Originally Posted by cabo35

Kahuna, why is it that you describe those who oppose the government's active role in national health care as "wailers" while you cloak your own support with a superior, aloof, pedantic Obamaesque attitude?

Like Obama, you state your case eloquently and intelligently but without the ever present teleprompter. However, do you really understand what is going on? Have you read Tom Daschle's book, "Critical: What We Can Do About the Health-Care Crisis"? The book is a boilerplate for the Obama Health Plan albeit an unoriginal ripoff of Britain's health care system. The significance of the book is that Daschle was selected to be Obama's Health Czar or Health and Human Services Secretary and sell the plan to Congress and the American people. Unfortunately or fortunately, depending on your perspective, he was derailed by a little $140,000 tax oversight for "consulting", (aka lobbying?), he was paid for. That and the chauffeured car he had at his disposal owned by whoever. I digress.

His proposal, largely lifted from the Brits, who by the way are largely not fond of it, calls for merging of employers' plans, Medicaid and Medicare with an expanded FEHBP (Federal Employee Health Benefits Program), no problem so far. However the system would be under the control of a Federal Health Board and you know what Federal implies as to control. Therein is the root of my opposition and "wailing". Do you think politics could enter the equation? Do you think politics could enter the life and death decision making? Let me explain further.

The essence of the plan is scary. It is built around and rooted in cost-effectiveness comparisons. Sounds like it could save money what with all that cost effectiveness overtone but I suspect it would be largely at the price of limiting patient access to certain medical treatments as determined by the Federal Board controlled by who?

In reality, medical treatment would be rationed according to "cost effectiveness as determined by the government. The British counterpart is called NICE for the National Institute for Health and Clinical Excellence. I talked to Brits just last week, who say most of their countrymen hate NICE. NICE apparently gets to decide who is going to get treatment and who is not, who is going to live, who is going to die. I understand the reality and economies of scale that could be realized and even heard a doctor support the concept. I am just not ready to abdicate to the government the right to decide who lives and dies in my family or any American family. Rank me with the "wailers" you mock if you wish, but I am not confident Obama and the government can distinguish and decide with political detachment such important considerations. If my recall of history hasn't left with my short term memory, didn't that little Austrian house painter in 1939 try to decide who was worthy of saving with medical treatment and who was not?

Further, the temptation to bait and switch in favor of power, is just to great for Washington to pass up. Who in the capitol is courageous enough to say what the Obama administration's true intention is......I believe it is to control health care in America at all costs. Banking, the automobile industry, health care, pharmaceutical vis-a-vis healthcare.........totalitarianism. Maybe that's just me "wailing".

Have a good evening in the Villages.

FYI... medical care is ALREADY rationed... spend some time learning about the "PRIOR AUTHORIZATION" process. Everyday in my office I need to smooch the behinds of dozens of insurance functionaries to allow pts to return for a certain # of visits, a certain type of medication, MRI scans etc. You need to spend a day in my shoes for an eye-opener.

Originally Posted by rshoffer

FYI... medical care is ALREADY rationed... spend some time learning about the "PRIOR AUTHORIZATION" process. Everyday in my office I need to smooch the behinds of dozens of insurance functionaries to allow pts to return for a certain # of visits, a certain type of medication, MRI scans etc. You need to spend a day in my shoes for an eye-opener.

Well said Doc! As a nurse I don't deal with the financials but I do deal with the worry and the concern the patients have over what their illness is going to cost them. Anxiety can worsen their already fragile state and it should be the last thing a patient is worrying about.

of health care. However, as with so many programs proposed and discussed....what are some of the specifics? Just what does "fixing health care mean? Entail?

Does or will it include:

stopping pharmaceutical companies from hiding behind patents keeping drugs at extreme high prices?

stopping provider institutions and individuals from exploiting the system for maximum personl gain contributing to maximum costs?

grandfathering what coverage YOU have today from Medicare, when bringing all the have nots on board?

all....I mean ALL government employees including congress, senate, et al (.....sorry I could not help myself!!!)?

understandable coverage that has no special coverages for vague differentiation?

drug coverage?

Just to name a few. Without the specifics, congress and Obama will pass another huge program with unspecified content that will benefit only providers and government officials and the usual medical provider special interest groups. There will be no accountability....no measurables.

The program will again get the Obama fast track label and be pushed through the partisan controlled system.

Skeptical? N egative? Absolutely!!!! Appropriately earned by previous actions/non actions by our incompetent lawmakers.

I have said it before and I will say it again....remember no matter what program is proposed for the masses will not be as good as what is available to us (retirees on Medicare) today. No matter what is proposed we will wind up having to offset the difference through private coverages just as we do with supplemental coverages today....except it will be more $$$$.

