Healthcare

[4dogknight]

Okay I'll start this thread because I see this issue becoming more pronounced and volitile as the year progresses and the rhetoric on Social Security stagnates.

Health Leaders Seek Consensus Over Uninsured (http://www.nytimes.com/2005/05/29/national/29insure.html?th=&emc=th&pagewanted=print)

{snip}
"At a time when Congress has been torn by partisan battles, 24 ideologically disparate leaders representing the health care industry, corporations and unions, and conservative and liberal groups have been meeting secretly for months to seek a consensus on proposals to provide coverage for the growing number of people with no health insurance.

The participants, ranging from the liberal Families USA to the conservative Heritage Foundation and the United States Chamber of Commerce, said they had made progress in trying to overcome the ideological impasse that has stymied action on the problem for eight years.

The group, which first came together last October, has not endorsed any specific plan, but has discussed a range of options, including tax incentives for the purchase of insurance, changes in Medicaid to cover more low-income adults and the creation of insurance purchasing pools at the state level.

"This effort holds as much promise as any I've participated in over the last decade, probably more," said Kate Sullivan Hare, the executive director of health care policy at the United States Chamber of Commerce.

Historically, such efforts have failed because of profound disagreements over the proper role of government. The group is far from any final agreement, but persists in seeking common ground, even as the problems of the uninsured have been eclipsed on Capitol Hill by Social Security and other issues.

The group also includes top executives from AARP, the A.F.L.-C.I.O., the American Hospital Association, the American Medical Association, America's Health Insurance Plans, the Blue Cross and Blue Shield Association, Johnson & Johnson, the National Conference of State Legislatures, the National Governors Association, Pfizer and the Service Employees International Union.

The group's overarching goal is to agree, by the end of this year, on proposals that expand coverage to as many people as possible as quickly as possible. By meeting in secret, the group has tried to shield itself from political pressures. Some of the proposals under discussion could lead to increases in federal spending or regulation, at a time when the government already faces large deficits and Republicans generally oppose further expansion of government.

Though federal policymakers talk little about the issue these days, the problems of the uninsured have been gaining urgency among people who provide and pay for health care, including employers."

{snip}
"The 24-member group takes a pragmatic approach, members said, looking for incremental steps.

"People are uninsured for different reasons," said Dr. Mary E. Frank, the president of the American Academy of Family Physicians and a participant in the talks. "No one solution will work for everyone. We need different solutions for different groups of the uninsured."

E. Neil Trautwein, assistant vice president of the National Association of Manufacturers, said the consensus group was "not biased in favor of big government solutions," and assumed that health care would continue to be provided through a mix of private insurers and public programs."

{snip}
"The group is considering these options:

* The federal government could require parents to arrange health insurance for their children up to a certain age, say 21. If the children were not eligible for public programs like Medicaid, the parents could obtain tax credits to help meet the cost.

* If an employer does not offer health benefits to employees, the workers could designate amounts to be withheld from their paychecks, along with taxes. These amounts would eventually be forwarded to insurers to pay premiums.

* The federal government could provide tax credits to low-income individuals and families or small businesses to help them pay for insurance. The full amount of the credit would be sent directly to the insurer.

* Medicaid could be expanded to cover any adult with income below the official poverty level (about $9,600 for an individual). Each state would decide for itself whether to do this, and the federal government would provide financial incentives for states to take the option.

* The federal government would offer small grants to states to help them establish insurance purchasing pools. Individuals and small businesses could buy coverage through these pools.

Asked what had prompted the initiative, Stuart M. Butler, the vice president of the conservative Heritage Foundation, said: "It's a coalition built of frustration. True believers on the left and the right have been stymied on this issue."

4dk - who asks those who post in this thread, please cite your sources and if it is opinion, please designate as such.

[colinmom71]

Sorry, I've been meaning to get around to this for a little while, but I've been busy with Colin's own health issues at the moment. He's been in and out of doctor's offices for the last month for eye surgeries...

The following is mostly opinions since my time for researching is limited of late.

"The group, which first came together last October, has not endorsed any specific plan, but has discussed a range of options, including tax incentives for the purchase of insurance, changes in Medicaid to cover more low-income adults and the creation of insurance purchasing pools at the state level. "

The tax incentives idea is nice, but it really only works for those persons whose income is comfortably high enough to be able to afford to purchase a private health insurance account. Seeing as those can run as high as $1000 a month for the self-employed, this is a poor incentive for the majority of working families, even those in the mid to higher middle class. That's a freakin' *mortgage payment* for most citizens!! (Actually, it's more than our monthly mortgage payment!). And the term "tax incentive" is very vague. Do they mean outright cash tax credits to supplement premiums (a good start) or list premiums as a pre-tax spending/tax free income spending level, a solution that would help almost noone.

