It's over on Health Care.

[SezMe]

You're right, dudalb, that single payer was never in the cards. That said, single payer as advocated for here in the USA is NOT like the UK system. There the NHS actually employes the doctors, etc. It is truly socialized medicine. Single payer as envisioned in the USA left all the providers as private practices but simply replaced all the insurance providers with the federal government. Big difference.

 

[boloboffin]

You're right, dudalb, that single payer was never in the cards. That said, single payer as advocated for here in the USA is NOT like the UK system. There the NHS actually employes the doctors, etc. It is truly socialized medicine. Single payer as envisioned in the USA left all the providers as private practices but simply replaced all the insurance providers with the federal government. Big difference.

No.

The public option here was a government insurance plan in competition with private insurers in the exchanges.

 

[MattusMaximus]

I would not bet money on the GOP wising up by 2012.

Ditto. If anything, this news on the public option will embolden the wingnuts in the GOP who will continue to act uber crazy. Note that I'm talking about the Palinistas here... and Palin & her followers absolutely repel moderates and independents in droves.

There are likely cooler & more reasonable heads in the GOP who will see this as an opportunity at bipartisanship, but I fear they will be drowned out by the wingnuts who will keep on crowing about how they stopped big bad Obama. You can see some of that stupidity on these boards already.

And, frankly, you are way,way, overestimatng the number of voters who are as far to the left as you are.
And Obama ran, and was elected as, a centrist,not someone out there on the left. There are a lot more moderate voters out there then Hard Line Lefties.

Exactly. As a somewhat slightly left-of-center Democrat myself, I am not upset with the notion of dropping the public option in the least. I'd prefer it to be there, sure, but if it is going to get in the way of the other 90% of the legislation that would help reform the health care system, drop it.

There are some hard liners on the left who will be pissed as hell about this, and I understand why. However, as I've told many of my colleagues on the political left, they must understand that - essentially - this is a rather centrist country.

Those of us on the (sort of) left would do well to heed the advice of the great philosopher Jagger...

You can't always get what you want, but if you try real hard, you might get what you need.

Now the ball is in the GOP's court, and they'd better not fumble it. If they do, they're totally screwed because the political middle of the nation will see them as essentially obstructionist. Bad mojo.

 

[MattusMaximus]

I disagree. I recently read an article (I can't find a link just now) that described what was left out of Social Security when it first passed. It was amazing. But slowly the holes were patched. Obama is probably thinking along the same lines. And he will spin passage of any health care package as a huge win for America.

And it won't be spin. Imo, and in the opinion of huge numbers of Americans, any legislation that prevents insurance companies from capping out your benefits or denying coverage due to pre-existing conditions will be big progress. This is why Obama has been repeatedly emphasizing these points of late.

Otherwise, I agree with the rest of your post. This will be the start of health care reform, and it'll be adjusted & tweeked as needed in the future. Anyone who thought this first shot was going to result in a totally completed reform of the system was being incredibly naive.

 

[MattusMaximus]

I've got to say, lefty, that your potty mouth, intolerant posting style damages your own cause. Give it a rest.

Seconded. Lefty, on most issues I tend to be on your side, but your rhetoric does us no favors. Please chill.

 

[Dymanic]

As I posted in another thread, California passed medical tort reform in 1975 effectively wiping out punitive damages. Hasn't done a damn thing to lower insurance premiums.

Daniel P. Kessler and Mark B. McClellan of Stanford University:

"We present four findings. First, physicians from states enacting liability reforms that directly reduce malpractice pressure experience lower growth over time in malpractice claims rates and in real malpractice insurance premiums."

So tort reform appears to save doctors money (on malpractice insurance premiums), but whether they pass those savings on by lowering fees may be another matter.

"Our 1996 study showed that reforms changed physician behavior, but stopped short of investigating the mechanism by which reforms altered medical practices. Our current results, however, indicate that mechanisms commonly cited by physicians in anecdotal reports namely the frequency and severity of malpractice claims may play an important role in fostering defensive medical practices."

