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TUESDAY JUNE 30 2009 9:30 AM

Democrats Blowing It On Health Care

Its really quite interesting to watch the Democrats throw it all away. This time, they seem to think blowing the chance at decent health care reform will aid them in future elections. Or perhaps they have taken so much money from the health care industry that they dont give a shit. Either way, it doesnt matter. Fixing health care is the biggest problem facing our country. If we dont do something drastic, it will completely destroy our economy in the years to come. As it is, were in bad shape. Democrats, specifically Senate Democrats, have decided to help the poor insurance industry out as much as possible. Es no bueno.

Most of the debate is over the dreaded public option. Oh, dear no. We cant have a public option. Thats socialized medicine! Americans must be able to choose! And by that I mean they cant choose a public option! They have to be able to choose between private monopolies! This is fucking America! We demand to be fucked over by private companies as much as possible!

And make no mistake about it; those against the public option want to continue with monopolies.

But the notion that most American consumers enjoy anything like a competitive marketplace for health care is flatly false. And a study issued last month by a pro-reform group makes that strikingly clear.

The report, released by Health Care for America Now (HCAN), uses data compiled by the American Medical Association to show that 94 percent of the country's insurance markets are defined as "highly concentrated," according to Justice Department guidelines. Predictably, that's led to skyrocketing costs for patients, and monster profits for the big health insurers. Premiums have gone up over the past six years by more than 87 percent, on average, while profits at ten of the largest publicly traded health insurance companies rose 428 percent from 2000 to 2007.

So, that's what the "free market" kids are fighting for. Monopolies. Yay!

A public option would guarantee the possibility of lower cost, reliable coverage. It will bring cost control by reforming how we pay for medical care. It will create competition between private insurers that simply does not exist today. It will also force private insurers to perform better, something they are not doing today.

To those who say the public option would drive the private companies out of business; I thought everything government did sucked? Is government bad or highly efficient? Please stick to one talking point, no matter the subject. Secondly, the private insurance companies have had their chance and to say they fucked it up would be an understatement. They deserve no protection. I have no interest in keeping pedophiles in business, either. Their time has come and gone. They could have kept costs lower, kept people from dying, insured anyone with preconditions, but they decided to go for the biggest profits possible and now they are on the deserving end of whats coming. They only compete to insure the well and reject the sick. Then they employ adjusters to get the company out of paying for health care services when the well become sick. Welcome to the world of failure. They made their bed, now they have to lie in it.

If any of you loud mouthed, utopian, not living in the real world Libertarians bring up regulation, feel free to explain the exact regulation that makes health care so expensive. If you cant detail these so called regulations, shut your face and stick your broad stroke arguments up your ass. Your simplicity has grown tiresome. This current debate is for adults and what you want will never be, so stay out of it or act like an adult and accept that what you want aint going to happen.

As far as the public plan, Democrats are right now working on a way to water it down until it is completely ineffective. Senator Jay Rockefeller, who is a son of a bitch because of his FISA legislation, has come up with a good public health care plan. His plan would partner a public plan with Medicare for more bargaining power and access to provider networks. According the non-partisan Lewin Group and the Commonwealth Foundation, Rockefellers plan would drop premiums 20 to 30 percent. Cant have that, now can we?

Rockefellers plan would force private insurance companies to be more honest. They would have to cut their bullshit administrative costs and fire quite a few of those adjusters whose job is to find ways to not pay for care. Right now, you have no choice. You can choose between one horrible private insurance company or another. There really isnt much difference. The idea is to force them to become insurers instead of profiteers.

Other Democrats are working on plans that would do almost nothing. Senator Chuck Schumer has a level playing field public plan that wont save much at all. It will just create a plan that will allow private companies to dump old, sick and high-risk patients onto the public plan. This is considered a compromise. It will be awesome because by doing it halfway, they will create exactly what the right wing claims will happen. It will be a terribly ineffective, expensive plan. It would not use low rates that Medicare sets or use taxpayer subsidies. It wouldnt force its way into networks. It would just be like any other insurer, except for the fact that it would be a dumping ground for private insurers to unload their expensive patients. Its one of those genius Democrats compromise and create a pile of shit plans.

Finally, theres Ben Nelsons Trigger Plan. You know its good because Nelson has taken millions and millions of dollars from insurance companies. The Trigger Plan would be like a big, invisible, scary fist looming over the insurance industry. If the private market didnt offer cost control or enough options, the public plan would come into existence - but it would be at the state level. Its a regional Trigger. Some states might have a public plan and others would not. Its basically set up as a way for private companies to game the system. Ben Nelson doesnt seem to realize the trigger should have been pulled 8 years ago. If he wants to set the threshold where costs are now, its a big lose. Go Blue Dogs!

