Nomad, that’s not much of an analogy. As a doctor, I despair at seeing millions of Americans without insurance. I hate seeing patients’ medical decisions being made by insurance company bureaucrats with no medical training. I worry about the trillions we’re spending on health care, and the fact that it’s increasing yearly to the point of unsustainability. I recognize that something needs to be done about it, and that Obama is giving it a go. I also recognize that the major arguments against it by the Republicans are based on lies. If all they can do is say “NO!”, and argue based on lies, and offer no alternatives except to continue with our broken system, then of course I’m going to back whatever the Democrats come up with. If the Republicans can’t come up with an alternative, and can’t come up with any legitimate arguments against it, but instead can only offer lies, why would I possibly side with them?
Can you explain how this is like someone picking my pocket?
Anthony my guess is any alternative proposed by Republicans/libertarians/conservatives that does not involve excessive governmental control will be rejected by you. Read the proposal by John Mackay. It is an alternative that should start a lively conversation. Did you ever rotate through the VA?
I’m pretty sure Anthony has not claimed to be a PhD, ANandy, but rather an MD. And once again you slipped right past his perfectly logical argument and made an ad hominem attack. What’s wrong with you, ANandy? You used to be able to put up some semblance of intelligence and maturity. Lately you’ve just been acting like a child.
Wachs, can you refresh me on the “the proposal by John Mackay”?
And no, no VA for me…but plenty of military hospitals, from tents in the sand, ships, and regional medical centers.
I’m sure there are viable alternatives to whatever is currently cooking in Congress, such as health care cooperatives. However, I can’t help but think that if the current effort gets defeated, none of the others will see the light of day. It’ll be Hillarycare all over again, and our current system will continue to spiral upward in costs until it crashes. However, many people will profit from it, which is their main goal.
If my rotation through the VA system is typical I want to stay as far away from government medicine as humanly possible. I know that is NOT what is being proposed for here and it is closer to the UK system but it is really really bad.
Below is John MacKey’s alternative health care proposal. For the entire week it was the #2 most emailed article. John is a Libertarian and espouses many of my views. I think what he proposes is very reasonable and should be put into the discussion.
Intelligent people learn from experience. In this country we actually have some experience see Massachusetts, Tennessee, California and now Maine
I think Mackey’s article makes a lot of sense. Unfortunately, some of his proposals like tort reform become very difficult when you confront the details.
Tort reform comes down to placing dollar amounts on body parts and function. Not only is that next to impossible, but when you add in the patient’s use, it gets even worse.
Example: Say a patient loses a non-dominant hand due to physician negligence. First, you have to compare that to losing an eye, a foot, a kidney, a parotid gland. Second, you have to consider what that hand did…is the patient a surgeon, a concert pianist, a skid-row bum? Third, how long did the patient need that hand…is he a 3 year old? An 88 year old on his death bed?
The number of permutations that enter the value calculation are near infinite.
On a more manageable level, what do you think of the health care non-government cooperatives?
Finally, I’m not that impressed with Maine’s difficulties. I think their system could probably have worked better with appropriate tweaking. Unfortunately, it’s the nature of our government that any such solutions are destined to fail because one party will be trying to make it work, and the other party will be trying to sabotage it solely to make the first party look bad. Same with “Obamacare”…it’ll undoubtedly be diluted to non-functionality…this will be his “Waterloo”…destroy his health care plan, and destroy him, as the Republicans have publicly stated as their goal. To hell with the American people.
GNWachs - Massachusetts has been successful.
Mackey has some good ideas, but he also embeds a lot of deceptive rhetoric – e.g., the “socialized medicine” label. He also applies a lot of spin from the perspective of a CEO, not a user of that healthcare (surprise! It’s the WSJ). I’d be interested to see what the employees of Whole Foods think of this. For example, what happens to someone with a family? Is that $2500 per person? He doesn’t say. In that case, a family of four would pay $10K, and the vast majority of annual costs would fall within the deductible. No wonder this would “reduce costs.” And indeed having this high a deductible would actively discourage people (not doctors) from getting pricey diagnostic procedures – CAT scans, for example. Anyone know offhand how much a typical year of good-quality medical care including preventative and minor medical costs per person, e.g., annual checkups for MD, dentist, optometrist, minor injuries? I’m curious to know if it is less than $2500!
