I’m on a bit of a roll with rap artist birthdays lately, so how about this: Tupac Shakur, had he not been killed in 1996, would be turning 38 today. Happy Tuesday!
- If certain Republican Senators are so against a “public” insurance option as a way to start reforming health care in this Country, maybe they should refuse to take their government provided insurance as a way to show just how “against” it they are. It is in effect what the Obama administration is proposing.. Oh wait, then they’d be uninsured?? Exactly.
- Just a thought… If Iranians do manage to overthrow a corrupt government, it won’t be because a bunch of Twitter icons were shaded green. Show your support and stand in solidarity and all, but there’s a bit of a difference between literally putting your life on the line against a corrupt government because you believe in freedom and coloring your picture green on a social networking site.
- I very much had a case of the Mondays when I failed to mention that over the course of the weekend at the DPW convention, we elected the youngest party chair in the Country. Mike Tate, the new DPW chair, is 30 years old and I personally look forward to working with him.
I also failed to note that my Red Wings lost the Stanley Cup finals last Friday night. They had a great season and all, but losing the championship is always tough.
I live in the Washington Heights neighborhood of Milwaukee, WI with my wife Jen, our daughter Emerson, and sons Carter and Colton.
I don’t follow how public employees, who are paid by taxpayer dollars, having taxpayer-funded insurance has anything to do with whether the private employees have taxpayer-funded insurance. Why can’t we just be intellectually honest and start legislating price controls on the health care industry instead of acting like we’re increasing competition?
Doesn’t this fall under the category of ‘accounting trick’? :)
If certain Democratic Senators and Congressmen are so against the creation of greenhouse emission gases as the primary cause of climate change in this Country, maybe they should refuse to use their government and private vehicles and jets as a way to show just how “against” it they are. Pretty convoluted logic isn’t it Dan?
You are right though, “it is in effect what the Obama administration is proposing”. When your Audi needs new brake shoes on it, do you take it into the shop and tell the mechanics to “overhaul the engine, rebuild the transmission, put on new tires, replace the air conditioning unit and battery, repaint the car, and put on new brake shoes?” I sure hope you wouldn’t, you would only have them repair what needs fixing.
It’s the same thing with our health care system. You don’t scrap the whole program and replace with another overpriced, inept government-run system. You only fix what needs fixing, and what needs fixing is the cost of healthcare.
According to a white paper put out by the Kaiser Commission on Medicaid and the Uninsured, there are about 44.6 million people in America without insurance coverage. Of that number:
25% are eligible for Medicaid or the State Children’s Health Insurance Program, SCHIPs. (These people didn’t bother to sign up for the coverage)
19% live in families with incomes above 300% of the Federal Poverty Level where coverage is more likely to be affordable (These people chose not to buy coverage)
56% are not eligible for public programs but need assistance to make coverage affordable (About 10 million of these people are not US citizens and are here illegally)
If those numbers are even close, it means that there are about 15 million US citizens (5% of our population) in this country without insurance coverage. Further, according to the Business and Media Institute, 45% of those 15 million citizens without insurance will have coverage again within four months after they complete their job transition. So, at any given time, there are about 6.75 million US citizens in this country (2.25% of our population), who, for whatever reason, economic, job situation, etc., that do not have insurance coverage, nor do they have any prospects of having any coverage soon.
We should be addressing the issue of affordable coverage for those 6.75 million US citizens and not scrapping our entire healthcare system. According to a statement put out this week by the CBO, the healthcare plan currently in the Senate would cost the US taxpayers 1 trillion dollars over 10 years. That comes out to $14,925 per year for each of the 6.75 million citizens without coverage!
Spending that amount of money will NOT reduce the cost of healthcare in this country, it only shifts the increasing cost of healthcare on to a dwindling number of taxpayers.
There’s no “scrapping” going on, and as to your car analogy, as Pres. Obama said, keep what works and fix what doesn’t.
You talk about “fixing the cost of healthcare” but then glide over any actual ideas about what your, or your party’s, plan actually is.
The private sector has had it’s chance with health care in this coverage over the last 20 years. During that time, insurance and care costs have both gone through the roof. I really don’t think the answer to a failed privatized health care system is more of the same.
40% of bankruptcies in America are caused by medical bills. That’s outrageous and it’s non-partisan.
Dan, health care is not private. It has been subsidized by public money for a long time. As long as cost is never a factor between the patient and the doctor, prices will continue to skyrocket. Bring insurance back to the realm of… well… insurance. Cover catastrophes and leave perfectly predictable things like a yearly physical out of it. Health insurance paying for predictable care is like car insurance paying for gas.
I don’t know about “my” party’s plan, but that’d be my suggestion. Divorcing cost even further from the people making the decisions will only inflate prices further (until price controls are established and we have shortages).
