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Upfront costs complicate Obama’s health care plan

Moon said:
If you mean the proposed budget and the invisible health care plan being funded by the budget, I disagree. I think it's a very important issue to discuss. If you mean the partisan issue, frankly, I'm just tired of the nonsense and distractions from the real issues.
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It's a very serious issue. Obama is going to push for a program that is going to cost upwards of 1,000,000,000,000.00 just to get started. How can anyone in their right mind believe that the cost will not end up being much higher?

And it's really not justifiable to do.

Is that hyper partisan CC? Hmm? Is that an "extremist" point of view?
 
Moon said:
One other point...why would the President want to set aside $634 billion dollars in his proposed budget if he hasn't even formed a health care plan yet? How could he even arrive at a number if no plan exists? See? Something else worth discussing in this thread.
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At a guess, and this is just a guess, he had a skeletal outline of a plan, and this was the approximate amount that plan assumed. Any big plan will evolve over time. My big hope is that Obama takes the time needed to do things right, and rethinks his rush to do things like this. I agree health care reform is needed, I just don't think the next two years are the time to do it.
 
MrVicchio said:
So your basis is merely that you can?

Got it.
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No, I think I explained my reason and basis...both here and in many other threads. My ability is because I can. I do not shut down discussions; I confront them. If you do not like that I confront folks on this, too bad. It isn't going to change.
 
MrVicchio said:
It's a very serious issue. Obama is going to push for a program that is going to cost upwards of 1,000,000,000,000.00 just to get started. How can anyone in their right mind believe that the cost will not end up being much higher?

And it's really not justifiable to do.
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I agree, and since no plan has been publicly proposed, why is funding being requested in the budget? I'm afraid this will end up like most government programs and cost 10x as much as projected, and provide 1/4 of what was promised. Any plan needs to be presented to the public and debated forthwith.
 
MrVicchio said:
It's a very serious issue. Obama is going to push for a program that is going to cost upwards of 1,000,000,000,000.00 just to get started. How can anyone in their right mind believe that the cost will not end up being much higher?

And it's really not justifiable to do.

Is that hyper partisan CC? Hmm? Is that an "extremist" point of view?
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No, it's not. You addressed the issue intelligently and positionally.

You're learning. :2razz:
 
Moon said:
I agree, and since no plan has been publicly proposed, why is funding being requested in the budget? I'm afraid this will end up like most government programs and cost 10x as much as projected, and provide 1/4 of what was promised. Any plan needs to be presented to the public and debated forthwith.
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See? Now this I agree with. I would not want to pay for a plan as far reaching as this, without knowing what that plan is. Just like those conservatives that are being silly about attacking something that does not exist, yet, liberals that want to pay for something that doesn't exist yet are being just as silly. All of this is presumptuous.
 
Redress said:
At a guess, and this is just a guess, he had a skeletal outline of a plan, and this was the approximate amount that plan assumed. Any big plan will evolve over time. My big hope is that Obama takes the time needed to do things right, and rethinks his rush to do things like this. I agree health care reform is needed, I just don't think the next two years are the time to do it.
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Health care needs to be reformed by getting the insurance companies and the government out of it and letting the competitiveness of the market force costs lower. In Moon's perfect world, people would carry insurance for serious things like cancer, hospitals stays, surgery, etc., and pay for routine office visits and lab work out of their own pocket.

I read an article a few years back while sitting in a doctor's office, strangely enough, that talked about some doctors who refused to accept patients using insurance. They were cash only practices. IIRC, an office visit was $10, and routine lab work was about $25 or $30. These doctors found that without all the overhead to process insurance claims, they could provide the same level of care for a lower price.
 
Moon said:
Health care needs to be reformed by getting the insurance companies and the government out of it and letting the competitiveness of the market force costs lower. In Moon's perfect world, people would carry insurance for serious things like cancer, hospitals stays, surgery, etc., and pay for routine office visits and lab work out of their own pocket.

I read an article a few years back while sitting in a doctor's office, strangely enough, that talked about some doctors who refused to accept patients using insurance. They were cash only practices. IIRC, an office visit was $10, and routine lab work was about $25 or $30. These doctors found that without all the overhead to process insurance claims, they could provide the same level of care for a lower price.
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I disagree that letting the market force fix things will work. It might provide a small improvement, but not to the level I think really is needed.