Plus, I’d be interested to know what the 11% who don’t work 30 hours get, since we tend to forget that the intent is to provide coverage to those not covered by benevolent businesses. And I wonder what would happen if the economy continues to decline. During the dot-com era so many companies offloaded employees to “contractors” who did as much work with no benefits that new laws had to be enacted to protect them and ensure that companies weren’t weaselling out of their obligations to the government for social security taxes, etc. (e.g., Microsoft theoretically had 60% of their total employee base as “contractors” who were described as NOT full-time employees and therefore had no benefits, but worked 40-60 hours a week). Might Whole Foods start decreasing hours?
Now I approve of many of his ideas – eliminate maximums on HSAs, yes, fix tax laws, make costs transparent. But saying that “Medicare is going bankrupt” is simply untrue; and repealing government mandates on what insurance companies must offer opens the door to insurance companies refusing to cover anything that costs money. When you set up the game by one set of rules, expect people to follow them. Remove government oversight, and insurance companies will “play the game” to maximize their profits. Period.
Two years ago when we were promoting HSAs the number we were told was something like 80% of Americans spend less than $2000/$2500/year on all their health related expenses. I am retired and don’t think I personally have ever spent more than $2500/year. If I could have purchased a policy for $1000 that had a $3000 deductible I would have been far far ahead.
No, that’s not the point, GNW. I mean that if the deductible is high enough, then effectively you have no health insurance, you have catastrophe insurance. Regular care and examinations, as I am sure you are aware, can extend life enormously and catch dangerous diseases sooner.
Fascinating when you actually do the research. Regular preventive care medicine is not cost effective. You spend more than you save, you cause a huge number of patients to have severe anxiety for naught, order additional tests to prove the first was a false positive etc.
When you buy auto insurance you don’t expect it to pay for your weekly gasoline run. Why do we expect our health insurance to pick up routine bills. At least the first $1000/year should fall under the deductible.
We do have the examples of States trying on their own. when the overwhelmingly Democratic California legislature plugged in the numbers they just walked away from it. Way too expensive. As a state they cannot run a deficit. Remember the non-partisan CBO said the congressional plan would be $1T/10 years.
Massachusetts has had to cut back on enrollment and benefits. Rationing because of expense. Tennessee tried it . Now Maine. State/congress funded either will not work or will bust the bank.
Tort reform. 20% of all health care expenses in this country are for unnecessary tests. I am willing to listen to any way of eliminating those expenses. How about no-fault?
Are your first two paragraphs referring to non-government cooperatives? If not, what do you think of those?
Tort reform: Wouldn’t no-fault just let bad health care providers off the hook? We still are left with the problem: If a doctor is obviously negligent, and the patient loses a leg, it would seem that patient is due a certain amount of money. How much?
If just a lost leg were the problem we wouldn’t need tort reform. You were an anesthesiologist. Think of any procedure you did 999/1000 without a problem but for the 1/1000 a problem did arise. To prevent that problem would entail a $1000 expense (MRI equivalent). So multiply and to prevent that one bad result costs $1M. But if the Trial Lawyers win $10M you spend the unnecessary $1M. Multiply that by a million cases a day. There must be a better way.
Go into more detail on how no fault would “solve all the problems”. Exactly how would it work?
For example, say I go into the hospital for a foot amputation, and they amputate the wrong foot. What happens next under a no-fault system?
Re: Bronx, without knowing anything about the case, it’s easy to say that $30M is too much. But what’s staggeringly difficult to say is, how much should it have been?
