My simple solution to healthcare

Hear me out but I think this might work:

Anything that is considered a catastrophic or chronic life-threatning injury should be covered by the government 100%. It will be paid through by taxes.

Everything else can be sold through the free market. No more freebies or benefits because you are lower income.

Bucky said:

Hear me out but I think this might work:

Anything that is considered a catastrophic or chronic life-threatning injury should be covered by the government 100%. It will be paid through by taxes.

Everything else can be sold through the free market. No more freebies or benefits because you are lower income.

Click to expand...

Should be the other way around

Basic health care free, including regular checks, fixing broken bones, checks for diabetes. Keep people healthy before thing get to the life threatening stage and it will be cheaper in the long run

So, single-payer with a deductible?

Or

You can go the lame horse route

Health care by shotgun, quick, easy and cheap if a bit messy

Lord Tammerlain said:

Or

You can go the lame horse route

Health care by shotgun, quick, easy and cheap if a bit messy

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LOL and all Trump supporters should be sign up for this policy free of charge.

BillRM said:

LOL and all Trump supporters should be sign up for this policy free of charge.

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Coming up with a health policy that saves money is easy!

Greenbeard said:

Coming up with a health policy that saves money is easy!

Click to expand...

A much less messy solution to mine

Bucky said:

Hear me out but I think this might work:

Anything that is considered a catastrophic or chronic life-threatning injury should be covered by the government 100%. It will be paid through by taxes.

Everything else can be sold through the free market. No more freebies or benefits because you are lower income.

Click to expand...

Trauma, catastrophic care, and chronic care is what is expensive though. A 3 day hospital stay will cost you more than a lifetime of routine care. One cancer diagnosis and you will spend more in month for treatment than you will for several lifetimes of routine care. It's not general practitioners, wellness checks, routine labs, and ancillary care that is expensive, that is but a small fraction of over all health spending, its the big stuff that any catastrophic policy would have to cover that is expensive.

Point being, I think such a plan would probably cost far more than you might think it would.

Bucky said:

Hear me out but I think this might work:

Anything that is considered a catastrophic or chronic life-threatning injury should be covered by the government 100%. It will be paid through by taxes.

Everything else can be sold through the free market. No more freebies or benefits because you are lower income.

Click to expand...

Low income? You mean all the Trump supporters in the red states that tend to be poorer then average citizens.

No freebies for them any longer?

SouthernDemocrat said:

Trauma, catastrophic care, and chronic care is what is expensive though. A 3 day hospital stay will cost you more than a lifetime of routine care. One cancer diagnosis and you will spend more in month for treatment than you will for several lifetimes of routine care. It's not general practitioners, wellness checks, routine labs, and ancillary care that is expensive, that is but a small fraction of over all health spending, its the big stuff that any catastrophic policy would have to cover that is expensive.

Point being, I think such a plan would probably cost far more than you might think it would.

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They used to be quite inexpensive with a $5000 deductible and 100% to a lifetime limit of $2,000,000. That used to set me back about $125.00 a month back before Obama care. Cant ever get that policy anymore.

PirateMk1 said:

They used to be quite inexpensive with a $5000 deductible and 100% to a lifetime limit of $2,000,000. That used to set me back about $125.00 a month back before Obama care. Cant ever get that policy anymore.

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Health insurance premiums have been going up dramatically every year for 20 years now. The ACA didn't start that. The trend line was the same before the ACA:



Everyone wants to blame the ACA or insurance companies, but the problem is providers. My wife works for an Insurance Defense firm, she pulls medical records and billing all the time. In the last 20 years a whole new consulting industry has formed whose sole purpose is to show provider how to maximize their billing all the way to the legal line of fraud. Health insurance is absurdly expensive now because you have hospitals charging over 400 dollars for a 22 dollar metabolic panel, orthopedic surgeons often billing in excess of a million a year, anesthesiologists double billing for their nurses, oncologists slowing down the rates of chemo infusions just to increase their billing, plastic surgeons charging 20k to put a handful of facial stitches in an ICU patient after trauma, specialists doing daily 30 second drive by's on patients just so they can bill another 2 to 4k for them asking you "How you feeling today?". Half of all markets now are monopolies where one health system owns all the hospitals, all the specialists, all the labs, and most of the GPs in the market and insures are then forced to pay up whatever they bill or just forgo selling any polices in the market. If it were any other industry we would call it what it is, fraud and extortion. Yet because the health sector out spends every other sector of economy in lobbying, no one in either party even talks about mandating price transparency so consumers can even know what they are paying for and how much it will cost them. None of that has anything with the ACA. Point being is your premiums would have skyrocketed even if the ACA was never signed into law.

