The New Healthcare Bill

[rigney]

Since I seem to stay confused on many issues as a conservative leaning right winger, would someone either from the left or right please explain this link to me. I realize it seems to be a biased spin on a troubling situation, but is it? At the end there is some great satire with Bill Maher and others. But actually, I was more interested in the bill.

http://www.youtube.com/watch_popup?v=HcBaSP31Be8&vg=medium

Edited July 25, 2012 by rigney

[CaptainPanic]

The page cannot be found (the movie works, but at the end of that movie, they give a link which fails)

First thing to do would be to check the texts quoted in that movie to the actual text, but I get a 404 Not Found when I try the address that the movie mentions at the end. The only source quoted does not work.

 

I then quickly went online, searched for things like "government healthcare plan" (which is what the movie calls it), and similar searches, and found several official documents (large .pdfs) that could be the right one... but none of them contained the quoted texts.

 

So... I dunno. Is any of this true at all? Does any of this make sense without the context in which it is placed in the real document?

My first impression is that this is overly dramatized. Stupid music sounds like someone just died... so that doesn't make me think that the message is completely objective either.

 

[edit] Then again, I am a soclialist Dutchman - what do I know of healthcare plans...

[rigney]

The page cannot be found (the movie works, but at the end of that movie, they give a link which fails)

First thing to do would be to check the texts quoted in that movie to the actual text, but I get a 404 Not Found when I try the address that the movie mentions at the end. The only source quoted does not work.

 

I then quickly went online, searched for things like "government healthcare plan" (which is what the movie calls it), and similar searches, and found several official documents (large .pdfs) that could be the right one... but none of them contained the quoted texts.

 

So... I dunno. Is any of this true at all? Does any of this make sense without the context in which it is placed in the real document?

My first impression is that this is overly dramatized. Stupid music sounds like someone just died... so that doesn't make me think that the message is completely objective either.

 

[edit] Then again, I am a soclialist Dutchman - what do I know of healthcare plans...

Thanks for your trouble. And since I don't have the computer knowledge to get it done, maybe someone else will give it a try.

But i did some scramble search after your response and came up with this.

http://www.factcheck.org/2009/08/twenty-six-lies-about-hr-3200/

Also this. Is there any truth in politics, other than what it takes to win? Damn!

http://factcheck.org/2012/06/obamas-outsourcer-overreach/#.T-4NAA6FXJU.twitter

Edited July 25, 2012 by rigney

[Phi for All]

Since I seem to stay confused on many issues as a conservative leaning right winger, would someone either from the left or right please explain this link to me. I realize it seems to be a biased spin on a troubling situation, but is it? At the end there is some great satire with Bill Maher and others. But actually, I was more interested in the bill.

http://www.youtube.c...31Be8&vg=medium

It's pretty much all outright lies. Here is a link to FactCheck.org listing many of the lies and what the bill really says.

 

For instance, the video claims page 29 says there will be a $5000 limit on yearly individual healthcare ($10k for a family). The truth is that the $5k/$10k limit is a cap on what you'll pay out of pocket if you have the basic package. HUGE difference, right? They take a very good thing and make it sound horrible, and so many people don't check facts like these.

 

Wizard's First Rule: People can be made to believe any lie because they want to believe it's true, or because they're afraid that it's true. (Terry Goodkind)

 

Let me also add, rigney, that although you take a lot of flack around here for some of the things you post, I have to applaud the fact that you're here at all, trying to get differing perspectives. You've got the balls to stick your neck out there and I wish more people on every side would stop only listening to thoe who share their perspective. +1 for you.

 

Edit: crossposted with you, good find, great minds and all....

Edited July 25, 2012 by Phi for All
crossposted

[rigney]

It's pretty much all outright lies. Here is a link to FactCheck.org listing many of the lies and what the bill really says.

 

For instance, the video claims page 29 says there will be a $5000 limit on yearly individual healthcare ($10k for a family). The truth is that the $5k/$10k limit is a cap on what you'll pay out of pocket if you have the basic package. HUGE difference, right? They take a very good thing and make it sound horrible, and so many people don't check facts like these.

 

Wizard's First Rule: People can be made to believe any lie because they want to believe it's true, or because they're afraid that it's true. (Terry Goodkind)

 

Let me also add, rigney, that although you take a lot of flack around here for some of the things you post, I have to applaud the fact that you're here at all, trying to get differing perspectives. You've got the balls to stick your neck out there and I wish more people on every side would stop only listening to thoe who share their perspective. +1 for you.

