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Thread: House bill would make health care a right

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    Re: House bill would make health care a right

    Quote Originally Posted by Richard Nixon View Post
    Surely it does? Without the enormous taxes raked in by the US government the military would not be as financially effective and thus not provide a US citizen his/her right to protect his/her country. Or have I misunderstood you?


    I refer you to the US constitution.
    Let evil swiftly befall those who have wrongly condemned us

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    Re: House bill would make health care a right

    Quote Originally Posted by Richard Nixon View Post
    Surely it does?
    No, it doesnt.
    Paying for health care provides someone the means to exercise their right to same.
    Paying for the military protects the opportinuty for someone to exercise their rights.
    Thus apples/oranges.

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    Re: House bill would make health care a right

    Quote Originally Posted by earthworm View Post
    The Constitution is over 200 years old, times, society, conditions were different.
    Do you fear change ?
    If so, join the crowd.
    This is another red herring farcical argument from those who attempt to defend the indefensible; that is, the notion that if you are against the Government running healthcare you must be against change.

    It begs the question; you have GOT to be kidding right?

    It’s almost as asinine an argument as the claim that you must hate the poor if you do not support Government run healthcare for all.

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    Re: House bill would make health care a right

    Originally Posted by Truth Detector
    I find these Government control arguments laughable. Let me ask you a question; do you believe that once Government manages our healthcare system they will not be in the business of denying care? Have you ever seen the comments coming from Obama and what other nations with centralized Government care do to deny coverage?

    Quote Originally Posted by LiveUninhibited View Post
    Healthcare will be rationed in any system, and I don't know where I implied it won't. But denying people on an arbitrary basis to make money is worse than denying people on the basis of what is effective and cost effective.
    There are no facts to support your assertion that private insurance companies deny services based on arbitrary monetary purposes. They in fact deny coverage based on CONTRACTUAL obligations between the parties to the contract.

    Insurance companies cannot LEGALLY deny coverage based on the CONTRACT.

    Once again, your assertions suggest that Government has a more moral purpose than the Insurance companies, but I assure that the FACTS suggest that if Government takes over your healthcare MONEY and FINANCIAL concerns will overwhelm the system and thus result in LESS services available, LESS choice and LESS technological research and development; in other words result in MEDIOCRITY.


    Originally Posted by Truth Detector
    You rail about the profit motivation behind Insurance companies in a vacuum of reality and facts and support some absurd and naive notion that once Government puts insurance companies out of business we will all get undeniable care.

    Quote Originally Posted by LiveUninhibited View Post
    No those who need care will have access to it, as private insurance excludes on the basis of how much of a risk an individual is as opposed to how effective and cost-effective a tx/rx is.
    Says you, but the REALITY is that there will be limitations and yes, while they may have ACCESS, they wont get the care in a timely fashion if at all.

    Take a look at the wait times to get heart bypass surgery in nations with these programs compared to our own.

    In Canada, you can wait more than a month just to see a doctor about your acid reflux problems. Is this really access?

    Originally Posted by Truth Detector
    The FACT is that competition is what keeps costs down. Once that is removed, there will be a never ending upward spiral of costs; the only difference is that the burden of those costs will no longer be borne by the individuals or insurance companies, it will be borne mainly by those who are still employed through excessive taxation and VAT taxes on everything we purchase.

    Quote Originally Posted by LiveUninhibited View Post
    The upward spiral of costs can be attributed to the lack of integrated and primary care.
    I would like to see some FACTS to support these farcical assertions.

    The upward spiral of costs can be directly attributed to Government regulations on the industry, the fact that people with insurance have little to do with the payment of their care, high litigation costs and the fact that many states like California LIMIT insurance companies from being able to provide services in their states if they do not reside within the state itself.

    Quote Originally Posted by LiveUninhibited View Post
    Lack of primary care is exacerbated by people being uninsured or underinsured.
    There are no FACTS to support this assertion. People, normally, do not WANT to see a doctor until they HAVE to. The notion that by having unlimited “access” to limited resources of Government sponsored health providers leads to better health is a lie.