Details not worked out re no-fault because it would never happen. But the format could be like workman’s comp. Long story but I lost my index finger while working. No lawyers. Open up book to fingers and it says index finger lost payment X dollars. Simple and all payments go to injured not 40c/$1 to lawyers.
The Bronx example is not rare, here in NYC and in Texas and I think Mississippi it is like a lottery. Stick it to the man.
Still doesn’t seem that simple to me. Would you rate the reimbursement of an index finger to be the same for a baby, a twenty-year-old, or a 90-year-old?
Same for a concert pianist and an accountant?
Same for a loss due to nosocomial infection and for loss due to cutting off the wrong finger because no one bothered to confirm which one?
believecommonsense almost 15 years ago
Nice job, Davies … the “just say no” and scream at top of your lungs crowd is indeed the true “death panel”
meowdam almost 15 years ago
Hysteria is a sign of desperation
ynnek58 almost 15 years ago
meowdam not necessarily – they could just be simply nuts.
parkersinthehouse almost 15 years ago
educators know the price paid by those who refuse to listen
charliekane almost 15 years ago
What nandy knows about constitutional law…
…comes from the voices inside his head.
riley05 almost 15 years ago
The Party Of No seems intent on making that a permanent label.
Led by ANandy, who has never offered a viable alternative to our failing health care system.
He’s too busy trying to show his intelligence by coming up with more “witty” variations on the name of our President.
GNWachs almost 15 years ago
Please G-D why don’t you answer my prayer?
He did. He said no.
nomad2112 almost 15 years ago
What’s wrong with NO Anthony 2816? If someone is going to pick your pocket what else are you going to say, take a number?
riley05 almost 15 years ago
Nomad, that’s not much of an analogy. As a doctor, I despair at seeing millions of Americans without insurance. I hate seeing patients’ medical decisions being made by insurance company bureaucrats with no medical training. I worry about the trillions we’re spending on health care, and the fact that it’s increasing yearly to the point of unsustainability. I recognize that something needs to be done about it, and that Obama is giving it a go. I also recognize that the major arguments against it by the Republicans are based on lies. If all they can do is say “NO!”, and argue based on lies, and offer no alternatives except to continue with our broken system, then of course I’m going to back whatever the Democrats come up with. If the Republicans can’t come up with an alternative, and can’t come up with any legitimate arguments against it, but instead can only offer lies, why would I possibly side with them?
Can you explain how this is like someone picking my pocket?
GNWachs almost 15 years ago
Anthony my guess is any alternative proposed by Republicans/libertarians/conservatives that does not involve excessive governmental control will be rejected by you. Read the proposal by John Mackay. It is an alternative that should start a lively conversation. Did you ever rotate through the VA?
tpenna almost 15 years ago
I’m pretty sure Anthony has not claimed to be a PhD, ANandy, but rather an MD. And once again you slipped right past his perfectly logical argument and made an ad hominem attack. What’s wrong with you, ANandy? You used to be able to put up some semblance of intelligence and maturity. Lately you’ve just been acting like a child.
Motivemagus almost 15 years ago
GNWachs - you are defining anything that conflicts with your view as “excessive” government control. Does the FDA strike you as “excessive?”
riley05 almost 15 years ago
Wachs, can you refresh me on the “the proposal by John Mackay”?
And no, no VA for me…but plenty of military hospitals, from tents in the sand, ships, and regional medical centers.
I’m sure there are viable alternatives to whatever is currently cooking in Congress, such as health care cooperatives. However, I can’t help but think that if the current effort gets defeated, none of the others will see the light of day. It’ll be Hillarycare all over again, and our current system will continue to spiral upward in costs until it crashes. However, many people will profit from it, which is their main goal.
deadheadzan almost 15 years ago
What kind of insurance do these people have? If it’s medicare then they have no excuse for their selfishness.
GNWachs almost 15 years ago
Anthony
If my rotation through the VA system is typical I want to stay as far away from government medicine as humanly possible. I know that is NOT what is being proposed for here and it is closer to the UK system but it is really really bad.
