Health Care Reform in the US

[dcmdale]

Are you really Sacha Baron Cohen?

One could only hope. All evidence seems to indicate that our potty-mouthed, porn-loving self-styled advocate of conservative Christianity is a college kid that hasn't learned how to participate in adult conversation yet. Freddy from Pepperdine's mimicry of the self-righteous hypocrisy that confirms what people expect from the religious right is so perfect that one has to think parody, but if it is he has kept up the act exceptionally well.

Back in the days of Reverse Lunge, I could laugh (even if I kept him on ignore), but this guy claims to be one of us. Ugh.

[I_luv_saber]

Meh... I'm reasonably sure it's a FF alter-ego. TDD says he's leaving -> FF is banned -> TDD is active, more active even than before FF was banned.

Shocking.

IP bans ftw!

[DonnaP]

I would like to see LESS government involvement in health care. IMO this interference is one of the biggest reasons for the rising price of medical care. I would abolish Medicare and Medicaid for a start, and probably the VA system as well. I would eliminate most regulation of doctors, hospitals and pharmaceutical manufacturers. ( I am not talking about safety standards or licensing and training standards, but rather about the thousands of bureaucratic straws which are piled upon the camel's back by all tiers of government, things like reporting requirements and paperwork burdens. )

Oooh, man - the lawyers won't like you one bit!!!! How dare you eliminate bureaucracy!

[trickery dickery dock]

One could only hope. All evidence seems to indicate that our potty-mouthed, porn-loving self-styled advocate of conservative Christianity is a college kid that hasn't learned how to participate in adult conversation yet. Freddy from Pepperdine's mimicry of the self-righteous hypocrisy that confirms what people expect from the religious right is so perfect that one has to think parody, but if it is he has kept up the act exceptionally well.

Back in the days of Reverse Lunge, I could laugh (even if I kept him on ignore), but this guy claims to be one of us. Ugh.

...and here's the problem with this country. Any thoughts and ideas which are outside the liberal scope are dismissed out of hand, and the presenter of the ideas is attacked. I hoped our discussions would lead somewhere, but apparently, I'm not liberal enough.

Yes, I am a "college kid," but I fail to see how that should affect anything I have to say. I suspect that you see me as too idealistic. I am idealistic, but I am no idealog. I pay attention to whats going on, I learn more and more about things, and as a result, I have an opinion. There is right and there is wrong. I am not yet ready to make compromises or concessions that throw away, bit by bit, the Christian values that created both me and this country, because I believe that's what has gone wrong in our world. That's why we are where we are.

You claim that you want an adult conversation, yet my words have by-and-large fallen upon blind eyes, because I'm not like the typical New England liberals whom occupy most of these message boards. It really seems that unless your a socialist, democrat, or McCain-style republo-crat, you're opinion is not welcome, and you will be personally attacked. I'm all for good-spirited light-hearted insults, but I hoped that I would be able to teach and be taught, and participate in real, sincere conversations. It doesn't seem like that will ever happen, so I won't waste any more of you're time or mine, but I will pray that you all will become more considerate of other people's opinions.

[Sins of the Fleche]

Well, I know I'm gonna get flamed for this, but hey, it's 3 AM and I've got insomnia tonight, so why not?

TDD, simmer down. I know you claim to not be an ideologue, but going around saying we need to impeach the lawfully-elected President and that the terrorists are going to blow up the country tomorrow is fairly…drastic. It’s a valid point to say, “You know, I disagree with President Obama’s politics. I’m concerned specifically with his national security policies.” It’s another ball game altogether to call for his job just because he’s making us “unsafe.” While most would agree Iran’s leadership has a collective screw loose, invasion isn’t the only option “to keep America safe.” Invasion as your primary means of international negotiation was a practice used by such wonderful groups as Nazi Germany, the Mongol Empire, and other factions who thought fighting got your message across, and didn’t really use other means of interaction. While I’m not saying I wholeheartedly agree with Obama’s stance on Iran, calling for his impeachment just because he won’t blow their asses back to the Stone Age is a bit much. Some would say it’s the talk of an ideologue.

I’m not saying all this to piss you off, but for your benefit. It’s alot nicer to have a civil discussion with your peers instead of railing at them. You might even learn something from them if you talk to them. “As iron sharpens iron, so does man sharpen man” Paul said. So like I said, simmer down; you might find people more receptive and willing to engage in debate rather than flame wars across the interwebz. And just in case you want to call me a New England liberal, just know that I too am a college student, an avowed Christian, and thoroughly apolitical, although if you pegged me as sort of conservative, I wouldn’t argue. All I’m saying is, just because someone holds different views than you doesn’t make them evil, and if you do care for their souls, then I find interacting with them and treating them with common respect is much more in keeping with the Christian religious credo rather than screaming at them and calling them names.

