Third Party & Independents Archives

Health Care, Profit vs. Non-Profit

The lines are drawn in all manner of peculiar and gerrymandered shapes around the issue of health care. Seems nearly everyone talking about it is attempting to obfuscate the core issue at hand: For Profit vs. Not-For-Profit health care insurance in America. Incumbents are getting loads of promises, threats, and campaign money for their war chests on this issue.

The core issue: The government is a not-for-profit organization. Virtually all private health insurance providers in America are for-profit. Profits are passed on to consumers as part of the price of their policy premiums. Investors, boards of directors, and executives and managers of for-profit health insurance companies, who have reaped enormous rewards from the health insurance industry profits, are lined up to oppose Obama's not-for-profit health insurance plan. Some consumer groups (not including investor consumer groups), are lined up to support Obama's plan.

What profits are at stake? 14.2 million per year, average salaries for the top 7 private health insurer executives to begin with. Some claim health insurance profits have risen nearly a 1000 percent over the last decade. That's probably overstated, but, even a conservative 700% estimate in 10 years, speaks to gouging. Here is a list of health care profit increases since 2005. One fact is known, health insurance premiums have risen 5 times faster than wages since the year 2000. And that has consumers railing. They are literally going broke due to spiraling health insurance premiums.

The National Coalition on Health Care cites:

A recent study by Harvard University researchers found that the average out-of-pocket medical debt for those who filed for bankruptcy was $12,000. The study noted that 68 percent of those who filed for bankruptcy had health insurance. In addition, the study found that 50 percent of all bankruptcy filings were partly the result of medical expenses.9 Every 30 seconds in the United States someone files for bankruptcy in the aftermath of a serious health problem.

Even employer paid health insurance rates are hitting employees in the pocket book, since wage increases which would have been passed on to employee's have been spent instead on the dramatic increases in health insurance premiums paid by employers.

Everyone, conservatives and liberals alike, agree that something has to be done ASAP to halt the rising cost of health insurance. It is bankrupting the government, the States, and 10's of millions of Americans. The debate is over how.

The single most effective cut in health care insurance premiums would be to cut insurer's profits out of the loop. No other step could would result in greater cost savings in as short a time, as this one step. This is why the Obama administration is pushing for government sponsored health insurance with no profits being skimmed off the top of every health care transaction.

Doctors, nurses, hospitals and clinics would not see any change in their occupational incomes, but everyone's health insurance premiums would stop rising as fast as they have been these last 5 years. Consumers groups hail the measure. Investor's and insurers are scared to death of it.

The reason investors fear government sponsored health insurance is not primarily the loss of profits by health insurance companies. In the short term, those would not change dramatically, but would likely drop in the longer term. What they fear most is the model. Non-profit health insurance could be so successful in reducing the inflation of health care premiums, that they are certain such success would lead to a slippery slope whereon, the next step would be non-profit health care delivery, (hospitals, clinics, private practices, and limited liability partnerships).

In fact, a national slide toward a predominantly not-for-profit health care industry, in which the boards of directors of non-profit hospitals and clinics are not paid at all, or at most, a 10th of what for-profit boards are paid, and where there are no shareholders and investors skimming profits, is a scary prospect for investors. Executives would see compensation packages pressured downward as competition between non-profit health care deliverers promoted the most and best health care delivery per dollar, as part of their advertising and reputation promotion.

Incumbents however, are going to make out like bandits on this issue. Republican incumbents are raking in money for their reelection campaigns from the for-profit corporate special interests of all kinds, not just health insurers, who fear this proposed non-profit model. Liberal Democrat incumbents of course, are benefiting from consumer advocate lobbyists promising potentially unprecedented get out the vote campaigns in favor of Democrats. Some conservative Democrats are benefiting from both sides of this issue, consumer advocate lobbyist's favor, and corporate lobbyists seeking to sway their vote on the reform bill.

Regardless of which side of this issue a voter stands on, the battle is being fought by lobbyists on Capital Hill, and Congressional incumbents seeking reelection are the monkey's in the middle. Usually, in circumstances like these, the American people wind up with something so compromised as to be of less benefit in the long run than doing nothing at all. When a problem goes unaddressed, the pressure builds to take dramatic action. Time will tell if the pressure on the health care cost issue has built up sufficiently to generate a real beneficial change for the nation and its health care industry future.

Conservatives are right in saying there is a slippery slope here, as organizations like the Alliance for Advancing Non-Profit Health Care already exist and are lobbying Congress. Liberals are also right in saying that the shortest most effective route to lower health care costs is non-profit health care where shareholder, director, and executive administration profits and fees are removed from the entire cost cycle of health care.

However, folks at Vote Out Incumbents Democracy are also right in saying there may be enough Congressional incumbents putting their gerrymandered reelection priorities far out ahead of consumers and patients, as a whole, to jeopardize any reform effort put forth.

The people have given the federal government a mandate: create affordable, sustainable, and accessible health care in America for all who want it. In fact, a recent poll says 72% of Americans want a government sponsored health care insurance option. Republicans are opposed to it (apparently, trying to keep their 25% approval rating intact). Though the number has been dropping, about 9 conservative democrats, (Blue Dogs), are threatening to block the bill's passage on a simple majority vote. As I wrote here at WB both before, and after, Obama's election, this President's biggest hurdle will be Congressional Democrats, not Republicans. It is true now of the Health Care reform.

