Health Care.

[BraveDave]

From Kerry's speech:
We believe in the family value expressed in one of the oldest Commandments: "Honor thy father and thy mother." As President, I will not privatize Social Security. I will not cut benefits. And together, we will make sure that senior citizens never have to cut their pills in half because they can't afford life-saving medicine

What about the people that aren't senior citizens that do the same thing and are expected to carry the burden?

[wurzel]

1. We are at war.

Health care should be part of our defense budget.

[BraveDave]

3. I'm missing your point.

I was referring to middle aged folks subdividing medicine for themselves or their children.

Please explain.

[BraveDave]

5. You're kidding right?

Major surgery and or/chemo can be more expensive than insulin and blood testing supplies over a lifetime.

[wurzel]

7. If we are at war shouldn't health care be part of national defense?

For everyone? Our current system is a national disgrace. Now we should be demanding health care as part of our national defense against terrorism. Make Bush face the logic of his arguments. How are we going to cope with all those victims of MWDs Bush keeps telling us about? Shouldn't we be building hospitals and clinics right now FOR EVERYONE if the threat is real? This business of "these people" are covered, but "these people" are not" is outrageous. Are hospitals going to check HMO coverage during an attack? A simple question no one has asked. The only answer is the one the Germans put in over a hundred years ago. National health care. Just like our politicians have.

[Warpy]

2. kerry's ideas aren't going to work

and I think he'll be retooling them pretty quickly. After all, taking care of large bills for surgery and chemo is the one thing insurance companies do fairly well; it's insuring people with chronic illnesses controlled by medications that they don't do at all, if they can avoid it.

We need universal health insurance, and I mean universal, no exceptions, no optouts, no private pay. The system we have now is broken beyond repair, and no amount of tinkering and bandaids will salvage it.

[sandnsea]

6. Your idea = nothing

It won't pass and it doesn't matter how many times somebody repeats it, it still won't pass.

If the government takes catastrophic cases out of the health insurance pool, then there's no excuse for them to not cover chronic and preventive illness now is there. In order for a company to get the catastrophic benefit, they have to implement a wellness program that focuses on those chronic illnesses so people are following the doctors orders so their cases don't grow into catastrophic care. That means the company itself will look for insurance that does cover chronic illnesses well because it's part of their requirement to get the benefit. They also have to pass the savings on to their employees which will make keeping employees easier and remove alot of the labor costs and incentives for employers to go overseas.

Getting everybody covered through the federal health plan, children covered through a separate federal program, will go a long way in getting people used to the idea of centralized health care. From there, it's one step to single payer. We have to make these goofy steps because, in this country, it's the only way to get there.

Besides, France, which has the best health system in the world, is a mixture of public and private health programs. About 50% of the people get their cancer treatments and surgeries through private hospitals. I think if people understood more about how health programs work in other countries, they wouldn't be so quick to slaughter this plan.

And NOBODY is offering free health care. I know you didn't say that, but it drives me nuts when people do. If a family of 4 made $50,000 a year, an 8% tax would be $320 a month and that's more than alot of people pay with their current employer-provided plan. It's less than alot of people pay too, but still, it's not free.

[sandnsea]

4. That's all he said?

Didn't talk about any other part of his health care plan? Just asking.

[BraveDave]

8. I'm talking about the portion that pertains to me.

[sandnsea]

9. Are you a senior?

If not, that's obviously not the portion that pertains to you.

[Caromill]

10. I can relate to what you're saying.

My husband and I aren't seniors, and we pay $1,131 a month for our health insurance premiums, for an HMO. We have a small business where he and I are the only employees and that's the cheapest coverage we can get. We do have a pretty good prescription plan, but the premiums are KILLING us. I am still waiting to see someone come up with a proposal for a health care plan that will help us -- people who do have health insurance, but whose premiums are so high that we wonder every month where the money will come from to pay them. Don't get me wrong, I think the Dems and Kerry are a better bet to get something done than the Republicans, but I'd like to hear something, someday, about helping people like us.