Those are the public plan options. Now which one do you think Democrats in the Senate will choose? Id bet big money on the Level playing field plan because it doesnt actually threaten the private insurance market. It actually helps them in their quest to be the biggest douche bags on Earth.

Prepare for failure.

FearTheReaper is a writer, actor and stand up comedian. Check back each Tuesday and Friday for more from FearTheReaper You may also enjoy his blog, Stop All Monsters.

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Comments

gfvella

Australia

November 2004

JUN 30, 2009 07:25 PM

SergeantPsycho said:
Oh, how so? If your not going to pay the doctors the same, what's top stop all the Qualified doctors from going into the private practice? If you are going to pay them the same, then you'll need taxpayer money for that (or else hire less doctors, lengthing wait times), and then we'll effectively be paying the same anyways.

Who said anything about forcing Doctors to cut their prices? No one I have seen has suggested price caps, which would be an idiotic socialist thing to do and end up with Soviet style medicine. Nor is anyone suggesting a government owned health system.

The idea is a not-for-profit government managed insurance scheme. The people who would get gouged are the medical insurance companies.

ZakSmith

Los Angeles, CA

August 2003

JUN 30, 2009 08:32 PM

SergeantPsycho said:

ZakSmith said:

You do realize that:

1) Even if all medicine went public, the expensive good doctors you went to would still exist--they just wouldn't be as expensive.

Oh, how so? If your not going to pay the doctors the same, what's top stop all the Qualified doctors from going into the private practice? If you are going to pay them the same, then you'll need taxpayer money for that (or else hire less doctors, lengthing wait times), and then we'll effectively be paying the same anyways.

Ok, I assumed everyone already grasped this dirt-basic pre-school-level premise of life in the US but I guess not:

Our current health care system has driven up prices for ALL medical care, from whatever source, in the US by inserting unnecessary middlemen.

EVEN IF YOU COUNT TAXES PAID IN COUNTRIES WITH SOCIALIZED MEDICINE, we are still paying more for our medical care than every other comparable nation for the same medical outcomes.

That is: it costs you MORE to get your hip fixed than it costs a French person. Get it?

The system drives costs UP rather than DOWN because people with broken hips are in no condition to comparison shop.

If you don't believe me, go look it up. If you do believe me, then now do you understand what's going on here in this thread?

QuargWarrior

Perry, GA

February 2008

JUN 30, 2009 09:20 PM

DevilsReject said:

SergeantPsycho said:
In that instance, I'd probably try and negotiate some kind of payment plan for services rendered. (Perhaps a "Medical Loan" industry is a business niche that might be filled).

I'll go ahead and save you the trouble of "trying to negotiate".

Hospitals don't, very few doctors do, my dentist on the other hand does take payments.

I too have a pre_existing condition. When I had insurance and was then laid off they gave me the Cobra option of maintaining my insurance for two years for the very reasonable sum of $750.00 per month. When you are laid off, with no income, how in the hell can you come up with that amount.

Then when my wife lost her job it was the same thing only Cobra now wanted $800.00 per month.

I went to the cardiologist in November of last year. He looked at my echocardiogram that was taken last May and told me that I needed a heart transplant and that if I can figure out a way to pay for it he will go ahead and put me on the transplant list. He said I should look into disability. I never wanted to do that because I like to pay my way but suddenly was faced with no other option. I was real numb when I left his office.

I went to my county Social Security office on the next day and filed for my SSI and my SSDI. They were incredibly nice. I was given SSI for the short run until my SSDI came through. I recieved a letter that I would be getting my SS Disability Insurance the same day I received my first and only SSI check. (I know most people say they automatically turn you down the first time but I did not experience that. Mine came through in less than 45 days)

Now here is the really fucked up thing. If I am on SSI I qualify for and get Medicaid. They would fix my heart (Hopefully). But now since I am on SSDI I make too much to qualify for Medicaid so I do not get that. Medicare does not kick in until I have been on SSDI for 2 years. So for a period of 2 years I have no insurance and am not allowed to look for a job with insurance because it will fuck up my disability (And in truth I am not in shape to work anyway) and am hung up in limbo.

I'm really tired of being treated like a criminal or a second class citizen because I have no medical insurance. When I went to my Cardiologist in April for my followup and another echocardiogram (Which costs $650.00) I was asked for the money up front. When I told them that I did not have it but could pay so much down and so much a month they looked like I had shit on their dinnerplates. I was told "You're gonna have to reschedule. When you have the money call us and we'll be glad to reschedule the test." I was not even seen. An appeal to the doctor did no good either.

I am not sure about puplic plans or options as opposed to private plans. I just want someone to fix my heart. I have written letters to my Congressman and to President Obama. Still waiting to hear from them. In the mean time I continue to soldier on and hope the time passes until I can qualify for Medicare and get my heart fixed. I really don't have any other option.

Sorry for the rant folks but I found myself with the need to unburden.