Will the American people and the Obama administration be able to twist the arms of those 9 or so, conservative D's, and force them to act on the bidding of nearly 3/4 of all Americans? At this moment in time, that is impossible to answer. It really could go either way at this point.

When incumbents put their gerrymandered constituents agenda ahead of the good of the nation and the majority will of the American people on so fundamental an issue as affordable health care, and feel secure in doing so, it is obvious that our political system is as broken as our health care system. Voting out such incumbents however, shall prove to be an even greater challenge than health care reform.

Posted by David R. Remer at June 23, 2009 08:04 PM
Comments
Comment #283479

For a long time I’ve wondered why nobody ever mentions the core issue of our health care problem. Well, not really wonder, since it is painfully obvious. But I think it is really unfortunate that the health care debate remains in the realm of rhetoric and Left vs. Right propaganda for the use of gaining voter support for elections.

The fact is that, like you said, the issue is about whether or not we can ever have a viable health care system that takes care of every American if at its core the system is designed to maximize profit instead of maximize the health of the country. This goes along with my core belief that some things just have to be above profit in order to work best for everyone.

Pretty much the only thing that should not be covered by a universal, not-for-profit health care system is elective plastic surgery!

Also, this is the core problem behind the reason why cholesterol/blood pressure medications are many times more expensive than Viagra. When drug companies are allowed to market their “products” like vodka, cell phones, or cars, how much more proof do you need that the system is corrupt and only exists for the benefit of stockholders, not the insured Americans who couldn’t afford a single medicine without insurance?

Posted by: Michael Falino at June 23, 2009 09:53 PM
Comment #283480

Very on key and timely article David. As an advocate for a new third party, with a different political attitude, I try to steer clear of social issues and stick to basic government reform, which is sorely needed. However - - healthcare is a major concern for nearly every American. Your post goes directly to the core of not only healthcare but our system of government as well. Our healthcare system is broken and so is our system of government. Done in by corporatists, special interest and the like. The money influence. The medical/pharma industry has been at work since WWII to keep the right people in the right positions to garner tax breaks, perks, etc for their corporations. C. Rangel is right, no debate needed, get on with it as the congress has been lobbied hard and paid well for their votes. No debate needed. The outcome can be easily forecast. There will be no real healthcare reform. Change, maybe. Change the name on some medical programs, change a few prices, etc.
If we have a broken government and a broken healthcare system there really is not much to debate. Before debating this or any other issue we would have to have completed government reform. Such as; abolish corporate personhood and abolish money is free speech, reform campaign finance to remove the influence of money, invoke a flat tax policy where the government can’t make winners and losers based on tax law. Then, you could begin to debate such social issues as healthcare with some acuity to purpose.

Post reform I think you could go either way with healthcare. In a more true capitalist economy competition would operate just fine to support a free market system for healthcare. I’m against socialism in government in all things but perhaps healthcare. Because healthcare is so important to life I could tolerate a government run system. Here too, if certain reforms were completed a government sponsored healthcare program would operate just fine.

However, we have to face the reality of the current situation. Makes little to no sense to me to waste time debating healthcare on anything else. IMO the only solution to our growing problems is government reform through a 3rd party effort such as Republic Sentry.

Otherwise, we have the corporatists we deserve.

Posted by: Roy Ellis at June 23, 2009 10:23 PM
Comment #283483

What we should try perhaps is a national non-proft health insurance system, which is voluntary, and has no riders or restrictions. It seems logical that many people would participate, since for-profit insurance is ridiculously expensive or unavailable for about 40 million Americans.

If for-profit insurance systems can compete, and still make a profit, we’ll know if we’ve all been getting gouged for years (which we know is true), despite the inefficiencies inherent in any government-run systems. For example, no private health care systems have any where near the degree of fraud as does Medicare.

Any way, it seems likely there would still be a market for premium health care and insurance that may very likely be difficult to get in any government-run system.

However, if the federal government runs a national health insurance system or national health care system the way they run Social Security and Medicare, then we’re screwed.

At any rate, the voters have the government that the voters elect (and re-elect, and re-elect, and re-elect , … , at least until that finally becomes too painful).

Posted by: d.a.n at June 23, 2009 11:38 PM
Comment #283487

M. Falino, thank you for your comments and perspective.

In my view, health education has to come with a public health care insurance option. People have to be informed, again, and again, of what behaviors are inherently unhealthy, and to be avoided. That would include 4 hours per day in front of the TV, drinking more than 2 alcoholic beverages in a day or more days than there are in a week. :-) Would include high fatty cholesterol breakfasts, lunches and dinners which excludes our entire fast food industry except Soup Er Salad.

One of the potential flaws of a public health care insurance plan is abandonment of concern for one’s health in lieu of letting the tax payers pick up the repair tab. At some point along the way, in a public option, there has to be some form of risk based premium assessed on those who choose high risk life styles.

As for elective procedures, that is a whole other kettle of entangled worms. Will a child’s psychological well being be harmed by a crooked front tooth? Should tax payers cover that corrective dental procedure in the absence of any pathology associated with the tooth, gums, or bone holding that tooth? How about a nose job for a young girl whose friends tell her she can never be Miss America because her nose is too big, and she believes it is true?