Eh, I know that was long-winded and preachy as crap, but it’s just my opinion, and I’m a new guy on the block, so take it for what it’s worth.

[thereom4]

“As iron sharpens iron, so does man sharpen man” Paul said.

Absolutely.

[Philistine]

Meh... I'm reasonably sure it's a FF alter-ego. TDD says he's leaving -> FF is banned -> TDD is active, more active even than before FF was banned. {snip}

FF got banned? When did that happen?

I figured TDD was somebody's strawman sock puppet, though I suppose it could just be a newbie pushing the boundaries of their real positions.

When it's clear someone is just trolling--I've always thought the best thing to do is completely ignore their posting, maybe an occasional one-liner like Telk's picture (which was pretty funny).

--Philistine

[FencingJunkie]

...and here's the problem with this country. Any thoughts and ideas which are outside the liberal scope are dismissed out of hand, and the presenter of the ideas is attacked. I hoped our discussions would lead somewhere, but apparently, I'm not liberal enough.

Yes, I am a "college kid," but I fail to see how that should affect anything I have to say. I suspect that you see me as too idealistic. I am idealistic, but I am no idealog. I pay attention to whats going on, I learn more and more about things, and as a result, I have an opinion. There is right and there is wrong. I am not yet ready to make compromises or concessions that throw away, bit by bit, the Christian values that created both me and this country, because I believe that's what has gone wrong in our world. That's why we are where we are.

You claim that you want an adult conversation, yet my words have by-and-large fallen upon blind eyes, because I'm not like the typical New England liberals whom occupy most of these message boards. It really seems that unless your a socialist, democrat, or McCain-style republo-crat, you're opinion is not welcome, and you will be personally attacked. I'm all for good-spirited light-hearted insults, but I hoped that I would be able to teach and be taught, and participate in real, sincere conversations. It doesn't seem like that will ever happen, so I won't waste any more of you're time or mine, but I will pray that you all will become more considerate of other people's opinions.

Does this mean you're leaving again? If so I get dibs on the fnet party arrangements.

[dcmdale]

Yes, I am a "college kid," but I fail to see how that should affect anything I have to say. I suspect that you see me as too idealistic. I am idealistic, but I am no idealog. I pay attention to whats going on, I learn more and more about things, and as a result, I have an opinion. There is right and there is wrong. I am not yet ready to make compromises or concessions that throw away, bit by bit, the Christian values that created both me and this country, because I believe that's what has gone wrong in our world. That's why we are where we are.

You claim that you want an adult conversation, yet my words have by-and-large fallen upon blind eyes, because I'm not like the typical New England liberals whom occupy most of these message boards. It really seems that unless your a socialist, democrat, or McCain-style republo-crat, you're opinion is not welcome, and you will be personally attacked. I'm all for good-spirited light-hearted insults, but I hoped that I would be able to teach and be taught, and participate in real, sincere conversations. It doesn't seem like that will ever happen, so I won't waste any more of you're time or mine, but I will pray that you all will become more considerate of other people's opinions.

Fred,

You say that you are heading off to law school in the Fall. Let me pass on to you the first and most important thing that I learned in law school: You cannot persuade and insult at the same time. All it takes to turn an unimpeachably strong argument into a loser is adding, "See Stupid?" to the end.

I have argued conservative positions on this board a number of years (and Inq and Epee_Pox and others, even longer). While that has provoked many sharp engagements, the discussions have never become disrespectful.

I don't see your views as being too idealistic. I see your ideas as not being presented effectively. I am not an Obama fan either, but if you want to advocate that he should be impeached, start with the Constitutional standard for impeachment then build up a case that his behavior has met that criteria. If you want to persuade people on this board to become Christians, start by making sure that your lifestyle and behavior on this board support your advocacy. If you think we should nuke Iran, be prepared to discuss how that position fits into your personal theology, long term American foreign policy considerations, global economics, and ecology.

This isn't the place for "good-spirited light-hearted insults." Mostly they come across as mean spirited attacks whether that is how they were intended or not. And they are returned in kind. If your posts are well reasoned and respectful, you will find plenty of people here willing to engage you at that level as well.

[Bayou Bum]

http://www.latimes.com/business/la-f...,5870586.story

Rescission was largely hidden until three years ago, when The Times launched a series of stories disclosing that insurers routinely canceled the medical coverage of individual policyholders who required expensive medical care.

A Texas nurse said she lost her coverage, after she was diagnosed with aggressive breast cancer, for failing to disclose a visit to a dermatologist for acne.

