*facepalm*

This is what is wrong with the bill. You can't trial and error people's healthcare! If this thing kills off private insurance (regardless of how nice that'd be), what the hell do we have to cover us after they're gone? This bill sure as hell isn't going to help us.

If they have to go back and draw up a proper universal healthcare bill, it'll be years where more and more Americans don't have healthcare! We'll be worse off than we are now, and tons of money in debt!

I also wish that people would stop mentioning right wing/left wing/socialist/etc crap in this thread. This is not about who's more corrupt or anything. This is about a specific bill that should not have passed regardless of who was voting for it.

I was listening to NPR the other day (not sure which show) & they were discussing how the maternal mortality rate in California has drastically risen in the past few years (I've heard as high as 17-18 per 100,000). Amongst blacks the numbers are worse than they were in the 1940s.

http://www.cmqcc.org/maternal_mortality

My take:

• Health care costs have risen over time due [in part] to artificial controls within the health care industry (including insurance and pharmaceuticals). They have done this in the name of greed at the cost of many lives. For a country that believes that the lives of it's people can not be quantified in currency, they have done so for a long time now.
• The other part of the reason Health Care costs have risen is because they have to overcharge the people who do pay because of the people who don't pay. In short, middle and upper class citizens are already paying for the health care costs of those who don't pay, except it's only being mitigated across the people who actually seek medicare attention that can pay.
• Basic (non-elective) Health Care is a right, not a privilege. It also makes economic sense. Many large companies have known this for years which is why the often have a nurse or doctor on staff in conjunction with providing health care insurance. It's not just a benefit cost to attract employees. It's a way to make sure your employees are healthy. Healthy employees are productive employees, which mean healthy employees generate more revenue then unhealthy employees. This applies to the national citizens as well. You can't pay your taxes if you're dead. The longer and healthier you live, the longer you are likely to continue working and pay taxes on that income. It's pretty simple economics.

I don't think this bill goes nearly far enough. But it is a start. It will be interesting to see if when the revenue to billed ratio changes from 30% to 70% if they'll start reducing costs. My guess is that they probably won't unless it's forced on them by either the government or the insurance companies. Competition would help bring the prices back down in a normal market, but that doesn't really apply to the Health Care industry as Hospitals are few and far enough between that there isn't much competition.

Actually, the single largest spike in health care costs was the result of the stock market crash, due to significant investment in stocks by the health insurance companies. Personally, our insurance went from $150/m for my grandparents and myself, to $600+/m, in one year. That didn't happen for either of the reasons you specified.

Of course it's still wrong and stupid, but it's important to keep in mind.



Yes, it didn't go far enough.

Which puts us in a worse position. We just spent nearly a trillion dollars for what is effectively a monster of an ineffectual bill. Health insurance companies aren't scared of this bill; they get to use it as another excuse to raise rates. That means more and more people won't have proper health insurance coverage.

In short: we will have more debt, and less people covered than we do right now, thanks to this bill.

No, he's right. I specifically formed the question in that manner to address what appeared to be your suggestion. That's why I asked. You are assuming that I assumed. I didn't.


...why do you keep saying this kind of stuff?

There are 7,569 hospitals in the United States. That is PLENTY of competition. Standard Bertrand competition theory says that all you need is 2 (and in this case, economic theory even works better because for the most part hospitals are quite similar and are providing the same "good" thus analyzing them as two identical firms works quite well). However, its somewhat moot because, let's face it, there is no real "market" in the hospital business. In the insurance business yes (and even that is not true because it is still heavily regulated / skewed), but not in the hospital business. That's an important point I think that needs to be kept in mind. I think (honestly) that if hospitals really did act like businesses, that it would help solve a lot of cost problems. Competing for patient care definitely could help I think more than reforming insurance (but I agree that insurance reform needed to take place if that is the route we chose).

Hell, just from where I live at home in the states, I'm within distance of at least 5 or 6 hospitals, and I live 30 miles outside of a relatively small city :/

One of the important things to note is that people blame our health care system on the evils of capitalism, free markets, and competition, but the health care sector and the insurance sector is anything BUT a free market or competitive system. It's a big reason why I agree with CM here. This seems like an overblown reaction to something that never really existed in the first place, and is more of a "LETS TRY THIS" move that really has the potential to really distort things.