Lowering overhead costs can be done without removing insurance companies, simply by streamlining the process, which is badly needed.
 
Redress said:
I disagree that letting the market force fix things will work. It might provide a small improvement, but not to the level I think really is needed.

Lowering overhead costs can be done without removing insurance companies, simply by streamlining the process, which is badly needed.
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processing insurance claims is a huge part of the overhead, and since your insurance company generally dictates which doctors they will cover, it eliminates any streamlining that competition would force. Our current system sucks, and no minor fiddling is going to fix it. The insurance companies are a big part of the problem.
 
Moon said:
Health care needs to be reformed by getting the insurance companies and the government out of it and letting the competitiveness of the market force costs lower. In Moon's perfect world, people would carry insurance for serious things like cancer, hospitals stays, surgery, etc., and pay for routine office visits and lab work out of their own pocket.

I read an article a few years back while sitting in a doctor's office, strangely enough, that talked about some doctors who refused to accept patients using insurance. They were cash only practices. IIRC, an office visit was $10, and routine lab work was about $25 or $30. These doctors found that without all the overhead to process insurance claims, they could provide the same level of care for a lower price.
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I cannot get into the main topic of this discussion due to NDAs, but the bolded phrase caught my eye. Are you for doing away all insurance such as auto and house or is it restricted to health?

IMO, the problem is employer paid insurance and CMS. If the consumer was selecting and paying for their own insurance and the government would get out of the mandate business the individual could select what coverage they wanted and there would be competetion for that business.


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TOJ said:
I cannot get into the main topic of this discussion due to NDAs, but the bolded phrase caught my eye. Are you for doing away all insurance such as auto and house or is it restricted to health?
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Health insurance was what I was talking about.

TOJ said:
IMO, the problem is employer paid insurance and CMS. If the consumer was selecting and paying for their own insurance and the government would get out of the mandate business the individual could select what coverage they wanted and there would be competetion for that business.

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I agree.
 
TOJ said:
IMO, the problem is employer paid insurance and CMS. If the consumer was selecting and paying for their own insurance and the government would get out of the mandate business the individual could select what coverage they wanted and there would be competetion for that business.
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Wouldn't that eliminate the savings for being in a larger buying pool that employers get buying insurance for employees, leading to higher costs for most people?
 
I believe, when left to their own devices, people will make the choice best suited for themselves.

Government will make the best choice for the politicians in power, thus should never be trusted on issues of a personal nature.
 
Redress said:
I disagree that letting the market force fix things will work. It might provide a small improvement, but not to the level I think really is needed.

Lowering overhead costs can be done without removing insurance companies, simply by streamlining the process, which is badly needed.
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Market forces would unquestionably lower costs. The simple economic reality that most people cannot pay for their own routine healthcare out of their own pocket is sufficient to ensure that market forces would quickly and dramatically slash healthcare costs across the board. That market forces would lower costs is not a major question in healthcare debate.

What is a major question is that of "who pays?" Dear Leader wants the government to pay through tax dollars--that $684Billion will not come out of thin air, and will be the result either of tax dollars or Helicopter Ben Bernanke and his magical printing presses. Hillary Clinton wanted to force everyone to buy health insurance. John McCain had a much underappreciated notion of providing a tax incentive for people to buy their own health insurance, resulting in the ending of health insurance as an employee benefit.

The problem with government-paid healthcare as well as health insurance as it currently is offered it that it is a perversity of everyone paying for someone else's healthcare. It isolates the patient from the full pricing information necessary to make effective economic decisions about healthcare. In effect, patients are denied the full opportunity to choose for themselves how they wish to provide for their own health and well being--and the consequences of this reach much farther than mere dollars and cents.

Consider, for a moment, this interesting comment on prostate cancer treatments:

Because of these side effects, some men, especially some older men, may decide that the cure is worse than the disease. Studies show that some men are willing to accept the risk of a shorter life span in return for a better quality of life than what they would have with treatment.
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The significance of this comment is that it begs the question of how do we determine what treatments are "necessary" for a given condition. Is a better quality of life obtained from longer life despite numerous expensive medical procedures? Or could a better quality of life be obtained by spending the money otherwise paid out for such treatments on other, more pleasant things, even though a shorter lifespan might be among the ultimate outcomes? Is prevention and a focus on healthy living preferable to treatment and remediation after the fact? Who is best situated to make such determinations if not the patient. What is the best use of that patient's resources for that patient's overall life?