Changes in Medicaid - We're already seeing changes in Medicaid at the state level. In Missouri, next month will see about 100,000 persons kicked off the program because income eligibility levels have been lowered to an almost impossible living standard. Many of those being dropped are disabled. Apparently, they've forgotten the compassionate part of Bush's election catch-phrase "compassionate conservatism". So, I highly doubt the option of expanding Medicaid will occur. (On a personal note, I'm not sure now if I'll be going to Nationals because of Colin's new issues, but I'm mighty tempted to not go simply as a boycott against a state that treats it's neediest citizens so poorly...)

The insurance "pooling" idea has been around for well over a decade, and has been shot down in committees by powerful lobbyists working for uber-profiting insurance companies. Risk sharing and cost reduction for self-employed and small business owners means less profit and they don't want that... With the current Republican controlled Congress which favors big business over the people they promised to govern fairly and wisely, this option ain't gonna happen any time soon either.

""People are uninsured for different reasons," said Dr. Mary E. Frank, the president of the American Academy of Family Physicians and a participant in the talks. "No one solution will work for everyone. We need different solutions for different groups of the uninsured." ***** E. Neil Trautwein, assistant vice president of the National Association of Manufacturers, said the consensus group was "not biased in favor of big government solutions," and assumed that health care would continue to be provided through a mix of private insurers and public programs."

I can think of one solution that WILL work for everyone, although not insurance companies - universal health coverage. We'd likely spend less money overall than is currently spent by employers and employees on private (for profit) insurance. Workers may become better workers in that they are less stressed about medical expenses and whether to keep a job they're unhappy with in order to keep insurance that may not meet all their needs anyway. You'd make malpractice suits and large awards virtually non-existent since any resulting medical issues or needs occuring due to the malpractice would be covered by the universal health fund. Hospitals will benefit because they will recieve payment for all patients. They won't need to write off large amounts of indigent care, forcing them to upcharge those patients with insurance or those who pay on a cash basis.

And I love Mr. Trautwein's use of "non-biased" language. In that statement against bias, he also automatically rejects the prospect of universal coverage by invoking the "no big government" catch-phrase big business interests are so fond of and immediately lobbies for the status-quo.

As for the suggested options this coalition has mentioned....

* The federal government could require parents to arrange health insurance for their children up to a certain age, say 21. If the children were not eligible for public programs like Medicaid, the parents could obtain tax credits to help meet the cost.

* If an employer does not offer health benefits to employees, the workers could designate amounts to be withheld from their paychecks, along with taxes. These amounts would eventually be forwarded to insurers to pay premiums.

Not sure how viable this first solution could be. Those parents whose income is low enough are already either eligible for Medicaid or their state's CHIP program. Those uninsured workers whose income is just above the CHIP income levels have no affordable solutions except maybe some HMO's, like Kaiser Permanente. While I've heard mixed feedback on Kaiser, a lot of HMO's are restrictive and may have contract disputes with health care providers over costs.

I find the pre-tax spending approach to the employee paying insurance premiums interesting. If the government could back a sliding scale fee approach to premiums for a good comprehensive health plan, this could be a good use of federal government regulatory powers to help employees access health insurance.

* The federal government could provide tax credits to low-income individuals and families or small businesses to help them pay for insurance. The full amount of the credit would be sent directly to the insurer.

Umm, the problem isn't just low income persons. It's also within the working middle class. IIRC, the biggest problem is in fact within the working class - folks with good paying jobs, just not good enough to afford privately contracted insurance. And a lot of small business owners are in the middle class and have the same problem. They need to address that it isn't just low income earners who need this help.

But yes, the direct disbursal of tax credits to pay for premiums to the insuring company is a good idea.

* Medicaid could be expanded to cover any adult with income below the official poverty level (about $9,600 for an individual). Each state would decide for itself whether to do this, and the federal government would provide financial incentives for states to take the option.

To quote Buffy, "The who's whatting how with the huh?"... Medicaid already covers this population!!!! What they're describing here IS Medicaid! In some states in fact, Medicaid eligibility is already expanded at the state level for incomes higher than the federal poverty level within certain programs for the disabled and for pre-natal care.

Now, some states have adjusted downward, reducing their income eligibility because of funding shortages (see Missouri reference above). Why are they experiencing shortages you ask? Because the federal government, under Bush's administration and current Republican controlled Congress, has severely slashed funding to states for Medicaid, education, etc. in order to pay for it's unjust war in Iraq (not to mention the private contractors within the war effort).

