about how many people will switch. How is that being estimated? Was this carefully predicted, or did someone pull a number out of a hat? Is it purely economic (which if recent times have taught us anything, its that economics has a long ways to go before accurately predicting human behavior)? Did it account for psychology of decision-making, loss aversion, etc.? What happens if one of the "outliers" happens to be CEO of GM, or some other company with huge numbers of employees? Will they be allowed to opt in as a company or will they still be required to provide private insurance? What about for part-time employees at major corporations who are often not insured?

This is the important stuff that needs to be discussed. The stuff that everyone is ignoring because they're debating whether Obama wants to kill grandma.

Edit: Again, I am not coming down for or against this bill. I plead ignorance on the issue. I don't feel I can make an informed decision until reading it, or seeing some discussion of the critical issues, which doesn't seem to be happening. I wish more people were willing to admit their ignorance...how many people in Washington have even read it cover to cover? I can't imagine going out and staging a demonstration for something I haven't actually read myself, but you know what, I'd wager the vast majority of folks at these demonstrations have absolutely no idea what is actually in the bill.
 
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Ollie123 said:
cara makes a great point about how many people will switch. How is that being estimated?
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One way I have heard that it is being estimated is by looking at the numbers in Massachusetts. Whether or not this is a good predictor depends on things like whether the national plan, like that of Mass, would be subsidized up to 300% of the poverty level. It also depends on whether health care would be made mandatory. Some economists and politicians whom I have heard on NPR are also looking at figures from England, which has a similar system with the public plan being an option.
 
If taxes are raised to support this new system, it's not illogical to think that some people may have to switch simply due to financial restraints.
 
cara susanna said:
KillerDiller: The problem is I think a lot of people/companies/etc will switch to the government-funded plan, placing a strain on the system. I hate insurance companies, too, which were also created by the government.
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How many people switch is a concern, as I acknowledged in a previous post. However, I don't think we should throw the baby out with the bath water. Public health care is something that I would be perfectly fine throwing some money at right now, especially considering that I and my family would benefit from it.

I don't know anything about the history of insurance companies. I do believe that, currently, insurance companies are beholden to the state insurance departments, not to the national government, so it's different than having centralized national oversight.

cara susanna said:
IMO what we need to do more than anything is fix the reason the costs of healthcare continue to rise, which is entirely political. I heard the analogy that Obama is trying to fix a watch with a sledgehammer, and I think it fits pretty well.
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I think this metaphor would only work if our current watches didn't tell time, broke down repeatedly, were prohibitively expensive, and required watch owners to pass background checks of pre-existing watch-related difficulties. Now a sledgehammer doesn't sound like such a bad tool to use, does it? ;)

How are the costs of health care entirely political? It seems like the drug companies are a big factor in this. Another factor is the fact that the uninsured are having to go to the ER to receive treatment for colds and the flu. I guess the latter is political, but it supports the idea that a public plan is needed.
 
cara susanna said:
If taxes are raised to support this new system, it's not illogical to think that some people may have to switch simply due to financial restraints.
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I think raised taxes is a certainty to address an array of issues in this country, not just to support the new healthcare bill.
 
KillerDiller: Cost of malpractice insurance, which has to do with tort reform. Which will never happen.

Also, the whole idea of HMOs (reason people go to the ER for a sinus infection is they can't afford one) is political. Ted Kennedy started it.
 
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Are you serious? The survey I presented to you was what they call in our field a random sample.

The survey you presented was an unscientific survey conducted by a pharmaceutical lobby group.

Who do you think composes the audience of the Pharmalive organization, the same group that on its website proudly proclaims itself to be "the pulse of the pharmaceutical industry."

I am sure that if Moveon.org or some other such group conducted a survey of its members who are doctors that 94% would support universal health care. Would you think that such a survey by Moveon.org is a legitimate representative of doctors nationally?

The study you cited proves nothing. Thank you, though, for proving my point about the dangers poised by individuals who do not critically examine what they read.

cara susanna said:
aagman: I don't watch Fox News. And I know what Reuters is, thanks. It was here: http://www.pharmalive.com/News/index.cfm?articleid=640694&categoryid=22 They surveyed around 9,000 doctors online.

KillerDiller: The problem is I think a lot of people/companies/etc will switch to the government-funded plan, placing a strain on the system. I hate insurance companies, too, which were also created by the government.

IMO what we need to do more than anything is fix the reason the costs of healthcare continue to rise, which is entirely political. I heard the analogy that Obama is trying to fix a watch with a sledgehammer, and I think it fits pretty well.
Click to expand...
 