The challenge of that position as a matter of healthcare policy is that it compels us to confront mortality directly. In government and in our individual lives we are compelled to ponder at what point should nature be allowed to take its course with the catastrophically injured or disastrously ill? If there is no insurance, no safety net, what happens when someone is the victim of a car accident through no fault of their own? Are we willing to consider the possibility that some conditions and some diseases are, in fact, "too expensive" to cure?

Thus, the drawback of imposing market forces is not that it will not have any impact, or will have only modest impact, but, to the contrary, that it will have traumatic impact--that at least in the immediate aftermath of such a transition many life-or-death decisions will be made solely on the depth of the pocketbook, which outcome is decidedly at odds with normal perceptions of social justice and fairness, while the disruptions and dislocations of such a transition would put some patients at risk of not having vital treatment and testing services available when they are needed.

If the imposition of market forces were merely a question of efficiency and cost control, there would be no argument of substance to the contrary. In a free market environment, every person would be assured of having access to all the medical care they were willing and able to pay for. As a matter of cost containment and systemic efficiency, the free market wins every time.

However, the challenge of the free market is not merely about cost, but also about what should be the governing philosophy of health care. Should there be guaranteed treatments and few resultant treatment choices? Should there be no guarantees and maximum treatment choices? What is more meaningful, the choices of the individual or the preferences of the collective?
 
Moon said:
Oh, I'm sure they'll find plenty to whine about, same as the partisan Bush haters did the last 8 years.
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Except that there was so much to hate about the Bush years that we don't have to "find" things to complain about... basically it went like this - Bush got up in the morning again and did a bunch of really stupid **** and then went to bed. Rinse repeat for 8 years.
 
Redress said:
Wouldn't that eliminate the savings for being in a larger buying pool that employers get buying insurance for employees, leading to higher costs for most people?
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There would be nothing stopping buying groups from popping up that you could join if you liked. There are already a lot of them even under the current system.

Do you think it would be better if employers paid for car and home insurance for their employees and the government provided it for old and poor people? If so, why stop at insurance? Why not food, housing, etc, etc?

Having the employer actually paying causes the incentives to be wrong. The employer needs to hold their costs down so they go with the lowest cost solution they can get and still attract employees. People accept jobs either knowing the terms or being too stupid to understand them. They then start complaining about the coverage and the government comes along and mandates coverages. That boosts the cost for everyone even those that do not want or need those coverages.

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Slippery Slope said:
Except that there was so much to hate about the Bush years that we don't have to "find" things to complain about... basically it went like this - Bush got up in the morning again and did a bunch of really stupid **** and then went to bed. Rinse repeat for 8 years.
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Thanks for proving my point.
 
Slippery Slope said:
Except that there was so much to hate about the Bush years that we don't have to "find" things to complain about... basically it went like this - Bush got up in the morning again and did a bunch of really stupid **** and then went to bed. Rinse repeat for 8 years.
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BDS is such a terrible disese. Its too bad it's not curable and the symptoms cannot even be ameliorated. Relief comes only with death. Sad, so sad. :roll:

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TOJ said:
There would be nothing stopping buying groups from popping up that you could join if you liked. There are already a lot of them even under the current system.

Do you think it would be better if employers paid for car and home insurance for their employees and the government provided it for old and poor people? If so, why stop at insurance? Why not food, housing, etc, etc?

Having the employer actually paying causes the incentives to be wrong. The employer needs to hold their costs down so they go with the lowest cost solution they can get and still attract employees. People accept jobs either knowing the terms or being too stupid to understand them. They then start complaining about the coverage and the government comes along and mandates coverages. That boosts the cost for everyone even those that do not want or need those coverages.

.
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I think that if employees negotiate for and get employers to pay their car or home insurance, that is fine. I doubt very much that will happen, but I do not see an inherent problem with it. It's not up to me to tell people at different workplaces how and what their compensation packages should be like.

Me personally, I have never had a problem with employee provided insurance. The times I have needed health care, I was able to use the doctor I wanted(Dr. Van Gelder is a great guy, very very Dutch), I paid my copay, and later got a bill for uncovered part, with a clear statement as to why I owed it. I admit your argument as to why employer paid insurance is bad is pretty compelling, but so far have not seen those negatives myself.
 
