Healthcare Reform Bill Implodes

[rn4]

Even the government run military can't compete with the private sector. Why do you think all the big dogs end up at private security contractors. The US military is like a draft league to private contractors pro league. This isn't to say that a privately funded contractor could beat the US Military in open war... but if they had equal budgets it would be a different story.

Yea, pay the private contractors what the U.S. military does and see how good their army would be. The private contractors loyalty belongs to the almighty dollar, those sure are the people I want wactching out for my freedom.

[retro-man]

This is why status quo is often preferrable.

 

I thought the debate on that point was pretty much over. I could be wrong.

[jpd80]

would it not be better to "evolve" health care

in the direction that people want it to go

rather than trying to change everything at once?

[napfirst]

I thought the debate on that point was pretty much over. I could be wrong.

Even the dems in Congress know that the debate is not over....hence the push to shove this through before they have to go back home and face the wrath of their constituents...

[retro-man]

Even the dems in Congress know that the debate is not over....hence the push to shove this through before they have to go back home and face the wrath of their constituents...

But seriously: "status quo"; is there anyone here who seriously thinks that's ok - you know with the large number of uncovered, the double digit increases annually, the drug prices that are 5 times what people in other countries are paying, the employer-based coverage in an economy where there is no longer job security? Anybody think that's ok? Show of hands?

Edited December 19, 2009 by retro-man

[jpd80]

For the sake of all my American friends, I hope that your government finds a way through this bear pit.

[RangerM]

But seriously: "status quo"; is there anyone here who seriously thinks that's ok - you know with the large number of uncovered, the double digit increases annually, the drug prices that are 5 times what people in other countries are paying, the employer-based coverage in an economy where there is no longer job security? Anybody think that's ok? Show of hands?

Not many that I know of think things are peachy the way they are, but the 'solutions' being pushed on us are worse than nothing.

 

Put it this way....

 

As written in the Senate bill, by law people are forced to purchase health insurance, but if they don't, the fine they will pay would be less than the premiums they would have paid, and given that they (supposedly) can't be denied coverage, this is supposed to encourage people to buy health insurance? Is that really a solution?

 

Given the choice between nothing and worse than nothing, I'll take things the way they are.

Edited December 20, 2009 by RangerM

[retro-man]

Not many that I know of think things are peachy the way they are, but the 'solutions' being pushed on us are worse than nothing.

 

Put it this way....

 

As written in the Senate bill, by law people are forced to purchase health insurance, but if they don't, the fine they will pay would be less than the premiums they would have paid, and given that they (supposedly) can't be denied coverage, this is supposed to encourage people to buy health insurance? Is that really a solution?

 

Given the choice between nothing and worse than nothing, I'll take things the way they are.

So are we incapable in this country of doing better? Because it's starting to seem that way. Why is that? Realpolitik? A balkanized voter base? Powerful industry groups got our legislators by the short hairs? All of the above?

[Roadtrip]

So are we incapable in this country of doing better? Because it's starting to seem that way. Why is that? Realpolitik? A balkanized voter base? Powerful industry groups got our legislators by the short hairs? All of the above?

 

I would explain the reason we are not doing better as all of the above and more.

 

Realpolitik plays a role because of the politicians' desire to buy votes from those who do not have coverage, or, more accurately, think that they do not have coverage, and who are naive-enough to think that the government can help them improve upon their existing state of affairs. From the perspective of liberal politicians, health-care reform is not, and has never been, about improving peoples' lives; it's about expanding the base of voters who are dependent on the government, and who will vote -- generation after generation -- for politicians who promise to make good on voters' dependencies.

 

Balkanization plays a role, too. We witnessed Howard Dean saying this week that, since the Senate version of the bill had dropped the "public option," they should "scrap" the thing and start over. (Dean is in favor of a full-blown single-payer plan -- a euphemism for government-controlled socialized medicine -- which many on the far left heartily endorse.) Others, namely moderate Democrats concerned about their re-election prospects, are reluctant to endorse taxpayer-funded abortions that any health-care legislation might provide. As it turns out, Democrats in the Senate who originally opposed the bill will vote for the Senate version because they were offered special spending measures for their home states. The concept of buying votes is not limited to average Americans.

