Concise Summary of Current Healthcare Debate

[Schwann]

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Can someone please provide a somewhat concise and informative summary of the current healthcare debate? I haven't been able to keep up with the news lately, as I have extensive research and school activities. Any enlightening information would be appreciated. Thanks.

 

[TopSecret]

Can someone please provide a somewhat concise and informative summary of the current healthcare debate? I haven't been able to keep up with the news lately, as I have extensive research and school activities. Any enlightening information would be appreciated. Thanks.

It's all pretty simple. Don't get confused by all the details.

1) People get sick and die.
2) It's hard work taking care of the sick.
3) It takes a long time to train to be a doctor and a lot of your own money to finance the medical education.
4) People want health care and don't want to pay for it.
5) 90% of people do not want to eat healthy, stop smoking, engage in regular physical activity, or avoid becoming obese, which according to the CDC, will reduce the risk of diabetes, heart attacks, strokes, and cancer by 80%.

http://www.latimes.com/features/health/la-sci-lifestyle11-2009aug11,0,148496.story

6) Medical advances raise the standard of care and with it the expense.
7) The threat of litigation encourages doctors to order the most comprehensive and expensive tests possible to avoid misdiagnosing a disease that affects 1 in 100,000 people.
8) The more tests a doctor orders, the more paperwork is generated.
9) The more tests that are done, the more likely it is that an error will be made whether it's in reporting or following up on test results.
10) Tests become more expensive to cover the cost of lawsuits from false reporting.
11) The large number of test results will also require a large database to store them and a large number of clerical staff to ensure its protection.
12) Electronic medical records are then sold to health care providers for millions or billions of dollars to reduce the number of errors and also to extract as much as possible from insurance companies and the government with the use of more efficient coding and reimbursement software
13) Diagnosis-related groups (an invention of government) encourage hospitals to send patients home as quickly as possible.
14) Doctors are then in a situation where they order a ton of tests and have less time to follow them up. If a doctor orders 20% more tests and has 80% of the usual time the workload effectively increases 50%!
15) Doctors are frustrated and yearn for the simpler times.
16) Medical students see the disaster that is US health care and run away from primary care and high-risk specialties and find refuge in radiology and dermatology, two of the most competitive specialties in the US.
17) The US sees a shortage of primary care docs and so the government opens the immigration doors to folks from Pakistan and India.
18) Foreign medical grads enter the residency pipeline and become primary care doctors.
19) Patients now see more and more foreign medical doctors as their primary care doctors and wonder where did all the American doctors go.
20) Government officials who know nothing about health care because many of them are lawyers think that more regulations are the answer. Unfortunately, there are so many regulations that they don't know how to make sense of any of them.
21) Government officials and the people then become so frustrated that they just want to enslave/socialize medicine.
22) Doctors balk at the idea of socialism. The lawyers then demonize the medical profession because of their reluctance to be enslaved and the number of lawsuits go up.
23) Lawyers masquerade as public interest groups on health care and make the pitch for universal health care and the preservation of the tort system.

 

[TopSecret]

The above is the gist of the health care woes we have today.

 

[wanderer]

24) A sizeable percentage of the population believe that the threat of litigation is necessary to prevent doctors from torturing people for their own sadistic desires; thus any chance of tort reform is quelled.

 

[redsquareblack]

24) A sizeable percentage of the population believe that the threat of litigation is necessary to prevent doctors from torturing people for their own masochistic desires; thus any chance of tort reform is quelled.

Um. While reform would def. be welcomed, the situation is nowhere near as cut-n-dry as you imply.

 

[TopSecret]

24) A sizeable percentage of the population believe that the threat of litigation is necessary to prevent doctors from torturing people for their own masochistic desires; thus any chance of tort reform is quelled.

25) Doctors then order even more tests and do more biopsies to avoid misdiagnosing the rarest diseases.
26) Pharmaceutical companies and laboratories take advantage of the practice of defensive medicine and encourage doctors to order even more drugs and tests for the patients' safety.
27) Pharmaceutical companies and laboratories make more billions of dollars.
28) There is less money for doctors.
29) Patients go broke.
30) Health care is the next bubble to burst. Be warned.

 

[TexasFight]

From my understanding of the debate, TopSecret pretty much hit the nail on the head with this one.