[Feanorcurufinwe]

18. You need to read Kerry's plan.

It is indeed designed to lower your premiums.

Controlling The Spiraling Costs Of Health Care

Health insurance has become too expensive. Double-digit increases in health care premiums make it hard for Americans and businesses alike to afford health care. Companies that do the right thing by providing good health insurance for their workers are getting squeezed by rising costs. As a result, more companies are asking workers to contribute a greater share of their health care costs through higher premiums and increased cost sharing - and even sometimes reducing their benefits to keep costs down. Skyrocketing costs have also wreaked havoc on state budgets, putting pressure on state health care programs at a time when job losses leave more Americans needing coverage protections.

Some increases in cost are due to advances in health care. However, too many of these rising costs are driven by waste, fraud, and abuse in the system; loopholes that keep prescription drug prices too high; meritless lawsuits; medical errors that undermine quality health care and raise costs; and too much bureaucracy and paperwork that contributes to approximately 25 percent of health care costs today. Many employers and purchasers have worked to make improvements, and their efforts demonstrate that progress is possible. But we need a national commitment to assure system-wide changes that can improve quality and reduce costs and keep health care from becoming too expensive.

John Kerry believes that all parts of the health care system - insurers, providers, lawyers, employers and patients -- have a responsibility to help make the health care system more affordable. John Kerry has a five-point plan that will save Americans, purchasers and the Federal government billions in health care costs every year.

Creating A New Approach To Control Spiraling Health Care Costs - And Passing The Savings On To Workers

Because catastrophic costs are both high and unpredictable, they raise the cost of health insurance for all people. John Kerry believes that cost of the sickest Americans should be shared - not just by people paying for private insurance but by the government. He proposes to create a "premium rebate" pool that will make health care more affordable for employers and employees by helping out with certain high cost health cases. Under this proposal, the pool would reimburse private and public employer and group health insurance plans that meet certain qualifications for a portion of catastrophic costs. "Catastrophic costs" would be defined as the annual claims for an individual that exceed a certain threshold. This catastrophic threshold would be set so that the average estimated savings would be approximately 10 percent for qualifying plans nationwide, which is estimated at 75 percent of the costs in excess of an approximate $50,000 threshold in 2013 (and about $30,000 in 2006). The resulting savings would decrease family premiums by up to $1,000 annually. In addition to lowering costs, the rebate will make premium increases more stable over time. To qualify for this "premium rebate" pool, employers and insurers will have to:

* Provide Health Coverage to Their Workers. Many companies work to provide quality coverage to all their workers. However, some companies have stringent rules that prevent some workers from obtaining affordable health care. To receive the premium rebate, employers would have to provide insurance coverage to their employees.

* Adopt Disease Management and Care Coordination Programs to Improve Quality and Lower Costs. Innovative programs targeting patients with chronic conditions have illustrated that both the human and cost consequences of chronic diseases can be alleviated through hands-on medical management. Employers and their insurers must adopt model programs to receive the premium rebate.

* Share Savings with Workers. By substantially reducing catastrophic costs, John Kerry's proposal will make it easier for employers to offer affordable coverage. Firms will be able to provide higher wages, maintain benefits, and make investments that help employers and workers alike. Health economists predict that these savings will automatically be passed onto workers in the form of higher wages and/or other forms of compensation. If employees do not share in the savings, the Secretary of Health and Human Services and the Secretary of Labor would develop policy options to ensure that employers do share these savings with workers.
MORE: http://www.johnkerry.com/issues/health_care/health_care.html

[Princess Turandot]

11. I think the single biggest obstacle ..

to universal health care in the US right now are the private insurance companies. The US could establish a healthcare program controlled by the federal government, from which companies would buy insurance for their employees just like they do now, and which would provide for insurance via tax revenues for the remaining people who are employed but cannot buy insurance, which while available,is incredibly expensive.

