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September 01, 2009 – Comments (11)

 I warned earlier this year that Americans and the media should pay close attention to the efforts insurers and their ideological buddies would undertake to demonize health care systems around the world that don't allow for-profit insurance companies to have the free reign they have here.

Americans must realize that the when they hear isolated stories of long waiting times to see doctors in Canada and allegations that care in other systems is rationed by government bureaucrats, the insurance industry has written the script.

And Americans must realize that every time they hear we will be heading down the "slippery slope toward socialism" if Congress creates a public insurance option to compete with private insurers, some insurance flack like I used to be wrote that, too.

Every time you hear about the shortcomings of what they call "government-run" health care, remember this: what we have now in this country, and what the insurers are determined to keep in place, is Wall Street-run health care....

...Wendell Potter

11 Comments – Post Your Own

#1) On September 01, 2009 at 9:06 PM, AdirondackFund (< 20) wrote:

That's exactly correct.  Canada and England both love their Health Care Programs. 

A few years back when Oil rocketed to the moon, the Province of Alberta ended up with a Budget Surplus by mistake.  So, they polled The People to find out what they wanted done with the extra money.  There were 3 fundamental choices as to what to do with the extra money.  1.)  Return it to The People.  2.)  Save it for Future Budgets.  3.)  Spend the Surplus on EXPANDED Health Care Coverage, including Dental.  The good people of Alberta decided, by an 80% Poll Result, to spend the 'found money' on expanded Health Care.

Do you think for one minute that The People of Alberta would decide to do this if their Health Care System was of no use to them?  Here in the States, everyone would have voted to have the money returned.  But, thankfully the question never comes up in America, simply because we have never seen a surplus.  It just never happens.  

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#2) On September 01, 2009 at 9:22 PM, truthisntstupid (92.94) wrote:

Even if the anti-reform crowd wins they have a limited time before they lose.  Our companies can't compete.  Healthcare broke the auto industry.  Or so I believe.  Also, all the wealth in this country keeps floating to the top few percent, leaving those at the bottom ever poorer and those at the top ever more wealthy.  And for how long do they think this will go on?  What's to stop it?  Do they think it can continue like that indefinitely?  No.  Eventually the poor would outnumber all other groups so badly that those at the top will feel less and less secure.  If they have any sense, that is.  If this ever were to happen I'll bet there will be no shortage of the same people crying anti-socialist sentiments now that would be demanding more "socialist"  services such as police, etc, then.  But it won't go that far.  Because if it does, the well-to-do will no longer be safe in their own house.   Maybe the next hot career field is law enforcement.  Bet they'll maintain their benefits!   They better keep those dudes happy if they want to continue down the road they're on.

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#3) On September 01, 2009 at 9:23 PM, dbjella (< 20) wrote:

We could have surpluses, but that would require less spending.  That never happens :)

Watch these surpluses in other countries fall.  It is easy to provide for everyone when the money flows like wine.   

 

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#4) On September 01, 2009 at 9:31 PM, starbucks4ever (99.08) wrote:

"Here in the States, everyone would have voted to have the money returned.'

And they would be right. Trusting the Illinois demagogue to create Expanded Health Care that expands anything but the bonuses of HMO execs would be asinine. 

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#5) On September 01, 2009 at 10:05 PM, devoish (97.62) wrote:

zloj,

Seems so. So I don't trust him. I want medicare for all. But McCain was worse.

Seems not so too. I would vote to fund medicare and not starve it financially to death.

On the other hand, I know BS when I hear it (usually). The drug companies don't fund most of the drug research, our tax dollars do. The drug companies spend more on marketing than research.

I know my care is rationed in pages 3 through 96 pages of my health insurance policy, yours is too.

And I know VA care has higher satisfaction rates than public care, and it costs half as much.

And I would love to know how much lower malpractice insurance awards would be if that award did not have to cover a disabled persons healthcare and sustenance for fifty years.

 

 

 

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#6) On September 01, 2009 at 10:12 PM, whereaminow (52.50) wrote:

But McCain was worse.

Ha, I knew there has to be something we agree on!  

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#7) On September 01, 2009 at 10:22 PM, BotsNBits (< 20) wrote:

A couple of ideas..