Edit:
TopSecret, would you happen to have any insight on the future of surgery? The future for most specialists does not look very bright right now, but surgery is a different boat.

 

[TopSecret]

From my understanding of the debate, TopSecret pretty much hit the nail on the head with this one.

Edit:
TopSecret, would you happen to have any insight on the future of surgery? The future for most specialists does not look very bright right now, but surgery is a different boat.

Surgery will probably be reimbursed less (10-30% decrease over the next decade?). Unless tort reform occurs, the malpractice insurance premiums will remain in the six figure range for surgeons. So they will feel the squeeze. The primary care docs will probably see a little more income or maybe no change in the next few years.

 

[Slowpoke]

this was beautiful.

thank you, i asked this same exact question on another thread and no one could reply with anything worthwhile.

Now if we can get someone from the other side of the debate to make a summary of their views and why they are for it, that would be awesome.

 

[TopSecret]

this was beautiful.

thank you, i asked this same exact question on another thread and no one could reply with anything worthwhile.

Now if we can get someone from the other side of the debate to make a summary of their views and why they are for it, that would be awesome.

There really is no other side of the debate. That's basically it.

Most people don't see the big picture, though. They just see that the costs are rising and don't have a clue why.

 

[TopSecret]

I should also mention that Obama is considering mandatory health insurance for all Americans or they will face fines much like driving without car insurance. This would help spread the cost of disease more widely but the problems above still remain. Also, health insurance is not the same as access to health care. Anyone who has ever been on Medicaid or Tricare ("try to get care") will know what I'm talking about.

So to keep things really simple..

Higher disease burden because 90% of Americans don't want to eat healthy, engage in regular physical exercise, or maintain a normal body weight.
Medical advances.
High utilization of expensive tests and procedures for CYAM (cover your *** medicine).
Pharmaceutical companies and laboratories encouraging the practice of CYAM to make $$$.
Government and insurance companies slashing payment to doctors so that doctors need to see more patients to keep up with expenses.
Less time with patients leads to patient dissatisfaction.
50% more labs and 50% less time means triple the workload and a greater chance of making a mistake.
Personal injury lawyers feeding off of the frenzied pace of medicine and want to overwork doctors even more to generate more business for themselves.
In the end doctors pay more for malpractice insurance (money which ends up in the hands of lawyers), have much less time with each patient, end up ordering a boatload of tests to avoid misdiagnosing a rare disease which keeps imaging centers and laboratories happy, and get their payments slashed by health insurance companies and the government because of the declining number of subscribers and lower tax revenues. Americans then have to work harder to maintain this vicious cycle which in turn leads to less time to exercise and sleep, behavior which makes it difficult to maintain normal appetite and body weight.

To break the cycle a few things need to be done...

1) Redefine the standard of care so that our health care resources are used in a more cost-effective manner (i.e., more practice guidelines on rationing that when adhered to will protect the physician from being sued).
2) Enact tort reform to keep the cost of emotional pain and suffering from skyrocketing and to limit the number of frivolous lawsuits.
3) Encourage patients to diet, exercise and sleep more to reduce the overall disease prevalence.

 

[LiveUninhibited]

this was beautiful.

thank you, i asked this same exact question on another thread and no one could reply with anything worthwhile.

Now if we can get someone from the other side of the debate to make a summary of their views and why they are for it, that would be awesome.

I might be considered the other side, as I do support NHI, but more like the French, not a Mass. Plan clone that lawmakers have been leaning towards.

And really the main point that TopSecret made that I am unsure of is:

21) Government officials and the people then become so frustrated that they just want to enslave/socialize medicine.

Enslave is obviously not what would happen, even in a worst-case scenario. To be enslaved is to be forced to work without pay. It is likely doctors would be paid less under socialized medicine, but not enslaved.

Also, socialized medicine is government financed and government run. The UK has socialized medicine, but most developed countries do not. What most developed nations do have is universal health insurance of some kind. This is what those who are for universal health coverage are pointing towards, as all nations have their problems but NHI seems to work well in other countries.

Liberals believe this is applicable to America. Conservatives believe it will work much less well in America due to our poorer health habits than elsewhere, and believe that it doesn't work well in other nations because they have long lines and ration care. The rationing care problem in other nations is overblown, and applies mostly to the UK and Canada for mostly elective procedures. A couple of years ago the UK approved a higher budget for the NHS, so that problem should be reduced, but it does cast doubt on the idea that we should have government-only healthcare.