 

The concept of powerful industry groups is not limited to industries. It also includes special-interest groups, such as the trial-lawyers association, which happens to be among the heaviest of campaign contributors to Democrat politicians, and which coincides with the fact that there is zero tort-reform legislation written into the current health-care reform legislation. Also consider the fact that the companies that constitute "big pharma" were also big contributors to democrat politicians. Big insurance companies also contributed heavily. Cynical as it may seem, it is unrealistic to expect legistators to vote contrary to the wishes of those parties who have provided so much financial support for their election campaigns. The concept of special-interest groups includes abortion-rights advocates, who seek publicly funded abortions.

 

What's a left-leaning politician to think? The cognitive dissonance must be unbearable! On the one hand he must appeal to his far-left, anti-corporate constituency (even though large corporations contributed to his campaign and he is beholden to them for future campaigns), and on the other, he must appeal to his more centrist voters, many of whom may be Catholic or otherwise who might be seriously opposed to abortion (let alone public funding of abortion). And yet the abortion-rights advocates in their districts and states just won't go away....

 

So what we have now is a politization of our health care. And it's not a good thing.

 

We have drug companies that have, over the years, come up with life-saving treatments for cancer and high-blood pressure -- treatments that cost untold millions of dollars to develop. And the politicians claim greed on the part of the drug companies for the prices they charge for these drugs, merely because it's politically expedient (even though they take their money...).

 

The reason we are not doing better in terms of health care is because we are (and have been) stifling competition. We stifle competition for health insurance between states, as the Republicans have pointed out. We stifle competition among providers by dictating within plans who those providers will be. As I pointed out in my post on the first page of this thread, competition in LASER eye-care has led to greater results and lower costs -- and I forgot to mention more popular demand -- without subsidization from the government or insurance. I haven't undergone the prodedure, but I know lots of aquaintances who have, and they swear by it. They say it's a "miracle." And they paid out of their own pocket, 100 percent.

 

Funny thing about that profit motive.... Funny too, how competitive forces benefit the end user.

 

Competition could apply in our health-care system, if only our government-led, litigation-centered system would allow it to happen. All of us would benefit from competition -- if our government would allow it.

[RangerM]

All of us would benefit from competition -- if our government would allow it.

Great post, RT. I'd only add that in the Senate Bill (as written)....

 

{and this is based on what I heard from another source, since you can't read the entire bill as of now}

 

.....does allow private health insurance companies to offer country-wide plans, available to any person(s) in any State. An idea I can support however, supposedly these plans have to be approved by some Federal (-ly appointed?) committee. That's not something I can support, because it doesn't change the problem of government mandates.

Edited December 20, 2009 by RangerM

[fmccap]

{and this is based on what I heard from another source, since you can't read the entire bill as of now}

This is the other fishy part. Last I heard the bill was over 2000 pages and not available to read. When will it be available and as of right now there is only 4 days until they want to have a vote on it.

[Ron W.]

When will it be available

 

 

When they add enough "pork" to buy the votes of certain members :shades:

[fmccap]

When they add enough "pork" to buy the votes of certain members :shades:

Oh, I see!

 

SOLD: Sen. Ben Nelson to vote for health care bill; Secured favors for his home state...

[goinbroke2]

Oh, I see!

 

SOLD: Sen. Ben Nelson to vote for health care bill; Secured favors for his home state...

 

WTF is wrong with people? Are they so me-me-me that they can't even allow something that's good for the country first? If a politician was bought like that and is proud of it, what does that say about his day-to-day dealings when he's not in the spotlight?

If a politician walked up and told me he got 10 billion for our province by allowing something that was obviously bad for the country overall, I'd punch him in the throat! Shit like that really pisses me off, self centred pricks!

[RangerM]

WTF is wrong with people? Are they so me-me-me that they can't even allow something that's good for the country first? If a politician was bought like that and is proud of it, what does that say about his day-to-day dealings when he's not in the spotlight?

If a politician walked up and told me he got 10 billion for our province by allowing something that was obviously bad for the country overall, I'd punch him in the throat! Shit like that really pisses me off, self centred pricks!

 

Not to worry, apparently the government is nothing more than a free-for-fall, and that's ok.

 

Deep in Health Bill, Very Specific Beneficiaries (link to article)

David Axelrod, a senior adviser to President Obama, .......said the provisions benefiting specific states, like Nebraska, and favored constituencies were a natural part of the legislative process.

 

“Every senator uses whatever leverage they have to help their states,” Mr. Axelrod said on the CNN program “State of the Union.” “That’s the way it has been. That’s the way it will always be.”

 

Given that the taxes for this healthcare monstrosity start in 2010 and none of the benefits begin until several years later (2013-2014), I wonder what the money will be used for? Think it might be to buy more votes?