 

Edit: crossposted with you, good find, great minds and all....

Yes, most times I bite off more than I can chew. In this instance all I can say is: Thanks! Edited July 25, 2012 by rigney

[Phi for All]

To me, it boils down to this: Modern medicine is not a good fit for a for-profit business model. We want cures, the business model requires recurring charges. Actually cure a patient, you lose a customer. Not good business.

 

There's no simple fixes for that, though, unless you take the profit motive away and create some sort of "Caregiver Class" that gets special privileges instead of superior wages and I'm not sure I want to pave THAT road anytime soon. Pharma is an even bigger fustercluck. As long as profit is the key motivator, Pharma is going to work harder on maintaining erections than they are on curing lucrative diseases like diabetes.

 

I'm not even sure I like H.R 3200, but it's a step in the right direction. The simplest fix, which is also the easiest, is to provide a government risk-pool for health insurance. Health is not like a car or a house or even a life where the value can be assessed and agreed upon by both parties. We can't put a value on what we don't know will happen. Without the profit motive, the draconian contortions and the slow payments to the actual providers, health insurance would cost less and be more accepted by the medical profession. The only political stumbling block is basically doing away with a whole private sector market, but I say screw 'em. Health insurers have been screwing the public ever since Nixon approved the whole managed healthcare scam.

 

So of course, with the kind of money and consequences involved, outright lies are necessary from those who stand to lose their fortunes. I guess you should ask yourself this, if enough experiments showed that an inexpensive shot of capsaicin administered directly into the pancreas would instantly allow the organ to start producing insulin again, do you think the procedures should begin immediately to cure diabetics, or do you think all those businesses that make a profit from artificially providing insulin and blood sugar testing equipment should be given a few years to adjust to the end of their market?

[Greg H.]

To me, it boils down to this: Modern medicine is not a good fit for a for-profit business model. We want cures, the business model requires recurring charges. Actually cure a patient, you lose a customer. Not good business.

 

For profit privatized health insurance is a conflict of interest is ever I saw one. Their goal is not to make you healthy, it's to make a profit for their shareholders.

[Phi for All]

For profit privatized health insurance is a conflict of interest is ever I saw one. Their goal is not to make you healthy, it's to make a profit for their shareholders.

Isn't medicine itself guilty of that as well? Most of what a general physician does is cure symptoms. It's partially our fault for not being willing to correct negligent lifestyles, but most doctors don't argue when we ask for quick fixes.

 

But yeah, health insurance seems like a no-brainer. Set up a publicly-funded risk pool for health insurance and model it after the best run private insurer. Make sure it's scalable to the whole country and then let the market decide who to go with, the public option or the private one that charges 25% more for the same thing.

[rigney]

Isn't medicine itself guilty of that as well? Most of what a general physician does is cure symptoms. It's partially our fault for not being willing to correct negligent lifestyles, but most doctors don't argue when we ask for quick fixes.

 

But yeah, health insurance seems like a no-brainer. Set up a publicly-funded risk pool for health insurance and model it after the best run private insurer. Make sure it's scalable to the whole country and then let the market decide who to go with, the public option or the private one that charges 25% more for the same thing.

In a sense, are we as people nothing more than chattel?

[zapatos]

For profit privatized health insurance is a conflict of interest is ever I saw one. Their goal is not to make you healthy, it's to make a profit for their shareholders.

I'm not sure I can agree with this. I understand why you say it is a conflict of interest but isn't there a conflict of interest in every business?

 

The goal of homebuilders is not to make a house for you, it is to make a profit for their shareholders.

The goal of fast food restaurants is not to feed you, it is to make a profit for their shareholders.

Fill in all the rest...

 

The other point is that making you healthy is not necessarily an impediment to making a profit. For example, paying a small amount for your blood pressure medicine is surely more cost effective than paying for the health care due to your heart attack. A health insurance company that does nothing to keep you healthy will surely not make a profit.

 

So if done correctly...

 

Home builders give you shelter and make a profit for the shareholders.

Fast food restaruants feed you and make a profit for the shareholders.

Health insurance keeps you healthy and makes a profit for their shareholders.

[Phi for All]

I'm not sure I can agree with this. I understand why you say it is a conflict of interest but isn't there a conflict of interest in every business?