 

[TopSecret]

I might be considered the other side, as I do support NHI, but more like the French, not a Mass. Plan clone that lawmakers have been leaning towards.

And really the main point that TopSecret made that I am unsure of is:

Enslave is obviously not what would happen, even in a worst-case scenario. To be enslaved is to be forced to work without pay. It is likely doctors would be paid less under socialized medicine, but not enslaved.

Also, socialized medicine is government financed and government run. The UK has socialized medicine, but most developed countries do not. What most developed nations do have is universal health insurance of some kind. This is what those who are for universal health coverage are pointing towards, as all nations have their problems but NHI seems to work well in other countries.

Liberals believe this is applicable to America. Conservatives believe it will work much less well in America due to our poorer health habits than elsewhere, and believe that it doesn't work well in other nations because they have long lines and ration care. The rationing care problem in other nations is overblown, and applies mostly to the UK and Canada for mostly elective procedures. A couple of years ago the UK approved a higher budget for the NHS, so that problem should be reduced, but it does cast doubt on the idea that we should have government-only healthcare.

The point is that doctors will have much less autonomy and will be forced to work harder for less pay. Why are doctors paid so much? Because there's a shortage and their skills are in demand.

What happens when you force doctors to work harder for less pay? You worsen the shortage, especially in primary care where doctors see patients at the pace of a sweatshop, and have to import doctors from Pakistan and India to address the shortage.

 

[LiveUninhibited]

The point is that doctors will have much less autonomy and will be forced to work harder for less pay. Why are doctors paid so much? Because there's a shortage and their skills are in demand.

What happens when you force doctors to work harder for less pay? You worsen the shortage, especially in primary care where doctors see patients at the pace of a sweatshop, and have to import doctors from Pakistan and India to address the shortage.

I'm not sure about the autonomy part. It really depends on the specifics of the bill. Many doctors already lost a lot of autonomy under managed care, so whether it makes a difference or not will depend on where you work.

Does America even have an organized way of controlling the supply of doctors? I thought each hospital decided, but they only get extra government money for inpatient residencies.

I thought I heard government saying they would push incentives for primary care. Loan forgiveness would be expensive, but helpful. Until the effects of that hit us, we'll have to continue to rely upon pediatricians, OB/GYN, other secondary care doctors, and foreign docs to help us fill the primary care gap.

 

[TopSecret]

I'm not sure about the autonomy part. It really depends on the specifics of the bill. Many doctors already lost a lot of autonomy under managed care, so whether it makes a difference or not will depend on where you work.

Does America even have an organized way of controlling the supply of doctors? I thought each hospital decided, but they only get extra government money for inpatient residencies.

I thought I heard government saying they would push incentives for primary care. Loan forgiveness would be expensive, but helpful. Until the effects of that hit us, we'll have to continue to rely upon pediatricians, OB/GYN, other secondary care doctors, and foreign docs to help us fill the primary care gap.

Medicare controls the supply of doctors by funding residency programs. The number of residency programs determines the number of medical students. Without residency training medical school grads cannot practice medicine.

 

[SteinUmStein]

25) Doctors then order even more tests and do more biopsies to avoid misdiagnosing the rarest diseases.
26) Pharmaceutical companies and laboratories take advantage of the practice of defensive medicine and encourage doctors to order even more drugs and tests for the patients' safety.
27) Pharmaceutical companies and laboratories make more billions of dollars.
28) There is less money for doctors.
29) Patients go broke.
30) Health care is the next bubble to burst. Be warned.

I really like your summary, I think it's spot-on. I would just hesitate to use the same economic terms and predictions for the health care field that apply to, say, housing or finance. The reason is because people don't stop needing healthcare, and not only that, but with the % of the population that is elderly and/or obese skyrocketing, that bubble is not about to burst anytime soon.

Not that this means good things for doctors, it probably won't positively affect anything for us in the future, but the insurance companies will be just fine. 🙄

 

[TopSecret]

I really like your summary, I think it's spot-on. I would just hesitate to use the same economic terms and predictions for the health care field that apply to, say, housing or finance. The reason is because people don't stop needing healthcare, and not only that, but with the % of the population that is elderly and/or obese skyrocketing, that bubble is not about to burst anytime soon.

