Oh, the criticisms of the proposed healthcare reform. I'd guess there's someone or some group against every single section. The problem is that no one has a better idea. If we're lucky, the traction being built against the proposed plan will result in it's defeat. But we'd be left with the same problem of too expensive and underfunded healthcare. No one seems to have a comprehensive better idea.

A couple things are for sure. Reform is necessary in order to bring down the cost of healthcare in this country and getting everyone insured. Whatever reforms are put in place should not add to the deficit or national debt. Those are simple objectives, really. Difficult and tough to achieve, for sure. To cut costs while insuring 20% more people means that someone's ox will be gored. There's simply no other way. The objective should be to eliminate the least necessary costs.

Here are a few ideas...again. I wish I had a Government Budget Office (GBO) to price them out.

• Set a standard, minimum coverages, for any healthcare insurance policy offered in the U.S. This could be done quickly by a consortium of the largest private insurance companies and then approved by the government. Or the standards could be set by the government itself.
• Stop reducing the funding of Medicare. This "cost cutting" idea is lunacy at a time when the number of Medicare-qualified people is increasing. All it does is drive more providers away from the system, resulting in more uninsured citizens.
• Use the terrifc technology we already have to assist doctors in diagnosis and the development of a medical plan or a protocol of prescription drugs. Once that data base of medical diagnostic data is in place, it should be used to determine whether certain treatments, procedures or drugs are paid for by insurance. Some will argue that we shouldn't adopt a "one size fits all" approach, but such use of technology would definitely result in reduced costs.
• Means test for government-provided healthcare insurance, Medicare or any new program. If people can afford to pay more in premiums, co-pays or deductions, they should.
• Include preventive medical measures either in the proposed legislation or in the tax code. The degree to which actions by individuals to prevent the onset of bad health will reduce future costs. What could this include? Maybe items like increased taxes on tobacco products, increased premiums for people not showing progress towards reducing obesity (that's me!), tax deductions for health club memberships...those sorts of things.
• Firm limits on how much any kind of insurance, government or private, will pay for experimental procedures and/or medical research. These are costs that should be funded privately.
• Enact medical tort reform. Some will argue that it won't work. But strict tort reforms do work in countries with national healthcare insurance. Remember one of the prime objectives of any reform--reduce spending on healthcare. Even if legal reforms saved a few percentage points, it's a step in the right direction. The reforms could be as simple as "loser pays" as a start.
• Permit the government, or some consortium of private companies or agencies, to determine the maximum price that will be paid for a formulary of prescription drugs. Drug companies can charge more for their drugs in the free market if they choose. If they can sell them at prices greater than the approved/negotiated price, they would be free to do so. It just wouldn't be paid for by health insurance.
• Certain procedures or drugs not necessary for the maintenance of good health should be eliminated as those paid for by any form of health insurance. I'm sure there's a long list that could be developed, but things like in vitro, any kind of cosmetic surgery, abortions not needed to protect the mother, etc. should be identified. The objective of "reform" should be to provide for improvements in the general health of the population at reduced costs--not addressing all health issues. If desired, pay for them privately.
• If there's still a "cost gap" after enacting everything anyone can think of, we may be left with increasing taxes to fill the gap. That should be a lst resort, but certainly one that would trump adding to the deficit or national debt.

These are probably just the beginning of a list of reforms that would work to accomplish the objectives. You all can probably add more. I wish we had a GBO to price them out.

One thing is for sure. Just saying "NO" doesn't accomplish the objectives that need to be addressed.

VK Says:

One thing is for sure. Just saying "NO" doesn't accomplish the objectives that need to be addressed.

I beg to differ. Saying NO will put an end to this rush to create a takeover of 17 per cent of our economy. This is not a time to mess with our fragile economic situation. Timing is everything. WE should put an end to this madness and concentrate on creating jobs for the millions of Americans that are on the verge of losing their homes and their way of life.
Fix the economy first. You can't build a house on a weak foundation.

Go after the abuse in these systems.
X-budget the illegal aliens coverages.
Eliminate all proposed programs like death counseling and birth counseling.
Grandfather current participants in existing over 65 programs till death.
Eliminate small businesses from mandatory contribution for those companies with _ _ X _ _ or less employees.

Do not add the newly covered have nots until such time as capacity is verified to be able to handle the surge of services to be required. Have an increasing phase in scale from year 'x' to year 'y'.