Don’t get me wrong, I am for the public insurance option. But, I am not able to close my eyes to the opportunity costs and inherent design problems of such a system. There is NO decision a human being, a family, a neighborhood, a State, or a Nation can make, that does not bear opportunity costs to be paid for having made that decision. I am for the public option, because the opportunity cost of 50 million uninsured Americans results in tax payers picking up the tab in the long run, anyway, and folks in America should not suffer from lack of health insurance while every other major democratic economy in the world provides such health insurance.

But, perfection, we will find, is not a word that will attend a public health insurance option. And many things about American life will have to change over time to improve the public health insurance option and make it more cost effective. And Americans generally are not very tolerant of changes in their daily lifestyles, especially if recommended by their government. Part of the American psychology, which will have to change too over time.

Posted by: David R. Remer at June 24, 2009 05:01 AM
Comment #283488

Roy, thank you for your comments and perspective. Your points regarding government reform are well stated.

I view the public health care option like I do democracy as a form of government. Its the worst option, except for all the others, which are even worse, yet.

Posted by: David R. Remer at June 24, 2009 05:07 AM
Comment #283489

d.a.n, great points. Of course, I would call 14.7 million per year annual salary by the top 7 health insurance executives a form of fraud perpetrated on insurance premium payers.

If everyone in America were making a million a year for 40 or more hours a week of employment, 14.7 would not seem like fraud. But, when our nation is falling off a debt cliff, 50 million Americans can’t afford health insurance and remain in the middle class, and when more than 9% of those who want to work, can’t find work, 14.7 million a year is morally bankrupt and the epitome of avarice, and simply unaffordable by our society. The interesting thing about greed is, it carries the seeds of its own demise. History is replete with examples. The starkest being the Last Emperor of China.

Posted by: David R. Remer at June 24, 2009 05:16 AM
Comment #283490

DAN
The public insurance option you speak of is what the administration and many in congress are proposing. It is getting fierce opposition from the industry and their legislative shills. One of the attacks they are making is siting CBO cost figures that were based on an incomplete plan that DID NOT INCLUDE the public option or employer mandates.The MSM is picking up the same fiction.
http://wonkroom.thinkprogress.org/2009/06/22/the-public-insurance-plan-is-not-responsible-for-high-cbo-scores/

What the health industry does not seem to realize is that the plans being discussed are the least intrusive they are going to get. Single payer or even direct public service provision are still an option.

Posted by: bills at June 24, 2009 05:53 AM
Comment #283494

bills, Yes. You seem to have been under the assumption that I thought otherwise, and/or was opposed to it. As long as it isn’t mandatory, there’s no problem.

If a non-profit national health insurance system can’t compete with the many manifestations of unchecked greed within the for-profit health insurance systems, then the federal government will prove how truly pathetic it really is.

At any rate, the voters have the government that the voters elect (and re-elect, and re-elect, and re-elect , … , at least until that finally becomes too painful).

Posted by: d.a.n at June 24, 2009 08:57 AM
Comment #283495

David, I agree for the most part.
See comment to bills above.

What remains to be seen is whether the severely bloated, wasteful, and corrupt federal government can compete with the many manifestations of unchecked greed within the for-profit health insurance systems.
If not, the federal government will prove how truly pathetic and dysfunctional it really is.

It’s not a given that any government-run national health insurance system won’t be riddled with massive waste, fraud, bloat, and corruption.

Consider Medicare fraud. Consider how many people could be treated with the $30 Billion in annual Medicare fraud (7% of the $432 Billion in Medicare expenditures in year 2007).
Consider former Senator Bill Frist’s HCA hospitals, which bilked Medicare out of $1 billion (resulting in a final fine of $631 Million, which ended the investigation (www.sourcewatch.org/index.php?title=Bill_Frist#HCA-Medicare_investigation).
There is the real potential for many manifestations of unchecked greed in for-profit and government-run systems.

At any rate, the voters have the government that the voters elect (and re-elect, and re-elect, and re-elect , … , at least until that finally becomes too painful).


Posted by: d.a.n at June 24, 2009 09:00 AM
Comment #283508

The link to health care profit increases since 2005 at cnnmoney.com doesn’t work. Can you fix the link or summarize what the chart says? I’ve been trying hard to find this exact information. Thank you.

Posted by: Julie at June 24, 2009 01:21 PM
Comment #283509

d.a.n.

I’m not entirely convinced that major fraud isn’t occurring under private insurance.

I’ve had odd experiences over the years with my private insurers. Recently, a new insurer (BCBS) denied a claim for several weeks. I had gone to the doctor to refill prescriptions. The denial included some vague language about a preexisting condition. She had failed to list a date for the onset of the condition. She finally listed the day she “treated” me as the date of onset, and it was approved. Funny thing is, I wasn’t treated for arteriosclerosis. None of the prescriptions had anything to do with that condition. It took a thirty minute call to BCBS being repeatedly told that I was denied for a preexisting condition babble when I was asking what the preexisting condition was. Finally after yelling at the clerk to stop repeating the canned dialogue, she explained what actually happened.

A similar thing happened when I was hospitalized several years ago for appendicitis. Lots of treatments I never received were on my bill. I suspect this is standard operating procedure.

The insurance industry has created such a confused, arcane billing system that almost no one can figure it out, with so many legal hoops, most insurance isn’t worth the paper it’s printed on.