When insurance companies go under oath and admit they are canceling innocent patients when they get sick, it makes it very difficult for lawmakers to pass a law that requires every American to buy a policy or face a tax fine. It opens the way for a public option to hold the companies in check.

To me, it sounds like a case for the courts. If the insurance companies are violating their contracts, they should be held accountable in court, as I am sure the case with the Texas nurse would be. I also imagine that the insurance company would not fare too well in court unless they had a valid reason.

[Hauptman]

To me, it sounds like a case for the courts. If the insurance companies are violating their contracts, they should be held accountable in court, as I am sure the case with the Texas nurse would be. I also imagine that the insurance company would not fare too well in court unless they had a valid reason.

The problem with waiting for civil courts or "market forces" to deal with bad behavior is that lives are at stake. A civil court has restorative power, but how do restore life to someone who died from lack of health care when their insurance improperly drops them?

Regulation provides a preventative power that makes more sense. Do all things need to be heavily regulated by our gov't? Absolutely not, but I do have a problem with the overarching zero regulation/free market approach that is advocated as well.

Sensible regulation is the key. If the civil courts can provide reasonable outcomes then regulation isn't needed. But I think that most people would agree that regulation is appropriate where lives and public safety are at stake.

[jeff]

Fred,

You say that you are heading off to law school in the Fall (snip) This isn't the place for "good-spirited light-hearted insults." Mostly they come across as mean spirited attacks whether that is how they were intended or not. And they are returned in kind. If your posts are well reasoned and respectful, you will find plenty of people here willing to engage you at that level as well.

Just about the best post I've ever seen in the Water Cooler. Hits everything right on the mark - and comes from a person whose behavior is always mature, even when discussing controversial issues.

I'll just add that it's unfortunate that TDD is going to a school where he is likely to only meet people with similar beliefs. Going to a school where he might have to have conversations with people of different belief systems might teach him to be more respectful of people with different beliefs, and to be polite. That would make him much more effective in convincing people than his current behavior. Maybe he could even learn to be more open minded, and realize that other points of view could actually have some validity. Well, he's awfully young, and dogmatism and stridency are not unknown to those who are passionate on some topic at an early age. Maybe this is a 'teachable moment'

[Inquartata]

When companies aren't forced to conform to safety regulation, not only do they frequently not do more testing, or improve their competitive position by being safer, but they go out of their way to cover up threats to health and safety in their products. We have decades of dangerous products to prove it.

The answer, could we but raise the shade of Uncle Miltie, would be: The sort of regulations we should have should be those which force the disclosure of all relevant and useful information needed for a consumer to make sound, self-interested decisions, rather than those which attempt to mandate outcomes. So I will give you, in the words of another economist, two cheers for regulation.

I have been in medical practice 22 years now. My payments are less now and going down. I'm being squeezed on one side by the Feds to "reduce my costs", be more efficient and not administer unnecessary tests or procedures. Medicare is cutting payments annually, and now imposing more regulations and "quality controls" IOW, more hoops to jump through if I want to get paid at all.

I'm getting squeezed on another side by the private insurance carriers who want to pay less (so they can keep more of the money they collect for themselves), and yes they do offer incentives to their staff to keep costs down via denials. I have to have extra staff just to track down and make the insurance companies pay what they by contract have agreed to pay me, but don't.

I'm squeezed on the third front by the lawyers for every patient who doesn't have a "PERFECT" outcome. BTW, it doesn't matter if the person didn't follow directions, didn't take their medication, didn't show up for their follow up, didn't keep their wounds dry, took their bandages off because they felt like it, etc. I have to show that I not only told them what to do/not to do, but have to prove it and then show that I did "diligent" effort to make sure they understood what I explained and that I made every attempt to follow them home and wipe their butts for them.....

Jeff! Would you care to demonstrate how in fact all of these worthies' interests are in fact aligned with Donna P's, rather than opposed to them?

I'm not sure what this link is supposed to show. On that link, various types of physicians (including GP's) have the top nine average salaries of any professions listed. CEO's come in at #10, the only types of physicians they are higher than are pediatricians, psychiatrists and podiatrists.

Don't forget to read the footnotes! For example, certain occupations ( cough* legislators* cough ) must have their salaries adjusted for the fact that they do not, technically, work all year long, but only a portion of it. ( I look askance at the idea that most of them "work" at all, but never mind that. )

These, and others such as teachers, resort workers, etc., usually have other sources of income which are not counted. That's the benefit of not being on salary, strictly speaking. The opportunities for playing games with compensation are much more attractive for those folks...

"The market has never been completely free" - well, yes it was before regulations were created.