[grbeck]

I would explain the reason we are not doing better as all of the above and more.

 

Realpolitik plays a role because of the politicians' desire to buy votes from those who do not have coverage, or, more accurately, think that they do not have coverage, and who are naive-enough to think that the government can help them improve upon their existing state of affairs. From the perspective of liberal politicians, health-care reform is not, and has never been, about improving peoples' lives; it's about expanding the base of voters who are dependent on the government, and who will vote -- generation after generation -- for politicians who promise to make good on voters' dependencies.

 

Balkanization plays a role, too. We witnessed Howard Dean saying this week that, since the Senate version of the bill had dropped the "public option," they should "scrap" the thing and start over. (Dean is in favor of a full-blown single-payer plan -- a euphemism for government-controlled socialized medicine -- which many on the far left heartily endorse.) Others, namely moderate Democrats concerned about their re-election prospects, are reluctant to endorse taxpayer-funded abortions that any health-care legislation might provide. As it turns out, Democrats in the Senate who originally opposed the bill will vote for the Senate version because they were offered special spending measures for their home states. The concept of buying votes is not limited to average Americans.

 

The concept of powerful industry groups is not limited to industries. It also includes special-interest groups, such as the trial-lawyers association, which happens to be among the heaviest of campaign contributors to Democrat politicians, and which coincides with the fact that there is zero tort-reform legislation written into the current health-care reform legislation. Also consider the fact that the companies that constitute "big pharma" were also big contributors to democrat politicians. Big insurance companies also contributed heavily. Cynical as it may seem, it is unrealistic to expect legistators to vote contrary to the wishes of those parties who have provided so much financial support for their election campaigns. The concept of special-interest groups includes abortion-rights advocates, who seek publicly funded abortions.

 

What's a left-leaning politician to think? The cognitive dissonance must be unbearable! On the one hand he must appeal to his far-left, anti-corporate constituency (even though large corporations contributed to his campaign and he is beholden to them for future campaigns), and on the other, he must appeal to his more centrist voters, many of whom may be Catholic or otherwise who might be seriously opposed to abortion (let alone public funding of abortion). And yet the abortion-rights advocates in their districts and states just won't go away....

 

So what we have now is a politization of our health care. And it's not a good thing.

 

We have drug companies that have, over the years, come up with life-saving treatments for cancer and high-blood pressure -- treatments that cost untold millions of dollars to develop. And the politicians claim greed on the part of the drug companies for the prices they charge for these drugs, merely because it's politically expedient (even though they take their money...).

 

The reason we are not doing better in terms of health care is because we are (and have been) stifling competition. We stifle competition for health insurance between states, as the Republicans have pointed out. We stifle competition among providers by dictating within plans who those providers will be. As I pointed out in my post on the first page of this thread, competition in LASER eye-care has led to greater results and lower costs -- and I forgot to mention more popular demand -- without subsidization from the government or insurance. I haven't undergone the prodedure, but I know lots of aquaintances who have, and they swear by it. They say it's a "miracle." And they paid out of their own pocket, 100 percent.

 

Funny thing about that profit motive.... Funny too, how competitive forces benefit the end user.

 

Competition could apply in our health-care system, if only our government-led, litigation-centered system would allow it to happen. All of us would benefit from competition -- if our government would allow it.

 

Very good post, but, in the long run, the "blame Republicans and corporations for everything" mantra is much simpler and easier to repeat.

 

Also makes it easier to ignore certain unpleasant facts, including the one that this bill will not save us any money...much of the cost "savings" promised us by the Congressional Budget Office (CBO) are achieved by shifting more costs from the government's books to those of business.

 

And let's not forget that the CBO has a history of underestimating the long-term costs of federal government health care programs - starting with Medicare in 1965 - by as much as 500 percent.

[xr7g428]

Getting funding for a project that would include US based employees is very difficult. There is just too much potential risk associated with hiring. This does not bode well for reducing unemployment.

[RangerM]

Concisely put. Perhaps so. But I stand by what I said regarding the support of the majority of surveyed physicians, the AMA, and the AARP for a public option. The first 2 groups in particular, are knowledgeable about the issue. That is not to say they are necessarily impartial - any more than the insurance or pharmaceutical industries are - but I have greater faith that their interests are aligned with my own and that of my family. Obviously you feel otherwise.

So are we incapable in this country of doing better? Because it's starting to seem that way. Why is that? Realpolitik? A balkanized voter base? Powerful industry groups got our legislators by the short hairs? All of the above?