Not that this means good things for doctors, it probably won't positively affect anything for us in the future, but the insurance companies will be just fine. 🙄

Maybe.

People thought the same about houses. People don't stop needing houses. It turned out to be a multitrillion dollar miscalculation.

 

[SteinUmStein]

Maybe.

People thought the same about houses. People don't stop needing houses. It turned out to be a multitrillion dollar miscalculation.

I'm not sure the two are really comparable... you can delay the purchase of a house by years and suffer no hardship, which is just long enough for the entire economy to crash on our heads. Triple bypass surgery is not quite as easy to reschedule.

I'm sure you're right about this whole mess coming to really hurt us in the next few years, I'm not questioning that physicians' quality of life is about to take a nosedive whether or not health care reform passes. The question I raise is whether a true economic bubble can burst in a field as essential and constant as health care. There's no question that if it did burst, this country would face a recession many times worse than what we've seen in the last few years.

 

[TopSecret]

I'm not sure the two are really comparable... you can delay the purchase of a house by years and suffer no hardship, which is just long enough for the entire economy to crash on our heads. Triple bypass surgery is not quite as easy to reschedule.

I'm sure you're right about this whole mess coming to really hurt us in the next few years, I'm not questioning that physicians' quality of life is about to take a nosedive whether or not health care reform passes. The question I raise is whether a true economic bubble can burst in a field as essential and constant as health care. There's no question that if it did burst, this country would face a recession many times worse than what we've seen in the last few years.

Kaiser Permanente, the largest HMO in California and one of the best at providing cost-effective care, just lost 36,000 subscribers and so they laid off 1800 employees in California. When the economy takes a huge nosedive, health care will feel the effects too. The health care bubble is already imploding much like the housing bubble imploding in the mid-2000's before really taking its toll beginning in 2007.

 

[TopSecret]

The most cost-effective approach to health care might not even involve doctors.

Things like exercising, dieting and not smoking can be done for free and the CDC researchers have found that those habits reduce the risk of diabetes, heart attacks, strokes and cancer by 80%. Do you need to go to a doctor just to be told these things? No.

http://www.webmd.com/balance/news/20090810/4-healthy-habits-that-cut-disease-risk?src=RSS_PUBLIC

It appears that dieting and exercising everyday can keep the doctor away.

 

[SteinUmStein]

Those quotes by David Lereah are pricless... I would never want to be any sort of analyst who goes on the record, because at any given moment you are probably making yourself look like a tool down the line. 😛

Though healthcare insurance company employees are getting laid off, how could they possibly lay off physicians when there is a worsening shortage happening right now? Or are you saying the bubble can burst without physicians being laid off?

 

[TopSecret]

Those quotes by David Lereah are pricless... I would never want to be any sort of analyst who goes on the record, because at any given moment you are probably making yourself look like a tool down the line. 😛

Though healthcare insurance company employees are getting laid off, how could they possibly lay off physicians when there is a worsening shortage happening right now? Or are you saying the bubble can burst without physicians being laid off?

Physicians are at the top of the food chain but they will see declining reimbursements and longer hours.

 

[SteinUmStein]

The most cost-effective approach to health care might not even involve doctors.

Things like exercising, dieting and not smoking can be done for free and the CDC researchers have found that those habits reduce the risk of diabetes, heart attacks, strokes and cancer by 80%. Do you need to go to a doctor just to be told these things? No.

http://www.webmd.com/balance/news/20090810/4-healthy-habits-that-cut-disease-risk?src=RSS_PUBLIC

It appears that dieting and exercising everyday can keep the doctor away.

I shadowed a neurologist this last week who worked a lot with sleep disorder patients - a lot of sleep apnea from obesity mostly - whose as a neurologist told almost every single patient that their problems would significantly decrease if they lost weight and/or stopped smoking.

 

[bamtuba]

I hereby nominate that this thread be stickied and that all other uninformed, politically motivated, knee-jerk threads on this topic be made off limits unless the topic has something ORIGINAL to add (which will very likely not happen).

👍

Great post TopSecret. Enough said.