Establishing a federal system would substantially reduce the amount of money made by the insurance companies, even if some continue to provide private insurance to those who want it. While there would be administrative costs to consider, they would not include high executive salaries and shareholder profits. My personal belief is that no one wants to take them on, or are afraid of what such changes would do to the financial markets. Even the proposed Clinton plan of establishing various buying groups to negotiate discounts on services, while presented as a way of reducing health care costs, never took the insurance companies out of the middle.


"Controls" on healthcare spending generally are passed along directly to the service providers, rather than decreasing insurance company profits. People who think those controls just reduce the salaries of highly paid physicians (leaving out of the debate of why they should not be among the highest paid of professions) should consider that after an accident, they may wind up in a hospital whose 7 year old CAT Scan machine is patched together with bubble gum and wires, and may just fail the night they need a scan, because the hospital may have contracts with insurance companies that provided for no rate increases over a three year period.

[eridani]

13. BINGO!!!!

Private health insurance is antithetical to the very purpose of insurance, which is to spread risk. They profit by deliberately excluding the sick or those at risk for sickness from their risk pools. They are like hypothetical fire departments who agree to put out fires, except they won't cover census tracts which have a statistically greater likelihood of having fires.

[Feanorcurufinwe]

14. I agree. I don't want health insurance, I want affordable health care.

However, as a practical matter, I support Kerry's health plan because it does seem to me that it will result in health care for more people at a lower price, than today, even though I don't think it will personally benefit me in any way.

[eridani]

16. That is most assuredly not the case

Kerry's plan retains private insurance. These folks don't mind insuring healthy risk pools like congresscritters (or for that matter employed people in general). They will mind a whole lot if the government insists that they contaminate the precious bodily fluids of their pristine comparatively healthy risk pools with actual sick people. They will therefore jack up their prices and/or refuse to play. You might get more health care for people, but it will damned well not be at a lower price.

[Feanorcurufinwe]

17. Your analysis doesn't seem to actually be based on Kerry's plan.

You can find the details here: http://www.johnkerry.com/issues/health_care/health_care.html

[eridani]

19. Straight from the URL--

According to independent analysis by Emory University professor Ken Thorpe, the plan would cost $653 billion over 10 years and would provide health care coverage to nearly 27 million Americans who were previously uninsured, while making health care more affordable for millions of others.

There are more than 44 million uninsured. That means he has just told 7 million people to fuck off and die.

Bottom line--his plan is a subsidy to private insurance, which is by definition legalized theft, and it still won't cover everybody.

The Kerry plan will provide uninsured individuals protection from unaffordable premiums by providing assistance with costs above six percent of their income.

Note that 'assistance' is not defined. People with big bills are still screwed unless most of the costs are reimbursed.

Preserving employer-based insurance just continues our present disaster. The fire department doesn't ask where you work if they come to your house to put out a fire. Why should a heart attack be treated differently?

Get rid of private insurance premiums and devote the money to actual care of the sick, and the need for more money disappears. WE ARE ALREADY PAYING FOR UNIVERSAL HEALTH CARE--WE JUST AREN'T GETTING IT.

[Feanorcurufinwe]

20. Your rhetoric is dishonest.

That means he has just told 7 million people to fuck off and die.

Since you seem to believe that just making things up and putting them in someone else's mouth is a valid debate tactic, I will respond to you using the same tactic:


Your post means you just told 200 million people to fuck off and die.


:eyes:

[eridani]

22. Missing the point

Single payer health care will cover everybody. There is no conceivable excuse for leaving out 7 million. None whatsoever. If Taiwan can have single payer, we damn well should be able to.

That said, Kerry is a lot more pushable on the subject than Bush.

[Feanorcurufinwe]

23. Your rhetoric is dishonest, which invalidates everything you say.

Since you are not discussing the issue in good faith, you might as well be blowing an airhorn.

[eridani]

24. So, does Kerry favor UNIVERSAL health care, or not?

And since we are paying for it anyway, why not?

[Feanorcurufinwe]

25. Your rhetoric continues to be dishonest.

I don't want to go around in circles with someone who is not discussing the issue in good faith. See post #14.