$940,000,000,000 to cover 32,000,000 people? That's less than 10% of the country, and it's costing nearly a trillion dollars?! That's bull****.

I ws under the impression that the $940 billion wasn't SOLELY for that 32 million people.

No, it mostly goes to line the pockets of the bureaucrats who are going to manage this new health care plan.

That's insurance cost, not medical cost. Medical Costs have been rising ever since the medical profession became legitimatized. Your insurance spike (like mine) was the insurance companies coming together and making a decision to hike their rates.



I'm not a proponent of the bill per se, but I think that most experts agree that any prediction right now is highly speculative. I think what you'll find happening is as insurance companies increase rates, people will start lowering their coverage. I did that with this resent hike. I went from a Level III premium plan to a Level I basic plan. I saved $25 a week from what I was paying, so I'm putting the difference into a separate checking account every week to cover my increased cost if/when I go to the doctor/hospital.



Yes, you need at least 2 in the same geographical area. Most rural areas only have 1 hospital in each city (if even that). Even in larger cities, per population, the number of hospitals aren't really sufficient enough to pull demand from one hospital to another to make competition work.



While I agree with you in part here, I disagree that this bill won't do anything. Yes, it will do very little to begin with, but it at least props open the door for additional revisions down the road. Keep this in mind when considering that it was the third major thing they voted on last night (house revisions to the bill to be sent to the senate).

[This is where I'm sure I'll catch a lot of flak]

The largest problem in Health Care (other than the Insurance and Pharmaceutical industries) that will need to be addressed, is hospital staff compensation. The salary cost of hospital employees is WAY to high. My theory of why this is (and I haven't researched it in detail) is that years ago back when Doctors still made house calls and made only modest wages, a bunch of doctors got together to figure out how they could make more money. What they came up with is a way of artificially limiting how many new doctors entered the medical market each year by significantly increasing the requirements for becoming a doctor. Since then, they have also added additional controls, such as setting up boards to decide how many and what doctors are allowed to practice from the state level down to the individual hospital level.

Yes, we all want our doctors and other medical providers to be knowledgeable, just like we want our attorneys and engineers to be knowledgeable. However, how much of their collage course work do they remember even 1 year after leaving? Like 95% of the other professions out there, I'm sure they keep medical books and other reference material (mostly all on PDA's now) easily available. What really separates a good doctor from a bad doctor in most cases is experience. The more experiences they've had and the more experiences they've learned something from, the better the doctor. This is also true for every other profession. 8-10 Years for General Practice, 12-14 years for specializing. Really?

I broke my hand a few weeks ago. Popped in to the NHS across the road, scanned me up, fixed me up, and now it's fine. Woo.

You do realize that just because a bill is passed in the manner prescribed by the Constitution that that does not necessarily mean said bill is constitutional, right?

You know, in all these talks about Obamacare we keep hearing about these "evil" Cadillac health insurance plans that are going to be heavily taxed. Isn't it funny that these plans are nicknamed after Obama's Government Motors luxury car brand? I think we should call Obamacare "Toyota Health Insurance Plan". Government programs, like most Toyotas, last forever but occasionally one accelerates wildly, crashes and burns, and kills somebody.

Yeah, if only that was what actually happened.

Most people are already paying the minimum amount as is, I would bet.

Yes, we just put a trillion dollar bill into effect, only to concede that "eh, we'll probably have to rework this in the near future". And only a moron would think that wouldn't cost us money. What's even more worrisome, is the fact that we don't know what the bill is going to do. I mean, what the hell?!

That's a very amusing theory you made up there. Thankfully, there are plenty of reasons to believe anything but. Any cost increases in payment to doctors usually stems from the ridiculous cost of malpractice insurance, which continues to skyrocket.