Results of the 1996 study referred to above:

"We find that malpractice reforms that directly reduce provider liability pressure lead to reductions of 5 to 9 percent in medical expenditures without substantial effects on mortality or medical complications. We conclude that liability reforms can reduce defensive medical practices."

So tort reform appears to save insurers money (by reducing the number of procedures), but whether they pass those savings on by lowering premiums may be another matter.

 

[Skeptic]

It is WAAAAAAAAAAAAAAAAAY to early to speculate about 2012, no matter what happens, or does not happen, with Obama's health care plan. Obama might well be reelected if it totally fails, or, conversely, be defeated if it succeeds.

For example, Clinton was reelected handsomely in 1996 despite his embarrassing 1994 health care plan debacle and the conservative "Gingrich revolution" in 1994. Bush was reelected in 2004 despite more or less constant battering from most of the media declaring him an illegitimate one-term failure to be easily defeated by Kerry.

Conversely, Obama's plan might pass public opinion and Congress with flying colors, but in the two or three years after that it might turn out that the law of unintended consequences does indeed mean more Americans pay more and/or wait longer and/or are denied care, making the whole thing a propaganda goldmine for the other side. Or, more likely, perhaps some other fiasco in 2011 -- another Wall Street crash, for instance -- will make everybody quickly forget health care and blame Obama for whatever is wrong now.

 

[MattusMaximus]

Well said, Skeptic. I think a lot of people here are expressing far too much wishful thinking and extrapolating far too much with far too little info. But that's politics for you

Though I do believe that if Sarah Palin keeps on getting air time as the public face of the GOP, they're screwed in 2012.

 

[Darat]

You're right, dudalb, that single payer was never in the cards. That said, single payer as advocated for here in the USA is NOT like the UK system. There the NHS actually employes the doctors, etc. It is truly socialized medicine. Single payer as envisioned in the USA left all the providers as private practices but simply replaced all the insurance providers with the federal government. Big difference.

Most GPs in the UK are self-employed or employed by a company. There is a large private medical system as well as the various NHSs. A very strange definition of socialism!

 

[DC]

After reading alot about diffrent systems, I think the UK system is the best atm. But i am a bit suprised how efficiently they run it. Not every nation can run it that efficiently i think.

 

[Darat]

My view is that the French and German systems are probably better!

 

[Fiona]

WHO puts France at the top, certainly

 

[leftysergeant]

So every time you use your car, or buy any product you are also committing a crime against humanity.

No. But when you rip the top off a mountain for coal and dump the tailings and all the arsenic and what not that they contain in a river, you do.

This is part of why I have no problem raising the taxes of the investor class and leaving the ability to sue for punitive damages in place.

A lot of our health problems right now may be related to ecconomic activity. There is a lot of mesothelioma waiting to be diagnosed. There are people recieving cap gains from companies that earned their first dollar from asbestos and grew from there. They may have walked away sice then from using asbestos for anything, but the people who had to breath that stuff can't.

Even autism may be linked to coal, if there is, as some speculate, a link between mercury and autism. I doubt that one shot of vaccine is going to over-load a body that badly. But WIC just hands out tuna to pregnant women and mothers of small children as though it were the greatest thing in the world for them.

Top predators are always full of whatever pollutants are in the eccosystem. Tuna is a mercury bomb. That mercury comes from a lot of sources, but coal is a major one. It is industrial waste. The investor class should be made to pick up the tab on that.

The working class is an asset that the investor class needs to survive. We can do without the investor class if they decide to leave the country. Somebody will figure out how to do their jobs. We can't survive as an industrial nation if the working class are keeling over with preventable diseases and untreated injuries.

If you use a resource, you need to help maintain it. Raising the taxes of the investor class to fund health care makes sense in that regard. They got a big break when their taxes were lowered to far less than the rates paid by working people on wages. Time to end the free ride.

 

[T.A.M.]

Canadian System is not quite Socialized...here is how it works.

Some Doctors are salaried employees. These tend to be those that work in rural areas, where the numbers are insufficient to make a living Fee For Service.

The vast majority of Doctors are Fee-For-Service Physicians. They work their own hours, make their own schedules, take vacation when they like, but bill the government for the services they provide. They have LIMITED "Self-Employed" status in terms of Tax Right-Offs.