* The federal government would offer small grants to states to help them establish insurance purchasing pools. Individuals and small businesses could buy coverage through these pools.

Riiiight... We can't even get this federal government to pay monies it is mandated to provide to the states for Medicaid, education, Special Education, domestic security, etc. You think they're suddenly going to fund a supplement program to pay for insurance pools they've defeated in committee for the past decade? Interesting idea, but the insurance lobby will never allow it.

Asked what had prompted the initiative, Stuart M. Butler, the vice president of the conservative Heritage Foundation, said: "It's a coalition built of frustration. True believers on the left and the right have been stymied on this issue."

No, true believers on the left and in the center have been stymied. The right wing, pro-business interests have won by keeping medicine and health care coverage a for-profit endeavor. The well being of the people of the US is what's being stymied here. The commonwealth of our country is what is being endangered.

I think we have truly lost sight of the ideal that a government that was devised to be "Of the People, By the People" is supposed to work FOR the People! (I'm gonna run for office and that will be my platform position! Heh, like I have time...)


OK, long ranting alert so if you've made it this far, congratulations! Yeah, I have a bias here, but this is too critical an issue to leave to committee exposition ad nauseum. At least these groups are talking together though. I just don't know what it's going to take to get the "powers that be" to realise that health cannot viably be a for-profit venture...

[EigthAv]

Considering the parties who are promoting this concept? It will go no where. I am all for socialized medicine! I want a programme like Sammi Todd & Family have in Great Britain. Not just more social welfare for those already in the 6 digit+ income bracket.If you have to strap it to the AFL/CIO,the AMA,ACLU and both of our most popular American poltical parties I will still have to decide between first aid at the Dollar General and the pros.Wake me up when it happens,so I can make a doctor's appointmnet.

[colinmom71]

Actually, I'm not necessarily an advocate for socialized medicine, which would entail total state control over doctors, hospitals, etc. That type system often becomes a too bloated and inefficient bureaucracy...

Some advocates of universal coverage support the idea of a single payer system, which would essentially expand Medicaid/Medicare to cover all citizens and workers (including permitted immigrant workers - ie. those with a "green card"). However, an argument against this is that it would put insurance companies out of business.

The system I like the most so far would be the "hybrid" system that France has - Universal Guaranteed Coverage, where the government backs access to insurance coverage for all citizens and workers with sliding scale contribution fees (premiums) based on income level. Persons under a certain wage level have free medical coverage with the government paying their premium. Over that level, the contribution fee is adjusted for earned income (wages only) and presumeably according to family unit size. There are also some exceptions to the fee for those on disability/workers compensation programs and those who are disabled. The government uses it's regulatory powers to control what constitutes fair and comprehensive coverage as well.

I think this system is the one that could transition most easily into our current capitalist aproach to health care without eliminating too many jobs in the private sector. Insurance companies will benefit in that they now have guaranteed business from all citizens with backing by the government. Employers will be relieved of the costly and confusing burden of how to provide health insurance to their employees. Doctors, hospitals, and patents alike would have fewer problems with determining which health care provider is covered by their plan since the government stipulates certain basic levels of care as covered by all policies at all providers' facilities. And most importantly, people can live without the overwhelming fear that a health crisis will bankrupt their family!!!

[bjb22]

I find it somewhat of an interesting juxtaposition that the number of uninsured in the U.S. is approxiamately equal to the number of the unborn aborted since the advent of Roe v. Wade (about 45 million).

It appears that even if you managed to not get aborted it is still tough to stay healthy.

"It's a wonder we can even feed ourselves"

"Idiot Wind"- Bob Dylan

[mr pru]

I guess we're lucky we're not in Grant's Pass-because no amount of health care would help.

Geesh-give us a break!

[bjb22]

The lead topic yielded and interesting analysis on the Healthcare situation. The HC topic is complex and multi-facted. I merely stated a similarity in total numbers made a stark comparison of a moral issue (abortion) and the entire heatlthcare situation. Often social-moral policies have a "cause and effect" relation of others.

As far as GP goes all I can tell you is that I have had 11 people I knew personally die young and from unnatural causes (suicide, murder etc.) in 13 years. That beats any actuarial table I ever heard of.

The "Gap" (how Grants Pass is often referred to as) is clearly an unhealthy place and this governments policy of cognitive dissonance to these atrocities is appalling.

[colinmom71]

I find it somewhat of an interesting juxtaposition that the number of uninsured in the U.S. is approxiamately equal to the number of the unborn aborted since the advent of Roe v. Wade (about 45 million).