 

Apparently there is something government is better at than my private health insurance company; denying claims. (Link to pdf)

 

(Here is a link to the entire report, not just the part about denial of claims)

 

In 2009 (according to the AMA), Medicare denied 4.00% of all claims, while my private insurer (United Healthcare) was 2.02%.

 

I calculate that the rate of denial for Medicare is about double that of my for-profit private insurer.

 

According to the AMA data, Medicare was second-highest in denial of claims (BCBS was first at 4.34%).

 

Thoughts?

Edited December 21, 2009 by RangerM

[fmccap]

Another one.

SOLD: $100 Million Payoff for Senator Dodd...

[Roadtrip]

And let's not forget that the CBO has a history of underestimating the long-term costs of federal government health care programs - starting with Medicare in 1965 - by as much as 500 percent.

 

This is an understatement!

 

Senator Sam Brownback, ranking Republican member of the Senate Joint Economic Committee, issued a report last July 31, entitled "Are Healthcare Costs Reliable?: History Shows True Costs are Often Significantly Understated".

 

Among the report's findings:

Medicare (hospital insurance).

In 1965, as Congress considered legislation to establish a national

Medicare program, the House Ways and Means Committee estimated that the hospital insurance

portion of the program, Part A, would cost about $9 billion annually by 1990. Actual Part A spending

in 1990 was $67 billion. The actuary who provided the original cost estimates acknowledged in 1994

that, even after conservatively discounting for the unexpectedly high inflation rates of the early ‘70s

and other factors, “the actual [Part A] experience was 165% higher than the estimate.”

 

Medicare (entire program).

In 1967, the House Ways and Means Committee predicted that the

new Medicare program, launched the previous year, would cost about $12 billion in 1990. Actual

Medicare spending in 1990 was $110 billion—off by nearly a factor of 10.

 

ESRD program.

In 1972, Congress enacted a universal entitlement to kidney dialysis for patients

suffering from end stage renal disease. The program proved twice as expensive as the publicly

predicted levels—$229 million in 1974 instead of the predicted $100 million. The bill’s authors had

seriously underestimated the demand for services, especially among the over-65 population.

 

Medicaid DSH program.

In 1987, Congress estimated that Medicaid’s disproportionate share

hospital (DSH) payments—which states use to provide relief to hospitals that serve especially large

numbers of Medicaid and uninsured patients—would cost less than $1 billion in 1992. The actual cost

that year was a staggering $17 billion. Among other things, federal lawmakers had failed to detect

loopholes in the legislation that enabled states to draw significantly more money from the federal

treasury than they would otherwise have been entitled to claim under the program’s traditional

50-50 funding scheme.

 

Medicare home care benefit.

When Congress debated changes to Medicare’s home care benefit

in 1988, the projected 1993 cost of the benefit was $4 billion. The actual 1993 cost was more than

twice that amount, $10 billion.

 

Medicare catastrophic coverage benefit.

In 1988, Congress added a catastrophic coverage

benefit to Medicare, to take effect in 1990. In July 1989, the Congressional Budget Office (CBO)

doubled its cost estimate for the program, for the four-year period 1990-1993, from $5.7 billion to

$11.8 billion. CBO explained that it had received newer data showing it had significantly under-

estimated prescription drug cost growth, and it warned Congress that even this revised estimate

might be too low. This was a principal reason Congress repealed the program before it could take

effect.

 

SCHIP.

In 1997, Congress established the State Children’s Health Insurance Program as a

capped grant program to states, and appropriated $40 billion to be doled out to states over 10 years

at a rate of roughly $5 billion per year, once implemented. In each year, some states exceeded their

allotments, requiring shifts of funds from other states that had not done so. By 2006, unspent reserves

from prior years were nearly exhausted. To avert mass disenrollments, Congress decided to

appropriate an additional $283 million in FY 2006 and an additional $650 million in FY 2007.

 

Given Congress's abysmal history of forecasting future costs of its healthcare programs, I see no reason to believe theirs or President Obama's claims that this new healthcare reform legislation will reduce the deficit or save costs. Believing them now would be the equivalent of believing Bernie Madoff's proposal for an investment scheme -- after he has already been tried and convicted for previous fraudulent behavior on a massive scale.

Edited December 22, 2009 by Roadtrip

[grbeck]

This is an understatement!

 

Senator Sam Brownback, ranking Republican member of the Senate Joint Economic Committee, issued a report last July 31, entitled "Are Healthcare Costs Reliable?: History Shows True Costs are Often Significantly Understated".