Tort reform. (I can hear the lawyers screaming now!)

Remove the limits that prevent insurance companies from competing in all states. Get rid of the local monopolies.

BnB

Best quote defining a politician..

"I'm a politician, which means that I'm a liar and a cheat. When I'm not kissing babies, I'm stealing their lollipops."

(Hunt for Red October)

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#8) On September 01, 2009 at 10:56 PM, devoish (97.62) wrote:

Botsnbits,

Tort reform; If you are injured in the USA and unable to do your job as well as as before the injury, you are screwed. You get some help from SSI, but you get paid less. And maybe you have to spend more, forever. Painkillers, physical therapy, dialysis, who knows. Unfortunately you need the jury award for sustenance and healthcare, and it might have to last decades.

Medicare for all, or single payer would solve a lot of that.

Jury awards are less than 1/2 of 1% of healthcare costs. Doctors estimate defensive medicine might add as much as 10% of the healthcare costs. Doctors are paid by insurers for doing tests, and increase their risk by not doing them.

Remove the limits on competing in all States.

No thanks on that idea. Private Insurers are doing enough to make to sure you don't know what you are buying, as is. If company A has a $5k maximum annual out of pocket expense limit because the State they are in mandates it, everyone in that State will lose that limit when company B from "do whatever the hell you want with them" State comes along with hidden out of pocket expenses and no limits and lower premiums. It is a race to the bottom and will cost you more than it saves.

Best quote; Sorry I disagree. Best quote defining a politician is from Franklin Delanor Roosevelt; "Now make me do it".

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#9) On September 02, 2009 at 6:23 AM, hsr0601 (< 20) wrote:

Theme : 6 Main Lies Have Nothing To Do With This Promising Reform /   Without reform, Medicare system doomed.
 
If the findings of CBO over inaction had been released earlier, Ted Kennedy could've seen his lifetime wish come true.
 
Inaction cost, $9trillion over the next decade, can not be compared to the balance between estimate and outcome in a worst case of scenario, and this balance could be adjusted each year.  ((Some of CBO analysis :  While the costs of the financial bailouts and economic stimulus bills are staggering, they are only a fraction of the coming costs from Social Security, Medicare, and Medicaid. Over the next decade, the Congressional Budget Office (CBO) projects that each year Medicaid will expand by 7 percent, Medicare by 6 percent, and Social Security by 5 percent. These programs face a 75-year shortfall of $43 trillion--60 times greater than the gross cost of the $700 billion TARP financial bailout)). Time does not fix endless greed and energy depletion.
 
When the public health is also one of commodity like a house, we come to a tragic and unthinkable conclusion : As to for-profit business, the more and longer ills patients get, the more profits they make, and it will debilitate the overall economy involving education for the future, not to mention continued bankruptcy of middle class.
 
Of young adults ages 19 to 29, 13.2 million, or 29 percent, lacked coverage in 2007, and that implies the total of this promising reform will be cheaper than expected, I guess.
 
In case of an unexpected injury or ill, they might give up their learning or aspiration, in this regard, this reform means liberty, job opportunity, competitiveness for them and future.
 
 
1. The contents of savings (below) in this reform 'have nothing to do with' limit to medical access, rationing, tax raise, and deficit etc.
 
Rather, without wiping out these wastes and roots of bankruptcy for middle class, all fronts are sure to face larger financial ruin than this recession, which leads to more limit to medical access, more rationing,  more tax raise, and more deficit etc than today.
 
$1.042trillion (cost of reform) + $245bn (cost to reflect annual pay raise of docs) = $1.287bn (actual cost of reform).
 
$583bn (the revenue package) + $80bn (so-called doughnut hole) + $155bn (savings from hospitals) + $167bn (ending the unnecessary subsidies for insurers) + 129bn(mandate-related fine based on shared responsibility)  + $277bn (ending medical fraud, a minimum of 3% , the combined Medicare and Medicaid cost of $923.5bn per year, as of July,) = $1.391trillion + the reduced cost of  ER visits (Medicare covers some 40% of the total) + the tax code on the wealthiest  more reduced than originally proposed = why not ? (except for a magic pill, an outcome-based payment reform & IT effects and so forth).
 