    Education of the public to the causes of poor health will do far more than access; smoking is bad, eating foods high in fat and cholesterol is a bad thing and not having a daily exercise routine is a bad thing.

    People’s HABITS are what causes poor health in many instances NOT the fact that they do not have “access” or the idiotic notion that if Government provides for everyone’s healthcare we will suddenly be healthier.

    Quote Originally Posted by LiveUninhibited View Post
    There is no meaningful competition in health insurance, except in the sense of encouraging pseudoinsurance, as it is mostly employer-based, but individual insurance is ridiculous in its overhead costs, and people do not generally have the expertise to evaluate the intricacies of insurance.
    There is no “meaningful” competition in many states because of GOVERNMENT rules.

    The claim that insurance is prohibitive in cost can only be made if one presumes that the consumer should not CHOOSE to spend their money on OTHER things that they CHOOSE to instead of buying insurance for health care.

    I would like to have better dental coverage, but I CHOOSE to pay for the lesser costly version because I CHOOSE to spend the money on OTHER items with a bigger priority and take the RISK of having to pay more later if I need emergency care.

    But at least I have a CHOICE.

    The most asinine argument in this debate is the notion that once Government gets involved in providing healthcare, the costs will miraculously go down; there is not one shred of historic evidence that suggests that whenever Government becomes involved in ANYTHING the costs will go down.

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    Re: House bill would make health care a right

    Quote Originally Posted by Truth Detector View Post
    There are no facts to support your assertion that private insurance companies deny services based on arbitrary monetary purposes. They in fact deny coverage based on CONTRACTUAL obligations between the parties to the contract.
    I covered this. Average people do not understand the contract they sign. You may say this makes them idiots, and I agree that most people are, but having poor coverage is better than nothing and not everybody can hire a lawyer to make sure they get their policy.

    Once again, your assertions suggest that Government has a more moral purpose than the Insurance companies, but I assure that the FACTS suggest that if Government takes over your healthcare MONEY and FINANCIAL concerns will overwhelm the system and thus result in LESS services available, LESS choice and LESS technological research and development; in other words result in MEDIOCRITY.
    Choice is pretty meaningless is healthcare, as people do not know what they need or when they'll need it. When somebody gets acutely ill, they go to the nearest hospital. They are in no position to negotiate for price with whoever treats them. The ethical provider will give them options when possible.

    But even if choice were relevant, you haven't really presented proof of your "facts" but rather restatements of your ideology. There really is no choice right now for people who get insurance through their employers, and HMOs quite literally restrict choices to their providers for non-emergency care. PPOs give financial incentives to go to their providers, but given the non-monogamous relationship between them and providers it's hard to know who is on what list. There's little to no choice in the private system, only confusion and waste. One confusing and wasteful payment source is going to be less confusing and wasteful than our disorganized and varied system.

    The insurance companies have nothing to do with technological research. In reality, governments fund healthcare research here and everywhere, and our supremacy is a function of our excellent medical schools and universities, both public and private. Profit does drive innovation on the provider level, and a government system that asks for cost benefit analysis and evidence-based medicine will give incentives for them to develop products that are actually new instead of me-too drugs and superficially better machines that do not aid in outcomes.

    Says you, but the REALITY is that there will be limitations and yes, while they may have ACCESS, they wont get the care in a timely fashion if at all.
    While there are exceptions, most of the waiting in the countries often cited is for elective procedures. And neither I nor Congress are advocating for us to copy Canada or the UK, who do not have the best systems either. France and Japan do much better.

    Take a look at the wait times to get heart bypass surgery in nations with these programs compared to our own.
    And do they have worse mortality rates for it?