Lord Tammerlain said:

Should be the other way around

Basic health care free, including regular checks, fixing broken bones, checks for diabetes. Keep people healthy before thing get to the life threatening stage and it will be cheaper in the long run

Click to expand...

In the above plan, you wouldn't have to worry about being covered after getting hit by a bus or if you suffered a heart attack. It would all be covered and paid through taxes. If you can't pay the taxes it would work like a student loan.

Preventive care and everything else should be priced at the market rate. An idea of true universal health care where everything is free is not realistic and would bankrupt the state. Sure, preventive care would shoot up the cost but at least you can keep sleep at night knowing that you would be covered in case something life threatening happened.

Is it perfect? No way, but it's a lot better than Obamacare.

Bucky said:

In the above plan, you wouldn't have to worry about being covered after getting hit by a bus or if you suffered a heart attack. It would all be covered and paid through taxes. If you can't pay the taxes it would work like a student loan.

Preventive care and everything else should be priced at the market rate. An idea of true universal health care where everything is free is not realistic and would bankrupt the state. Sure, preventive care would shoot up the cost but at least you can keep sleep at night knowing that you would be covered in case something life threatening happened.

Is it perfect? No way, but it's a lot better than Obamacare.

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What you just described sounds just like what existed before the ACA. The uninsured were showing up at emergency rooms with illnesses that could've been prevented and taxpayers and the insured were footing the bill through higher insurance premiums. It was not better than Obamacare.

SouthernDemocrat said:

Health insurance premiums have been going up dramatically every year for 20 years now. The ACA didn't start that. The trend line was the same before the ACA:

Everyone wants to blame the ACA or insurance companies, but the problem is providers. My wife works for an Insurance Defense firm, she pulls medical records and billing all the time. In the last 20 years a whole new consulting industry has formed whose sole purpose is to show provider how to maximize their billing all the way to the legal line of fraud. Health insurance is absurdly expensive now because you have hospitals charging over 400 dollars for a 22 dollar metabolic panel, orthopedic surgeons often billing in excess of a million a year, anesthesiologists double billing for their nurses, oncologists slowing down the rates of chemo infusions just to increase their billing, plastic surgeons charging 20k to put a handful of facial stitches in an ICU patient after trauma, specialists doing daily 30 second drive by's on patients just so they can bill another 2 to 4k for them asking you "How you feeling today?". Half of all markets now are monopolies where one health system owns all the hospitals, all the specialists, all the labs, and most of the GPs in the market and insures are then forced to pay up whatever they bill or just forgo selling any polices in the market. If it were any other industry we would call it what it is, fraud and extortion. Yet because the health sector out spends every other sector of economy in lobbying, no one in either party even talks about mandating price transparency so consumers can even know what they are paying for and how much it will cost them. None of that has anything with the ACA. Point being is your premiums would have skyrocketed even if the ACA was never signed into law.

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Healthcare costs have been going up considerably for a long time. That is one reason we needed healthcare restructuring and why it is so sad that ACA didn't do it or make plausible how it could achieve it.

Bucky said:

Hear me out but I think this might work:

Anything that is considered a catastrophic or chronic life-threatning injury should be covered by the government 100%. It will be paid through by taxes.

Everything else can be sold through the free market. No more freebies or benefits because you are lower income.

Click to expand...

What about life long illnesses or debilitating illness? There is also mental illness as well as crippling pains.

Bucky said:

Hear me out but I think this might work:
Anything that is considered a catastrophic or chronic life-threatning injury should be covered by the government 100%. It will be paid through by taxes.
Everything else can be sold through the free market. No more freebies or benefits because you are lower income.

Click to expand...

Wow, in 3 sentences you completely solved America's healthcare crisis. Who knew changing the healthcare system for 300 million people would be so easy and simple!