Exclude all proposals included that result in an increase in cost with no identified funding or offset.

Do not fix or expand or eliminate any coverages that are working effectively.

Eliminate all proposals that result in any take aways of existing benefits.

to name a few.

btk

btk

One thing is for sure. Just saying "NO" doesn't accomplish the objectives that need to be addressed.[/QUOTE]

There seems to be two parts to this health care debate. The first is weather the government SHOULD mandate health care coverage and the second being weather we SHOULD ram a program through this year, never mind before the summer recess. The just say no's may be equally split between the two parts, but the overall result is they both say NO. Cramming a proposal down our throats just to say we did SOMETHING in OB's first year is not what the people want. WE THE PEOPLE have no problem expressing a NO to higher taxes, social security reform, military spending, etc. ,why is it wrong to say NO to health care at this point? It took a lifetime to get to where we are in health care and it is unwise to think that the government can set a specific date this year to solve the problems.

[QUOTE=Villages Kahuna;219592]Oh, the criticisms of the proposed healthcare reform. I'd guess there's someone or some group against every single section. The problem is that no one has a better idea. If we're lucky, the traction being built against the proposed plan will result in it's defeat. But we'd be left with the same problem of too expensive and underfunded healthcare. No one seems to have a comprehensive better idea.


got me thinking of a possible help in the health care problem. A neighboring community's electric utility provider has applied for the state commission to allow them to adjust their rates DOWN (imagine that if you will). MA already has utility commissions in place to set rates, an auto insurance commission to set rates, why not a state run health insurance commission to set insurance rates. Having it work on the state level will compensate for the differences in cost of care from state to state.

All the states would have to have such commissions or the health insurance companies s would jump state if they didn't like the rates determined. (it happened here in MA with auto insurance companies.) Competition for gross $$ should keep companies interested.

No federal government involvement, state only. Total involvement to provide maximum efficiency of scale to costs. Means testing for cost coverage (verifiable under oath or loss of benefits). Multiple plan offerings over a base plan. And anything else that passes the quack test.

In spite of my conservative bent in this issue I do believe health care is a social necessity, if not a right. The argument is for me what roll government has in the process and the rush to provide anything in a fixed time frame.

Kahuna, your blanket criticism of Obamacare critics misses an important element. GNU nails it in his response. A lot of taxpayer critics acknowledge the need for reform. It may or may not come as a shock to you that I believe the healthcare system needs reform. Our difference is in the process used to achieve meaningful, cost effective reform that maintains or elevates the efficiencies of the existing system and eliminates its cost generating, ill conceived flaws and faults.

The present White House/Congress effort was designed to be "rammed" through by creating a "the sky is falling" crisis mentality. I believe the Clinton's were at the top of the list advising Obama to act quickly because Hilliary's plan faltered when the people were given too much time to absorb the details and cost implications. This speaks volumes to the contempt many in Washington have for the American people.

I disagree with you when you say "no one has a better idea." There are plenty of ideas out there including many on the superlative list you compiled. Most of them and others have been previously discussed in the forum. There are plenty of "better" ideas to work with.

Our points of view diverge over process not need. I believe Congress needs to look at a long term plan to implement reform and not a "one shot fix" or sound bite band aid that will bankrupt America. The timing for healthcare reform couldn't be worse. If you concede that premise...you may not...wouldn't it be prudent and responsible to first insure the continued delivery of Medicaid and Medicare. I leave what needs to be done in the world of finance and our economy to you and other forum finance professionals because you are eminently more conversant and articulate in that bailiwick. In the words of Dirty Harry, "A man has to know his limitations", ergo I defer.

Regarding healthcare, tort reform could be implemented without direct funding consequences to the system. The cost of practicing medicine could arguably be reduced. Further, and more important, redundant, unnecessary, CYA testing and procedures that constitute the astronomic cost of "defensive" medicine may come down. Who knows?

Efficiencies of scale could be researched, prioritized, and implemented when funding is in place.....no artificial timetables. Give the taxpayer an opportunity to weigh in. While there will always be critics, the feelings and emotions framed in the mistrust and deceit of Washington politicians and bureaucrats may be reduced enough to arrive at a consensus to move forward on a pay as you go basis. Maybe....