 

[TopSecret]

I shadowed a neurologist this last week who worked a lot with sleep disorder patients - a lot of sleep apnea from obesity mostly - whose as a neurologist told almost every single patient that their problems would significantly decrease if they lost weight and/or stopped smoking.

People are addicted to food and overeat.

This is happening in part because the food industry want to increase their profit margins by making portion sizes larger than what they should normally be and by making the nutritional labels deceptive or hidden (e.g., McDonald's nutrition info on the backside of the paper that's on the tray). It also doesn't help that Americans are addicted to TV and the TV tells them to keep eating every 20 or so minutes when the commercials air.

 

[Mace1370]

Great summary, TopSecret. Very well said.

People are addicted to food and overeat.

This is happening in part because the food industry want to increase their profit margins by making portion sizes larger than what they should normally be and by making the nutritional labels deceptive or hidden (e.g., McDonald's nutrition info on the backside of the paper that's on the tray). It also doesn't help that Americans are addicted to TV and the TV tells them to keep eating every 20 or so minutes when the commercials air.

It's also because being fat doesn't have major health repercussions until further down the line. Sadly, most people are short sighted and food tastes good now.

 

[TopSecret]

Great summary, TopSecret. Very well said.



It's also because being fat doesn't have major health repercussions until further down the line. Sadly, most people are short sighted and food tastes good now.

I bet if TV is made black and white again that Americans would eat less. Why? Food that is in black and white is less appealing.

But with widescreen HDTV in all its digital glory, everything looks so juicy and delicious.

 

[Compass]

That cheese looks like a piece of paper...

 

[Exalya]

Well... on the obesity thing... I think food companies need to bear some responsibility. I've seen studies that with the advent of high fructose corn syrup, obesity rates went up alarmingly. I'm not so sure that the obesity thing is 100% lack of willpower, although I believe that does have a lot to do with it. Along with a media obsession with being thin for the beauty aspect as opposed to the health aspect--unhealthy body image and crazy diets only make obesity problems worse, I think.

It's a combination of a lot of problems. In the end it is up to the average citizen... and I have very little faith in the average citizen.

 

[LiveUninhibited]

Given that, why not tax saturated fat and things like that to fund healthcare while removing corn subsidies (corn syrup cheap = bad). People seem to be so opposed to that, but I see it as holding people responsible for eating poorly while encouraging them to eat less poorly.

 

[SteinUmStein]

Given that, why not tax saturated fat and things like that to fund healthcare while removing corn subsidies (corn syrup cheap = bad). People seem to be so opposed to that, but I see it as holding people responsible for eating poorly while encouraging them to eat less poorly.

There will always be cheap corn syrup. If you want to know the (surprisingly complex) reason why corn will always be cheap, I recommend the following books:

http://en.wikipedia.org/wiki/The_Omnivore's_Dilemma

http://www.michaelpollan.com/indefense.php

Also, removing corn subsidies is political suicide in the Midwest, and Iowa has a huge say in presidential politics.

 

[TopSecret]

Well... on the obesity thing... I think food companies need to bear some responsibility. I've seen studies that with the advent of high fructose corn syrup, obesity rates went up alarmingly. I'm not so sure that the obesity thing is 100% lack of willpower, although I believe that does have a lot to do with it. Along with a media obsession with being thin for the beauty aspect as opposed to the health aspect--unhealthy body image and crazy diets only make obesity problems worse, I think.

It's a combination of a lot of problems. In the end it is up to the average citizen... and I have very little faith in the average citizen.

It is indeed up to the average citizen.

The obesity rates, however, started climbing soon after TV began broadcasting in color in the 1970's. Coincidence?

There should be a study to see if vivid images of food have any effect on appetite, caloric intake, and weight gain. Probably. It would make for an interesting student research project, I think.

 

[Ignition]

I completely agree that an unhealthy cultural attitude is a huge factor in rising health costs.

However, how do we encourage people to change their habits? Even after being bombarded with mountains upon mountains of scientific research on the hazards of poor habits such as binge drinking and smoking, a large percentage of the population still feels compelled to engage in such activity.