    I would like to see some FACTS to support these farcical assertions.
    lol, the fact that more use of primary care would help with costs is not seriously in dispute. The conservatives who are informed on this merely say that NHI will not increase use of primary care. While I'd agree that NHI is not sufficient in itself to increase use of primary care, it is necessary.

    Primary care is necessary for continuity of care, as you have a physician who follows you over a longer period of time and sees your baseline conditions prior to developing acute/chronic complications. This aids in coordination of care, minimizing overtreatment and undertreatment at the secondary and tertiary levels. And offers comprehensive care that is not limited to one system or disease state.

    Many studies corroborate this. The increased continuity of care that comes with primary care is associated with greater use of preventive measures, higher medication compliance, better outcomes for diabetics, better outcomes for pregnant women, reductions in hospitalizations, and declines in overall costs.

    Coordination is also more likely to be present with primary care utilization. Elderly patients receiving primary care from generalists (as opposed to specialists) are more likely to receive their immunizations and preventive services. International comparisons indicate that nations with a greater primary care orientation (America has 1/3 primary care physicians, other countries have 1/2 - 2/3) have more satisfied patients, lower infant mortality, higher life expectancy, and lower total health expenditures.

    Even within America, states with more primary care physicians per capita have lower total mortality rates, higher life expectancy, even adjusting for factors like age and income. States with higher specialists per capita have higher costs but not higher quality.

    A study of adults in America who report a primary care physician (PCP) as their personal physician had 33% lower health costs, and 19% lower mortality than those seeing primarily specialists, this is even adjusting for age, sex, ethnicity, health insurance status, diagnosis, and smoking status.

    While the above information is taken from many sources, I found them in Understanding Health Policy: A Clinical Approach, 5th edition by Dr. Thomas S. Bodenheimer and Dr. Kevin Grumbach, pages 50-53.

    The upward spiral of costs can be directly attributed to Government regulations on the industry, the fact that people with insurance have little to do with the payment of their care, high litigation costs and the fact that many states like California LIMIT insurance companies from being able to provide services in their states if they do not reside within the state itself.
    Initially it was doctors themselves. Blue Shield and Blue Cross were founded by doctors and hospitals for doctors and hospitals as their capabilities expanded they did not have a reliable source of income from out of pocket. Hospitals used to be primarily a place to die, not to get expensive treatment. Blue Cross for hospitals grew directly out of the Great Depression.

    The doctors and hospitals also consolidated their political power, and the governments actions reflected that. Unfortunately hospital-based care is expensive. When Richard Nixon passed his own healthcare reform in 1973, requiring that employers utilize HMOs when available, he very foolishly included second generation HMOs, which grew into the confusing and wasteful system known as PPOs that continue to plague us.

    There are no FACTS to support this assertion. People, normally, do not WANT to see a doctor until they HAVE to. The notion that by having unlimited “access” to limited resources of Government sponsored health providers leads to better health is a lie.
    Actually yes there are. Same book I mentioned before has a chapter that talks about Community Health Centers, which were focused upon providing charity primary care to underserved areas:

    The neighborhood health centers made important contributions. By improving the care of low-income ambulatory patients, the centers were able to reduce hospitalizations and emergency department visits by patients. Neighborhood health centers also had some success in improving community health status, particularly by reudcing infant and neonatal mortality rates among African Americans.
    Where I did my undergraduate work, I volunteered for such a place called Community Outreach. The clinic is actually funded by the local hospital, as it helps them stay out of the red by reducing the use of the ER by the poor.

    Education of the public to the causes of poor health will do far more than access; smoking is bad, eating foods high in fat and cholesterol is a bad thing and not having a daily exercise routine is a bad thing.
    I agree that is a good idea, but it doesn't really take away from my positions.

    People’s HABITS are what causes poor health in many instances NOT the fact that they do not have “access” or the idiotic notion that if Government provides for everyone’s healthcare we will suddenly be healthier.
    And one thing the stats I mentioned above highlight is that primary care can have an effect on habits.