The push to pass this bill now....without a responsible cost projection is manifestly negligent malfeasance. It ranks with fiduciary corruption and would be subject to true tort liability consequences if committed by anybody but Congress, our fiduciary caretakers, who seem to flaunt their immunity.

Originally Posted by cabo35

Kahuna, your blanket criticism of Obamacare critics misses an important element. GNU nails it in his response. A lot of taxpayer critics acknowledge the need for reform. It may or may not come as a shock to you that I believe the healthcare system needs reform. Our difference is in the process used to achieve meaningful, cost effective reform that maintains or elevates the efficiencies of the existing system and eliminates its cost generating, ill conceived flaws and faults.

The present White House/Congress effort was designed to be "rammed" through by creating a "the sky is falling" crisis mentality. I believe the Clinton's were at the top of the list advising Obama to act quickly because Hilliary's plan faltered when the people were given too much time to absorb the details and cost implications. This speaks volumes to the contempt many in Washington have for the American people.

I disagree with you when you say "no one has a better idea." There are plenty of ideas out there including many on the superlative list you compiled. Most of them and others have been previously discussed in the forum. There are plenty of "better" ideas to work with.

Our points of view diverge over process not need. I believe Congress needs to look at a long term plan to implement reform and not a "one shot fix" or sound bite band aid that will bankrupt America. The timing for healthcare reform couldn't be worse. If you concede that premise...you may not...wouldn't it be prudent and responsible to first insure the continued delivery of Medicaid and Medicare. I leave what needs to be done in the world of finance and our economy to you and other forum finance professionals because you are eminently more conversant and articulate in that bailiwick. In the words of Dirty Harry, "A man has to know his limitations", ergo I defer.

Regarding healthcare, tort reform could be implemented without direct funding consequences to the system. The cost of practicing medicine could arguably be reduced. Further, and more important, redundant, unnecessary, CYA testing and procedures that constitute the astronomic cost of "defensive" medicine may come down. Who knows?

Efficiencies of scale could be researched, prioritized, and implemented when funding is in place.....no artificial timetables. Give the taxpayer an opportunity to weigh in. While there will always be critics, the feelings and emotions framed in the mistrust and deceit of Washington politicians and bureaucrats may be reduced enough to arrive at a consensus to move forward on a pay as you go basis. Maybe....

The push to pass this bill now....without a responsible cost projection is manifestly negligent malfeasance. It ranks with fiduciary corruption and would be subject to true tort liability consequences if committed by anybody but Congress, our fiduciary caretakers, who seem to flaunt their immunity.

Plans, no matter what kind, are only as good as the authors. We have yet to hear from anyone who wrote any paragraph or section within HR 3200 or any other such plan.

Why is that? We know the HR 3200's sponsor and co-sponsors have no competence in developing national service management and delivery systems.

I wouldn't buy a car that wasn't labeled showing who made it, or eat at a restaurant that wasn't approved by competent inspectors whose names are on the certificate of inspection. I'm hesitant to believe a "plan" on changing health care within the United States, authored by anonymous sources, has considered all (or even most) of the ramifications for initiating untried, untested, and uncredentialed actions on such a massive scale.

I can agree there is a sizable minority who are not satisfied with health care management and delivery in the USA. However, to risk the health care of the majority to possibly satisfy the minority with untried, untested, and uncredentialed actions authored by anonymous sources who may even have a vested (and profit motive) interest - which may be why the authors remain anonymous - is ludicrous.

One of the greatest advantages we have is the ability for experimentation at the state level. If we can get it right at the state level, success at the national level becomes less risky AND less expensive. Failure at any degree at the national level is highly expensive, both in money and lives. But since that doesn't generate headlines (logic rarely does)........

I agree with what Steve has said. We do not have to accept and either/or position on healthcare. We can go one step at a time. I personally find it unbelievable that people are seriously proposing such a drastic change to our way of living and our economy without having any real life evidence that it would be a good idea for this country. There is a great deal of talk, both pro and con, about the Canadian system. It should, however, be noted that Canada rolled this system out on a Province-by-Province basis. Surely we should take the time to do a test pilot of the ideas in one or two states, rather than “jump off the cliff.”

Candidate states should have both a large city and a rural population. In addition, they should have relatively small populations - you do not want to try to pilot in California or Texas.