OK, just a quick question then, if those Republican Senator’s refuse to take the insurance, will the left than stop talking about nationalizing healthcare?!?!?!
It was just a point that the same people who are railing against “GOVERNMENT RUN!” health care are the same ones who benefit from it.
If Republican Senators are so against “bureaucrats making decisions” for them in regards to their own health care, why don’t they stop using it?
The answer of course is simple, but it goes against their overblown talking points that only serve to drum up fear and doubt about any kind of change to the failing system.
Dan, your comparison is kiwis to bananas. Senators get health insurance that they use to make their own medical care decisions. That is not government run medical care (and you know it).
GOP senators aren’t the only ones opposed to Obama’s plan. There seem to be plenty of Dems who are wavering on this plan, otherwise it would be a fait accompli like the stimulus spending bill.
The President said he didn’t want to run GM or Wall Street, and now he does. When he says that he doesn’t want to take over the medical care system in the USA, no one really believes him, and things he’s said and supported in the past buttress that concern.
While the Senate’s health benefits are not gov’t run health care, the VA medical system is. At the end of the fiscal year when the system is out of money, veterans are routinely denied medical care (rationing). The system is filled with shoddy equipment and doesn’t attract the best staff. If the gov’t won’t take of our veterans, what makes you think they’ll take care of you?
Since my wife is a physician, I am familiar with all the ways that the poor and indigent in this country get medical care and it is impressive. The only part of our system that is “broken” is the gov’t run portion (Medicare/Medicaid) that has huge deficits looming. This is what the President would foist upon the rest of us.
Lastly, if the GOP Senators did refuse the Senate health benefits, my guess is that it would be disregarded as something that those old, privileged, rich white men can do that the rest of us can’t. It’s a straw man.
Matt, your second sentence is exactly correct! Any plan put forward by the Obama administration would mirror the plans that Federal workers, Senators included, have access too.
My point is all this bluster about “government run healthcare” and “bureaucrats making decisions instead of your doctor” is just hot air.
Having many family members who have been on Medicare, and knowing many older folks who use it, I’ve never heard any of them say it’s broken.
Those who get medicare or medicaid are very happy with the level of service and care they get. It’s one of the most popular and successful programs out there.
I don’t know how you can refer to a program (Medicare) as successful when it has deficits looming that are so big they will require either a dismantling of the program or more massive spending and taxation by the gov’t. That’s a broken system, whether the people receiving it say so or not.
Medicaid folks get shifted around from provider to provider because the payments often don’t cover the cost to the doctor providing the service. These programs are popular because THEY COST THE RECIPIENT NOTHING.
A common tactic in medical care debates that I see you employed here is to discuss the wonders of the Medicare system and then equate it with Medicaid in the next paragraph, “Those who get medicare or medicaid are very happy…” Seniors want to get on Medicare, but do you really know anyone who wants to be on Medicaid? C’mon.
Cash payers and the privately insured are what buoy medical care providers in the face of anemic payments by gov’t “insurance.” Putting everyone on the public side of the system (which AP reports may exactly be Obama’s goal: http://tinyurl.com/mh4vs4) will bankrupt the system and as usual the gov’t will be there to bail us out in exchange for our liberty. Then we’ll have the VA medical system for everyone.
Matt,
Could you please explain the “impressive” way that the “poor and indigent” get their health care? Unless you are already bankrupt or don’t care about going there, an uninsured medical catastrophe will wreck your life.
I realize there are charitable programs for care for the poor, but they obviously aren’t doing the job if medical bills are such a huge part of bankruptcies in this country.
BTW, I was once married to a physician, a raving Republican if there ever was one, and even he is at the point of saying that universal health care should exist. He doesn’t feel like much will change, as care is already rationed by insurance companies, and his reimbursements are practically as bad under insurance as they are under Medicare…
I don’t understand how you can acknowledge the current problems with rationed health care due to third party payment, and then decide that the solution is to further remove cost decisions from the patient by having is paid by tax dollars and run by Washington.
Not to be a complete wing-nut here, but how about we talk about the causes for the price inflation and then suggest solutions that, you know, actually address the price inflation.
Exactly right! Here’s a suggestion to start attacking the price inflation: TORT REFORM.
However, which profession claims the highest number of our lawmakers in Washington? You got it, being an attorney. And which major political party does The American Trial Lawyers Assoc. support (based on number of $ donated to it)? You got it, the Democrats. So we can kiss this start to real reform goodbye!
Dan, I wasn’t going to respond to your comments to my earlier post, but as long as I’m here.
YES, the Republican do have ideas. Please check out the “The Patients Choice Act of 2009″ submitted to Congress on May 20, 2009 (H.R. 2520 and S. 1099). Rep. Paul Ryan was one of the cosponsors of this bill. Just because you didn’t read it, or maybe don’t like what’s in it, don’t claim that the Repbulicans to not have any ideas.
