Questions Arising From The Healthcare Debate

[Guest]

Watching the heated debate regarding the various healthcare reform proposals bring a couple of common proverbs to mind.

Those members of Congress that are so vehemently arguing against any sort of "government option" bring the saying from Hamlet to mind..."The lady doth protest too much, methinks." Why such protest? There is evidence that government-provided health insurance works satisfactorily, in Canada and England, but also our own Medicare program which so many seniors vehemently demand remain untouched. Why such protest by some in Congress, at this point mostly from the minority party? Is there a possibility, just a remote possibility, that the lobbyists for interests whose profits would be threatened or diminished by these proposals are at work here? Those same interests who at the conclusion of the heated debate over prescription drug coverage actually wrote the Medicare Part D bill which has proven so ineffective for seniors, hugely expensive for the taxpayers, and dramatically profitable for the drug companies?

Another question that seems so obvious given the administration's stated objectives for the reform being discussed is why has there been no mention of tort reform in the discussions regarding this legislation? A stated goal--maybe the most important objective of the proposed reform--is the reduction of the cost of healthcare. Clearly, the cost of litigation, settlements and malpractice awards are a significant element of the cost of healthcare. That alone may be a reason why healthcare in countries which provide "single payor" coverage is so much less expensive. Is is possible, just possible, that the lobbyists for the trial lawyers have already completed their work successfully with our elected representatives from both parties?

Another proverb, although not in the form of a question, is the devil will be in the details. Regardless of how the fundamental elements of whatever "reform" is finally agreed to, we--the electorate and the folks who will ultimately pick up the tab for this "reform"--better pay attention to who's making out from the details of this legislation. Even though the Democrats appear to have a sufficient majority to push some sort of legislation thru to passage, they shouldn't get a pass on the possibility of having been influenced by special interests. They already have and will be as these negotiations progress. We'd all better stay aware of how the legislation they pass effects us, how expensive it will be for us, and which special interests turn out to be big beneficiaries. Otherwise, how will we know who to blame?

[Guest]

Analysis: States hit hardest by recession get least stimulus money.
I, personally, do not trust the government to take charge of 1/6th of our economy.

http://www.foxnews.com/story/0,2933,533841,00.html

[Guest]

Watching the heated debate regarding the various healthcare reform proposals bring a couple of common proverbs to mind.

Those members of Congress that are so vehemently arguing against any sort of "government option" bring the saying from Hamlet to mind..."The lady doth protest too much, methinks." Why such protest? There is evidence that government-provided health insurance works satisfactorily, in Canada and England, but also our own Medicare program which so many seniors vehemently demand remain untouched. Why such protest by some in Congress, at this point mostly from the minority party? Is there a possibility, just a remote possibility, that the lobbyists for interests whose profits would be threatened or diminished by these proposals are at work here? Those same interests who at the conclusion of the heated debate over prescription drug coverage actually wrote the Medicare Part D bill which has proven so ineffective for seniors, hugely expensive for the taxpayers, and dramatically profitable for the drug companies?

Another question that seems so obvious given the administration's stated objectives for the reform being discussed is why has there been no mention of tort reform in the discussions regarding this legislation? A stated goal--maybe the most important objective of the proposed reform--is the reduction of the cost of healthcare. Clearly, the cost of litigation, settlements and malpractice awards are a significant element of the cost of healthcare. That alone may be a reason why healthcare in countries which provide "single payor" coverage is so much less expensive. Is is possible, just possible, that the lobbyists for the trial lawyers have already completed their work successfully with our elected representatives from both parties?

Another proverb, although not in the form of a question, is the devil will be in the details. Regardless of how the fundamental elements of whatever "reform" is finally agreed to, we--the electorate and the folks who will ultimately pick up the tab for this "reform"--better pay attention to who's making out from the details of this legislation. Even though the Democrats appear to have a sufficient majority to push some sort of legislation thru to passage, they shouldn't get a pass on the possibility of having been influenced by special interests. They already have and will be as these negotiations progress. We'd all better stay aware of how the legislation they pass effects us, how expensive it will be for us, and which special interests turn out to be big beneficiaries. Otherwise, how will we know who to blame?