We owe a debt of gratitude to Richard Nixon and Ronald Reagan. They, more than any presidents, are to blame for the current healthcare problems. De-regulation passed by each of them contributed to the HMOs and insurance company practices as they now exist.

If you truly need articles on this, I can dig them up. Recent tapes of Nixon's role, for example, have even been fairly extensively discussed in the mainstream media.

KillerDiller said:
How many people switch is a concern, as I acknowledged in a previous post. However, I don't think we should throw the baby out with the bath water. Public health care is something that I would be perfectly fine throwing some money at right now, especially considering that I and my family would benefit from it.

I don't know anything about the history of insurance companies. I do believe that, currently, insurance companies are beholden to the state insurance departments, not to the national government, so it's different than having centralized national oversight.



I think this metaphor would only work if our current watches didn't tell time, broke down repeatedly, were prohibitively expensive, and required watch owners to pass background checks of pre-existing watch-related difficulties. Now a sledgehammer doesn't sound like such a bad tool to use, does it? ;)

How are the costs of health care entirely political? It seems like the drug companies are a big factor in this. Another factor is the fact that the uninsured are having to go to the ER to receive treatment for colds and the flu. I guess the latter is political, but it supports the idea that a public plan is needed.
Click to expand...
 
socialcog said:
I think raised taxes is a certainty to address an array of issues in this country, not just to support the new healthcare bill.
Click to expand...

I'd say that's a very poor plan. I think many important issues would be resolved by drastically reducing taxes (or, preferably, eliminating them).

Taxes in the US are ridiculous. Currently, the US is a complete socialist nation; the difference between it and most is merely that in the US the poor pay welfare to the rich.
 
aagman: It wasn't a Pharma Live survey, it was done by a doctors message board, much like this one only not for students. So much for critical reading, huh?

And if you think deregulation is the problem, I really have nothing more to say to you because we'll NEVER agree. It's the typical argument of conservatives vs. liberals. For instance, liberals think that the economy was caused by deregulation, and conservatives think it was caused by too much regulation.
 
cara susanna said:
And if you think deregulation is the problem, I really have nothing more to say to you because we'll NEVER agree. It's the typical argument of conservatives vs. liberals. For instance, liberals think that the economy was caused by deregulation, and conservatives think it was caused by too much regulation.
Click to expand...

CS: this kind of partisan debate disgusts me. No one is innocent in politics, regardless of party. 'Groupthink', people!

JN: agreed. I actually never said it was a good idea, only that I predict it as a certainty.


Here is my cynical take....

Our country is in a recession with no promising outlook on the horizon. We are 9+ trillion in debt (3+ trillion increase in Bush W's 2 terms, btw) and haven't been able to balance the budget, save for 4 years during the Clinton administration, since...what ...WWII? God himself couldn't correct that disaster, let alone the Obama administration.

In my opinion, if you're smart, in the next 10-20 years we need to consider what other countries might provide the kind of quality lifestyle that our own country could not provide---and vacation in the US.
 
socialcog: Sorry, but as a Republican, I'm going to tend to agree with them on many things. I don't agree with them on everything, of course, but if I disagreed with a ton of stuff I wouldn't be one.

Not going to comment on Obama and the deficit.
 
Well, now. Eliminating taxes and regulation. That makes for an interesting thought experiment. Imagine no taxes, and no regulation. No money for any public services (courts, military, highways, food safety, law enforcement, education, sewer systems, environmental protection....) everything either privatized or non-existent, and complete, unfettered free markets.

Maybe the reason people get so passionate about whichever political position they endorse is that there is truth to both sides. So another experiment: What if instead of trying to make the other side "wrong", we acknowledged the merits of each position, and put our collective intellect to work identifying a workable balance between opposing forces, knowing that neither position, taken to extreme is in any way desirable.
 
Edit: This is why I didn't want to get involved in this debate, I don't like what politics brings out in me :/

But, in regards to the above, I just want people to acknowledge that there are different points of views and that feeling a different way than someone else about an issue or a principle doesn't necessarily make a person dumb or evil.

So, yeah, if it's all right I'm going to step out of this debate and keep myself away from this thread through sheer willpower. Sorry if I got a little out of hand in my remarks or anything.
 
Last edited:
strad48 said:
Well, now. Eliminating taxes and regulation. That makes for an interesting thought experiment. Imagine no taxes, and no regulation. No money for any public services (courts, military, highways, food safety, law enforcement, education, sewer systems, environmental protection....)
Click to expand...

One of those things (you get one guess!) accounts for an unbelievable amount of the expenses of the US, completely unnecessarily. Elimination of the maintenance of the Empire would result in plenty of nice things (much less taxes, much more money for the other things, much less terrorism).
 
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