Not at all. Most product-oriented businesses are perfect for the normal market models. Make something people will pay enough for so you make a profit. Simple. No conflict, especially because we all know what's on the table. How can you know what your health will be like for the rest of your life?

 

The goal of homebuilders is not to make a house for you, it is to make a profit for their shareholders.

The goal of fast food restaurants is not to feed you, it is to make a profit for their shareholders.

Fill in all the rest...

But in those instances, what you as the consumer wants is perfectly aligned with what the business wants to do. You want a home, they make you one and sell it to you at a profit. You're hungry and the restaurant fixes that, and it's in the nature of hunger for it to happen on a recurring basis. Is it in the nature of health for you to keep getting sick?

 

The other point is that making you healthy is not necessarily an impediment to making a profit. For example, paying a small amount for your blood pressure medicine is surely more cost effective than paying for the health care due to your heart attack. A health insurance company that does nothing to keep you healthy will surely not make a profit.

Blood pressure meds are a GREAT example. Do you think much effort goes into figuring out a way to fix your blood pressure problems permanently, the way you'd really like? Why would they when you'll have to take their meds for the rest of your life? That's the conflict. What you want is to fix your blood pressure without the constant costs and restrictions, and what they want is a customer for life.

 

Of course, your doctor could insist that you stop doing the unhealthy things that are really causing your blood pressure to rise. But I understand that most people aren't willing to give up what's really causing the problems. And the doctors businessmen are smart enough to ease you into their model. Can you imagine your doctor telling you in a single consult that suddenly you need blood pressure meds, which will raise your cholesterol, so you'll need meds for that too, and you'll likely have some anxiety so you should take some of these, which will make you susceptible to arrhythmia, and the meds for that often cause seizures, so we've got another pill for that. I'll bet most people in THAT situation would start hitting the club and eating salads pretty quick. Throw a frog into boiling water....

 

So if done correctly...

 

Home builders give you shelter and make a profit for the shareholders.

Fast food restaruants feed you and make a profit for the shareholders.

Health insurance keeps you healthy and makes a profit for their shareholders.

Except health insurance through a public risk pool keeps you healthy more cost-effectively and is more motivated to fix you truly as opposed to spending the least amount possible on you.

[zapatos]

Not at all. Most product-oriented businesses are perfect for the normal market models. Make something people will pay enough for so you make a profit. Simple. No conflict, especially because we all know what's on the table. How can you know what your health will be like for the rest of your life?

It may be difficult to sell an individual a health policy, but that is not really what they are doing. They are selling a large group of people health policies, and they do that very well. Health insurance is no different than life, car, or home owners insurance in that respect. They have a very good idea how much to charge individuals so that they can pay all their expenses and make a profit. Need we also put car and life insurance under the same umbrella as you propose for healthcare?

 

But in those instances, what you as the consumer wants is perfectly aligned with what the business wants to do. You want a home, they make you one and sell it to you at a profit. You're hungry and the restaurant fixes that, and it's in the nature of hunger for it to happen on a recurring basis. Is it in the nature of health for you to keep getting sick?

Yes it is in the nature of health for me to keep getting sick.

 

Again, I don't see the home builder and the health insurer as different. A home builder can short change me just as much as a health provider can. Low grade materials, poor workmanship, etc. There can be good and bad home builders, just as there can be good and bad health providers. And if they build the home poorly, they can keep you coming back for repairs, etc.

 

Blood pressure meds are a GREAT example. Do you think much effort goes into figuring out a way to fix your blood pressure problems permanently, the way you'd really like? Why would they when you'll have to take their meds for the rest of your life? That's the conflict. What you want is to fix your blood pressure without the constant costs and restrictions, and what they want is a customer for life.

They do have a customer for life. No one drops health insurance because they get well. It is profitable for an insurance company to get me to stay healthy. I'm on my wife's policy. They pay us if we meet certain health requirements, such as weight and exercise.

 

Of course, your doctor could insist that you stop doing the unhealthy things that are really causing your blood pressure to rise. But I understand that most people aren't willing to give up what's really causing the problems. And the doctors businessmen are smart enough to ease you into their model. Can you imagine your doctor telling you in a single consult that suddenly you need blood pressure meds, which will raise your cholesterol, so you'll need meds for that too, and you'll likely have some anxiety so you should take some of these, which will make you susceptible to arrhythmia, and the meds for that often cause seizures, so we've got another pill for that. I'll bet most people in THAT situation would start hitting the club and eating salads pretty quick. Throw a frog into boiling water....