Regarding the underlined areas in the quote:

1. http://www.liberty-page.com/issues/healthcare/socialized.html#britain
This link documents what experiences the locals in the countries with nationalized health have. It is not a pretty picture. What these experiences make obvious - it's a good system if you are healthy, but if you have significant problems and are not in the correct age-bands, you are SOL (**** out of luck) .

2. http://www.cbo.gov/ftpdocs/71xx/doc7174/04-28-MedicalMalpractice.pdf
The Congressional Budget Office is about as reliable as it gets. According to the CBO, less than 2% of all health care costs were attributed to medical malpractice. That's the tort payoffs, malpractice insurance, et al. The numbers show that 'tort reform' won't make a hill-of-beans difference in health care costs, and the CBO estimates the most that could be gained is less than 0.4-0.5% reduction in costs maybe.

Again, medical care is the only US industry without foreign competition in the domestic marketplace. While the rest of the economy gets clobbered with foreign competition, the medical industry is doing what we wished the rest of the economy would do. Just goes to show what unbalanced foreign competiton in the marketplace is doing to us.

So, is it possible we are looking at a situation made politically convenient for intervention, when the actual underlying problem is a couple of degrees away? If that's the case, meddling with health care will just make government bigger, increase costs via higher taxes, and lower wages (if benefits go up, wages go down). If wages do go down to offset higher benefit costs, the impact of higher taxes will be harder on folk, and the result will be another slowdown in the economy as there will less discretionary income in the family budget .

As the old FL adage states: "When you are up to your @$$ in alligators, it's tough to remember your only intention was to drain a swamp."

[Guest]

...This link documents what experiences the locals in the countries with nationalized health have....The Congressional Budget Office is about as reliable as it gets. According to the CBO, less than 2% of all health care costs were attributed to medical malpractice....First, I think I'll still rely more on a scientific poll than a series of one-sided anecdotal reports.

Secondly, CBO is pretty good. But does the "less than 2%" that they say results from legal liabilities and actions include all the unnecessary tests and procedures that physicians prescribe in an effort to cover their fannies in the case they might be sued later? I would find that a statistic that is hard to believe. If we want to rely on anecdotal reports, I can tell you with 100% certainty that based on the bills I've received, the various tests that my internist prescribed as a part of a "pre-surgical" physical increased the cost of what I thought to be a reasonable set of tests to qualify me for orthopaedic surgery by more than triple. Of course, I'm not a physician, but what both an electrocariogram AND an echo cardiogram AND a chemical stress test (for someone with no personal or family history of heart problems) were necessary prior to hip revision surgery didn't make sense to me--other than the need for both the internist and surgeon to cover their butts and/or generate fees for the hospital that employs them...or both.

Like I said, the CBO's "less than 2%" estimate seems WAAAY too low to me.

[Guest]

First, I think I'll still rely more on a scientific poll than a series of one-sided anecdotal reports.

Secondly, CBO is pretty good. But does the "less than 2%" that they say results from legal liabilities and actions include all the unnecessary tests and procedures that physicians prescribe in an effort to cover their fannies in the case they might be sued later? I would find that a statistic that is hard to believe. If we want to rely on anecdotal reports, I can tell you with 100% certainty that based on the bills I've received, the various tests that my internist prescribed as a part of a "pre-surgical" physical increased the cost of what I thought to be a reasonable set of tests to qualify me for orthopaedic surgery by more than triple. Of course, I'm not a physician, but what both an electrocariogram AND an echo cardiogram AND a chemical stress test (for someone with no personal or family history of heart problems) were necessary prior to hip revision surgery didn't make sense to me--other than the need for both the internist and surgeon to cover their butts and/or generate fees for the hospital that employs them...or both.

Like I said, the CBO's "less than 2%" estimate seems WAAAY too low to me.

Polls are often manipulated to reach a desired result. The weighting of various factors , sampling technique and location can do wonders to achieve an end. The only poll that matters in the end involves the 545 Congressfolk, and they are motivated by concerns other than health care costs.