You also stated in your comments that health care costs have gone through the roof. The CBO Report that I mention earlier has been revised. They’re now sayting the proposed plan will cost $1.6 trillion and still leave 37 million Americans without coverage. In addition, the report also states that 23 million Americans will be forced to drop their coverage and take the government sponsored coverage. We don’t have a failed “privatized health care system”, we have one that costs too much. And this Senate proposal will not address any of those issues (if fact, it will cost us more).
Finally, your number (and the number that the Administration uses) of the number of medical bankruptcies is bogus. Goto Factcheck.org at http://www.factcheck.org/askfactcheck/what_is_the_percentage_of_total_personal.html and check out who your numbers include. It includes those that filed bankruptcies because they got sick and lost their job, not because they didn’t have insurance. It also included backruptcies due to addiction, childbirth, death of a spouse.
Yes, we need to reform healthcare, but not with a new inept govenment program that will cost us more and still not cover everyone!
Ah yes, tort reform would solve every problem.
Except a system that allows some (insurance companies) to make decisions regarding the health of others for financial game.
I’m not saying no to tort reform, but let’s acknowledge that people should have a right to sue doctors who screw up. Sorry, there are some bad ones out there – going to medical school sadly doesn’t guarantee that you are smart.
At the same time, let’s take the unbridled capitalism out of this. Insurance company profits are rarely demonized as a factor in the current health care system. Which is interesting, because 20 years ago, it was “rich doctors” who were the villains. Then insurance companies started dictating what they were reimbursed. Next thing will be individuals being demonized for getting sick.
As usual, follow the dollars. In addition to trial lawyers’ contribution, let’s also take into account the money thrown at lawmakers by insurance and pharmaceutical companies.
Unbridled capitalism? Who are you kidding, Jill? I really am confused at the attitude here, which seems to be that the current solution is a free market solution. The free market solution would be that individuals pay for their own health care, or they pay for their insurance. Noticeably absent from that solution is your employer paying for your insurance and your government paying for your insurance and your normal health checkups being paid by a third party.
All I hear from the left is complaints about health care costs. What I don’t hear is a thoughtful discussion on why those costs are high and whether the left’s solution (single payer government health care) will address that. And frankly I’m at a loss to explain why that isn’t the discourse…
Actually, I take that back. I know why this isn’t the discourse. This isn’t the discourse because the left wants health care costs of low-income people to be paid by higher-income people. That’s why it has to be funded by income tax dollars.
Yeah, there are docs out there who think some sort of universal insurance program would be good, but ask them for specifics, and they will not describe a system like Medicare or Medicaid. What they will describe is more akin to the Patients’ Choice Act.
You say an “uninsured medical catastrophe will wreck your life.” What you mean is that it will wreck your credit and lifestyle. Chances are, you can still get the medical care you need to stay alive and not end up paying for it. Is that ideal? No, but it’s the best system in the world and I know a lot of docs who give a lot of time and money to making sure the indigent are cared for.
The gov’t will not guarantee Ted Kennedy’s level of health care for everyone; it will guarantee a Medicaid level of health care. Right now you can be seen in an ER most anywhere in the country without so much as hint of financial discussion until after you’re treated. Ideal? No, but it’s as good as health care is in countries where the gov’t runs the system.
Here in WI we claim that no one is left out of the health insurance umbrella; we have a program for everyone! Badgercare is even going to start insuring adults without dependents in July. How do the poor and indigent get some of the best medical care in the world? Through the generosity of tax payers and doctors, that’s how.
The main difference between the centrally controlled single payer and our current free market choice plan is that you can change insurance and doctors. In the free market, you or your employer can change providers anytime you like. I have been through many different plans as my employer shops the market… and pre-existing conditions do not disqualify you. Perhaps more group type plans should be made available to the public, and certainly some tweaking of the rules for acquiring new insurance is in order, but why scrap a plan that works pretty well for 85% of America. Canadians are not going to Britain when they are denied care… are they.
With the government-as-the-only-option plan, you are stuck with whatever care… or lack of care, that some federal lackey decides you can have. Other than going herbal, you have no option for appeal.
I prefer to make my own choices rather than trust a DC bureaucrat to look out for me.
As someone who moved to Wisconsin 12 years ago and has since moved back to the west coast, I think it’s important to realize that the private health care you get in Wisconsin is not the same that you get in other places. In Wisconsin, I had very few restrictions on who I could see with my insurance. In other places (California at least in my experience) networks are much, much tighter and the hoops one has to go through in terms of prequalification, etc. are much harder. To the point that you may not be able to get the care you need (unless you have tens of thousands of dollars to pay out of pocket at undiscounted, out-of-network rates).