Below is John MacKey’s alternative health care proposal. For the entire week it was the #2 most emailed article. John is a Libertarian and espouses many of my views. I think what he proposes is very reasonable and should be put into the discussion.
Intelligent people learn from experience. In this country we actually have some experience see Massachusetts, Tennessee, California and now Maine
http://online.wsj.com/article/SB10001424052970204251404574342170072865070.html
http://online.wsj.com/article/SB10001424052970204619004574322401816501182-email.html
riley05 almost 15 years ago
I think Mackey’s article makes a lot of sense. Unfortunately, some of his proposals like tort reform become very difficult when you confront the details.
Tort reform comes down to placing dollar amounts on body parts and function. Not only is that next to impossible, but when you add in the patient’s use, it gets even worse.
Example: Say a patient loses a non-dominant hand due to physician negligence. First, you have to compare that to losing an eye, a foot, a kidney, a parotid gland. Second, you have to consider what that hand did…is the patient a surgeon, a concert pianist, a skid-row bum? Third, how long did the patient need that hand…is he a 3 year old? An 88 year old on his death bed?
The number of permutations that enter the value calculation are near infinite.
On a more manageable level, what do you think of the health care non-government cooperatives?
Finally, I’m not that impressed with Maine’s difficulties. I think their system could probably have worked better with appropriate tweaking. Unfortunately, it’s the nature of our government that any such solutions are destined to fail because one party will be trying to make it work, and the other party will be trying to sabotage it solely to make the first party look bad. Same with “Obamacare”…it’ll undoubtedly be diluted to non-functionality…this will be his “Waterloo”…destroy his health care plan, and destroy him, as the Republicans have publicly stated as their goal. To hell with the American people.
Motivemagus almost 15 years ago
GNWachs - Massachusetts has been successful. Mackey has some good ideas, but he also embeds a lot of deceptive rhetoric – e.g., the “socialized medicine” label. He also applies a lot of spin from the perspective of a CEO, not a user of that healthcare (surprise! It’s the WSJ). I’d be interested to see what the employees of Whole Foods think of this. For example, what happens to someone with a family? Is that $2500 per person? He doesn’t say. In that case, a family of four would pay $10K, and the vast majority of annual costs would fall within the deductible. No wonder this would “reduce costs.” And indeed having this high a deductible would actively discourage people (not doctors) from getting pricey diagnostic procedures – CAT scans, for example. Anyone know offhand how much a typical year of good-quality medical care including preventative and minor medical costs per person, e.g., annual checkups for MD, dentist, optometrist, minor injuries? I’m curious to know if it is less than $2500! Plus, I’d be interested to know what the 11% who don’t work 30 hours get, since we tend to forget that the intent is to provide coverage to those not covered by benevolent businesses. And I wonder what would happen if the economy continues to decline. During the dot-com era so many companies offloaded employees to “contractors” who did as much work with no benefits that new laws had to be enacted to protect them and ensure that companies weren’t weaselling out of their obligations to the government for social security taxes, etc. (e.g., Microsoft theoretically had 60% of their total employee base as “contractors” who were described as NOT full-time employees and therefore had no benefits, but worked 40-60 hours a week). Might Whole Foods start decreasing hours? Now I approve of many of his ideas – eliminate maximums on HSAs, yes, fix tax laws, make costs transparent. But saying that “Medicare is going bankrupt” is simply untrue; and repealing government mandates on what insurance companies must offer opens the door to insurance companies refusing to cover anything that costs money. When you set up the game by one set of rules, expect people to follow them. Remove government oversight, and insurance companies will “play the game” to maximize their profits. Period.
GNWachs almost 15 years ago
MM
Two years ago when we were promoting HSAs the number we were told was something like 80% of Americans spend less than $2000/$2500/year on all their health related expenses. I am retired and don’t think I personally have ever spent more than $2500/year. If I could have purchased a policy for $1000 that had a $3000 deductible I would have been far far ahead.