Redress said:
I think that if employees negotiate for and get employers to pay their car or home insurance, that is fine. I doubt very much that will happen, but I do not see an inherent problem with it. It's not up to me to tell people at different workplaces how and what their compensation packages should be like.

Me personally, I have never had a problem with employee provided insurance. The times I have needed health care, I was able to use the doctor I wanted(Dr. Van Gelder is a great guy, very very Dutch), I paid my copay, and later got a bill for uncovered part, with a clear statement as to why I owed it. I admit your argument as to why employer paid insurance is bad is pretty compelling, but so far have not seen those negatives myself.
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The problem is the one-size-fits-all approach. For example, all female employees do not want or need OB coverage, but in employer paid plans, the government mandates it and someone has to pay for it and this is only one of the many mandates.

Like I said, I cannot get into this too deep so I better back out of this discussion.

Thanks.


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Slippery Slope said:
Except that there was so much to hate about the Bush years that we don't have to "find" things to complain about... basically it went like this - Bush got up in the morning again and did a bunch of really stupid **** and then went to bed. Rinse repeat for 8 years.
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Sounds just like you.
 
Slippery Slope said:
Except that there was so much to hate about the Bush years that we don't have to "find" things to complain about... basically it went like this - Bush got up in the morning again and did a bunch of really stupid **** and then went to bed. Rinse repeat for 8 years.
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Moon said:
Thanks for proving my point.
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Precisely, Moon. Left or right. Same flavor, same old song and dance.
 
MrVicchio said:
I believe, when left to their own devices, people will make the choice best suited for themselves.
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Then you have a whole lot more faith in humanity than has been proven time and again. I believe that when left to their own devices, people will make the choices that are most self-indulgent without regard for how these choices may impact anyone or anything else.

Government will make the best choice for the politicians in power, thus should never be trusted on issues of a personal nature.
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Since government is mostly run by politicians, I agree with this for the most part.
 
Moon said:
I read an article a few years back while sitting in a doctor's office, strangely enough, that talked about some doctors who refused to accept patients using insurance. They were cash only practices. IIRC, an office visit was $10, and routine lab work was about $25 or $30. These doctors found that without all the overhead to process insurance claims, they could provide the same level of care for a lower price.
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I've read about this before, but haven't looked at it in a while. Of course I found a lot of information, so I'll just touch on a little for now.

I found a lot of 'we lowered our fees X%', but didn't get more specific than that i.e...a dollar amount.

I also found a lot of what I already knew about the sea of paperwork. This is primarily why I am in favor of a single payer insurance
Six years ago, Cherewatenko was drowning in paperwork and red ink, accepting more than 300 different insurance plans with 7,500 different medical codes.
[...]
“We were losing $80,000 a month. We were inundated with paperwork.
[...]
“We have lowered our fees anywhere from 30 percent to 50 percent on some of our services which is incredible,” he says. “And it’s really charging less and making more.”

Doctors launch cash-only practices - Nightly News with Brian Williams- msnbc.com
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This Doctor's Professional fees vary from 'very simple' ($40) to 'complex' ($100)
Not bad.

Home


I found this website and is more in tune to what I was looking for (comparative shopping, albeit a little skimpy) it is currently only for the state of Washington.

PriceDoc - Better Price + Better Healthcare.

I put in a Seattle zip code and searched for a GP and a Specialist office visit.

General Practitioner:
Office Visit/Consultation Procedures...around $120

Endocrinologist:
Office Visit/Consultation...$199

For me and the relatively healthy that visit a doctor maybe two or three times a year that's still not too bad...IF and that's a big IF...insurance companies reflect their savings of not paying for that office visit, back to the consumer.

Then you will still have the problems with people who aren't as healthy or whose dependents aren't and require more frequent visits and don't have an overabundance of income. To a low income family, two office visits a month at a co-pay of $20 each is a lot easier to handle than two cash payments at $120 each. Now if the monthly insurance premium savings would offset that $200 difference that would be a different story.

If doctors are going to save a lot of money on paperwork by going to an all cash practice, how much are they going to have to spend on market-based medicine? They are going to need to be prepared to prove that their quality, service, and prices are better than those of their competitors. They're going to have to advertise. Todays patients haven't had to compare shop doctors before. They're going to have to be educated in the nuances of making buying decisions regarding healthcare.
 
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