A public option is the only meaningful reform. It may well end up being a bust, and we will likely need to look at a single payer system.

Posted by: gergle at June 24, 2009 01:29 PM
Comment #283514

Ain’t that the truth gerg, when i had my second back surgery a spinal fusion I did push the button almost until it broke and yelled for pain shots they only give a person so many and they taper them off,I received an itemized statement from the hospital and it was like 12 pages thick i told my wife I knew what was going on even with all them shots for the pain no way no how did i received all those items and shots I remember her giving me a few Tylenol the day I left and not 35 of them and the place was filthy and smelled and my doctors office called in a few ahead of time the day i went home.

Posted by: Rodney Brown at June 24, 2009 02:39 PM
Comment #283520

Julie, thank you for bringing that to my attention. The typo in the link has been corrected.

Much appreciated.

Posted by: David R. Remer at June 24, 2009 03:41 PM
Comment #283522

d.a.n and gergle, there is a clear form of fraud occurring in the private sector evidenced by the following:

1) The links in the article demonstrating profits increases and:
2) The private sector’s fallacious testimony before Congress that the rising costs are due uninsured’s visiting ER’s and the growing cost of R&D.

If the private industry’s testimony were true, their profits would not have skyrocketed, their costs would instead. They are hiding their price gouging and profit increases under false testimony.

Medicaid provides coverage for some of the least educated in our society. They can’t be counted on to spot and report fraud. What is needed is independent oversight and accounting review, much like the IRS auditing, of billers to Medicare and Medicaid. Under a public option, this will have to be put in place.

Once in place, such an auditing system would easily be applied to private sector billing to Medicare and Medicaid as well. Is it any wonder the private insurers and corporate health care deliverers are so adamantly opposed to the public insurance option? Not to me.

Posted by: David R. Remer at June 24, 2009 03:50 PM
Comment #283525
Pretty much the only thing that should not be covered by a universal, not-for-profit health care system is elective plastic surgery!

So, you don’t mind if a person like me and my wife spend thousands and thousands of dollars on invitro year after year? Great! What about having an 85 year old on kidney transplant lists or having a lot of expensive surgery to keep themselves alive? Because the president is apparently against that kind of thing…

For a ‘not for profit’ system to work, rationing of healthcare would have to take place and people would have to be either ‘enticed’ or ‘drafted’ into public healthcare services.

It is interesting to see people want something but have no idea what the consequences of those desires will bring about.

Posted by: Rhinehold at June 24, 2009 03:57 PM
Comment #283536

Sam,

No one really wants to lower the cost of healthcare, unless it occurs as a part of their official party platform so that they can gain power for their party.

Posted by: Rhinehold at June 24, 2009 07:15 PM
Comment #283547

DR
BHO is blowing it with his willingness to compromise on the public plan. Even with the modification to encourage collective,semi-public carriers there will still be the same opposition. What he does not seem to get is this “free market” rubbish is just one tactic. The real goal is not to protect a free market, it is to protect local insurance monopolies,to protect vested interest.

http://krugman.blogs.nytimes.com/2009/06/22/competition-redefined/

RH
What nonsense. There are people involved in public policy that actually want to help solve problems and make the country a better place. I understand this does not fit with your Ann Rand,screw everybody else world view, but its true nonetheless.

Posted by: bills at June 24, 2009 11:54 PM
Comment #283548

“For example, no private health care systems have any where near the degree of fraud as does Medicare.”

The good thing D.A.N is if the fraud could be minimized the money saved by the medicare system could be used to pay for additional health care without increasing costs.
If as part of this reform package we could rescind the drug company mandate, in the previous medicare bill, that doesn’t allow for the government to negotiate better drug prices (which I consider fraud) and further increase the savings. I am sure you are aware with a for profit insurance company the people insured would not see such savings.


http://www.msnbc.msn.com/id/22184921

Posted by: j2t2 at June 25, 2009 01:17 AM
Comment #283549

bills, Obama continues to surprise and amaze me with me with his adherence to strategy for long run gains in policy evolution, as opposed to short run tactics designed around an all or none effort, more likely doomed to achieve the ends desired. I don’t pretend to know what is in Obama’s mind, but, in looking back over his words and actions he has an absolutely amazing strategic record so far.

Of course, it could partly be the benefits of coming in on the heels of a collapsed GOP, but, he has demonstrated incredible strategic capability from his campaign to his response to Iran and the economy.

Posted by: David R. Remer at June 25, 2009 01:22 AM
Comment #283550

Rhinehold said: “No one really wants to lower the cost of healthcare, unless it occurs as a part of their official party platform so that they can gain power for their party.”

I haven’t heard anything that cynical in awhile. There are good people with good intentions who seriously wish to lower the cost of health care and make it available to all. And some of them are even in our government. One doesn’t need to be political to have those motivations, Rhinehold. One does need to be political to get those motivations carried through into policy.

Posted by: David R. Remer at June 25, 2009 01:27 AM
Comment #283551

Rhinehold said: “For a ‘not for profit’ system to work, rationing of healthcare would have to take place and people would have to be either ‘enticed’ or ‘drafted’ into public healthcare services.”

We already have health care rationing in this country. Those who can afford it, get it. Those who can’t, don’t, until life or limb are threatened, and all too often it is then too late for medical help to save them.