As lawmakers debate how to pay for an overhaul of the nation's health care system, a new report from The Commonwealth Fund claims that including both private and public insurance choices in a new insurance exchange would save the United States as much as $265 billion in administrative costs from 2010 to 2020.

"Health reform can help pay for itself, but both private and public insurance choices are critically important," said Commonwealth Fund President Karen Davis, who coauthored the new report. "A public insurance plan can help drive new efficiencies in the system that will produce large cost reductions. Without a public plan, much of those potential savings will be lost."
 
Unlike high fuel price and mortgage rate in recent years as the roots of great recession and bankruptcy of middle class,  the severity in the high cost of health premiums has come to light lately. Similarly, in an attempt to hide these deficit-driven corruptions and wastes, the greed allies struggle to turn the savings via removing these wastes into limit to medical access, rationing, tax raise, and deficit etc.
 
In contrast, not to mention a wide range of consumer protection, options across state lines, this promising reform takes initiatives in more primary care docs and improved long-term care. And the bill expands coverage for mental health services, and defines what will be covered.  It also prohibits co-payment charges for wellness and preventive medical care. There is no mention of rationing. The use of this term is, again, a gratuitous distraction aimed at feeding fear
 
2. Greedy insurers with no competitors by consolidation have nothing to do with the law of price, demand & supply.
 
Under the free market theory and the premise that the public health is also one of commodity like a house, if the demand decreases on a large scale, accordingly the price tends to reflect it, as in the case of house price, and it never happens for the price to spiral up. One step forward, in case the price is spiraling up, to be sure, the remaining clients should withdraw the contract or choose the other options. In practice, runaway premiums with no competitors by consolidation drive the enrollees out,  and 4C + 2R (canceling, capping, cherry-picking, cash for special lobby, rationing, rapid premium hike) guarantee multiple times as much profit. Sadly, no way-out other than the prohibitive ER is allowed in America. Therefore, the victims today and tomorrow deserve long overdue protection from non-profit Government.
 
3.  The plans to stem inflation in the House have nothing to do with crowd-out.
With the heartbreaking tears in mind (In no other industrialized country do 20,000 people die each year because they can’t afford to see doctor. Nearly 11 Million Cancer Patients Without Health Insurance), private market also needs changes and should join together to complete this reform , as promised, otherwise, the runaway premium only has itself to blame while new firms are filling the void with competitive deals.
And It can be said that fair competition starts with a fair, sustainable market value.

However, the plan in the House is designed to keep people in an employer-based health insurance system, and the public option would be offered to those for whom employer-provided insurance is not available. And job-based coverage (indirect payment), some mandate code, ample capital, the reduced exorbitant ER costs, IT base to streamline the administrative processes and trim the costs might be favorable to the private market. Over time, supposedly, the public plan will concentrate more on basic, primary cares, and the private insurers will provide their clients with differentiated services. And focus should be on the uninsured, the underinsured.

-- Except For The Underinsured, The Uninsured Alone Outnumber The Entire Population In Canada --

In an attempt to avert innovation, moderation, and social responsibility, accusing essential affordability, citing take-over, will be a dirty play.

4.  Profit-driven markets have nothing to do with affordable, sustainable public health.
 
When the public health is also one of commodity like a house, we come to a tragic and unthinkable conclusion :  As to for-profit business, the more and longer ill patients get, the more profits they make, and it will debilitate the overall economy involving education for the future (Of young adults ages 19 to 29, 13.2 million, or 29 percent, lacked coverage in 2007).  
 
Under the most wasteful structure on the planet like no coordinated preventive care program waiting until people get ill, about 50% of idle world's best practices, a pay for each and every service reimbursement and frequent readmissions, no e-medical record and deaths, crushing litigations and the more profits via the unnecessary, risk-carrying procedures, and the most inefficient paper billing systems imaginable, overpriced pharmaceuticals, bloated insurance companies, incredible medial fraud, exorbitant costs by the tragic ER visits etc, it might be no wonder with the comprehensive, systematic reform in the pipeline, just one attitude of patient-oriented value in 10 regions has attained 16% of savings in Medicare while their quality scores are well above average.
 