Well, I find it to be a complete non sequitor. Keep in mind that the 40 million number given for the uninsured in the US is an estimate. I'm willing to bet the actual number would be a good deal higher if there were a way to quantify it accurately. Either way, it has nothing to do with the projected numbers of legal abortions performed since the Roe v. Wade decision was handed down in 1973. BTW, that number you quote doesn't include those abortions performed in states where abortion was legal pre-Roe.

Are you per chance making a correlation between a lack of health coverage and abortion rates? Pehaps something along the idea that women wouldn't resort to abortion if they didn't have to worry about whether they have good coverage for pregnancy care? Or am I reading you wrongly here?

[4dogknight]

Mass. Gov. Romney's health care plan says everyone pays (http://www.usatoday.com/money/industries/health/2005-07-04-health-insurance-usat_x.htm)

{snip}
"You have to buy car insurance if you own a car. You have to buy home insurance to get a mortgage. Why don't you have to buy health insurance?
Massachusetts Gov. Mitt Romney re-ignited that debate last month when he announced a plan to expand health coverage to all the state's residents, with a caveat that those who don't buy coverage could face a penalty.

"We can't have as a nation 40 million people — or, in my state, half a million — saying, 'I don't have insurance, and if I get sick, I want someone else to pay,' " says Romney, a Republican who says he might run for president in 2008."

{snip}
"Romney's plan says everyone should: The state would work harder to enroll all residents eligible for Medicaid; employers, most of whom already offer insurance, would be encouraged to continue doing so voluntarily; and individuals who don't have insurance would have to sign on to one of two new insurance pools, one of which would be subsidized for lower-income residents.

Failing to sign up could lead to a loss of a personal tax exemption or garnishment of wages.

Romney's plan comes as politicians, employers and benefit consulting firms are focused on the latest trend in health care cost control: "personal responsibility."

That trend is playing out in several ways: larger payments by workers toward their own health costs; efforts by employers to get workers to change unhealthy behaviors; and new health savings plans that allow people to set aside money, tax free, to cover health costs."

{snip}
"Skeptics of an individual requirement abound.

Can politicians muster support from business, labor and patient advocacy groups?

Will people sign up, particularly young, healthy folks who often eschew coverage out of a sense of invulnerability? How far would states go to punish those who don't buy coverage?

"I am very pessimistic that it will work," says Merrill Matthews Jr., director of the non-profit Council for Affordable Health Insurance, based in Alexandria, Va.

He says employers might drop coverage if the state has a program, thereby increasing the number of uninsured. He also questions whether insurers will offer coverage at competitive rates."

{snip}
"Currently, the majority of insured Americans get their health insurance through benefits voluntarily offered by employers; 63% of all firms currently offer health coverage. But 45 million Americans are estimated to be uninsured, many of them working adults. Attempts to require employers to provide insurance have also been defeated, in large part because of opposition from small businesses, which would be the hardest hit by such a requirement.

Proposals to force individuals to buy coverage are also problematic, but might be less politically explosive than forcing employers or creating a government-run system. Still, Romney's plan might face opposition. The state's lawmakers will debate the issue over the summer. If adopted, the program would go into effect in July 2006.

"I think you'll see us pass legislation this year," says Romney. "It's not a mandate. It's basically saying you have a personal responsibility to either pay your own way or get insurance."

COMMENT: Aside from the slams against Democrats and the Clintons in particular and the punishment if individuals didn't purchase insurance, some of the stuff Romney proposes has merit. However all of his proposal must be read in the light of the fact that Romney may run for President in 2008.

4dk

[bjb22]

WTF is Romney going to have People pay with? With soda pop and beer cans ...now that's work.

[4dogknight]

Meth Abuse Cited as Top Drug Problem for Law Enforcement Agencies (http://www.washingtonpost.com/wp-dyn/content/article/2005/07/05/AR2005070501421.html?referrer=email&referrer=email)

{snip}
"The crippling reach of methamphetamine abuse has become the nation's leading drug problem affecting local law enforcement agencies, according to a survey of 500 sheriff's departments in 45 states.

More than half of the sheriffs interviewed for a National Association of Counties survey released Tuesday said they considered meth the most serious problem facing their departments."

{snip}
"The report comes soon after the White House Office of National Drug Control Policy restated its stance that marijuana remains the nation's most substantial drug problem. Federal estimates show there are 15 million marijuana users compared with the 1 million that may use meth.

Dave Murray, a policy analyst for the White House, said he understands that the meth problem moving through the nation is serious and substantial. But he disagrees that it has become an epidemic."