    The claim that insurance is prohibitive in cost can only be made if one presumes that the consumer should not CHOOSE to spend their money on OTHER things that they CHOOSE to instead of buying insurance for health care.
    But pooled risk on a larger level makes costs more manageable, especially by reducing overhead. Hence government insurance. As I said before, individual plans cost even more overhead than employer-based plans, and most people cannot afford coverage that covers all contingencies.

    The most asinine argument in this debate is the notion that once Government gets involved in providing healthcare, the costs will miraculously go down; there is not one shred of historic evidence that suggests that whenever Government becomes involved in ANYTHING the costs will go down.
    The costs go down automatically because of reduced overhead and the lack of need to make a profit. Whether it will be a lot better or a little better depends on how well it is managed. If they emphasize primary care, evidence-based medicine, and electronic medical records, we will be a lot better off. If not, we will only be a little better off.

    The shred of historic evidence that it CAN be done, as I have linked many times, is the VHA: Veterans' health system blazing trails
    Last edited by LiveUninhibited; 07-22-09 at 03:35 PM.

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    Re: House bill would make health care a right

    Quote Originally Posted by LiveUninhibited View Post
    I covered this. Average people do not understand the contract they sign. You may say this makes them idiots, and I agree that most people are, but having poor coverage is better than nothing and not everybody can hire a lawyer to make sure they get their policy.
    This is false. But equally absurd is the notion that because people are idiots, they sign things they don't know what is in them.

    Yet the FACTS are that they put their faith in their employers trained professionals to negotiate contracts with HMO's in MOST cases. Are they idiots?

    Quote Originally Posted by LiveUninhibited View Post
    Choice is pretty meaningless is healthcare, as people do not know what they need or when they'll need it. When somebody gets acutely ill, they go to the nearest hospital. They are in no position to negotiate for price with whoever treats them. The ethical provider will give them options when possible.
    Fascinating argument; choice is the main thing that makes our system work better than others that have NO choice.

    Do you have any evidence that suggests people are so stupid that they don't know when they need care or a check up? REALLY?

    But it begs the question; how is a Guvuhmint system going to provide MORE choice or better services? The facts do not support such assertions whereas in most countries with Guvuhmint managed systems the people who need an alternate choice typically come HERE.

    Quote Originally Posted by LiveUninhibited View Post
    But even if choice were relevant, you haven't really presented proof of your "facts" but rather restatements of your ideology. There really is no choice right now for people who get insurance through their employers, and HMOs quite literally restrict choices to their providers for non-emergency care. PPOs give financial incentives to go to their providers, but given the non-monogamous relationship between them and providers it's hard to know who is on what list. There's little to no choice in the private system, only confusion and waste. One confusing and wasteful payment source is going to be less confusing and wasteful than our disorganized and varied system.
    It is apparent that you know very little about how employer provided systems and HMOs work. I would like to see one shred of evidence where the person with the insurance didn't have a choice; they could choose what coverage they wanted, most provide several choices of care providers and you can get more or less services based on what you are willing to pay and the employer even matches the costs.

    The notion that your argument has merit that private systems provide less choice than the alternative Government systems requires outright denial.

    Quote Originally Posted by LiveUninhibited View Post
    The insurance companies have nothing to do with technological research. In reality, governments fund healthcare research here and everywhere, and our supremacy is a function of our excellent medical schools and universities, both public and private. Profit does drive innovation on the provider level, and a government system that asks for cost benefit analysis and evidence-based medicine will give incentives for them to develop products that are actually new instead of me-too drugs and superficially better machines that do not aid in outcomes.
    I find this argument stunning in its lack of any connection with reality; but I will give you the benefit of the doubt and ask that you back this statement up with credible sources.