When was that golden age? They had business regulations in ancient Mesopotamia...

Why then did companies at the time, say, during Coolidge administration, not compete with one another to create the safest products.

Because that is not what consumers wanted? That's my guess.

Really, it's just like the damned Communists - always bleating that Communism would have worked if only it had been tried out.

Heh. Yes.

I recall Paul Samuelson adopting Shaw's bromide about how Christianity might be a good thing if anyone ever actually tried it, and applying it to perfect competition...

Want a raw free market economy? Look at our own history, or some of the emerging nations to see how they work.

But not too closely, or you'll find that there was always SOME government interference in business.

FF got banned? When did that happen?

About a week ago or so. If only Craig or Gav had posted a formal notice, there might have been dancing in the halls of f.net...

I am forbidden the proper emoticon at this juncture, but you may imagine which I would have chosen.

[dcmdale]

To me, it sounds like a case for the courts. If the insurance companies are violating their contracts, they should be held accountable in court, as I am sure the case with the Texas nurse would be. I also imagine that the insurance company would not fare too well in court unless they had a valid reason.

In California, until a few years ago, the courts *did* hold insurance companies accountable for grossly fraudulent behavior. The landmark case involved a construction worker who had purchased disability insurance. He was later involved in an accident in which he fell off a roof and became a quadriplegic. The insurance company denied the claim on the basis that "there was no showing of disability." In court, it was proven that the insurance company *always* denied claims where there was permanent disability taking the attitude that it would be difficult for the injured person to sue and that all that would happen if there was a suit would be that they would have to pay what they owed anyway. And immediately after the suit, they would refuse to pay again, forcing repeated suits.

The California Supreme Court was not amused and slapped the insurance company with significant punitive damages. This case became the basis of a doctrine against unreasonable failure to settle insurance claims.

I say "was" because the California voters repealed this protection about 4 years ago by initiative. The main sponsor of the initiative to overturn this protection. The medical lobby.

[jeff]

The answer, could we but raise the shade of Uncle Miltie, would be: The sort of regulations we should have should be those which force the disclosure of all relevant and useful information needed for a consumer to make sound, self-interested decisions, rather than those which attempt to mandate outcomes. So I will give you, in the words of another economist, two cheers fo regulation.

Levolor shade? (emoticon goes here)

If that method could be done, and was effective, then ducky. But I expect that regulations that compel full disclosure is even more quixotic an endeavor.

Jeff! Would you care to demonstrate how in fact all of these worthies' interests are in fact aligned with Donna P's, rather than opposed to them?

Nah, I got a lighter job of cleaning out the Augean stables this weekend

Seriously: I agree with DonnaP's descriptions.

When was that golden age? They had business regulations in ancient Mesopotamia...

How about 'pertinent' regulations. Teddy Roosevelt signed the law that created the FDA in 1906. What regulations did you think applied before that?

http://www.fda.gov/AboutFDA/WhatWeDo...aw/default.htm

Because that is not what consumers wanted? That's my guess.

Do you suggest that they wanted ground up rats in their sausage meat? (as disclosed by Upton Sinclair) Or cars that burst into flame? *(Ford Pinto) Or downer cows in their burgers (contemporary). If they knew all these things (or to dcmdale's recent post, that insurance companies routinely deny claims because it's lucrative to do so - nice job of alignment of interests there!), perhaps they would have had different buying patterns.

This demonstrates the asymmetry of information you alluded to earlier.

Interesting example: Upton Sinclair publishes The Jungle. Meat sales drop by 50%. FDA created shortly after, restoring some belief that food supply has some safety controls on it: resumption of business. Parallel to the beneficial effect on the markets caused by post Great Depression regulation. QED: regulation can help business.

Heh. Yes.

I recall Paul Samuelson adopting Shaw's bromide about how Christianity might be a good thing if anyone ever actually tried it, and applying it to perfect competition...

An aphorism that keeps going, and going, and going! The Samuelson comment sounds like Gandhi's answer to the question "what do you think of Western Civilization"

But not too closely, or you'll find that there was always SOME government interference in business.

Always? Y'all got proof of that?

Just giving back the "you just made one of those 'everybody/nobody' unproveable assertions" you always nail me with

Seriously: what governmental standards where their on environmental damage pre-EPA? Or on automobile safety pre-Pinto? Or on tobacco pre-1964 Surgeon General report? What kept paint manufacturers from putting lead in paint? Just what "interference" do you have in mind, and was it pertinent to this issue?

About a week ago or so. If only Craig or Gav had posted a formal notice, there might have been dancing in the halls of f.net...