My two candidate states would be Arizona and Massachusetts. Others could easily be chosen, but do a pilot. Discover what works and what needs to be changed. Answer such questions as:
“Is tort reform necessary for the idea to succeed?”
“Will the system be open to all who show up or limited to those in the United States legally?”
"Will elective procedures be covered, and if so, which elective procedures?"
“Will all medical providers be placed on a salary rather than a fee for service system?”
“Who will be considered a medical provider, MD, DO, Dentists, Optometrists, Chiropractors, Massage Therapists, Acupuncturists, etc or all of the above?”
“What about Hospice, adult day care, in home assistance, Nursing Homes, Memory Care Facilities, Assisted Living Facilities, etc.?”
The number of questions is nearly endless and the only way to find the answer is to go at it one step at a time.

Medicare works well because in nearly every medical situation the treatment is decided by the doctor and the patient. There are exceptions but nothing is perfect.

If we end up with a government program for all of us regardless of our age ,which is what obama wants, it will only work if it is precicely like medicare.

Originally Posted by Villages Kahuna

The problem is that no one has a better idea.

Beg to differ! The attached article by Charles Krauthammer makes abundent sense and is a practicle approach. The only thing I would add to Krauthammer's recommendations is to implement some from of electronic medical records to reduce the long term records cost and ease the access to critical medical records as needed. Of course, the cost to implement a universal electronic medical records system is substantial.

See Krauthammer's article at http://www.redding.com/news/2009/aug...s/?partner=RSS.

Originally Posted by Villages Kahuna

Oh, the criticisms of the proposed healthcare reform. I'd guess there's someone or some group against every single section. The problem is that no one has a better idea. If we're lucky, the traction being built against the proposed plan will result in it's defeat. But we'd be left with the same problem of too expensive and underfunded healthcare. No one seems to have a comprehensive better idea.

A couple things are for sure. Reform is necessary in order to bring down the cost of healthcare in this country and getting everyone insured. Whatever reforms are put in place should not add to the deficit or national debt. Those are simple objectives, really. Difficult and tough to achieve, for sure. To cut costs while insuring 20% more people means that someone's ox will be gored. There's simply no other way. The objective should be to eliminate the least necessary costs.

Here are a few ideas...again. I wish I had a Government Budget Office (GBO) to price them out.

• Set a standard, minimum coverages, for any healthcare insurance policy offered in the U.S. This could be done quickly by a consortium of the largest private insurance companies and then approved by the government. Or the standards could be set by the government itself.
• Stop reducing the funding of Medicare. This "cost cutting" idea is lunacy at a time when the number of Medicare-qualified people is increasing. All it does is drive more providers away from the system, resulting in more uninsured citizens.
• Use the terrifc technology we already have to assist doctors in diagnosis and the development of a medical plan or a protocol of prescription drugs. Once that data base of medical diagnostic data is in place, it should be used to determine whether certain treatments, procedures or drugs are paid for by insurance. Some will argue that we shouldn't adopt a "one size fits all" approach, but such use of technology would definitely result in reduced costs.
• Means test for government-provided healthcare insurance, Medicare or any new program. If people can afford to pay more in premiums, co-pays or deductions, they should.
• Include preventive medical measures either in the proposed legislation or in the tax code. The degree to which actions by individuals to prevent the onset of bad health will reduce future costs. What could this include? Maybe items like increased taxes on tobacco products, increased premiums for people not showing progress towards reducing obesity (that's me!), tax deductions for health club memberships...those sorts of things.
• Firm limits on how much any kind of insurance, government or private, will pay for experimental procedures and/or medical research. These are costs that should be funded privately.
• Enact medical tort reform. Some will argue that it won't work. But strict tort reforms do work in countries with national healthcare insurance. Remember one of the prime objectives of any reform--reduce spending on healthcare. Even if legal reforms saved a few percentage points, it's a step in the right direction. The reforms could be as simple as "loser pays" as a start.
• Permit the government, or some consortium of private companies or agencies, to determine the maximum price that will be paid for a formulary of prescription drugs. Drug companies can charge more for their drugs in the free market if they choose. If they can sell them at prices greater than the approved/negotiated price, they would be free to do so. It just wouldn't be paid for by health insurance.
• Certain procedures or drugs not necessary for the maintenance of good health should be eliminated as those paid for by any form of health insurance. I'm sure there's a long list that could be developed, but things like in vitro, any kind of cosmetic surgery, abortions not needed to protect the mother, etc. should be identified. The objective of "reform" should be to provide for improvements in the general health of the population at reduced costs--not addressing all health issues. If desired, pay for them privately.
• If there's still a "cost gap" after enacting everything anyone can think of, we may be left with increasing taxes to fill the gap. That should be a lst resort, but certainly one that would trump adding to the deficit or national debt.