Also, I'd say that many doctors do indeed remember a lot of information. They may not remember everything, and information changes rapidly so obviously having a reference is handy, but they have to know such a wide variety of things, and then make interpretations and judgments on those things, that it's shocking that doctors help us as much as they do. It's unlike engineers and lawyers in that doctors have to work with what they see. Lawyers have very well defined (too defined sometimes) laws that tell them what to expect. About the only thing they have to guess on is how a judge or jury might react. And they don't have a person's life in their hands. Also, keep in mind, they can't rely on their reference books or PDAs to help them remember when they're trying to save your life in the ER.

A better name for government plans would be "Edsel" - cost a lot of money, are supposed to be so great and wonderful, then end up being sub-par and a huge let down.

Your point?

That's a real amateur analysis of that situation. I'm sure it's quite easy to say, but it just isn't plausible. If that happened, those companies would be disbanded immediately for collusion. If there is one thing that people DO take seriously, it's collusion, and if it was that "easy" to see that they "got together" to raise prices, believe me something would've been done about it.

While I don't agree with your belief that there is little competition in hospitals, you bring up what I think is the most important point and you are in my opinion dead on right about it, which is the quantity of doctors. And actually, even though I think there are lots of hospitals, obviously the quantity of hospitals is important too.

I just want to now that how adding 32 Million people to the same amount of staff, the same amount of doctors, and the same amount of hospitals, is going to help anything.



I've waited at NHS with my friend for 6 ****ing hours at the hospital for a torn ligament, and all he got was crutches. Seriously. No painkillers. No tylenol. Just crutches. No X-Rays or anything. That IS the reality that we are facing if we do not solve the shortage of doctors and also the stagnating growth of hospitals. Like I said, just because it works in certain areas of the UK, doesn't mean that it will work in the US. And now you give a perfect example of just because it works in one area of one country, doesn't mean it works everywhere else even WITHIN that country. We are adding the equivalent of 3x the population of London suddenly to a constant # of doctors and hospitals. That is just not smart, logistically.

There has been arguments for deregulating the way doctors train for a very very very long time. Most of the super free-market people will say that doctor's shouldn't even need regulation. Frankly, if I want to go get my sickness treated by a kid who has 3 years of schooling, I should be allowed too. Now, if I suffer greatly because of it, that's my fault. But I should still be able to if it means that the treatment might be cheaper. And if someone is bad, it's not as if he'll just remain forever and keep treating people badly. No one will go to him. We've seen how successful ConsumerReports is with cars, TVs, etc, and we are starting to see now ConsumerReports-esque sites for medical care as well.

I would love a Consumer Reports style magazine for health care. Every doctor I've ever been to sucked, just like every mechanic I've ever been to sucked. Spent a lot of money, wasted a lot of time, never actually figured anything out, and definitely never fixed anything.

What? Universal health care only covers 10% of the population? WTF.

Terrible thread.

<Everybody> w/e, it's cool
<Lord Kuat> ffffflakshd i'm in med school for the PRESTIGE AND NOW YOU'RE TAKING MY PRESTIGE AWAY! RAR! *seriously argues against healthcare reform, furiously masturbates*

I wish I could conjure up $940,000,000,000 to spend however I wanted.

Fixed.

Found this non-biased summary of what is supposed to happen in the bill on Reddit:

http://www.reddit.com/r/AskReddit/comments/bgemw/so_healthcare_has_passed_can_someone/

It's not talking about money lost or saved or being communist or anything, just a nice simple summary of the contents of the bill.

I don't blame that on the man, but on how weak and pathetic the Democratic Party is.



The Taiwanese just picked and chose what they liked from other countries healthcare systems (including US Medicare) and then switched over. It's worked brilliantly for them. They have low per person costs, competition amongst healthcare providers and a beautifully integrated bureaucratic system. It cost them a hefty amount when they switched over (which they unwisely borrowed), but now they have the lowest administrative costs in the world. America is not Taiwan for sure, but it shows with some determination and willingness to spend it can be done. Because we sure as hell can't keep going like we're going.