SouthernDemocrat said:

Health insurance premiums have been going up dramatically every year for 20 years now. The ACA didn't start that. The trend line was the same before the ACA:

Everyone wants to blame the ACA or insurance companies, but the problem is providers. My wife works for an Insurance Defense firm, she pulls medical records and billing all the time. In the last 20 years a whole new consulting industry has formed whose sole purpose is to show provider how to maximize their billing all the way to the legal line of fraud. Health insurance is absurdly expensive now because you have hospitals charging over 400 dollars for a 22 dollar metabolic panel, orthopedic surgeons often billing in excess of a million a year, anesthesiologists double billing for their nurses, oncologists slowing down the rates of chemo infusions just to increase their billing, plastic surgeons charging 20k to put a handful of facial stitches in an ICU patient after trauma, specialists doing daily 30 second drive by's on patients just so they can bill another 2 to 4k for them asking you "How you feeling today?". Half of all markets now are monopolies where one health system owns all the hospitals, all the specialists, all the labs, and most of the GPs in the market and insures are then forced to pay up whatever they bill or just forgo selling any polices in the market. If it were any other industry we would call it what it is, fraud and extortion. Yet because the health sector out spends every other sector of economy in lobbying, no one in either party even talks about mandating price transparency so consumers can even know what they are paying for and how much it will cost them. None of that has anything with the ACA. Point being is your premiums would have skyrocketed even if the ACA was never signed into law.

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That's a nice diatribe.. well except for the facts..

The like that fact that reimbursements per procedure are stagnant or dropping .. while costs to physicians do not.

The reasons that there is a consulting industry for us to show providers how to maximize billing is because insurance companies DO NOT PAY US WHAT WE BILL.

Not at all. No rhyme or reason to it by the way. An insurance will pay more for an easy procedure.. with less of my time.. than they will for a complicated procedure. Insurance reimbursement is what drives the bus.

Take a look at your bill and when you see the hospital charge for that 22 metabolic table.. know that they are not getting paid 400 bucks.. and actually.. it probably doesn't matter WHAT the charge is.. because its a DRG system.

Bucky said:

Hear me out but I think this might work:

Click to expand...

Uh oh.

Anything that is considered a catastrophic or chronic life-threatning injury should be covered by the government 100%. It will be paid through by taxes.

Everything else can be sold through the free market. No more freebies or benefits because you are lower income.

Click to expand...

How does this help, exactly?

For example, let's say you contract diabetes. It's a chronic condition, and if untreated it will eventually kill you. Is that covered? If you let it go until it threatens your life, then is it covered?

What about elder care? Millions of seniors rely on Medicaid to cover the cost of nursing homes and similar facilities. They are basically otherwise broke. Are we now going to toss millions of people on the street, to die in agony? WTF.

And you do realize that you're basically taking away insurance from tens of millions of Americans, right? What's the brilliant motivation for this? Are people not going to get sick if they don't have coverage?

Lord Tammerlain said:

Should be the other way around

Basic health care free, including regular checks, fixing broken bones, checks for diabetes. Keep people healthy before thing get to the life threatening stage and it will be cheaper in the long run

Click to expand...

I'd throw broken bones into the catastrophic category. that can add up fast.

Outside of that, not too bad.

Maybe the maintenance care supported by a SS Style deduction?

Perhaps this care could be provided by nurses who make referrals in neighborhood clinics?

The cost of healthcare is constantly rising. I don't know enough about this to know the answer to this, but it seems like advances in communication could be leveraged to help reduce healthcare costs.

It feels like the method of payment is only one part of the puzzle. The method of delivering the services probably has some impact on the cost of delivering the services.

Bucky said:

Hear me out but I think this might work:

Anything that is considered a catastrophic or chronic life-threatning injury should be covered by the government 100%. It will be paid through by taxes.

Everything else can be sold through the free market. No more freebies or benefits because you are lower income.

Click to expand...

My simple solution to healthcare

Click to expand...

emphasis on the 'simple'

jaeger19 said:

That's a nice diatribe.. well except for the facts..

The like that fact that reimbursements per procedure are stagnant or dropping .. while costs to physicians do not.

The reasons that there is a consulting industry for us to show providers how to maximize billing is because insurance companies DO NOT PAY US WHAT WE BILL.

Not at all. No rhyme or reason to it by the way. An insurance will pay more for an easy procedure.. with less of my time.. than they will for a complicated procedure. Insurance reimbursement is what drives the bus.

Take a look at your bill and when you see the hospital charge for that 22 metabolic table.. know that they are not getting paid 400 bucks.. and actually.. it probably doesn't matter WHAT the charge is.. because its a DRG system.