Motivemagus almost 15 years ago
No, that’s not the point, GNW. I mean that if the deductible is high enough, then effectively you have no health insurance, you have catastrophe insurance. Regular care and examinations, as I am sure you are aware, can extend life enormously and catch dangerous diseases sooner.
GNWachs almost 15 years ago
MM
Fascinating when you actually do the research. Regular preventive care medicine is not cost effective. You spend more than you save, you cause a huge number of patients to have severe anxiety for naught, order additional tests to prove the first was a false positive etc.
When you buy auto insurance you don’t expect it to pay for your weekly gasoline run. Why do we expect our health insurance to pick up routine bills. At least the first $1000/year should fall under the deductible.
riley05 over 14 years ago
Wachs ignored my post.
Humph.
<Deep funk…>
GNWachs over 14 years ago
@Anthony
What part did you want me to reply to? Torts? Maine?
riley05 over 14 years ago
Yeah, the difficulty of tort reform would be good.
Plus your opinion of non-government cooperatives.
Offering the example of Maine…well, forget that. No decent way to respond.
GNWachs over 14 years ago
Anthony
We do have the examples of States trying on their own. when the overwhelmingly Democratic California legislature plugged in the numbers they just walked away from it. Way too expensive. As a state they cannot run a deficit. Remember the non-partisan CBO said the congressional plan would be $1T/10 years.
Massachusetts has had to cut back on enrollment and benefits. Rationing because of expense. Tennessee tried it . Now Maine. State/congress funded either will not work or will bust the bank.
Tort reform. 20% of all health care expenses in this country are for unnecessary tests. I am willing to listen to any way of eliminating those expenses. How about no-fault?
riley05 over 14 years ago
Are your first two paragraphs referring to non-government cooperatives? If not, what do you think of those?
Tort reform: Wouldn’t no-fault just let bad health care providers off the hook? We still are left with the problem: If a doctor is obviously negligent, and the patient loses a leg, it would seem that patient is due a certain amount of money. How much?
GNWachs over 14 years ago
Anthony
If just a lost leg were the problem we wouldn’t need tort reform. You were an anesthesiologist. Think of any procedure you did 999/1000 without a problem but for the 1/1000 a problem did arise. To prevent that problem would entail a $1000 expense (MRI equivalent). So multiply and to prevent that one bad result costs $1M. But if the Trial Lawyers win $10M you spend the unnecessary $1M. Multiply that by a million cases a day. There must be a better way.
riley05 over 14 years ago
See what I wrote four posts ago. How can you have tort reform if you can’t put limits on patient damage?
GNWachs over 14 years ago
No fault would solve all the problems but that will never happen because the lawyers would not permit it
I don’t know where you live but here a Bronx jury will award $30M to an unemployed laborer for a medical mishap. That comes out of everybody’s pocket.
riley05 over 14 years ago
Go into more detail on how no fault would “solve all the problems”. Exactly how would it work?
For example, say I go into the hospital for a foot amputation, and they amputate the wrong foot. What happens next under a no-fault system?
Re: Bronx, without knowing anything about the case, it’s easy to say that $30M is too much. But what’s staggeringly difficult to say is, how much should it have been?
GNWachs over 14 years ago
Details not worked out re no-fault because it would never happen. But the format could be like workman’s comp. Long story but I lost my index finger while working. No lawyers. Open up book to fingers and it says index finger lost payment X dollars. Simple and all payments go to injured not 40c/$1 to lawyers.
The Bronx example is not rare, here in NYC and in Texas and I think Mississippi it is like a lottery. Stick it to the man.
riley05 over 14 years ago
Still doesn’t seem that simple to me. Would you rate the reimbursement of an index finger to be the same for a baby, a twenty-year-old, or a 90-year-old?
Same for a concert pianist and an accountant?
Same for a loss due to nosocomial infection and for loss due to cutting off the wrong finger because no one bothered to confirm which one?