[eridani]

26. I saw post #14, and agree with half

I think that Kerry will cover more people, but that it will be at an atrociously high cost because he won't take the private insurance bull by the hors.

[Feanorcurufinwe]

27. I understand that your premise is Universal Health Care or nothing

but that seems to me like it should be the conclusion of an argument, not the premise. And I share that as a goal -- as does Kerry. However, as a practical matter, saying Univeral Health Care now, or nothing, is the same as saying, nothing.

Since I detect a more engaging tone in your last post, I will attempt to draw you into a discussion of the specifics, in particular, this particular cost-cutting component of Kerry's plan:

Because catastrophic costs are both high and unpredictable, they raise the cost of health insurance for all people. John Kerry believes that cost of the sickest Americans should be shared - not just by people paying for private insurance but by the government. He proposes to create a "premium rebate" pool that will make health care more affordable for employers and employees by helping out with certain high cost health cases. Under this proposal, the pool would reimburse private and public employer and group health insurance plans that meet certain qualifications for a portion of catastrophic costs. "Catastrophic costs" would be defined as the annual claims for an individual that exceed a certain threshold. This catastrophic threshold would be set so that the average estimated savings would be approximately 10 percent for qualifying plans nationwide, which is estimated at 75 percent of the costs in excess of an approximate $50,000 threshold in 2013 (and about $30,000 in 2006). The resulting savings would decrease family premiums by up to $1,000 annually. In addition to lowering costs, the rebate will make premium increases more stable over time. http://www.johnkerry.com/issues/health_care/health_care.html

To me, this sounds like a workable proposal that actually will cut people's costs -- comment?

[eridani]

30. The following is the nub of the matter

Because catastrophic costs are both high and unpredictable, they raise the cost of health insurance for all people.

This slides right over the fact that these costs account for the lion's share of health care expenses. In every age demographic, 15% of the people account for 80% of the costs. Your odds of getting expensively sick are higher than having your house burn, but the same logic that applies to fire department economics applies to health care economics. We long ago figured out that it was seriously stupid to impose the cost of maintaining fire departments on only those people who have fires.

The above plan just says "OK, let the comparatively healthy 85% keep shovelling money into the pockets of private insurance CEOS and getting mostly nothing back, and the government can take over paying for more of the care of the 15% of really sick people, but only if they've blown $50,000 first, assuming they have that much in the first place.

The plan is a complicated expensive mess that will wind up covering more people, but at considerably higher overall cost. It will cut costs for people who don't get seriously sick and leave the seriously sick as screwed as ever. Universal health care means that instead of taking money from healthy people and wasting it on profit and overheard for insurance companies, you take money from healthy people and use all but 3% or so to pay for the care of sick people.

If your house doesn't burn, you still pay property taxes to support the fire department. We have found it far cheaper to just send out the trucks whenever there is a fire than to waste money on trying to figure out which census tracts will have more fires and fussing with adjusting taxes accordingly. Our federal budget is extremely cash-strapped, and universal health care is just plain cheaper, period.

I can certainly understand that Kerry doesn't want insurers putting huge amounts of money into Shrubbie's campaign fund to prevent him from implementing universal health care, so I'm willing to overlook the timidity of his approach during this campaign. That tolerance ends when we actually get him in there.

[Feanorcurufinwe]

32. Incredible obtuseness

'Because catastrophic costs are both high and unpredictable, they raise the cost of health insurance for all people.'

This slides right over the fact that these costs account for the lion's share of health care expenses

Actually, no, that's the whole point!


This conversation is not worth pursuing.

[eridani]

33. The point is that the money to take care of sick people--

--comes ultimately from the much larger majority of healthy people. Cutting them out of the loop is like giving people who don't have fires property tax rebates.