Obama is absolutely honest about this topic. Do you not appreciate this President’s honesty when he addresses this very issue in public:

He said: “the chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health care bill out here. … I think that there is going to have to be a conversation that is guided by doctors, scientists, ethicists. And then there is going to have to be a very difficult democratic conversation that takes place. It is very difficult to imagine the country making those decisions just through the normal political channels.”

President admits that for a non-profit system to succeed in lowering costs, we must address the baby boom generation consuming 80% of the health care system’s costs, and find ways to lower them. He says this rationing which will become necessary will have to be created by the society as a whole, doctors, scientists, and ethicists will need to define the problem and choices and then the American people themselves will have to debate and decide on a course of action.

Posted by: David R. Remer at June 25, 2009 01:38 AM
Comment #283558

An interesting AP article:

http://www.kentucky.com/512/story/841363.html

Posted by: gergle at June 25, 2009 08:41 AM
Comment #283562

DR
Careful of putting words in BHO’s mouth.Those other guys do that.
There is an active federal program to determine the comparitive effectivness of treatments.What works. What does not. What works better. This also is being fought tooth and nail. One example are gallstone treatments. Gallstones are painful. They also usually go away. The most frequent treatment is the recommendation of drinking lots of liquids, bed rest and possibly some pain killers. The most lucrative for doctors is surgical removal,which on top of the risk of infection and other surgical complications also requires bed rest, pain relievers and drinking lots of liquids. Which makes sense for federal reimbersment? Is that rationing care? Or just being rational?

Posted by: bills at June 25, 2009 09:07 AM
Comment #283563
What nonsense. There are people involved in public policy that actually want to help solve problems and make the country a better place.

Yes, and to do so they feel that they must work within the political environment, which means blocking possible fixes if they don’t match the agenda of the group they belong to. An honest look at both sides here will show what I mean.

I understand this does not fit with your Ann Rand,screw everybody else world view, but its true nonetheless.

Hilarious. Of course it is completely invalid an innacurate, but since when has reality gotten in the way with a good liberal, right?

BTW, it is Ayn Rand, and I have never read the author. So no, my ‘world view’ is not based on her writings at all. You’ll have to find another insult for the future I’m afraid.

Posted by: rhinehold at June 25, 2009 09:14 AM
Comment #283568

http://www.ask.com/bar?q=heath+care+percent+of+GDP+global&page=1&qsrc=19&ab=0&u=http%3A%2F%2Fglobalhealthnet.com%2FHealthcareExpensesasPercentofGDP.html

We are at a distinct competitive disadvantage. Read a piece in ATLANTIC suggesting that the Reps should recognize this and ,as Nixon went to China,come up with a better plan. More of the same don’t cut it.

DR
BHO has so far proved to be a good political strategist and you were correct that the “blue dogs” you often support are indeed an obstacle going forward with what is a weak reform agenda.I say, fine lets go for it.We know what to do. If there is a filibuster,let the Reps stand there and explain why Americans should not have health care,why we should pay more than any other country on Earth and still have millions without coverage, why a 16 year old from Detroit’s inner city should die from a toothache. Let them read reciepies or Hoyles or whatever. The last time that happened was to block civil rights legislation.This is at least as important. Senators were known to strap cans of soup to their legs so they could last. The rules are still extant. No leaning on the podium etc. Those fat assed Reps wouldn’t last a day.
The solutions proposed are already past the middle of the road. That’s it . No more. Its put up, or shut up time and I hope BHO has got that.

Posted by: bills at June 25, 2009 10:29 AM
Comment #283569

RH
Apologies. You
struck me as a devotee.

Yes, and to do so they feel that they must work within the political environment, which means blocking possible fixes if they don’t match the agenda of the group they belong to.”

So if you think a public policy direction that makes sense might be put into effect,it is therefore a mistake? You third party guys. A laugh a minute. I have had the same discourse with DR, BTW.
Really,where is the great Rep or Lib proposal to reduce the health care cost our country bears? How do we take the burden off responsible companies that provide for their workers?How do we get rid of the competitive dis-adnatage we are paying because health care cost continue to eat up more of the GDP than any country in the world and still leave us with millions without coverage? Drop dead if you get sick is not going to work . Come on. Whats your program? Any way you can do it without” work within a political environment”?

Posted by: bills at June 25, 2009 10:56 AM
Comment #283570

bills

“One example are gallstone treatments. Gallstones are painful. They also usually go away. The most lucrative for doctors is surgical removal,which on top of the risk of infection and other surgical complications also requires bed rest, pain relievers and drinking lots of liquids. Which makes sense for federal reimbersment? Is that rationing care? Or just being rational?”

i guess that depends on who you feel should ultimately make that call, you, and your doctor, or some gov’t beauracrat trying to keep costs down. which is more rational in your opinion? BTW i didn’t know you were a doctor.