So I have a tough time buying the “government bureaucrat” argument because I’ve dealt with the “insurance company bureaucrat” many times. Seriously, bad attitudes, disrespect for one’s fellow human being, this is usually the brush that some of you like to paint the government worker with, right? Well, these people aren’t any more accountable.
I’m hoping at the minimum that this scares the insurance industry so they get off their asses and start acting like human beings. Why can’t my small business or an individual get decent rates on insurance? And while I understand that pooling is part of the Republican plan out there, the paltry $2,200 tax credit (a whopping $5,700 for a family) doesn’t buy coverage for a common cold in today’s market.
The current tax subsidies need to go away. They are the problem and the root cause for the above-normal price inflation. That’s what the Republicans get wrong.
If the same problems you experience in CA happen with a federal system, you won’t be able to move away from it. As it stands now, you could “vote with your feet” and move to a state that provides more likable options.
Just an observation, but when people mention the potential for “bureaucracy” in any kind of health care reform, I have to wonder what they think the current private insurance company represents..
We’ve personally had between 5-10 “claims” denied by our health insurance provider in the last year for no reason at all. So we have to call a toll free number, wait for 15-20 minutes to talk to someone who usually can’t fix the problem and asks us if an immunization for our son was “necessary”. An immunization!
Then we have to call the doctors office to have them resubmit the bill back to our insurance company, and if we’re lucky the claim is paid and we don’t have to repeat the whole thing again.
That’s bureaucracy. And at the end of the day, no one is held accountable because the purpose of health insurance companies isn’t to provide health care, it’s to provide profit margins. That’s an important fact to remember in this whole debate.
Dan, if you read between the lines of Orszag’s plan, he intends on forcing more reimbursement rejections.
http://firstread.msnbc.msn.com/archive/2009/06/15/1964898.aspx
By the way, I worked for a company developing software that handled billing for chiropractic offices. Our customers paid a ton of money for our software because we automated the claim coding process. Miscoding means rejected MA claim and was one of the biggest costs for them. This results in increased prices for services, since such a low percentage of services ever get paid for. So if you look at prices, they increased; but total collections did not change… this is a reason why the reported price inflation numbers aren’t the full story.
The company I worked for is an example of the market fixing problems that government created. That company would have no opportunity if not for the problems the government-mandated standards created.
Matt, you’re a much smarter guy than I am, but how does an insurance company incorrectly rejecting my claim raise the cost of health services? That is, the cost of the immunization itself?
Maybe I’m missing something, but there is a fixed cost in administrating the shot and the cost of the shot. If the health insurer rejects the claim – fairly or not – why would that impact the cost of the services rendered?
There’s a separation between the cost the insurer incurs as a result of their own mistakes and the cost of the service they’re covering.
On a bigger level, it comes down to the fact that it’s cheaper for insurance companies to just deny claims, hoping that the patient will get so sick of the run around that they’ll just pay up.
I think our friend Matt Damon did a little movie about this same subject a few years back…
First, you give me too much credit. I just like to hear myself talk (read myself write?).
To answer your question though, on the single unit there is no effect. However, let’s say a shot costs the provider $10, so they charge $13. In a healthy (no pun intended) insurance system, each claim would be reimbursed by the insurer. In a set of 10 shots, a total of $130 would be collected, $100 of which is to cover costs.
Now let’s talk about a system where only 60% of claims are accepted. This is not due to fraud or attempting to submit stuff that isn’t covered. These are coding errors (it’s difficult to convey how complicated the coding is; but if you are ever up late at night and see commercials for community colleges, the degrees are criminal justice, electrician, and medical coding technician!). Now out of those 10 claims for $13, only 6 are collected for a total of $78. But it still costs the provider 10*$10 to administer those shots, for a net LOSS of $22.
Obviously this cannot continue, so pressure from providers is put on health insurance companies to raise the rates at which a shot is reimbursed to, say, $20… which in our scenario would result in a total collection of $120. (This of course results in higher premiums, too.)
But on the surface, the price of a shot has “skyrocketed” from $13 to $20, or 54%!!! Beneath the surface, providers are getting about 8% LESS revenue for administering the shot than if the system worked and providers were actually paid for each service rendered.
Obviously it is a contrived example, but hopefully that explains what I was talking about a little better.
Dan,
It sounds like you have a crummy insurance company, or a doctor with incompetent coding staff. My insurance is great; we have NEVER had a rejected claim for our family of 5.
Why not change insurance? Perhaps it’s because your insurance is employer-provided and you have to take what you get or change jobs.
Maybe your provider’s staff is the problem. Change providers! With a national system you will be able to change neither.
Rather than a national overhaul that will eliminate competition (the gov’t never competes on an even playing field), why don’t we give the insurance tax credit to you instead of your employer so you can get insurance that works for you rather than forcing us all into some national system?