"Defensive medicine" costs are blatant thievery and should be considered in the same manner as Medicare fraud. There is nothing in the Health Care Bill that changes fraudulent behavior by medical care providers. Let's call "defensive medicine" for what is really is - fraud, and possibly battery! When professionals bank on the ignorance of their customers regarding the technical facets of the provided service - and bilk them for higher costs - that's fraud. A battery occurs when there is an intentional harmful or offensive contact, and an invasive medical test/procedure initiated for fraudulent reasons qualifies as a battery. As long as unscrupulous medical care providers have ANY liability, they will take care of themselves first at others' pain and expense.

Come to think of it, have you ever had a medical care provider say,"Based on the information I have available to me, I know what's wrong with you and how to treat the problem. However, if you want me to treat you, there will be additional, unnecessary tests you will have to endure so that in case there's a screw-up or just to protect myself from you in general, I've got more evidence to protect me. Those are my conditions for treating you. - take it or leave it" That's also "defensive medicine," but at least the customer isn't BS'ed by the medical care practitioner. Fraud and battery occur when you don't get that caveat, and endure out of ignorance.

I just find it difficult to accept any kind of extortion, whether it be by "defensive medicine" or by the government seeking to expand its size. And I have a harder time rewarding such behavior.

And if the CBO's "2%" estimate seems way too low, is that just a gut feeling or based on the numbers? The CBO based its report on hard numbers that it could lawfully obtain from all involved parties. Since the issue of that 2006 report, there has been no rebuttal (that I've found) from any responsible medical association to the numbers or findings. In fact, the CBO has been pretty consistent over the past few years, to include its latest reports, in not falling into the hysteria and puffing related to perceived versus actual health care costs and ratios.

[Guest]

Interesting perspective:Television advertising 34.5 million from Jan.1-July 14. Could it stay at 50 million or hit 100 million?

http://adage.com/article?article_id=138013

[Guest]

I think you really need to take a close look at some other things our Congress has got involved with and tried to fix. Let's see, hummmmm, housing comes to mind. Lets make it more affordable. (health care and housing) Lets force banks (for health care think insurance) to make loans to people who really can't afford them. (force insurance on people who can't afford it) Lets create sub prime lending to support this. Oops, it failed, now lets spend billions to bail them out. (insurance companies)

Lets see, Medicare is going broke and oh yes, the wonderful part D to line the drug company pockets.

And social security, that will be broke in 10 years.

If they really feel they need to spend money, fix programs they have already put in place, not create new programs with new problems. So far the track record of government run programs is abysmal. Why would we want them to take over more. Stay away until you can prove your capable of success.

I can see it now. The government physical year is about to end. They have 28 billion they have to spend or lose it. OK everyone, line up for your Proctologist exam. Looks like the tax payer will be sc***wed either way.

[Guest]

but way more cerebral than necessary for the topic. Numbers can be made to look like anything that one wants to prove. Health care, like finance, will be screwed up like all government programs.

Can anyone think of any government program that works without graft, corruption, nepotism, cost over run or public abuse?

Only one answer is applicable to any new, or old for that matter, government spending and that is for government to simply stay out of our lives! Socializing medicine is just one more boondoggle waiting to happen.

[Guest]

http://www.washingtonpost.com/wp-dyn/content/article/2009/07/19/AR2009071902176.html


Heading into a critical period in the debate over health-care reform, public approval of President Obama's stewardship on the issue has dropped below the 50 percent threshold for the first time, according to a new Washington Post-ABC News poll.

[Guest]

...Polls are often manipulated to reach a desired result...
Unfortunately, a poll in this case is worthless unless you poll people that were exposed to more then one system....Numbers can be made to look like anything that one wants to prove...
I could debunk the Washington Post-ABC News Poll as being unreliable, produced by media doing nothing more than trying to hype readership or viewership. (Hey, they got Keedy's attention pretty quick, didn't they?) That's how lots of readers on this forum respond when information is presented that they don't agree with and refuse to even consider.

But I won't. I'll accept that the Washington Post and ABC News sponsored the poll, and had it conducted by an experienced pollster with no particular "agenda" in mind. I intend to consider the poll results and the trends that it presents (the same poll was conducted several weeks in a row in order to capture trends in public opinion). My initial reaction is that the poll results are probably a good thing. They suggest that the American public is beginning to take the time to understand the details of the healthcare reform legislation being considered...at least I hope that's what the poll results suggest. I certainly hope that the poll results don't suggest that the American public is beginning to believe that no action is necessary or no money should be spent to reform healthcare. That would be tragic.