Posted by: dbs at June 25, 2009 11:03 AM
Comment #283588

I posted earlier that delivering a healthcare package or any similar large legislation package is impossible as our government is so completely broken as to be virtually useless for anything other than defense of the country and even that is costly sector is being quickly eroded. Here are a few notes from today’s Wash Post. “53 indicted in Medicare Fraud Sting”. $50M in billing for unneeded services or for services that were not provided. I find that kind of special since healthcare fraud has been rampant through my lifetime and now that healthcare is on the front burner we get some enforcement action. How special! Yesterday the Senate Commerce Committee released a report stating that insurance companies have bilked consumers of billions that the insurance companies should have paid. Three healthcare specialist testified that insurers go to great lengths to avoid responsibility for sick people, use deliberately incomprehensible documents to confuse clients about their benefits and sell ‘junk’ policies that do not cover needed care. Well, this has been going on throughout my lifetime as well. Didn’t need a gov. committee to educate me on that one. Attny. Gen. Cuomo, NY, found that insurers under reimbursed consumers by as much as 28%. The insurance companies complained saying that paying whatever doctors charge is simply not economically tenable. A nice capitalists statement coming from a biz exec.
Let’see. What else is in the news that I already know. Ah, here’s one! Hospitals in the area are bracing for more cutbacks as they are experiencing soaring demand from uninsured patients (read illegal immigrants). Uninsured in this country stands at around 51M folks. The administration is pushing for free healthcare for illegals in their new public healthcare plan. Medical coverage for illlegal children was provided for in the recovery act for children to the age of 32 under the SCHIPS program.
Turns out that the Fed employees healthcare plan doesn’t provide the low drug price competition and market dominance they theoretically should bring 2, but that’s about to change according to the Fed. ‘Change’ will clear away the smoke and mirrors that surround the employee program. Ain’t that special! All these years we’ve heard about how great the Fed Emp healthcare program is and now they are talking of ‘change’ and smoke and mirrors. It was found that the OPM, which runs the program, pays substantially more for drugs as it does not regulate or negotiate on the price of drugs as other federal agencies such as Medicare, VA and Public Health Service in spite of the fact that the FED has the buying power of 8M members. It was found that Costco and drugstore.com offer better drug prices than the FED program. Seems some pharmacy managers were receiving rebates of up to 50% that wasn’t being passed back to OPM. Who’d of thunk!? Can u believe it?
I saw something in the post today that knocked my socks off. Twice, the writer of one article referred to ‘reform’ of the healthcare system! When is the last time you heard the word reform relating to any gov entity? I’m blown away! To wit; “White House officials said Obama opened the meeting with his pitch for reform, calling the status quo unsustainable—“ and, “with cost estimates for health reform soaring beyond $1 trillion over the next decade- -“.

In an earlier post I discussed why reform attempts at anything is useless with a corpocrisy government in place. I noted that certain government reforms would be necessary before reform legislation on any major issue could be achieved. After reading Bills latest post on healthcare reform I want to add another necessity.

Reform of government would be incomplete without including the Congress as part of the effort. Congressional reform is needed to regain the proper representation a Representative or Senator should provide for his/her state. The goal would be to set a level playing field for all members so that the words ‘junior’ or ‘senior’ become superfluous. Thus, salaries of all members should be the same with no yearly pay increases and no retirement program. A new senator should have as much clout as a senator who has held office for several terms. The business model organization of tenure, pay and advancement to positions of power should be abolished. Organization and scheduling would still be done by appointed members but any perks associated with the position would be nil. The legislature is not a career oriented business and should not be operated as such.

Thank you Bills, for your recent post reminding me of my third party advocate responsibilities on reform issues.
I shall add Congressional reform to our VisionUSA page soonest.

Otherwise, we have the corpocrisy we deserve.

Posted by: Roy Ellis at June 25, 2009 03:50 PM
Comment #283590

Rhinehold-
It may be that you’re an objectivist, and just don’t know it!

Seriously, though, it is often the case that people do not necessarily know what the provenance of the views they came to believe in, or what the goals and strategies behind those expressed views were.

It also helps if you realize that some of the commentators who bring up notions like yours are part of the establishment of right-wing pundits and media figures, and that people’s confusion about your political identity owes itself to their attributing the political sensibilities of these other folks to you, on account of your similar expressed views.

Posted by: Stephen Daugherty at June 25, 2009 04:33 PM
Comment #283592

Roy Ellis, careful of throwing out the baby with the bathwater. Over what period of time did this 50 billion in fraud take place?

If it took place under the Bush administration and Republican Congressional control, it is understandable. They had their agenda, and upholding the Constitution and law of the land was not part of it. They were cutting police, pulling law enforcement manpower from crime to their obsession over creating terrorists in our midst whether they existed or not.

What you describe is a failure of those elected to office, not of government intrinsically. And you and I and the rest of the voting public have the power and control to insure that our government prevents such massive fraud, waste, and abuse of our tax dollars, IF we choose to accept and exercise that responsibility. Otherwise, as d.a.n is fond of saying, we have the government WE deserve by our voting choices.

Posted by: David R. Remer at June 25, 2009 05:12 PM
Comment #283593

bills made the erroneous statement: “BHO has so far proved to be a good political strategist and you were correct that the “blue dogs” you often support are indeed an obstacle going forward with what is a weak reform agenda.”

I don’t support Blue Dogs, and with a bit of literacy, you would know that from my writings here. I don’t support incumbents, of any canine version, and haven’t for years. I do support responsible fiscal management of our tax dollars, economy, and future viability of our nation. That is quite different from the baseless statement of yours that I often support the Blue Dogs.