    Quote Originally Posted by LiveUninhibited View Post
    While there are exceptions, most of the waiting in the countries often cited is for elective procedures. And neither I nor Congress are advocating for us to copy Canada or the UK, who do not have the best systems either. France and Japan do much better.
    False; in fact, even the most basic care can require month long waits. In Canada, one can wait a month and a half to see a doctor for something as mundane as acid reflux (this based on a personal friend of mine who is Canadian and needed the care). How long do you think you would wait in this country for the same care? A few hours perhaps?

    In countries with Guvuhmint run healthcare resources are scarce and specialists in extremely short supply; it is so bad that some actually die waiting for surgery that they would never have been permitted to leave the hospital for in this country.

    Quote Originally Posted by LiveUninhibited View Post
    And do they have worse mortality rates for it?
    I am curious how one can use infant mortality rates as a measure of the quality of a healthcare system; how is that?

    Quote Originally Posted by LiveUninhibited View Post
    lol, the fact that more use of primary care would help with costs is not seriously in dispute. The conservatives who are informed on this merely say that NHI will not increase use of primary care. While I'd agree that NHI is not sufficient in itself to increase use of primary care, it is necessary.
    Yet there is no data that can support this THEORY using reality as one of the variables. First off it ASSumes that everyone will start going to the doctor; and secondly is ASSumes that this massive influx of new patients will not overwhelm the system.

    Quote Originally Posted by LiveUninhibited View Post
    Primary care is necessary for continuity of care, as you have a physician who follows you over a longer period of time and sees your baseline conditions prior to developing acute/chronic complications. This aids in coordination of care, minimizing overtreatment and undertreatment at the secondary and tertiary levels. And offers comprehensive care that is not limited to one system or disease state.
    Are you claiming that the current system does not allow this? Are you also claiming that in a Guvuhmint run system we will all have our own primary care doctors to see whenever we want at no additional costs?

    REALLY?

    Quote Originally Posted by LiveUninhibited View Post
    Many studies corroborate this. The increased continuity of care that comes with primary care is associated with greater use of preventive measures, higher medication compliance, better outcomes for diabetics, better outcomes for pregnant women, reductions in hospitalizations, and declines in overall costs.

    Coordination is also more likely to be present with primary care utilization. Elderly patients receiving primary care from generalists (as opposed to specialists) are more likely to receive their immunizations and preventive services. International comparisons indicate that nations with a greater primary care orientation (America has 1/3 primary care physicians, other countries have 1/2 - 2/3) have more satisfied patients, lower infant mortality, higher life expectancy, and lower total health expenditures.
    Please provide a link to the source of these studies.

    Quote Originally Posted by LiveUninhibited View Post
    Even within America, states with more primary care physicians per capita have lower total mortality rates, higher life expectancy, even adjusting for factors like age and income. States with higher specialists per capita have higher costs but not higher quality.
    Regardless, the notion that Guvuhmint managed care will lead to MORE primary physicians certainly requires willful denial don't you think?

    Quote Originally Posted by LiveUninhibited View Post
    A study of adults in America who report a primary care physician (PCP) as their personal physician had 33% lower health costs, and 19% lower mortality than those seeing primarily specialists, this is even adjusting for age, sex, ethnicity, health insurance status, diagnosis, and smoking status.

    While the above information is taken from many sources, I found them in Understanding Health Policy: A Clinical Approach, 5th edition by Dr. Thomas S. Bodenheimer and Dr. Kevin Grumbach, pages 50-53.

    Initially it was doctors themselves. Blue Shield and Blue Cross were founded by doctors and hospitals for doctors and hospitals as their capabilities expanded they did not have a reliable source of income from out of pocket. Hospitals used to be primarily a place to die, not to get expensive treatment. Blue Cross for hospitals grew directly out of the Great Depression.

    The doctors and hospitals also consolidated their political power, and the governments actions reflected that. Unfortunately hospital-based care is expensive. When Richard Nixon passed his own healthcare reform in 1973, requiring that employers utilize HMOs when available, he very foolishly included second generation HMOs, which grew into the confusing and wasteful system known as PPOs that continue to plague us.