Insurance companies in Canada cover limited things, such as,

- Hospital Room Upgrades (from a shared room to a private when available)
- Lost Wages due to medical illness
- Drug Coverage
- Adjunctive services such as Physio, Massage Therapy, Chiropracty, Orthotics.

What Insurance Companies do not need to cover (as it is in your basic health care);

- Doctor Visits
- Specialist Visits
- Surgical Procedures
- Joint Replacements
- All Investigative procedures (XR, U/S, CT, MRI, etc...)

TAM

 

[Rolfe]

After reading alot about diffrent systems, I think the UK system is the best atm. But i am a bit suprised how efficiently they run it. Not every nation can run it that efficiently i think.

It's not that efficient, trust me on this! Just listen to almost anyone who works in it, and they'll be hoarse (and you'll be asleep) before they run out of things to tell you about its inefficiencies.

What has struck me very forcefully in all this, though, is how well it compares in efficiency to so many other systems. It makes you wonder what could be achieved by a truly efficient system!

Rolfe.

 

[GreyICE]

I read, somewhere, that defensive medical procedures account for $500 billion/year in costs.

I read, somewhere, that we have secret moon bases. It seems about as credible as the crap you're spouting without the least little bit of evidence.

 

[Dymanic]

I read, somewhere, that defensive medical procedures account for $500 billion/year in costs.

According to the McKinsey report:

"Although the direct costs of malpractice lawsuits are limited -- $30 billion in 2006 -- research using data from 1984 to 1990 suggests that the practice of defensive medicine could produce extra costs of up to $50 billion per year."

(The footnote references the studies by Daniel P. Kessler and Mark B. McClellan of Stanford University I linked above)

Not 500 billion, but still, nothing to sneeze at.

 

[Beerina]

Im sorry...how is a non-profit member owned Co-op...a bad thing???

anyone who cant afford it will have it subsidized by the govt. but the govt. will not control or run the co-op.

as long as most Americans have health insurance, that is all that matters....right???

this is about protecting the American people...right??

this isn't about making the Republicans look stupid..right?

this isn't about installing socialist-like programs...right?

One of the things lost on so many pro-universalists (for lack of a better term) was that the solution to "not everybody having health care" was "find a way* ".

And "find a way" was synonymous with "government-run, single-payer health care".

The first time this came up under Clinton in 1993, the medical insurance industry said, "f-it. We'll just cover everybody." That is, of course, a suggested solution. But it's not the one in accordance with getting people dependent on government care for the purpose of getting re-elected, something the Clintons publically stated they wanted to do, just like, they said, FDR did with social security, which FDR also publicly stated, and which is often posted on the wall of the round room that displays the Constitution and the Declaration of Independence in the National Archives building.




* With the attendant implication "...that doesn't leave people worse off".

 

[GreyICE]

One of the things lost on so many pro-universalists (for lack of a better term) was that the solution to "not everybody having health care" was "find a way* ".

And "find a way" was synonymous with "government-run, single-payer health care".

The first time this came up under Clinton in 1993, the medical insurance industry said, "f-it. We'll just cover everybody." That is, of course, a suggested solution. But it's not the one in accordance with getting people dependent on government care for the purpose of getting re-elected, something the Clintons publically stated they wanted to do, just like, they said, FDR did with social security, which FDR also publicly stated, and which is often posted on the wall of the round room that displays the Constitution and the Declaration of Independence in the National Archives building.




* With the attendant implication "...that doesn't leave people worse off".

Which you can, of course, cite, since you're obviously not making things up.

 

[Marc39]

According to the McKinsey report:

"Although the direct costs of malpractice lawsuits are limited -- $30 billion in 2006 -- research using data from 1984 to 1990 suggests that the practice of defensive medicine could produce extra costs of up to $50 billion per year."

(The footnote references the studies by Daniel P. Kessler and Mark B. McClellan of Stanford University I linked above)

Not 500 billion, but still, nothing to sneeze at.

$50 billion. $500 billion. A billion here, a billion there. Soon, you're talking real money, to borrow from the late Everett Dirksen.