I am forbidden the proper emoticon at this juncture, but you may imagine which I would have chosen.

There is global celebration and pandemonium. Most people think that the demonstrators in Teheran are shouting "God is great!" on their rooftops as a protest against their "elections", but it's really to celebrate FF's ban from f.net.

[lindajdunn]

To me, it sounds like a case for the courts. If the insurance companies are violating their contracts, they should be held accountable in court, as I am sure the case with the Texas nurse would be. I also imagine that the insurance company would not fare too well in court unless they had a valid reason.

The problem is that they are not violating their contracts. Not technically. California is introducing legislation to stop this action except in the case of intentional fraud.

[Phaeton]

The answer, could we but raise the shade of Uncle Miltie, would be: The sort of regulations we should have should be those which force the disclosure of all relevant and useful information needed for a consumer to make sound, self-interested decisions, rather than those which attempt to mandate outcomes. So I will give you, in the words of another economist, two cheers for regulation.

I love having information out there. I love having consumers make their own decisions. I'm a bit reluctant when it comes to medicine.

There's a lot to know. All relevant and useful information has a name. It's called lots of personal research, time, and most likely med school.

We have an educational system that teaches next to nothing about health insurance or healthcare. The fact of the matter is that weighing coverage and medical procedures is of a lot more import than car insurance, and a lot more complex than measuring car insurance plans or the difference between two different laptops. I really don't know how much a layman can understand about medical procedures and how the medical insurance industry works. I don't think the full weight or understanding of the situation is something that is going to effect any of the people that need the reform that this country is due to have.

I support this kind of regulation, and if it would solve the problems that we have all the better. But I sadly think that it's only one step towards greater regulation of the industry as a whole. People aren't going to get what's going on. Industry watchdogs and policy makers might.

[I_luv_saber]

FF got banned? When did that happen?

I thought it was a few weeks ago, but maybe I was mistaken...

However, point still stands either way due to inactivity or to being banned.

[I_luv_saber]

To me, it sounds like a case for the courts. If the insurance companies are violating their contracts, they should be held accountable in court, as I am sure the case with the Texas nurse would be. I also imagine that the insurance company would not fare too well in court unless they had a valid reason.

Basically echoing Hauptman here, but...

The problem with this being that insurance companies do two things:

1) They will try in every way, shape, or form to deny your claim. I believe most times it is on shaky ground, at best. Courts need to handle it? Brings me to number...

2) If they are unable to deny your claim, or deny your claim and you fight back, they jump to this one. They wait you out in court as long as possible until you are forced to take a lowball settlement.

In fact, this is how my family ended up in the poorhouse for awhile. My father blew a disk. Anyone who knows anything about back surgery can tell you it's a long, expensive process. Here's the thing... these guys have good lawyers... very good lawyers. Any decent lawyer can get the proceedings held up for a very long time. After 6 months of no income and bills piling up, you start to get to a point where you desperately must accept any amount of money they throw your way, regardless of how small it is. This is fundamentally not right, but insurance companies do it all the time.

This isn't even mentioning the dirty practices of finding ways to cancel their customer's policies once they become sick, or their other ways of rigging the system in their favor.

I'm in favor of much heavier insurance regulation. Insurance companies should have to make their payout FIRST, then if they suspect fraud or somesuch, pursue it after the payout is made.

Insurance companies should not be able to cherry pick only healthy customers. I propose regulation similar to Hungary, where there must be a certain number of "high risk" customers in each insurance companies' pool. If you have fewer than you should, you are penalized by the government. If you have more than you need to, you receive some sort of incentive from the government.

More importantly, caps on what they can charge. If PG&E can't charge me up the wazoo for utilities because they are deemed necessary for modern survival, then insurance companies should not be able to charge whatever they damned well please for HEALTHCARE. This isn't even mentioning the near blatant discrimination practices (which I'm surprised have not been attacked already).

These are just a few simple, but I think very major changes that would go a long way to alleviating the problems in our system. Regulate the insurance and pharma companies, and you fix a big chunk of problem.

[Inspector Gadget]

Okay, in taking a look at our paystubs we see several taxes: state, local, federal and FICA. The feds get the most, the state gets another amount, some cities collect a smaller amount, but FICA and Medicare gets very little from us. I hate to bring this up, but FICA and Medicare should get more. When I look at each 100 of gross pay; only $3.00 is taken out for FICA and medicare. It should be higher I feel I would be willing to put $10.00 of $100 into my FICA/Medicare pot; and let's take some out of the general fund. The general fund gets wasted and then we spend most of our time trying to track it down. At least we know where our loot is going when it goes right into the FICA/Medicare fund.

Any thoughts on this?