So in your scenario, the insurance provider and doctor are under the same roof? Split the profits rather than the insurance companies loss is the doctor's gain? I can certainly both under the same roof being better.

 

Except health insurance through a public risk pool keeps you healthy more cost-effectively and is more motivated to fix you truly as opposed to spending the least amount possible on you.

But again, this is the same as a home builder. That builder also want to spend the least amount possible on your home.

 

I like how the new healthcare bill, which kept private insurers, insists insurance companies do things like spend less on advertising and more on healthcare or pay a penalty. Of course they've been regulating minimum standards for home builders for ages.

[iNow]

The goal of healthcare is to ensure health and quality outcome regardless of cost.

 

The goal of insurance companies is to be profitable, regardless of impact on the insured.

Insurance companies maximize profits by charging the highest premiums possible while paying the fewest claims possible. Premiums are revenues to maximized. Claims are costs to be minimized.

 

This is anathema to the central goal of improved health outcomes for patients, and is why so many people rightly argue that healthcare coverage should never be setup as a for-profit industry.

[Joatmon]

There seems to be a great reluctance for Americans to have what we in the United Kingdom have and appreciate - a decent public, free at the point of contact for people over 60, paid for out of taxation, healthcare system.

Also there seems to be a strong suspicion that medications supplied to people are foisted on people simply to make a profit for drug companies when you could do equally well, or even better, without them.

In particular drug treatment for blood pressure problems has been highlighted as an example. In the UK, where operations and drugs are free to everyone over 60 years old (most blood pressure and heart problem patients) there would be no advantage to the system to prolong more expensive treatment.

I would like to describe my experience as I have had surgery and will be on drugs for the rest of my life. I started blood pressure problems in my fifties. To keep it simple I will just say that It was found that an ECG found an abnormal trace that may have been inherited genetically or may have shown I had had an earlier silent heart attack. The trace could not be corrected with surgery so I was prescribed drug treatment. Later I started to get angina attacks and following a body scan I was given a stent in a blocked artery to my heart. Since a major cause of this problem is a build up of cholesterol and since this effect can block arteries to the brain and/or the legs It seems the fact that anti-cholesterol drug treatment was started was a reasonable thing to do. Lately I have been diagnosed with atrial fibrillation. There are surgical options for example ablation or kicking the heart back into rhythm with electric shock treatment. There are risks but I am happy that my specialist prescribed simple drug treatment, to stop blood eddying in my heart chambers from clotting, as I am coping well with the situation.

Because of the British system I feel every decision made on my behalf has been based on what was my best option.

So I roll on a reasonably fit septenagerian having had several ECG's a few body scans, the odd operation and a lunch box sized container of prescribed drugs I take every 12 hours.

From what I read I am glad I live in the UK!

I'll just mention, more for fun than anything, I have recently been given a hearing aid which I'm sure is for my benefit rather than "Siemens"

Edited July 25, 2012 by Joatmon

[Phi for All]

It may be difficult to sell an individual a health policy, but that is not really what they are doing. They are selling a large group of people health policies, and they do that very well. Health insurance is no different than life, car, or home owners insurance in that respect. They have a very good idea how much to charge individuals so that they can pay all their expenses and make a profit. Need we also put car and life insurance under the same umbrella as you propose for healthcare?

Car/home/life insurance are based on insurable values. Even life insurance is purchased this way, with the insuree deciding how much they need in coverage. Health insurance is intangible in this regard. You know how much your car or house is worth, but you have no idea how your health is going to play out.

 

Health insurance used to be based on actuarials that were quite accurate. You paid based on your age, and the sooner you got it, the less you paid throughout your life. But managed healthcare changed all that in favor of the privilege of changing insurers as often as you liked. And when the insurers kept losing customers, they came up with the "pre-existing condition" scare to stop people jumping ship. At least H.R. 3200 stops that atrocity.

 

Yes it is in the nature of health for me to keep getting sick.

Is it really, or is it because that's the way doctors practice? iNow will tell you that a cure for his Type I diabetes would stop him having to buy insulin and testing equipment and syringes and all the other stuff he has to buy, in addition to constant monitoring and injections. Can you honestly say that a cure for high blood pressure, one that you took once to actually cure you, is a better for-profit product for a business to sell than what you're taking now?