These are probably just the beginning of a list of reforms that would work to accomplish the objectives. You all can probably add more. I wish we had a GBO to price them out.

One thing is for sure. Just saying "NO" doesn't accomplish the objectives that need to be addressed.

Let's start here.

Pass a law. Congress may pass no law from which it is exempt.
Do not let them give us crap while they get the cream.


Tort reform. Put a reasonable limit to pain and suffering paymevts. 1 of 2 million. Looser pays court costs. No limit for payment of actual loss.
This alone will save billions. There will be a few less millionair lawyers.

Clamp down on fraud. Jail Doctors and lawyers.

Pass that legislation and wait a couple of years. Then lets see what we really need.

It is not the medical care system that needs to be fixed at this time.

Yoda

A member of the loyal opposition

Originally Posted by Yoda

Let's start here.

Pass a law. Congress may pass no law from which it is exempt.
Do not let them give us crap while they get the cream.


Tort reform. Put a reasonable limit to pain and suffering paymevts. 1 of 2 million. Looser pays court costs. No limit for payment of actual loss.
This alone will save billions. There will be a few less millionair lawyers.

Clamp down on fraud. Jail Doctors and lawyers.

Pass that legislation and wait a couple of years. Then lets see what we really need.

It is not the medical care system that needs to be fixed at this time.

Yoda

A member of the loyal opposition

Great link SNOK. Yoda...Really good ideas. I wish that people would get their heads out of their you know what and be active and write their reps and go to Tea Parties. It is exciting when Americans feel threatened and we fight back!!!!!!

Originally Posted by cabo35

.....It may or may not come as a shock to you that I believe the healthcare system needs reform....

Wow! Cabo, where in the world did you get the idea that my original post was a "blanket criticism of Obamacare". In the second paragraph of my opening post I say, ..."A couple things are for sure. Reform is necessary in order to bring down the cost of healthcare in this country and getting everyone insured. Whatever reforms are put in place should not add to the deficit or national debt."...

If given a choice, would I prefer Congress to put together a Rube Goldberg healthcare reform bill, or wait until next year and thoughtfully craft a piece of legislation that will work. I'll take "wait". If that's what you mean by "blanket criticism of Obamacare", I'm guilty. Congress has been considering then avoiding doing anything on healthcare for decades. We can wait another few months to do it right.

But I don't believe for a nanosecond that a thoughtful reform bill isn't needed. Quite to the contrary, significant reform is needed ASAP.

Notwithstanding the claims that there are other good alternatives out there, I am still a big doubter. There are lots of reform plans that have been published--the supposedly bi-partisan Dole-Daschle-Baker proposal http://www.bipartisanpolicy.org/ht/a...Action/i/10782 is one that I read today. Having earned a living as a consultant for a few years, the use of "consultantese" in this proposal was maddening. Maybe not as confusing as the "legalese" in HR 3200, but maddening in that it wasn't any more understandable.

What I mean by a good alternative is one that can be understood by the majority of Americans and whose costs and benefits are reasonably measurable.

By the way, even though Dole, Daschle and Baker made an attempt to make their plan look "bi-partisan", I am left with some doubts. Dole and Daschle fail to mention that are both full-time employees of one of Washington's biggest lobbying firms, and that their firm represents 31 major companies in the healthcare industry. And I'm supposed to believe that their counter-proposal is simply a compendium of their "good ideas"? Yeah, right.

I think you may have misread my post or perhaps my point wasn't clear. I never said that your original post was a "blanket criticism of Obamacare". I said, "your blanket criticism of Obamacare critics misses an important element".

The essence of my post was to advocate process over details. I actually agree with you on much of the detail you have recently posted.

When are CD rates going up? Don't hold my breath right?

Kahuana: I have heard many alternatives that I would like to see regarding our health care system. They do not destroy what we have, but they do correct alot of what is currently wrong regarding costs, etc.

If you care to hear alternatives, which in this case are from some Republicans, then I will channel you to their sites. If you are against anything a Republican has to say, then that's okay too.

Your statement is incorrect in suggesting that there are no one has a better idea.