Is there not enough research? Is it not being distributed in an effective manner? No, rather I think there are two larger issues at play:

1) People don't understand the principles of scientific research. I can't count the number of times I've heard people say "did you see that one report on TV last night about the benefits of blah blah blah". People seem to have preconceived notions on what is healthy and what is not, and are willing to ignore mountains of evidence suggesting something they do is unhealthy/bad as long as they can find a single report citing a finding that shows there might be some remote chance of some beneficial aspect of their activity. In short, people don't appreciate meta-analysis;

2) People like things that make their lives quick/easy. Short-term solutions seem to be favorable over long-term considerations, even if repeated short-term decisions can lead to highly-unfavorable long-term complications. Fast food solves a short-term problem of eating in a short period of time. Smoking (including marijuana) satisfies a short term desire for smoking regardless of the well-documented risks in the long-term. Binge drinking satisfies a short-term desire for participating in a socially-accepted activity, regardless of the risk of alcohol poisoning or the longer-term problem of liver failure.

Hell, even with relatively significant short-term risks of serious injury or death, people are still willing to engage in activity as long as there is some sort of acute payout.

How can this cultural philosophy be changed? Education doesn't seem to work. Legislation doesn't seem to work, at least not to eliminate the activity in its entirety (illegal drugs and prohibition). It seems the only thing that is relatively successful is waiting the unhealthy person has a near-death experience (or witness a family member who has similar unhealthy habits experience a near-death experience), and even then that doesn't stop some (hard drug users for example). So what is left?

Perhaps the solution is to teach appreciation for statistical analysis and meta-analysis in a much more thorough manner, and earlier in education (i.e. high school). Educate the people on how to educate themselves, rather than trying to tell them what to do. Public ignorance with regards to appreciation of research is the real disease that needs to be treated.

 

[TopSecret]

I completely agree that an unhealthy cultural attitude is a huge factor in rising health costs.

However, how do we encourage people to change their habits? Even after being bombarded with mountains upon mountains of scientific research on the hazards of poor habits such as binge drinking and smoking, a large percentage of the population still feels compelled to engage in such activity.

Is there not enough research? Is it not being distributed in an effective manner? No, rather I think there are two larger issues at play:

1) People don't understand the principles of scientific research. I can't count the number of times I've heard people say "did you see that one report on TV last night about the benefits of blah blah blah". People seem to have preconceived notions on what is healthy and what is not, and are willing to ignore mountains of evidence suggesting something they do is unhealthy/bad as long as they can find a single report citing a finding that shows there might be some remote chance of some beneficial aspect of their activity. In short, people don't appreciate meta-analysis;

2) People like things that make their lives quick/easy. Short-term solutions seem to be favorable over long-term considerations, even if repeated short-term decisions can lead to highly-unfavorable long-term complications. Fast food solves a short-term problem of eating in a short period of time. Smoking (including marijuana) satisfies a short term desire for smoking regardless of the well-documented risks in the long-term. Binge drinking satisfies a short-term desire for participating in a socially-accepted activity, regardless of the risk of alcohol poisoning or the longer-term problem of liver failure.

Hell, even with relatively significant short-term risks of serious injury or death, people are still willing to engage in activity as long as there is some sort of acute payout.

How can this cultural philosophy be changed? Education doesn't seem to work. Legislation doesn't seem to work, at least not to eliminate the activity in its entirety (illegal drugs and prohibition). It seems the only thing that is relatively successful is waiting the unhealthy person has a near-death experience (or witness a family member who has similar unhealthy habits experience a near-death experience), and even then that doesn't stop some (hard drug users for example). So what is left?

Massive rolling blackouts to get people off the sofa and walk more?

But seriously, I think the most cost-effective way is to re-educate people on what a normal amount of food is. People unknowingly eat a lot of calorie bombs.

 

[Ignition]

NIH funding for Supersize Me II. 🙂

Still, I think education will unfortunately fall short to the desires of satisfying short-term needs. I would imagine (though I honestly haven't looked for evidence) that most people have an understanding that McDonald's isn't a health food.

 

[TopSecret]

NIH funding for Supersize Me II. 🙂

Still, I think education will unfortunately fall short to the desires of satisfying short-term needs.

If the NIH had a $10 billion budget to take over primetime television with a lot of programming on the horrors of obesity and other tidbits, a lot of people would eat less or turn their TV sets off.

With that kind of money the NIH could produce 50 movies with a budget of $200 million each as part of a massive public awareness campaign. It would be more effective than $10 billion worth of doctor's appointments and labs, especially if the doctor and his staff are themselves pudgy.