All I ask in the future is that readers here accept some of the information that is provided that they might not necessarily agree with, if for no other reason than to understand different points-of-view regarding an issue, a candidate, or legislation. It seems to me that's what this forum is supposed to be all about. If it gets reduced to partisan bashing and counter-bashing of others' ideas, beliefs or candidates, I can tell you for sure that I can find better ways to spend my time.

[Guest]

I could debunk the Washington Post-ABC News Poll as being unreliable, produced by media doing nothing more than trying to hype readership. (Hey, they got Keedy's attention pretty quick, didn't they?) That's how lots of readers on this forum respond when information is presented that they don't agree with and refuse to even read.

But I won't. I'll accept that the Washington Post and ABC News sponsored the poll, and had it conducted by an experienced pollster with no particular "agenda" in mind. I intend to consider the poll results and the trends that it presents (the same poll was conducted several weeks in a row in order to capture trends in public opinion). My initial reaction is that the poll results are probably a good thing. They suggest that the American public is beginning to take the time to understand the details of the healthcare reform legislation being considered...at least I hope that's what the poll results suggest. I certainly hope that the poll results don't sugest that the American public is beginning to believe that no action is necessary or no money should be spent to reform healthcare. That would be tragic.

All I ask in the future is that readers here accept some of the information that is provided that they might not necessarily agree with, if for no other reason than to understand different points-of-view regarding an issue, a candidate, or whatever. It seems to me that's what this forum is supposed to be all about. If it gets reduced to partisan bashing and counter-bashing of others' ideas, beliefs or candidates, I can tell you for sure that I can find better ways to spend my time.

A thoughtful and reasonable post.

With your last paragraph, I fear you are fighting an uphill battle to expect it will be received any differently than others in this vein.

[Guest]

"If it gets reduced to partisan bashing and counter-bashing of others' ideas, beliefs or candidates, I can tell you for sure that I can find better ways to spend my time."

This forum is no better or no worse than the campaigns run buy the parties/politicians themselves during the election. To think that it should/would change here is mistaken.

It only gets nasty when one or two regulars start up with the my politician/party is great, yours is/has been bad. Otherwise I enjoy the back and forth of debating. Good job to almost all.

If you don't stay, and I hope you do, GB&GL.

[Guest]

Well, did I hear someone mention my name in vain?? :yuck: Hey, I read a thread this morning from January about Rush L. started by VK. It was a rough mean thread. It seems the left really get excited about Sarah Palin and Rush L. I can see some people getting mad when their man's ratings start to go south, too.
You can't have it both ways....when your man is riding high...it is fun to bash Rush....
I voted for Bush only because I didn't like Gore's or Kerry's politics....Even though I didn't like alot of things Bush did...it still wasn't easy listening to the left bash him each and every day. You can't stand the heat...get out of the kitchen.......:beer3:

[Guest]

The response to VK's post started as expected, and about as soon as expected.

I guess all is normal again.

[Guest]

Got this in the wrong thread earlier. Oops.

Anyway, check out www.pledgetoread.com to see which ones in congress say they will actually read the bill before signing/not signing. It is supposed to also list the ones who have said they won't. I haven't check it out yet, but plan to do it.

[Guest]

I could debunk the Washington Post-ABC News Poll as being unreliable, produced by media doing nothing more than trying to hype readership or viewership. (Hey, they got Keedy's attention pretty quick, didn't they?) That's how lots of readers on this forum respond when information is presented that they don't agree with and refuse to even consider.

But I won't. I'll accept that the Washington Post and ABC News sponsored the poll, and had it conducted by an experienced pollster with no particular "agenda" in mind. I intend to consider the poll results and the trends that it presents (the same poll was conducted several weeks in a row in order to capture trends in public opinion). My initial reaction is that the poll results are probably a good thing. They suggest that the American public is beginning to take the time to understand the details of the healthcare reform legislation being considered...at least I hope that's what the poll results suggest. I certainly hope that the poll results don't suggest that the American public is beginning to believe that no action is necessary or no money should be spent to reform healthcare. That would be tragic.