[depakid]

12. A real life example

This was posted today on a message board from a group that I'm involved with. It's very typical of the dilemmas that people find themselves in under the American health care system. I've seen thousands of these in the past couple of years:

"My son has recently been diagnosed as having "manic bipolar". He has been confined two times at local mental hospital facilities as directed by his psychiatrist. Now having to take some very expensive medicines (can't recall names) which his insurance paid for initially. His wife has a very menial job and cannot afford the medicines for my son. We too (parents) are very low on the income ladder. He now has lost his job and has zero insurance. My question is this: What happens when he can no longer buy and use the prescribed medications? Is there any other possible source that he could go to and get financial help for the medicines he needs? Obviously, if he can't afford the drugs, he cannot take them, and if he don't take them, it's seems to be a one-way street to self destruction. Can anyone give me any ideas here. Your help would certainly be appreciated by both me and my son. He is now (30) years old. Thanks again."

[Kanary]

15. At the risk of sounding hard-hearted, people like this

are going to have to stop looking to others to come up with "ideas".

Just think...... if all these people with bad medical situations would COME TOGETHER and start pressing the government HARD for solutions, something would happen. Yet, they can't seem to get beyond that barrier of collectively working for improvements. They want an individual solution, and that isn't going to happen.

I'm also willing to bet that a lot of these people vote RW. It's amazing the lack of ability to connect dots.

When we're all really hurting enough to push us to pressure to kick out the insurance companies, then we'll start getting what we all need.

Kanary

[DaveinMD]

21. Kerry

has a health care plan that would cover a great many of the uninsured and lower the cost for those that have health care. Its a good plan and will get more play as the campaign rolls on.

[Princess Turandot]

28. An anecdote of something I actually experienced vis a vis insurance

companies. I happen to have worked in the health care finance area, on the provider side. For years, NY State set hospital payment rates for all payers except Medicare. The rates were based on cost information submitted by the hospitals each year. HMO's & Blue Cross, which was a non-profit insurance company at the time, were afforded a rate which was purely cost based, because they would enroll anyone who applied and could pay the premiums. Medicaid paid a similar cost based rate. Other private insurance companies were paid 113% of the Blue Cross rate, and self-pay patients paid 120% of the insurance rate. (I'm not endorsing that, but the theory was that if you opted to not pay for insurance, if you were not poor enough for Medicaid, you should pay more because you didn't pay monthly premiums as other individuals did.) The methodology details changed over time but were basically close to what I described above.

In the late 1990's, NYS decided to allow insurance companies to negotiate payment rates, because of the hoopla of how much managed care would keep down the cost of health care. In the case of one of these HMO's, we not only had a fair number of patients insured by them, but we also offered their coverage to employees along with a few other options. (Not that many of our employees used them however.) When discounting became legal, they demanded and got a 25% discount from what they were previously paying, which was actually substantially lower than the COST-based rate they had been paying. A few months later, when they sent us a proposal for their charge to us to insure any of our employees who chose them, their premiums for us to pay went UP by more than 10%. That 35% spread did not provide anyone with better healthcare; it bought them new offices and higher executive salaries.

Ironically, right now in NYS, hospitals who have a lot of medicaid & medicare patients are actually the most stable (unless they have a huge donor base and endowments), because those 2 government based programs make a stab at paying a reasonable rate.

[cyclezealot]

29. Don't get uptight, we are going to vote Kerry.

But how many more decades do we have to live with people suffering, those insured doing a half A$$ attempt to pay for the uninsured by having to pay $1 for a band aid...( ie- Cost shifting.)
Anyone read about the unemployed woman in Utah, where the insurance company would not finish a brain surgery and kept the woman's skull in the refrigerator until she paid her bill..Incredible.
The future threat of me being without health insurance as I have in the past. having to wait until 65 and work a job you can't stand to have coverage. Even when your employer demands to get rid of older workers..
Wake up Americans...The AMA and US Steel Corp. has endorse single payer...The only one wanting this is the insurance companies that are fleecing you...Kerry is a coward to take them on..(Insurance companies.) all Kerry's plan will do is increase the cost of Health Care in relation to the GDP and still not cover a goodly percentage of Americans.

[Andromeda]

31. When we get national healthcare,

everybody will be entitled to the medical care and medication they need.

This means everybody. Men, women, children, seniors and any other human being that might fall into another category.