 

[elyswim]

So I asked my father to explain this to me and while he said a lot of what you said, topsecret, but he also mentioned how it would work from a business perspective (keep in mind he's very much a republican so this is biased).

He said that what Obama wants to do is create a public option for private insurance, so those that don't have health insurance will have some. Now, unlike private insurance the government has no profit motive so they don't care to regulate nearly as much as private insurance. As such, surgeries that would normally be deemed unnecessary would be occurring frequently or procedures that would normally require a copay from the insurance would be free. This would work for a while...
From the business perspective, my dad said the government insurance would be cheaper, so rather than businesses giving private insurance, everyone would switch to teh government option, at some poitn private insurance companies could no longer compete and they woudl go out of business. Now we have nationalized healthcare.

My dad then mentioned that even this would be fine for a while except that medicare (which I believe what this new plan is based off of) is going to go bankrupt in 7 years, so where is all the money for all these surgeries going to come from? Well things will start getting rationed. My dad mentioned that people who are very old may not get things like hip replacements because the government feels that they will die soon, he equated it to Euthanasia. Also to help manage the increasing costs to the government obama plans to tax the wealthy (docs among them) and at the same time cut down docs salaries.

I'm sure this is very much one-sided but that's what I gleaned from our discussion

 

[AlXguy]

Personally, I think there has to be a public option, which is government run and funded. The govt insurance will likely be affordable to the average person. Insurance companies would never lower their rates if there's not a competition in the market which actually offers affordable health insurance.

 

[TopSecret]

So I asked my father to explain this to me and while he said a lot of what you said, topsecret, but he also mentioned how it would work from a business perspective (keep in mind he's very much a republican so this is biased).

He said that what Obama wants to do is create a public option for private insurance, so those that don't have health insurance will have some. Now, unlike private insurance the government has no profit motive so they don't care to regulate nearly as much as private insurance. As such, surgeries that would normally be deemed unnecessary would be occurring frequently or procedures that would normally require a copay from the insurance would be free. This would work for a while...
From the business perspective, my dad said the government insurance would be cheaper, so rather than businesses giving private insurance, everyone would switch to teh government option, at some poitn private insurance companies could no longer compete and they woudl go out of business. Now we have nationalized healthcare.

My dad then mentioned that even this would be fine for a while except that medicare (which I believe what this new plan is based off of) is going to go bankrupt in 7 years, so where is all the money for all these surgeries going to come from? Well things will start getting rationed. My dad mentioned that people who are very old may not get things like hip replacements because the government feels that they will die soon, he equated it to Euthanasia. Also to help manage the increasing costs to the government obama plans to tax the wealthy (docs among them) and at the same time cut down docs salaries.

Once again, I know this is probably very one sided but this is what I gleaned from the discussion.

Your dad is a very wise man. I agree with his viewpoint.

 

[CoolWhipp]

...4) People want health care and don't want to pay for it....

I love this one. It's funny how many people think health care is just like a walk in the park for people. Free.

 

[Longshanks]

So I asked my father to explain this to me and while he said a lot of what you said, topsecret, but he also mentioned how it would work from a business perspective (keep in mind he's very much a republican so this is biased).

He said that what Obama wants to do is create a public option for private insurance, so those that don't have health insurance will have some. Now, unlike private insurance the government has no profit motive so they don't care to regulate nearly as much as private insurance. As such, surgeries that would normally be deemed unnecessary would be occurring frequently or procedures that would normally require a copay from the insurance would be free. This would work for a while...
From the business perspective, my dad said the government insurance would be cheaper, so rather than businesses giving private insurance, everyone would switch to teh government option, at some poitn private insurance companies could no longer compete and they woudl go out of business. Now we have nationalized healthcare.

My dad then mentioned that even this would be fine for a while except that medicare (which I believe what this new plan is based off of) is going to go bankrupt in 7 years, so where is all the money for all these surgeries going to come from? Well things will start getting rationed. My dad mentioned that people who are very old may not get things like hip replacements because the government feels that they will die soon, he equated it to Euthanasia. Also to help manage the increasing costs to the government obama plans to tax the wealthy (docs among them) and at the same time cut down docs salaries.