All I ask in the future is that readers here accept some of the information that is provided that they might not necessarily agree with, if for no other reason than to understand different points-of-view regarding an issue, a candidate, or legislation. It seems to me that's what this forum is supposed to be all about. If it gets reduced to partisan bashing and counter-bashing of others' ideas, beliefs or candidates, I can tell you for sure that I can find better ways to spend my time.

No idea-bashing intended. We learn better through questioning than blind acceptance.

I will say that I never believe polls - ever. That does not say they can't be accurate occasionally, or that they are always done by folk with an agenda. Humorously, even a blind squirrel finds an acorn once in a while. I just don't trust them because I've seen so many done by both political parties and their allies which were tainted. This is especially true when the folk polled are uninformed on the topic, but want to "follow the leader," whomever the leader (Rep, Dem, other). The "most people believe" opinion is bandied too much by too many.

All too often opinions and positions are based on subjective information which is colored to appear to be objective. Finding objective sources is becoming more and more difficult, so secondary analysis of the source is necessary. Some folk will take a Fox poll and discount an ABC or CNN one, or vice versa. Why? Because that secondary analysis is indeed the basis for self-determination of the efficacy of the poll.

I like objective data, prepared by sources with "no dog in the fight." These sources are rarely bright, shiny, colorful and demonstrative. In fact, most of these sources are downright dull. Sources like the Congressional Budget Office and the Congressional Research Service are apolitical by their very nature and not popularly quoted since their products are, well, dull and don't make inspired reading. Yet, they are substantive, neutral, objective and factual.

That's why I rely on CBO and CRS reports so much, even if they lack popularity. Their analyses are subject to both political parties' attack when and if they drift into subjectivity. If neither party rebuts a CBO or CRS report, it's easy to conclude the data is factual and any analysis is sound. Yet, folk often want to ignore the CBO or CRS reports, because the reports don't confirm a media article, poll or political position.

ADDENDUM: VK, I can't think of too many better ways to spend time than debating, contrasting, questioning and formulating opinions, and it's even more fun being involved in intellectual calisthenics with folk who see things differently. If we thought the same, life would indeed be dull, and nothing would ever be learned. The activity keeps the synapses firing, and that's a healthy thing.

[Guest]

The response to VK's post started as expected, and about as soon as expected.

I guess all is normal again.

This must be painful for you.

[Guest]

A few quotes from a report put out by National Center for Policy Analysis...

"Of the 46 million nominally uninsured, about 12 million are eligible for such public programs as Medicaid and the State Children’s Health Insurance Program (SCHIP).
They can usually enroll even at the time of treatment, arguably making them de facto insured. About 17 million of the uninsured are living in households with at least $50,000 annual income. More than half of those earn more than $75,000, suggesting that they are uninsured by choice. Although 36% of people in families with incomes under 200% of the poverty level are uninsured, 44% have private coverage, and there are reasons to believe that expansion of private coverage is a better avenue to greater access to care than expansion of public programs."

This report covers all those arguements about countries with nationalized medicine having better health and health costs and debunks them almost totally.

This section is very interesting...


"Are Administrative Costs Higher for Private Insurance Than Public Insurance?

The Congressional Research Service has estimated the administrative costs of Medicare at 2% of the total program costs, compared to 10% for private insurance and 12% for HMOs. Some single-payer advocates have used this estimate as an argument for a universal Medicare program. These estimates ignore hidden costs shifted to the providers of care, and the social costs of collecting taxes to fund Medicare. A Milliman & Robertson study estimates that, when these costs are included, Medicare and Medicaid spend two-thirds more on administration than private insurance spends on administration: 27 cents, compared to 16 cents, respectively, for every dollar of benefits.
According to Himmelstein and Woolhandler, if the US adopted the Canadian system, the savings on lower administrative costs could pay for insuring the uninsured.

Their calculation includes the cost of private insurance premium collection (advertising, agents' fees, etc.), but ignores the cost of tax collection to pay for public insurance. Danzon estimates the deadweight cost of tax finance in Canada to be at least 17% of claims. Using the most conservative estimate of the social cost of collecting taxes, Zycher calculates that the excess burden of a universal Medicare program would be twice as high as the administrative costs of universal private coverage."


Interesting reading for anyone who has the time.

http://www.ncpa.org/pdfs/sp_Do_Other_Countries_Have_the_Answers.pdf