Again, with a bit of review of my writing, one would easily see that I support Health Care Reform, driving down the costs and increasing insurance coverage for all who wish it. In general, I support the current proposal coming out of the White House. It will not however, solve our health care crisis without creating other problems to be dealt with. And of course, the details, where devils love to reside, are not all available yet for review and debate.

To weigh and consider policy initiatives BOTH for its merits and potential costs, is the only rational approach to take. I recommend it to all who will rely on the Health Care Reform legislation, in any way, for anything. And then make a decision as to whether they support it or not.

To support a legislative bill for little other reason than Progressives or Democrats champion it, is about the dumbest and most irresponsible justification for support, imaginable. That kind of approach brought us the GW Bush crippling years of debt, failed policies, and crumbling infrastruture in nearly every facet of society save space exploration and terrorist oriented activities.

Posted by: David R. Remer at June 25, 2009 05:25 PM
Comment #283595

bills said: “Careful of putting words in BHO’s mouth.”

Huh!? I quoted Obama directly. What is this literacy problem? Quoting a person is not putting words in their mouth. Obama spoke directly to the rationing issue. And I offered my understanding of what he said. I wouldn’t presume to put words in Obama’s mouth. In fact, I said, I don’t pretend to know Obama’s mind or thinking, right up front.

As for your question, I agree with rational health care choices, which optimize the patient’s health while saving the society and nation costs we can ill afford.

A great many Americans need to grow up or continue being ignored as the petulant and ignorant citizens they are. I refer here to choice based on who is paying. If one wishes to pay for one’s own health care through self-insurance, one can elect any medical procedure whatsoever they choose. If on the other hand, they are relying upon the pooling of monies from thousands to 10’s of millions of others, they must accept limitations on how much of those other’s money they can spend on their own medical choices.

Under the public option, people’s medical needs should be met. Their elective choices should not be. If that constitutes rationing and is the only criticism the conservatives can lob at public health insurance, it will not carry the day. Idjuts do sometimes fool all the people. But, they never fool all the people all the time. Idjuts blocked needed health care reform in ‘93 or ‘94, when it could have been vastly cheaper to implement and could have prevented the massive inflation in health care costs we are now experiencing. But, the Idjuts will not prevail this time.

The general public is often found ignorant on this or that issue, which can permit Idjuts to prevail for awhile. But, the general public has a way of becoming informed on issues that hurt them, and that right quickly. Then the Idjuts lose their power to lead on that issue.

Idjuts, btw, are people led by their Id, instead of their rational and objective capacity, if they have any at all.

Posted by: David R. Remer at June 25, 2009 05:40 PM
Comment #283616

DR
Literacy problem? That was a caution against inferring to much from BHO’s comments. I can smell a frantic Red Column piece already about how Obama wants death camps for seniors as part of the health care overhaul.

Posted by: bills at June 25, 2009 11:24 PM
Comment #283617

DR
You might like this from Robert Reich.

http://robertreich.blogspot.com/2009/06/what-can-i-do.html

Posted by: bills at June 25, 2009 11:34 PM
Comment #283620
It also helps if you realize that some of the commentators who bring up notions like yours are part of the establishment of right-wing pundits and media figures, and that people’s confusion about your political identity owes itself to their attributing the political sensibilities of these other folks to you, on account of your similar expressed views.

My views are based on those of James Madison, Thomas Jefferson, Benjamin Franklin, etc. I guess I didn’t realize that those views were so ‘radical and anti-american’. That others use some of those views but the left no longer does doesn’t mean we are all the same.

The left USED to believe in those as well, but that was a while ago…

Posted by: rhinehold at June 25, 2009 11:56 PM
Comment #283624

bills, you are not doubt right about GOPUSA coming up with a death camp scenario from Obama’s words, but, there is a difference between understanding a person’s words, and manipulating them, and in the case of a great many Republicans and Libertarians response to Obama’s words, the difference is readily discernable.

The majority of Americans can tell B.S. from understanding, even if they can’t repeat it as stated. Which explains Obama’s still high approval ratings against a background of still enormous challenges. I don’t think Americans are worried about Obama disappearing to Argentina’s Appalachian trails for a tryst while our nation continues to face challenges.

The human brain is capable of so very much more than even itself gives it credit for. And therein lies the perpetual hope and perseverance based on our history as a people in meeting and overcoming many dark days and times that will live in infamy. That is also why America will never let the shame of its past block its path toward a more proud future.

Posted by: David R. Remer at June 26, 2009 12:46 AM
Comment #283625

Yeah, Riech is pretty much spot on. Obama does believe in the American democracy, and will respond to the people. He is acutely aware that his position today is a direct result of the people. Violating their trust or majority will where it is enlightened by facts and reality, is not something Obama is likely to do. Where is the incentive or motivation for him to do so?

It is up to the people and the voters to force their government to their own account, or force that government out of office. It always has been so in America.

Posted by: David R. Remer at June 26, 2009 12:53 AM
Comment #283626

All their views, Rhinehold? Or just the ones you have cherry picked and interpreted to your own value system? These are rhetorical questions.

Posted by: David R. Remer at June 26, 2009 12:54 AM
Comment #283634

Yes, they are rhetorical because you don’t have anything to back them up or counter anything I’ve stated. Doing so would prove you wrong so you don’t bother. I understand how you play the game here.

Make the accusation out of whole cloth and then slip back behind the ‘these are rhetorical questions’ slosh, no need to get your feet wet that way.