I'm sure this is very much one-sided but that's what I gleaned from our discussion

everyone hide the death panels are coming to get us

Other than the euthanasia comment your father gets the picture, except with private insurance going out of business and the government lacking money for this. That slippery slope won't happen. There was a time when private insurance (when the majority of them were still non-profit) payed out 85cents to your dollar into reimbursing health care. Now the non-profits are still around that range, a little lower, but for profit insurance averages around the uppers 70s of how many cents per dollar are put into funding procedures. The insurance lobby is asking the government for the new bill to allow health insurance companies to only pay back 70cents for a dollar. There is another industry in which such a practice is illegal - casinos are not allowed to make with with 30 cents for every dollar (its as low as 22cents in atlantic city).

The public option, like medicare, would be similar to the non-profit private health insurance companies "medical-loss" ratio, in that it will hover around 85cents to the dollar. Why can they fund more for procedures? They aren't paying large overheads for advertising, lobbying, and making pockets full of gold for CEOs. Private insurance companies will not go out of business, as they will most likely still provide broader coverage plans. The only difference here is now through the Health Insurance Exchange, they will actually have to start covering their members, as they'll be forced to compete with the public option. The public option simply helps to inject competition into a market which lacks competition, and the HIE will put everything into an easily accessible place for businesses/individuals to purchase health insurance. It increases individual liberty and provides a fair marketplace for the consumer.

Its easy to compare car or home insurances to one another and purchase them, why not have it be the same for health insurance? Everyone on the road is required to have car insurance, why shouldn't everyone have to get health insurance (and like wise those who are unable to pay for insurance since they are below the poverty level or unemployed, should have public insurance available to them)? We're already paying for the uninsured in our premiums, taxes, and hospital bills. By mandating coverage, individual premiums and hospital bills would go down. Taxes is a whole other mess, but the basic premise would be if your premium goes down $100 and your taxes go up $10 who made out better? The mandate also spreads out risk among a larger population rather than concentrating it, and in the nature of how insurance works, actually increases the funding available, so both private and public insurance alike will be able to pay for more procedures. In the short term will profits be less? Absolutely, but in the long-term those should rise again once the market becomes competitive.

edit: I tried uploading a .ppt summary of the House bill that we went over and discussed at the hospital I work at but the forum won't let me upload it, so if someone wants it just message me and I'll e-mail it.

edit 2: also nationalized health care is when the gov't runs healthcare, and physicians are technically their employees.. that would be the UK. If your father's slippery slope did happen that would be single-payer which is not nationalized, and not a government take over. Physicians and hospitals would still be private institutions (unless they're a public hospital of course).

 

[G1SG2]

Awesome thread, very informative 👍

 

[WaterBird]

2 missing points (unless I missed them)

- Large number of insured patients drives up the cost for everyone. People without health insurance get care in the ER which:
a) Is way more expensive than preventative care or earlier treatment in a clinc
b) is subsidized by the health insurance of people who do have insurance.
So we already have nationalized health care, in a way, it's just crappy and forces people to often take the more expensive hospital option

- Insurance companies are not well regulated and the paperwork is difficult for the average consumer to understand, much less compare plans. So there is little competition in practice since it's hard for people to tell what they are buying. And much of what insurance companies do is deny claims for small-print reasons. A government plan that was easier to understand and actually covered stuff would force insurance plans to start paying for what they claim they cover or go out of business. ****ty companies that are not paying for what they claim they will SHOULD go out of business - don't buy the "all business failure is bad" meme.

 

[SteinUmStein]

2 missing points (unless I missed them)

- Large number of insured patients drives up the cost for everyone. People without health insurance get care in the ER which:
a) Is way more expensive than preventative care or earlier treatment in a clinc
b) is subsidized by the health insurance of people who do have insurance.
So we already have nationalized health care, in a way, it's just crappy and forces people to often take the more expensive hospital option

- Insurance companies are not well regulated and the paperwork is difficult for the average consumer to understand, much less compare plans. So there is little competition in practice since it's hard for people to tell what they are buying. And much of what insurance companies do is deny claims for small-print reasons. A government plan that was easier to understand and actually covered stuff would force insurance plans to start paying for what they claim they cover or go out of business. ****ty companies that are not paying for what they claim they will SHOULD go out of business - don't buy the "all business failure is bad" meme.

👍👍