Click to expand...

I realize that. Anyone can look at an EOB and see that an insurer does not reimburse for what a provider bills. However, the provider bills at a rate that is higher than what any providers anywhere else on earth would bill for the same service or procedure (other than at the GP / routine care level), and the insurer still reimburses at a rate that his higher than what providers get reimbursed at for the same service or procedure anywhere else on earth.

Medicine is a highly skilled profession requiring extensive education and training and thus should be a well compensated profession, yet despite the bitching you hear from specialists on insurance and Medicare reimbursement rates, I have never seen a poor specialist, or even a middle class specialist (particularly any kind of surgeon). They still manage to earn more than they would doing the same job anywhere else on earth. Healthcare consuming a 6th and soon to be a 5th of the economy is untenable. At some point, someone will have to make less money.

Think about it this way. I work in IT, a highly skilled, and thus well compensated profession. Can you imagine the impact to the economy if IT professionals in the United States earned and billed at a rate that was as much as 2 to 5 times what they would earn and bill at anywhere else on earth? For example, a Sr Developer in Germany earns about 80 to 100k a year. A Sr Developer in the United States earns between 85k and 120k a year. If it were like our health care sector, that Sr Developer in the United States would earn 200 to 400k a year. Moreover, they would no competition from foreign professionals. That is not tenable in an economy. Moreover, if it were like the health care sector, that Sr Developer would do everything imaginable to obfuscate all billing for his services making it impossible for any lay person to do a cost comparison.

I am not saying that other reforms are not needed. Obviously there needs to be more insurance reforms. Obviously Medical School is too expensive. Obviously there needs to be tort reform and malpractice insurance rates need to come down. However, even with all of that, if we don't cut healthcare costs over all, which will involve some providers, medical device manufacturers, and pharmaceutical companies earning less money, then we are not hitting the heart of the problem. If a patient can fly to Europe, pay cash for a hip replacement, stay in first class hotels the whole time they are recovering, and still be out less money for what it would cost them here, then obviously someone in the system is being overcompensated.

SouthernDemocrat said:

I realize that. Anyone can look at an EOB and see that an insurer does not reimburse for what a provider bills. ..

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Yep...so? See below

Medicine is a highly skilled profession requiring extensive education and training and thus should be a well compensated profession,

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Sure.. But lets put this in my perspective. Medicine is a higher skilled profession requiring extensive education and training. It has tremendous stress and burnout. I can't remember when I worked a 40 hour week regularly.... 40 hours? Hah.. late nights, weekends, on call. What that has done to my family life, my children. Oh there are perks.. like watching a fellow take his first steps when no one thought he would be able to walk again.. that's kinda cool.

But I get told.. you make too much. Hmmm.. now I watch a fellow hit a little white ball into the stands with a stick.. and he makes more than me.. why doesn't someone complain about that? Where isn;t there regulation to stop him from making money?

Or I watch an actress.. don't get me wrong.. there is skill in acting... but I doubt she spent almost a decade with her nose in a book or cadaver learning her craft. And she makes more.

then I watch just about any businessman or company owner.. and watch them make way more.. heck CEO's run companies into the ground and still make millions. But I apparently am the Bad GUY..

Whatever. But you know what.. being a doctor takes smarts and skills.. especially to be a good one. And those skills translate into a lot of things that make a lot more money for a lot less effort. So imagine what happens when folks like me decide that its just not worth going into medicine.

Healthcare consuming a 6th and soon to be a 5th of the economy is untenable. At some point, someone will have to make less money.

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there is the irony.. why is it untenable? Would you say that if the housing market was exploding because there was demand for housing.. we should stop it. oh wait.. not only did we not stop it.. we fueled it and then when it went to crap.. we bailed the industry out.

Okay.. well what if say cars and trucks were astronomically high and people were buying big expensive cars that they did not need... should we stop that... oh wait.. when it crashed we decided to bail it out.

But then there is healthcare.. were reimbursements per patient continue to stagnate or drop. That's a fact. Of course, we have a high demand from an aging population. And we pay very good wages.. we are in many communities the primary employer. We provide 18% of Gross Domestic product.. an income by the way.. that stays in the country.. because its pretty hard to outsource healthcare.. and increases in technology generaly increase the need for workers in healthcare.

and those are good paying jobs.. that also push up the wages of other workers because of wage competition.