COMMENT: I don't know about anyone else but the 'tunnel vision' of this administration and the inability to change an opinion is becoming very disturbing to me. Actually this trait has made me uncomfortable since 2000. No I take that back, this trait was much in evidence when GW was the Gov. of Texas.

4dk

[kwanpistonsfan]

IMO, we need to completely change the health care system to a single payer system instead of having this patchwork type deal where the government keeps trying to "patch up" the leaks in a faulty pipe, which ultimately will prove to be a Sisyphus-type endeavor. I'm tired of the public having almost a conditioned response to the idea of a single payer system because they fear it is "socialist," or they fear "higher taxes."

1) It's not socialist. The gov't would interfere minimally with actual practice of medicine. All doctors and hospitals retain their autonomy. The gov't would implement a reasonable fee limit, but think about it. Doctors are being white-knuckle controlled by managed care companies now. Corporate executives make all the decisions about what is or isn't medically necessary, as opposed to elected officials if single payer were instituted.

2) Taxes would probably not even increase by much. Single payer would reduce administrative inefficiencies in private sector managed care. Overhead's only 1% in Medicare, as opposed to 20% for managed care companies, and HMOs don't mind, because they're making profits. Even if taxes do increase, compare that with how much you're paying for health care now, with the co-pays, deductibles, premiums, etc. Does it make sense how much individuals and employers are paying now?

[4dogknight]

Universal health care push being revived (http://www.usatoday.com/news/nation/2005-07-10-universal-health-care_x.htm)

{snip}
A push for universal health coverage is being rekindled in some states by the soaring cost of health care and the lack of political support in Washington for federal changes.
Advocates of a single-payer system — where the government would collect taxes and cover everyone, similar to programs in Canada and across Europe — have introduced bills in at least 18 state legislatures. Some are symbolic gestures, but heated debate is taking place in California and Vermont.

In Ohio, doctors, union officials and religious leaders are gathering signatures to get a single-payer health system placed on a ballot next year.

"The level of misery with private insurers is rising, and that's why we're seeing this increased activity," said Larry Levitt, vice president of the California-based Kaiser Family Foundation, which analyzes health care issues. "But whether one state can succeed, I don't know."

{snip}
"Maine started enrolling people this year in a state-private program that offers affordable health coverage to small businesses and families. The goal is to bring coverage to the 130,000 Mainers who lack it by 2009.

"It's really going to the states to push health care reform along," said Janne Hellgren, coordinator for a universal health care movement in Massachusetts. "Washington just isn't willing to change the status quo."

AND

Cash crunch threatens children's insurance program (http://www.usatoday.com/news/nation/2005-07-09-states-healthinsurance_x.htm)

{snip}
"A government program that provides health insurance for poor children could run into money problems in several states over the next two years unless Congress acts.
Six to 14 states will use up their share of federal money for the State Children's Health Insurance Program during the 2006 budget year, according to a report by the nonpartisan Congressional Research Service. By the next year, that number will range from 12 to 20 states and could include Michigan.

The range occurs because analysts looked at two scenarios. One projected low demand for the program; the second factored in high demand.

Once states spend their federal share, they either have to use more of their own money to provide insurance coverage or find ways to reduce expenses by cutting services. Neither is a particularly attractive option for state legislatures."

{snip}
Ron Pollack, the executive director of Families USA, said he hopes the program's bipartisan support in Congress would lead to an expansion.

"I don't know of any Republicans or Democrats who don't like the program," he said. "I think they all like it."

With a budget deficit for the year projected near $350 billion, many lawmakers have little appetite for expanding any government program.

Pollack said tinkering with the distribution formula, as Grassley suggests, is not something he opposes. In the end, he said, Congress will have to put more money into the program if it hopes to meet demand.

"Remember, there are 6 million children eligible for this program who are not getting it," he said. "We want to get them enrolled."

COMMENT: Looks like the ball is going to be the "States" court for health care reform and maintenance. I am of mixed emotions on this, while I'd prefer to wait until this current administration is out of office to begin work on healthcare reform,certain segments of our population, primarily children and folks my age, can't wait for that to happen.

4dk

[pbluu]

Gosh, some people act like socialism is a disease.
Socialism is not a bad idea when it comes to health care.
Capitalism is a bad idea when it comes to health care.

Why should the bottom line be the most important thing?
Healthcare is about compassion, nurturing and healing. Instead this is not the priorities anymore because hospitals and medical institutions are more concerned with making a profit.

More effiency with the profit model? Please, guess where the cuts in expense that translates more profits for these medical centers? The patients? I don't think so. If that is the case, then why are medical fees keep on going up? Hello, stockholders, high execs and the high paid doctors are reaping the most of the profits that disguise as being more effient.