Aside from the already allocated $583 billion and the savings of this reform package, 16% of $923.5bn (the combined Medicare and Medicaid cost per year, as of July) is around  $147.76bn per year and 1.4776trillion over the next decade, and this patient-oriented value alone could be enough to meet the goal. 
 
Please be 'sure' to visit http://www.nytimes.com/2009/08/13/opinion/13gawande.html?hp  for credible evidences !
 
Today, another innovative, fundamental change in payment system, or patient's outcome based payment reform that is able to turn the profit-oriented malpractices and volume into the patient-oriented value and quality is waiting for a final decision.
 
Now that Minnesota spends "20 percent" less per patient than the national average and 31 percent less than in the highest cost state, under a pay for patient's outcome pack, this promising reform could be successful along the way, I believe.

Aside from the already allocated $583 billion and the savings of this reform package, "20%" of $923.5bn (the combined Medicare and Medicaid cost per year, as of July) is around  $184.7bn per year and 1.847trillion over the next decade, and this patient-oriented value alone could be sufficient to meet the goal. 
 
 
5.  Inflation-driven greedy allies backed by the insurers have nothing to do with deficit-neutral.
 
When some part of our body is ailing seriously, we are going to lose competitiveness, equally, when some part of a nation is ailing servery, it is going to loose competitiveness, too. In case somebody in the house gets ill, health will be put over house, in practice.


6.  The analyses of CBO have nothing to do with common sense and practice.
 
Costs of Preventable Chronic Disease account for around 75% of the nation’s $2.4 trillion medical care costs. U.S. health care spending  is also expected to double in the next 10 years.  and they are largely preventable -- 80 percent of the risk factors are behavior-related.
 
Unlike the analyses of CBO, world-wide outstanding public programs put heavier emphasis on preventive program equally, and preventable swine flu pandemic is expected to cost about $2trillion dollars world-wide for the lack of prepared vaccines. (Genes included in the new swine flu  have been circulating undetected in pigs for at least a decade, according to a team led by Rebecca Garten of the federal Centers for Disease Control and Prevention who have sequenced the genomes of more than 50 samples of the virus).
 
If CBO asks the profit-driven interests about why they have hindered the budget request for preventive program in Medicare and Medicaid,  they will say, " just look at the health Katrina special lobbying has made, the more and longer ills, the more profits, we are professional, and we are obstructing this reform right now, too " .
 
7.  Conclusion : The public health is a fundamental human right.
 
As I said above, patient-oriented value alone could be enough to meet the goal, and another innovative, fundamental change in payment system, or patient's outcome based payment reform that is able to turn the profit-oriented malpractices and volume into the patient-oriented value and quality is waiting for a final decision.
 
If At least, some media pay attention to this flower of reform, people will feel empty as the past and current discussion has been time-consuming for sure.


 Thank You !


 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

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#10) On September 02, 2009 at 11:38 AM, davejh23 (< 20) wrote:

"Jury awards are less than 1/2 of 1% of healthcare costs."

I know an anesthesiologist who pays over $150K/year for malpractice insurance.  When a third of your income goes to malpractice insurance, that's a big problem.  I would say that this is directly related to these jury awards, so one might argue that jury awards are 33% of healthcare costs.

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#11) On September 02, 2009 at 6:51 PM, Alex1963 (28.73) wrote:

 davejh23

Hmm so am I hearing you argue that since the insurance premium is high therefore it must be because they are paying out? I don't think so. Again a major issue is monopolies.

There is misinformation that there ar 1500-1800 insurance companies in the U.S. There aren't, there are a few dozen that control the lion's share of the market. They have 100's of subsidiaries. Many states only have 2-3 insurers particularly in rural markets. This isn't really choice or a "free market" IMHO 

I would like to explore the conservative ideas of tort reform and letting insurers cross state lines as long as there are federal reasonable guidelines to level out the playing field across states, courts etc. But I'd like to see a little more good faith negotiating and a little less hysterics from the anti-"Obama care" cadre.

However the fact that these ideas are pushed by folks so seemingly against meaningful change makes me suspicious :)

Best

Alex 

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