Unfortunately, the majority of people still follow the Protestant notion that ******s and spics are poor because they're lazy, and the have-nots don't deserve.



no u



That's debatable. Physicians serve a necessary role, no one can deny, but they're not very cost-effective to train or maintain. The problem isn't sheer number of doctors, but the specialties they enter. Think about it. You spend $40-50 thousand a year for medical school, are you going to become a GP with lots of overhead and relatively low income (still six figures even after the overhead) or a hotshot thought leader in internal medicine/surgeon? in short, lots of overpaid prima donnas in areas with dense population, very few general practitioners in low population/economically deprived areas.

More cost effective supplements to physicians are physician assistants (who have an extensive medical training but practice under a physician), nurse practitioners (who practice an advanced form of nursing and can function as the primary care provider in some states) and preventative care. Preventative care keeps people from needing to see the expensive specialists in most cases.



I would like to meet them. Most doctors are doctors because their families wanted them to be, for the prestige or for the money. Sure there are some good ones out there, but on a whole I'd consider them a mostly self-serving group.



I completely forgot how bureaucrat free our current system is.



Medical costs have been rising to coincide with insurance costs.



The vast majority of hospital workers are per diem or part time workers making between $14 (for technicians) to $~25 (for nurses) per hour.



That's bull****. Doctors have that much training because they have one of the most demanding and difficult jobs that exist. The only thing limiting the number of doctors are the competition to medical schools (even if we went to a single payer system they'd still be making six figures with 2s and 3s in the front), the difficulty of the course work and the prohibitive time and financial costs of medical education.



You're out of your mind if you don't think the uninsured are seeking healthcare now. They just go to emergency rooms when they can't take the pain any longer. Sure there's a wackadoo here and there who tries to set their own broken bones, but the vast majority of uninsured people go to the emergency room when a minor condition gets extremely serious. When sepsis sets in or the cancer has spread. What would have originally been a simple to treat disorder becomes an expensive ordeal that bankrupts the families.

If only this bill did something to solve that.

In reality, the "DO SOMETHING" is not as good as the "DO NOTHING". You either get it right, or don't do it at all. Because if you don't do it right, then you are going to hurt more people than you will help.

Overall, I don't think it's a very good bill. Sure it's a step in the right direction (anywhere but here), but it's watered down, forced to serve special interests and doesn't have any set goal, other than getting uninsured people insured, maybe, one these days.

If you want to lower healthcare costs for the American people, there will need to be a greater focus on preventative care, a change to malpractice law (that guts the hospitals and doctors and they take it out on the people) and a change to how Medicare/Medicaid pays insurance companies. For example, almost all dialysis patients are covered by Medicare. Medicare pays for something like 80% of the treatment (the other 20% is covered by private insurance, Medicare supplemental plans or out of pocket). Medicare pays for every dialysis drug that the patient is given. Guess how many drugs the doctors are going to put the patients on?

The whole thing is ****ing byzantine and self-serving. Anyone who claims that reform is only going to add more bureaucracy has never bothered looking at the current system.

I don't understand what your point is. Our whole system is out of hand - this is only worsening things. Further, I'm merely pointing out the fact that $940,000,000,000 doesn't go directly to "helping the people" - a large portion of it will go to administrative costs, useless programs, and lots of other stupid things.

Also, they should start printing these to pay for all of this:

They can do that, right? Just print more money when they need it?

I wonder what it feels like for your purpose in life to be a reminder that gun-totin' redscarin' bumpkin is the other Californian stereotype.

There's a lot of legalese, and a lot of (heavily biased) analyses floating around. I've read a bunch. Want to know what I think?
This bill can be boiled down to one mission statement: increase competition in the healthcare industry.

Bland.

Inoffensive.

The Republicans are opposed to the bill for two reasons:
1.) It's very similar to the bill they proposed in (I think) 1993, and they don't want the democrats sniping it. ...Seriously, it's because they want the voters to think the Democrats are incapable of passing legislation.
2.) The healthcare industry is the major pool of corporate support for the Republicans. By far, most other industries (even munitions) lean Democrat. The whole controversy is just one big pat on the back for the GOP moneybags.

Neoconservatives on the forum: I am very sorry but your elected representatives have been lying to you to manipulate your emotions.