 

Among the report's findings:

Medicare (hospital insurance).

In 1965, as Congress considered legislation to establish a national

Medicare program, the House Ways and Means Committee estimated that the hospital insurance

portion of the program, Part A, would cost about $9 billion annually by 1990. Actual Part A spending

in 1990 was $67 billion. The actuary who provided the original cost estimates acknowledged in 1994

that, even after conservatively discounting for the unexpectedly high inflation rates of the early ‘70s

and other factors, “the actual [Part A] experience was 165% higher than the estimate.”

 

Medicare (entire program).

In 1967, the House Ways and Means Committee predicted that the

new Medicare program, launched the previous year, would cost about $12 billion in 1990. Actual

Medicare spending in 1990 was $110 billion—off by nearly a factor of 10.

 

ESRD program.

In 1972, Congress enacted a universal entitlement to kidney dialysis for patients

suffering from end stage renal disease. The program proved twice as expensive as the publicly

predicted levels—$229 million in 1974 instead of the predicted $100 million. The bill’s authors had

seriously underestimated the demand for services, especially among the over-65 population.

 

Medicaid DSH program.

In 1987, Congress estimated that Medicaid’s disproportionate share

hospital (DSH) payments—which states use to provide relief to hospitals that serve especially large

numbers of Medicaid and uninsured patients—would cost less than $1 billion in 1992. The actual cost

that year was a staggering $17 billion. Among other things, federal lawmakers had failed to detect

loopholes in the legislation that enabled states to draw significantly more money from the federal

treasury than they would otherwise have been entitled to claim under the program’s traditional

50-50 funding scheme.

 

Medicare home care benefit.

When Congress debated changes to Medicare’s home care benefit

in 1988, the projected 1993 cost of the benefit was $4 billion. The actual 1993 cost was more than

twice that amount, $10 billion.

 

Medicare catastrophic coverage benefit.

In 1988, Congress added a catastrophic coverage

benefit to Medicare, to take effect in 1990. In July 1989, the Congressional Budget Office (CBO)

doubled its cost estimate for the program, for the four-year period 1990-1993, from $5.7 billion to

$11.8 billion. CBO explained that it had received newer data showing it had significantly under-

estimated prescription drug cost growth, and it warned Congress that even this revised estimate

might be too low. This was a principal reason Congress repealed the program before it could take

effect.

 

SCHIP.

In 1997, Congress established the State Children’s Health Insurance Program as a

capped grant program to states, and appropriated $40 billion to be doled out to states over 10 years

at a rate of roughly $5 billion per year, once implemented. In each year, some states exceeded their

allotments, requiring shifts of funds from other states that had not done so. By 2006, unspent reserves

from prior years were nearly exhausted. To avert mass disenrollments, Congress decided to

appropriate an additional $283 million in FY 2006 and an additional $650 million in FY 2007.

 

Given Congress's abysmal history of forecasting future costs of its healthcare programs, I see no reason to believe theirs or President Obama's claims that this new healthcare reform legislation will reduce the deficit or save costs. Believing them now would be the equivalent of believing Bernie Madoff's proposal for an investment scheme -- after he has already been tried and convicted for previous fraudulent behavior on a massive scale.

 

There you go again, bringing facts to the discussion! It's much easier to wail about the (largely imaginary) sins of corporations, Republicans, "big pharma," etc. That is apparently much more satisfying.

[RangerM]

I think Paul Ryan summed up things very well. I'd like to know where the rebuttal is, because AFAIK there hasn't been one offered..

 

http://www.youtube.com/watch?v=zPxMZ1WdINs

[suv_guy_19]

There probably was one. Obama was actually quite good with his rebuttals....like the one about cutting meat inspectors.

[RangerM]

There probably was one. Obama was actually quite good with his rebuttals....like the one about cutting meat inspectors.

Feel free to watch it. Obama doesn't address Ryan's points, and changes the subject to Medicare advantage.

 

Ryan starts about 49:15. Obama's non-response-response, begins about 55:15.

http://www.youtube.com/watch?v=P8EzIK_b4aA&feature=player_embedded

[mettech]

The point is:

 

People with money will have to pay more for health care to cover the people that don't have health care.

 

In order for the bill to pass, the statement above has to be covered up to make it sound like health care is free for everyone.

 

My issue with the health care agenda is:

 

The fat, smoking, ill health, heavy drinking, lazy, sugar and fat eating mother fuckers will cost me more money. And I don't want to spend my money on them.