LAst of all how will it be paid for? And as stated above just how will it affect the economy?

Sorry for asking for specifics....I know it is an age old requirement not subscribed to by lawmakers and partisans!!

btk

My question would be along the same lines as BTK but not nearly as intelligent !!

The poll asked "What is your position on healthcare reform"....most of, if not all of the replies assume total government control and cost.

Is there not a middle ground for all of this so that it is not 100% government ?


Great discussion by the way !

Tort reform. Until you fix that any system will fail. Get the lawyers out, drop the cost of malpractice insurance for doctors and hospitals and drug componies, and ALL other health care becomes affordable.

The hosts of this very enjoyable and informative forum tout the fact that it "gets a million hits a month" which is quite impressive. So far there have been 42 responses to the survey. What's up with that? Seems kinda low.

Let me give you all an example of this health care problem. On Wed I saw a very nice young lady who was having a very unpleasant discontinuation reaction to a medication she was taking but had abruptly stopped. She was a single parent, had recently lost her job (economy) which WAS providing health care benes. She could not afford to continue the coverage under COBRA, she could not afford to refill her prescriptions and now comes to see me on an urgent basis because of the complications of abruptly stopping her meds. This isn't a "rare case".
I would estimate at least 25% of the meds, therapies or diagnostic studies I order are "denied" by insurance reviewers as "not medically necessary" or because there is a cheaper alternative. Folks, this is rationing. At least with a single payor system I'll know the rules and who I'm dealing with. It is impossible to know which insurers allow what, cover what etc. The pts are stuck in the middle..... they come in and say "my medication was denied.... YOU need to call 1-800-nooneeveranswers to get "prior authorization" This is why I have pleaded with my son to NEVER leave his position as a US Army physician. Our current system is insane.

Originally Posted by rshoffer

The hosts of this very enjoyable and informative forum tout the fact that it "gets a million hits a month" which is quite impressive. So far there have been 42 responses to the survey. What's up with that? Seems kinda low.

Let me give you all an example of this health care problem. On Wed I saw a very nice young lady who was having a very unpleasant discontinuation reaction to a medication she was taking but had abruptly stopped. She was a single parent, had recently lost her job (economy) which WAS providing health care benes. She could not afford to continue the coverage under COBRA, she could not afford to refill her prescriptions and now comes to see me on an urgent basis because of the complications of abruptly stopping her meds. This isn't a "rare case".
I would estimate at least 25% of the meds, therapies or diagnostic studies I order are "denied" by insurance reviewers as "not medically necessary" or because there is a cheaper alternative. Folks, this is rationing. At least with a single payor system I'll know the rules and who I'm dealing with. It is impossible to know which insurers allow what, cover what etc. The pts are stuck in the middle..... they come in and say "my medication was denied.... YOU need to call 1-800-nooneeveranswers to get "prior authorization" This is why I have pleaded with my son to NEVER leave his position as a US Army physician. Our current system is insane.

TO your point on the voting...great one. I have not voted as I am still reading and am not that bright in that I think there is need for healthcare reform, but not sure I want what is dubbed universal. Not sure if that makes sense but looking for maybe some alternative where we can reform the current system but not become dependent on the government !

Originally Posted by Russ_Boston

Well said Doc! As a nurse I don't deal with the financials but I do deal with the worry and the concern the patients have over what their illness is going to cost them. Anxiety can worsen their already fragile state and it should be the last thing a patient is worrying about.

I am sympathetic to your position as a nurse. I have some experience myself as a former combat medic and also working in a Mash type unit in a war zone. Anxiety is described as intense fear resulting from anticipation of a threatening event. No?
Well, I can tell you with certainty that millions have been affected with this syndrome since September 11, 2001. It further escalated after November of last year. People wake up every day to news that more and more of our fellow citizens have been laid-off from employment. People look at their financial statements and see that they have lost 40% of their wealth.
The world as they knew it is disappearing. One of the biggest companies in the world is bankrupt. (GM) The price of fuel is going up and inflation is rearing it's ugly head again.
All that being said, the USA has many reasons to have anxiety, and everybody wants everybody to be healthy. But we have to fix alot of things, especially the economy, before we tackle something as enormous as healthcare.

It should not be an either/or.

Access at a reasonable cost is not out there for so many Americans. Throw in a pre-existing and there might be no access at all.

Why does everybody think it has to be either/or? We need middle ground. A solution that provides access to decent coverage at a reasonable cost. Something we could buy into. (both literally and figuratively)

We let the present system get away from us. Are we now at the point of no return?

Prescription cards for convenience. Yeah, that was great. A Trojan Horse that hid the real cost of the drugs as they skyrocketed.