Posted by: rhinehold at June 26, 2009 10:57 AM
Comment #283635

“Here are a few notes from today’s Wash Post. “53 indicted in Medicare Fraud Sting”. $50M in billing for unneeded services or for services that were not provided. I find that kind of special since healthcare fraud has been rampant through my lifetime and now that healthcare is on the front burner we get some enforcement action.”

Roy this fraud has been ongoing and has been fought for years by the feds, contrary to your belief that they have just started do so. They have put up hotlines for people to call, prosecuted fraud etc. for years. Perhaps because they have only a 3% overhead they are taken advantage of but to raise the overhead to combat the fraud may not be economically feasible.

The real issue here is who is perpetrating the fraud. It is those in the medical profession and those that imitate the medical profession. These criminals also commit fraud against private insurance companies. Some insurance companies perpetrate fraud against the people of this country as part of doing business. I would think that those that imitate the medical community should be thrown into the domestic terrorist category and treated as such when caught. Theoretically, at least, they cause many deaths due to their actions.

Posted by: j2t2 at June 26, 2009 10:58 AM
Comment #283646

J2T2, I feel the real issue is that we have a corpocrisy government run of, by and for those with the most money to put a buy and hold on the legislators. Therefore, I see little sense in debating reform of any major program. The best we will get is a few cosmetic changes.
Let’s just look at Congress for a minute. Put in place by the system, a representative, after a couple of terms, becomes a chairman of some committee or similar powerful position. Often this one person can hold sway over which legislation comes to the table and when. This one person is given power over your representative, not through the Constitution but by a business oriented pecking order established by the corpocrisy over the last 100 years or so. So, the big donations are targetted at those who pull the strings of Congress. Now, since the only way these powerful folks can remain in a powerful position is to enjoy the support of the corpocrisy they are likely to support the copocrisy position rather than utter the word ‘reform’. That could get them sent home to Podunk, Somewhere rather than a high rise suite working for UBS or some big Pharma in later life. Thus, no healthcare reform, just a few changes to keep the old folks happy.
Come on J2T2, get innovative! Change your name to J3T3 and come out supporting a new third party for government reform.

Otherwise, we have the corpocrisy we deserve.

Posted by: Roy Ellis at June 26, 2009 01:05 PM
Comment #283648

So Rhinehold, this is what you believe?

That wasn’t really difficult.

Posted by: gergle at June 26, 2009 01:56 PM
Comment #283656

Roy I can agree that our representative democracy has been replaced with an unrepresented capitalistic system of government and unfortunately I can not argue against you comment that the end result of the current health care reform may well be a token for us old folks. However while the debate is still ongoing in DC I will continue to hope the Congress will do something for the people on this issue other than let the insurance companies off the hook.

As far as changing to j3t3 as far as political parties I would prefer to change it to j5t5 or j6t6 but until the time that a serious party emerges I will continue to be j2t2. The trouble with 3rd parties is they all want to start out at the top. In Colorado we had 11 choices for president and 2 for representative.

Posted by: j2t2 at June 26, 2009 03:17 PM
Comment #283657

j2t2 agree with that. We generally have some fair haird dude like Perot who most often turns out to be a flash in the pan. Republic Sentry is different. Taking the field of dreams approach. Build it and they will come. “I will continue to hope the Congress will do something for the people on this issue”. That sentiment continues to reverberate across the country. Befuddles me! Let’s break out our Tommy Jefferson took kit and make it happen.

Otherwise, we have the corpocrisy we deserve.

Posted by: Roy Ellis at June 26, 2009 04:04 PM
Comment #283660

I am interested in the idea of competion between the government and private enterprise with healthcare.

Conservatives have shouted for many years about the need for competition with government in education. If education is the subject, conservatives are for it, liberals against it.
With healthcare we might learn something useful.

Liberals are quick to point out profits of insurance companies and salaries of executives. On the contrary they shy away from talking about medicare fraud.

My guess is that government would provide better care for the masses which is important. On the other hand the best thing government can do for my personal coverage is to leave it alone. My coverage is fine as is.

I would be very angry if my benefits became taxable. We were promised no tax increases if we made under $250,000 a year. That’s a promise that we need to hold the Democratic party to.

Posted by: Craig Holmes at June 26, 2009 06:43 PM
Comment #283681

Interesting article:

Debunking Canadian health care myths

Posted by: womanmarine at June 27, 2009 10:44 AM
Comment #283781
Craig Holmes wrote: I am interested in the idea of competion between the government and private enterprise with healthcare.
Me too.

As many here have pointed out, for-profit health insurance is riddled with fraud and corruption too. Medicare and Social Security are also riddled with fraud, bloat, waste, and corruption (e.g. 7% of Medicare is lost to fraud in 2007, and many trillions have been pilfered from the Social Security and Medicare trust funds).

It will be interesting to see which will be the most fraudulent and corrupt:

  • for-profit health insurance?

  • or a federal government-run non-profit health insurance system?

And will people be forced to participate via new taxes? Seems to me if it is voluntary, there would be tens of millions of Americans who would participate, since no private insurance companies will insure them now.

At any rate, the voters have the government that the voters elect (and re-elect, and re-elect, and re-elect , … , at least until that finally becomes too painful).

Posted by: d.a.n at June 30, 2009 08:14 AM
Post a comment