Can you imagine the impact to the economy if IT professionals in the United States earned and billed at a rate that was as much as 2 to 5 times what they would earn and bill at anywhere else on earth?

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If that would happen? It would be awesome for the economy. Imagine what thousands of IT people.. making so much money would do for the economy? Think of the wage pressure that would be on other industries to compete with IT.. imagine how money would flow from being concentrated in a few rich people and would now be going to professionals like yourself.. all that money spread out among thousands of IT professionals.

instead of wealth being concentrated in a few.. it would be out there circulating making so much more for the average person and thus more for the economy.

If a patient can fly to Europe, pay cash for a hip replacement, stay in first class hotels the whole time they are recovering, and still be out less money for what it would cost them here, then obviously someone in the system is being overcompensated.

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Hmmm.. I can fly to china.. stay in first class hotels.. and talk to a manager in a manufacturing company and have 10,000 units made for about 1/10 of what it would cost in the US.. (I know because I did it).

Hmmm I guess that means all those us workers in manufacturing are getting overcompensated... Lets put some controls so that they make less! How does that sound? Think that will help the economy?

Think about it.

jaeger19 said:

Yep...so? See below



Sure.. But lets put this in my perspective. Medicine is a higher skilled profession requiring extensive education and training. It has tremendous stress and burnout. I can't remember when I worked a 40 hour week regularly.... 40 hours? Hah.. late nights, weekends, on call. What that has done to my family life, my children. Oh there are perks.. like watching a fellow take his first steps when no one thought he would be able to walk again.. that's kinda cool.

Click to expand...

Do you honestly think you are the only that does that? I am on call 24/7 every single day of the year with the exception of when I am on a wilderness backpacking / fishing trip and thus am unreachable. If a site goes down at 3:00 AM in the morning, I have to fix it at 3:00 AM in the morning. We had a cooling system fail in a datacenter at a 11:00 PM and I worked over 30 hours straight to bring everything back on line, and that was after working a normal work day and with the added stress of knowing that hundreds of employees can do nothing until we get everything back on line.

Point being that medicine is not the only industry where you can be on call and work crazy hours. Hardly any professional works just 40 hours a week these days.

But I get told.. you make too much. Hmmm.. now I watch a fellow hit a little white ball into the stands with a stick.. and he makes more than me.. why doesn't someone complain about that? Where isn;t there regulation to stop him from making money?

Or I watch an actress.. don't get me wrong.. there is skill in acting... but I doubt she spent almost a decade with her nose in a book or cadaver learning her craft. And she makes more.

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You don't have practically every family in America paying over 20k in insurance premiums every year to pay for the salaries of actresses and professional sports players.

then I watch just about any businessman or company owner.. and watch them make way more.. heck CEO's run companies into the ground and still make millions. But I apparently am the Bad GUY..

Whatever. But you know what.. being a doctor takes smarts and skills.. especially to be a good one. And those skills translate into a lot of things that make a lot more money for a lot less effort. So imagine what happens when folks like me decide that its just not worth going into medicine.

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Something tells me that if the average compensation for an orthopedic surgeon drops from 550k a year to 400k a year, we still will have orthopedic surgeons. Sometime tells me that if anesthesiologists average 250k to start rather than 300k to start, we will still have them. Something tells me that if Pharmaceutical companies start averaging 29% margins (what banks average) rather than 42%, we will still have plenty of new drugs being developed. Medical devices currently have the highest profit margins of any industry on earth, something tells me that if they were more in line with other industry, we would still have new medical devices.

there is the irony.. why is it untenable? Would you say that if the housing market was exploding because there was demand for housing.. we should stop it. oh wait.. not only did we not stop it.. we fueled it and then when it went to crap.. we bailed the industry out.

and those are good paying jobs.. that also push up the wages of other workers because of wage competition.

Hmmm.. I can fly to china.. stay in first class hotels.. and talk to a manager in a manufacturing company and have 10,000 units made for about 1/10 of what it would cost in the US.. (I know because I did it).

Hmmm I guess that means all those us workers in manufacturing are getting overcompensated... Lets put some controls so that they make less! How does that sound? Think that will help the economy?

Think about it.

Click to expand...