Well no ****. That's been blatantly stated by the basset hound orphan himself.

What's wrong with that is the result of the bill is going to be putting us in the same position we are now (no change) or with no private health insurance, as they go out of business.

This isn't fostering competition, this is going to make them raise their rates to the point where they will lose all of their customers, everyone who can possibly manage will go on Medicare, Medicare will go further in the red than it already is, etc etc.

I thought this was hilarious. Obama appealed to peoples emotions in this debate far more then anyone else did. Every interview of his I watched he loved talking about this person with cancer or that person without insurance and how much the health care bill would help them and shouldn't we all be compassionate and pass this bill. Lying to manipulate emotions? There's plenty of that going around on both sides of the aisle.

Every politician manipulates emotions. It's called being charismatic. The distinction that Jon made is lying. And no one said that Democrats don't do it as well.

I'm really not seeing how you could possibly predict this. Seriously, what makes you think this will be the case?

slippery slope, chicken little, etc etc

Yes, you're right: a part of the bill does put more financial burden on health insurance companies.

By forcing them to provide services that have already been paid for.

The big thing I've noticed is the fact that the US government is finally putting the screws on pharmaceutical companies. Between government price-fixing and Medicare, Americans pay far more for drugs than people in any other country. This bill is going to do a lot to bring the cost of healthcare back in line with the actual social benefit.

Not how the economy works.

We'll see, I guess. I predict a 2 week dip in the stock prices of HMOs and then business as usual.

Why's that? Surely people will be willing to spend more money to receive the compassion, quality of care and promptness of service that only the American private healthcare system can offer.

....bahahahahahaha!

That's a tautology: Medicare cannot be in the "black," because it is a publicly funded social program.

I'll admit that I got a boner when I read that. A world w/o private insurance companies & the associated lobbies? It's a dream come true. Once that day comes I'll buy you a pint to celebrate!

My families health care is compassionate, high quality, and very very very prompt, and it is private.

I don't think people are pissed off at the care that private health care provides, more the lack of access to it. If you can afford private health care, like pretty much 100% of everyone at my private school had, it works quite well. Never heard one complaint from them. Especially with a high deductible plan, you can stand to receive a lot of money back just by responding to the incentives private health care / deductibles give you to be healthy.

Private health care is fine.....if you can afford it (which is the problem). There is still a reason many people flock to the United States and do pay exorbitant of moneys to get their surgeries done promptly because they don't want to wait the apparent 18.3 weeks for their surgeries in Canada (and I believe that wait time is still increasing, I think that was the 2007 statistic). Hell I believe that at one point the wait time for bladder cancer was so high in Canada that it was deemed dangerous and people were dying. Not knocking the Canadian system, I'm just pointing out that if you do go the private route in America you DO get prompt and quality service. I believe the Newfoundland Premier said when he got his surgery in the US, "I wanted to get in, get out fast, get back to work in a short period of time" and that he went because "this is a very specialized piece of surgery that had to be done and I went to somebody who's doing this three or four times a day, five, six days a week." So there obviously is SOMETHING that the US health care system can provide. Note I'm not saying our system is better. I'm just saying that if you can afford it, the US system can provide quality and prompt health care.

Forcing them to provide what? Short of the wonderful requirement to serve those with pre-existing conditions, I don't see the health insurance companies being required to do much of anything at all.



I don't see anything in this bill that stops the businesses from passing this on to consumers.



That's one of my predictions. It either does nothing, or puts them out of business.



Obviously because having no coverage is better than crappy coverage.

....bahahahahahaha!



It can from the crazy idea of a "budget". You pay taxes specifically for Medicare. When those taxes do not cover the cost of said Medicare, you're gonna have to draw elsewhere, and last I checked, that's what being "in the red" means. When cost is greater than revenue.

I'll buy you water. Don't want to tax that liver in case you need to go to the hospital without any sort of coverage.

I've actually taken a liking to the term "basset hound orphan", now. Funny how my use of his initials were deemed offensive but now we can all humorously refer to him as a dog!

Yeah but then people can just point out that good things can be referred to as the dog's bollocks.