I remember saving receipts in a shoebox and sending them in to my insurance company for reimbursement. I knew what the cost was. But then, somewhere in the early 90's, or maybe late 80's, suddenly everybody at work wanted that card with that co-pay. A few bucks at the pharmacy and we could be on our way. No pesky shoeboxes.

That drug card turned out to be a Trojan Horse.

For the sake of convenience, we as consumers of health care pulled that wooden horse inside the walls. The insane cost of prescription drugs has slaughtered us in our sleep. Just like in the story when those soldiers climbed down out of their hiding place inside that horse and slaughtered the Trojans. It was an easy slaughter. They were sleeping off the partying they had been doing because they thought they had won the war. They thought that wooden horse was a gift from the enemy. Just like people thought that prescription card was so wonderful.

So Big Phama could hide those cost hikes from the consumer. And hide them and hike them they did. We all know pipelines are not the whole picture.

And now, I really must state the obvious......Paper-pushers in cubicles at insurance companies spend their days trying real hard to prescribe drugs and limit procedures. And they often succeed. Gee. With all that experience, should a national plan arise, maybe they could transfer right on over to a government job.

And speaking of government jobs. And speaking of taxes. Isn't that our tax money that provides that health care for life that comes with a government job.

I know it is all a big mess. A huge ugly mess. But either/or is not the answer.

And I am glad to see some real experiences showing up in this thread.

Boomer

Originally Posted by Bucco

TO your point on the voting...great one. I have not voted as I am still reading and am not that bright in that I think there is need for healthcare reform, but not sure I want what is dubbed universal. Not sure if that makes sense but looking for maybe some alternative where we can reform the current system but not become dependent on the government !

For one perspective go to www.pnhp.org Remember this is a physician organization. Their stats indicate over 60% of practicing docs support a single payor system.... why? Well, it certainly is NOT because there will be more $$$ in it for the docs. In fact, the opposite is more likely. I believe it is because the current "system" is so fragmented and chaotic that most docs simply can't stand dealing with it anymore.

Originally Posted by Villages Kahuna

Healthcare for Americans has been primarily the product of insurance plans negotiated by employers and offered by private insurance companies. For those of us that have coverage, it's become dramatically more expensive over the last decade or so. At the same time, payments to providers--with the exception of the pharmaceutical companies--have declined to the point where doctors and hospitals are being very selective on which insurance companies they will accept for assignment. Many big city doctors and hospitals won't accept Medicare anymore. And in Illinois, a large group of hospitals and doctors have opted not to accept the largest insurer in the state, Blue Cross-Blue Shield.

At the same time this is happening to those of us that are insured, there are 50 million Americans--almost 20% of our population--that have no health insurance at all. If they get sick or are injured, their only option is a hospital emergency room which, when they can't pay the bill, adds to the cost that must be shared by the rest of us.

THE PRIVATE SYSTEM OF HEALTHCARE INSURANCE THAT WE HAVE NOW ISN'T WORKING!

Clearly, something needs to be done to correct the problems I've cited. I'm sure there are all kinds of possibilities that will be discussed by Congress. The opponents of any form of government healthcare insurance will wail that the government will become our health care provider, they will pick our doctors and prescribe our treatment. That allegation will circulate, even on this forum, even though no one--NO ONE--has proposed that to be the case. The worst scenario I've heard is that the government will provide an insurance option, but that everyone will have the right to remain with their existing insurer if they so choose. But the plans being discussed will provide for healthcare coverage for the 50 million or so who don't currently hve coverage.

If in the process of legislating a plan, some of the abuses that have resulted from the lobbying of special interests--the effect of the pharma lobby on the Medicare prescription bill is a good example--so much the better.

I only hope that as a country we can afford to pay for a plan that private companies have failed horribly to provide.

WELL SAID

Originally Posted by rshoffer

Define "works"... By all standard benchmarks developed by industrialized countries to measure health, The USA is way down toward the bottom (despite the fact that we spend more per capita than ANY other country). I would recommend forum members go to www.pnhp.org to learn how damaged the current health care industry really is.

GREAT WEBSITE... IF YOU HAVEN'T LOOKED AT IT, YOU SHOULD THANKS

http://www.pnhp.org/reader/Section%2...20(Geyman).pdf

http://www.nytimes.com/2009/06/11/us.../11health.html

Originally Posted by Keedy

All that being said, the USA has many reasons to have anxiety, and everybody wants everybody to be healthy. But we have to fix alot of things, especially the economy, before we tackle something as enormous as health care.

We're in basic agreement except I think that health care IS a major part of the economic woe. Since you brought up GM, they said that the UAW's contract, which did not allow for employee copays, was one of the major reasons the company went bankrupt. This may or may not be the truth and GM could have said no to the union if they wanted to hold the line but they did say it. So I would have to content that health care costs are a major talking point when it comes to economic recovery.