You can fly to China because and get something made for cheap because they pay slave wages and have little to no environmental protections. No one is saying that anyone should be paid slave wages or have no protections. However, when you have families paying 20k or more in premiums (either fully out of pocket or partially paid for by their employer which ultimately reduces their compensation), then the current system is indeed untenable. You could strip out every insurance industry executive bonus, every dividend out of that, and as much overhead as possible and you have taken a 20k family premium (or even more in some cases) and get it down to maybe 18k, still untenable, particularly considering health insurance premium inflation and healthcare inflation. Surely you see a problem with middle class families paying that much?

Also, I am not advocating government price controls. What I think should be done is in the next post.

To repeat what I posted in another thread on this subject:


1. We should mandate clear and transparent pricing from providers. My wife works in insurance defense and sees medical records and billing all the time. A hospital bill is unreadable by anyone that doesn't work in the industry. If you think your insurance policy is hard to read, try reading a bill for a 3 day hospital stay.

2. We should require providers to give a good faith cost estimate at the time of consent (many countries do this).

3. We should figure out how to give insurers better leverage in negotiating more reasonable prices (this goes in with number 4).

4. We need to look at breaking up provider monopolies. In about half of all markets, one health system has a monopoly owning all the hospitals, all the specialists, all the labs, and even most of the GPs.

5. We should require providers to disclose any financial interest they have in any other providers they refer you to. For example, if a specialist has a financial interest in a medical imaging company that they refer you to, they should be required to disclose that when they refer you to it.

6. We need to help out insurers with implementing more reference pricing programs within their networks.

7. Promote more physician cooperatives.

8. Figure out how to bring down the cost of med school.

9. Tort reform.

10. Malpractice insurance reform.

11. A much more heavily regulated health insurance market.

Of course if we could get more people to eat a whole foods diet, exercise regularly, and maintain a lean healthy weight, we would save hundreds of billions that way too.

SouthernDemocrat said:

Do you honestly think you are the only that does that?
.

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Nope. But I don't hear you stating that there need to be controls on the IT industry. I don't see you complaining that you make too much money and need a cut.

You don't have practically every family in America paying over 20k in insurance premiums every year to pay for the salaries of actresses and professional sports players.

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Hmmm.. then maybe you should talk about INSURANCE COMPANIES.. because I am certainly not making 20k per family. Not even close.

Nahh wait.. its better to complain about the guy that just fixed you so you can walk.

Something tells me that if the average compensation for an orthopedic surgeon drops from 550k a year to 400k a year, we still will have orthopedic surgeons.

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and something tells me that we would also have IT guys if you took a cut. But I would hazard a guess that you would have fewer of them. and/or the quality of them would drop.

Something tells me that if the average compensation for an orthopedic surgeon drops from 550k a year to 400k a year, we still will have orthopedic surgeons. Sometime tells me that if anesthesiologists average 250k to start rather than 300k to start, we will still have them. Something tells me that if Pharmaceutical companies start averaging 29% margins (what banks average) rather than 42%, we will still have plenty of new drugs being developed

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And something tells me that if you did that? The insurance companies would be EXTREMELY happy.. particularly their CE0's.. and local economies would do worse.. people would have fewer health services.

But you probably would feel better that you stuck it to us.

Medical devices currently have the highest profit margins of any industry on earth, something tells me that if they were more in line with other industry, we would still have new medical devices.

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Well.. on that you would be wrong. Because unlike other industries that manufacture goods.. Medical devices are created for small populations of people that need them. that's what insurance allows. You have to have a high profit margin if you are creating say a respirator for a select few people that will need them. There is no where near the volume of say selling a toothbrush. And the technology and cost that's needs is way higher.

You can fly to China because and get something made for cheap because they pay slave wages and have little to no environmental protections. No one is saying that anyone should be paid slave wages or have no protections. However, when you have families paying 20k or more in premiums (either fully out of pocket or partially paid for by their employer which ultimately reduces their compensation), then the current system is indeed untenable

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Two points... 1. There is no free lunch here. The medical industry contributes to 18% of GDP here in the US. Its good jobs that are hard to outsource, when it creates technology it generally creates MORE jobs, it is a major employer and is a growth industry for employment and it is populated by a lot of non profits. When you decide to cut this industry YOU ARE.. going to hurt wages in this country, you are going to reduce wage pressure in other industries, you ARE going to increase inequity.

2. Your complaint seem to be more with the insurance companies. You keep talking about premiums. I don't get premiums. I have been watching my reimbursement per patient drop or stagnate.. inspite of increasing demand. That's a fact.