 

Again, I don't see the home builder and the health insurer as different. A home builder can short change me just as much as a health provider can. Low grade materials, poor workmanship, etc. There can be good and bad home builders, just as there can be good and bad health providers. And if they build the home poorly, they can keep you coming back for repairs, etc.

Poor quality is a general market concern. My public health insurance option would compete alongside private insurers, it would simply be cheaper since it doesn't need to profit shareholders.

 

And you're mixing the arguments. I'm saying medicine in general is a poor for-profit business for the consumer, but at least we could make it more cost-efficient if we took the profit motive out of the insurance part of it. Poor quality is not so much the issue as the conflict between focusing on profit and focusing on health.

 

So in your scenario, the insurance provider and doctor are under the same roof? Split the profits rather than the insurance companies loss is the doctor's gain? I can certainly both under the same roof being better.

No, not really. I suppose doctors have to stay private businesspeople, it's too difficult to change that. I'm just saying that the government could model an insurance product after the best of the private insurers, but with no need for shareholder profits and ludicrous C-level salaries and bonuses, and let it compete in the market like any other insurer.

 

 

But again, this is the same as a home builder. That builder also want to spend the least amount possible on your home.

And you can stop him from being too cheap if your contract says you can. He can't substitute cheaper fixtures if you've paid him for better ones, and he certainly can't tell you he's not going to include the garage in the agreed upon price because your car is a pre-existing condition.

[zapatos]

The goal of healthcare is to ensure health and quality outcome regardless of cost.

 

The goal of insurance companies is to be profitable, regardless of impact on the insured.

Insurance companies maximize profits by charging the highest premiums possible while paying the fewest claims possible. Premiums are revenues to maximized. Claims are costs to be minimized.

I do understand your point but I think you are presenting it a bit unfairly. I agree they wish to maximize shareholder value, but that is not accomplished by simply charging the highest rates possible and paying the fewest claims possible. If they ran their operation like that they would soon be out of business as the competition would charge a bit less and offer a bit more to run you out of business. There are many business models to follow to maximize shareholder value, all the way from barebones coverage to care that allows you to advertise that you have 'The healthiest group of customers in the world!'

 

Car/home/life insurance are based on insurable values. Even life insurance is purchased this way, with the insuree deciding how much they need in coverage. Health insurance is intangible in this regard. You know how much your car or house is worth, but you have no idea how your health is going to play out.

Again, I don't think I have to know how my health is going to play out. My insurer, by covering millions of people, know very accurately how many heart attacks, cancers, etc. they will have to pay for each year. I know how the average health of all those covered is going to play out.

 

But managed healthcare changed all that in favor of the privilege of changing insurers as often as you liked. And when the insurers kept losing customers, they came up with the "pre-existing condition" scare to stop people jumping ship. At least H.R. 3200 stops that atrocity.

Agreed.

 

Is it really, or is it because that's the way doctors practice? iNow will tell you that a cure for his Type I diabetes would stop him having to buy insulin and testing equipment and syringes and all the other stuff he has to buy, in addition to constant monitoring and injections. Can you honestly say that a cure for high blood pressure, one that you took once to actually cure you, is a better for-profit product for a business to sell than what you're taking now?

Yes, and the reason is because if there is a cure that is cost effective to the consumer, they will buy it. If the business doesn't provide the cure and tries to keep me on insulin, I will walk away to another provider. That is a clear advantage to the private model.

 

Poor quality is a general market concern. My public health insurance option would compete alongside private insurers, it would simply be cheaper since it doesn't need to profit shareholders.

Ok, that sounds like a good idea.

 

And you're mixing the arguments. I'm saying medicine in general is a poor for-profit business for the consumer, but at least we could make it more cost-efficient if we took the profit motive out of the insurance part of it. Poor quality is not so much the issue as the conflict between focusing on profit and focusing on health.

OK.

 

And you can stop him from being too cheap if your contract says you can. He can't substitute cheaper fixtures if you've paid him for better ones, and he certainly can't tell you he's not going to include the garage in the agreed upon price because your car is a pre-existing condition.

He can always be cheap. Cheap inexperienced labor. Cheap construction materials that meet code but not current standard practices.

 

There are builders I would buy from and builders I would not. When my son had Lasik we paid a lot of attention to quality.

Edited July 26, 2012 by zapatos