Adroitbeing

I'm lost

September 2003

JUN 30, 2009 10:12 PM

SergeantPsycho said:
Just some points I'd like to make:

1) I'm not sure how it's a monopoly if like there are ten different "Big Insurers" according to FTR's link.

Insurers vary by state and are selective about the types of coverage they offer. There are several states, mine included, where carriers have abandoned certain types of coverage. There are only two carriers in my state offering coverage for self-employed or company of 1. Also note the point I make later about congressional investigation into antitrust behavior by insurance companies.

I know you are smart enough to understand that health insurance underwriters chase profits - not customers.

3)I agree with drdetox. There seems to be a lot of money spent towards migigating minor risks. This goes for other things too, like Pharmecuticals and human trials. I think there's an over abundance of litigousness for an industry whose practice is far from an exact science.

Phrases like "I think" are mostly useless when it comes to defining situations where research provides insight. Yours is standard blather trotted out by the usually uninformed libertarian.

Healthcare costs in the US are approaching 18% of GDP and the rate of increase has little to do with "tort tax." If pharma companies chase profits with products that made it through the FDA on false premise and people die or become injured, that pharma company deserves whatever a jury awards.

Principally academics and physicians agree that the biggest problems with the healthcare system today are

A.) Lack of coverage for somewhere between 15 and 25% of the nation

B.) An adjustment in the way services are priced and paid. In short, we underpay for basic care services and overpay for special services. The health insurance industry is largely responsible for driving this trend by their underwriting and actuarial models

C.) Technology and processes have encouraged doctors to spend less time with patients; tests are ordered in place of increased interaction with the patient - not as a methodology for mitigating lawsuits

D) Congress must modify the McCarran-Ferguson Act, which enabled insurers to raise prices and reduce coverage while avoiding federal antitrust laws
(Sources: James Rohack (AMA), Dartmouth studies, Congressional testimony given during review of the proposed Medical Malpractice Insurance Antitrust Act

5) How in god's name are we going to pay for "Public Option"? We're a gazillion dollars in the hole.

How about we try to address the problem instead of whining about how hard it might be or how expensive it could become.

50 million US citizens are uninsured, yet we spend more on healthcare than other industrialized nations that provide health insurance to all of their citizens.

1.) Healthcare in the US will almost certainly approach 20% of the GDP by 2020.

2.) The great socialistic devil France spends just 9.5% of its GDP on healthcare for every citizen of that nation

3.) Canada spends just 9.7% of its GDP on healthcare

4.) Germany and Switzerland top the list with healthcare costs running about 11% of GDP

As for the risk of socialized medicine, that horse left the barn years ago - just as soon as insurance companies began forcing the use of standard procedural coding and standard pricing for everyone - there was no turning back.

Now, before you launch into the next predictable false statement about quality, I will tell you that as a US citizen, I spend 50% of my life in the US and 50% in the UK. The quality of care I receive in the UK is every bit as good as what I receive in the US AND I can usually see a doctor on the same day I call AND that doctor will likely spend 2 - 3X as much time with as a US doctor.

Our son was born in the UK and the care he and my wife received was unmatched by any experience we had with our other three children born in the US.

In summary, the problem is reform, the first step to reform is to set the proper priorities, and the first priority is to get the citizens of this country protected under a health insurance program. Once established, we can work on runaway premiums for doctors and patients, inefficient hospitals and administration, proper revenue cycle management by docs and hospitals, the proper use of technology, etc.

DevilsReject

Cleveland, OH

February 2007

JUN 30, 2009 10:31 PM

QuargWarrior said:

DevilsReject said:

SergeantPsycho said:
In that instance, I'd probably try and negotiate some kind of payment plan for services rendered. (Perhaps a "Medical Loan" industry is a business niche that might be filled).

I'll go ahead and save you the trouble of "trying to negotiate".

Hospitals don't, very few doctors do, my dentist on the other hand does take payments.

SPOILERS! (Click to view)

You're not alone man.

I would post what i am going through, but it would be huge and no one would probably want to read it.

I will add this to it though, my condition isn't necessarily considered "life threatening" because i have one healthy kidney and one that is not completely healthy, in so much it is usually causing more and more trouble. Of course if the healthy kidney starts taking a shit, then i guess it would be considered life threatening.

I don't qualify for disability or SSI because of that. There is no such thing as a "medical loan" even if there were, with the way the banking industry is right now, i probably wouldn't qualify.

From what i understand, the procedure would take about an hour and a half, it isn't very technical, it just requires a surgeon, an operating room and it's actually outpatient.

Right now, to remedy the situation, until i can get the surgery, i have a doctor perform an "in house" procedure in his office that takes about ten minutes. I only do that when the pain is finally immense enough that i can't deal with it anymore, because that procedure alone takes about a grand out of pocket.

You're not alone, it's definitely fighting an uphill battle.