    Actually yes there are. Same book I mentioned before has a chapter that talks about Community Health Centers, which were focused upon providing charity primary care to underserved areas:
    I have no idea how this supports the absurd notion that Guvuhmint run healthcare will lead to more efficiencies, lower costs and better care.

    Quote Originally Posted by LiveUninhibited View Post
    But pooled risk on a larger level makes costs more manageable, especially by reducing overhead. Hence government insurance. As I said before, individual plans cost even more overhead than employer-based plans, and most people cannot afford coverage that covers all contingencies.
    Yes pooled risk combined with COMPETITION to provide those services will make costs more manageable and reduce overhead. But there is not ONE example where the Govuhmint has ever accomplished this; therefore it begs the question, what data suggests that Government stewardship leads to lower costs and lower overhead?

    Once more your notions about the REAL world are idealistic and not practical and there is no evidence that your theoretical views can be substantiated in the REAL world.

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    Re: House bill would make health care a right

    CONTINUED:

    Quote Originally Posted by LiveUninhibited View Post
    The costs go down automatically because of reduced overhead and the lack of need to make a profit. Whether it will be a lot better or a little better depends on how well it is managed. If they emphasize primary care, evidence-based medicine, and electronic medical records, we will be a lot better off. If not, we will only be a little better off.
    Please provide on shred of credible evidence that will suggest that any Government run program led to lowering of costs. Yes, by confiscating wealth and re-distributing it to someone who has less, it reduced their cost, but the overall cost of the system went up.

    Presently, Europeans are struggling with the REALITY that their social systems of which health care is the single largest cost factor are causing huge demands in their budgets.

    The REALITY is that the Guvuhmint manages costs by limiting what surgeons and doctors can charge, by limiting how much drug companies can charge for their products and by limiting services or eliminating them altogether. This is REALITY. Nothing these other systems have done has resulted in lower costs that were not associated with disallowing the service or lowering what one can charge.

    The reality leads to a lack of healthcare professionals, doctors, little innovation and long waits times. Those are the FACTS and the REALITY.

    Quote Originally Posted by LiveUninhibited View Post
    The shred of historic evidence that it CAN be done, as I have linked many times, is the VHA: Veterans' health system blazing trails
    I am sorry, but this coming from the Canadian Medical Association leaves one to doubt the merits of its integrity. This is more a propaganda piece for Government care than it is an honest look at Government managed care.

    But that concern aside, I guess you missed the part where it only cares for a few million versus a population of 300 plus million and this pertinent reality check:

    Of course, the Veterans Administration has its problems. Its low-cost prescription drugs, network of community clinics and a 1996 bill authorizing it to care for all veterans brought in more patients, resulting in backlogged enrolments and long waits for appointments. It expects to treat 5.8 million patients this year, up from 3.2 million in 1999. The government's failure to provide additional funding for the increased workload forced the agency to begin rationing care in 2003 by freezing enrolment of vets without service-related injuries who didn't meet a stringent needs test. “Denying any veteran his or her earned benefit is a broken promise of a grateful nation,” Marty Conatser, national commander of the American Legion, told a Congressional committee in 2007.

    The bottom line is this; there is no evidence to support the notion that Governments lower costs; Governments only lower costs by cutting services, limiting access and controlling how much people get paid.

    This leads to inevitable short term shortages and in the long term and even more debilitating, little innovation in care or development of new drugs.

    The profit motive of competition is always proven to be the best way to manage costs and provide innovation. The notion that the proven failures of Government will now be overcome by allowing them to control 1/3 of the US economy requires willful denial or even worse, ignorance.

    The ONLY honest comment I have seen from those who support the failed idea of Government managed care were those who made this statement; “I don’t care what the costs are, we have a moral obligation to care for ALL of our citizens.”

    At least they were being honest rather than the semantics and spinning presented by people like you who farcically believe that Socialism actually works and does not bankrupt and eventually destroy a nations economic output.

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