This article from tpmcafe trying to convince that the bill is good had the exact opposite effect

[Phoebe Loosinhouse]

on me. The real meat and potatoes is in the MIT chart.It pretty much proves the point that healthcare is unaffordable now and it will remain unaffordable after "reform". With these projections, I don't see any mechanism that will prevent the continuing slide of American familes into bankruptcy due to medical bills. We cannot afford to pay between a 1/4 and 1/5 of our personal incomes for healthcare/insurance. This reform is no reform and will have to be readdressed in just a few short years. This reform has been a waste of time and energy and is just a cynical ploy to engrave profits into law for a few until the whole stinking system collapses on top of itself and we get the real reform we should have gotten this time around.

I will vote for anyone who will be smart enough and strong enough to tell the American people the truth- that our uniquely American system is unique because Americans are, quite frankly, the only ones dumb enough to stand still for it.

********************************************************************************
http://tpmcafe.talkingpointsmemo.com/2009/12/26/obamas_art_of_the_possible/
Obama's Art of the Possible

By Jon Taplin - December 26, 2009, 11:43AM
Like many progressives, I've been critical of Obama on Afghanistan, the health care debate and financial reform. But I've also been critical of the institution that is federal politics, with its arcane Senate rules that allow for essential minority "negative" control. So during the holiday break, I've come to reconsider the 'art of the possible" in Washington, DC, and put my energies towards this new political unit I call the City State.

First, on Washington compromise. Jonathan Cohn, a pretty smart economist, has convinced me that the Health Care Bill is a significant step in the right direction.



complete column at the link
**********************************************************************************

[TreasonousBastard]

1. How much do you want to spend? And who should come up...

with the rest?

I suspect that no amount will be low enough for some people. Civilization will surely come to an end if spending a couple of bucks on healthcare reduces the amount spent on the important stuff, like movie rentals and ski trips.

(Instead of whining about his bill, find out why cancer treatments can run up over a million bucks and dialysis can cost you over 50 grand a year.)

[Phoebe Loosinhouse]

4. I can see no reason why our costs should not be more in line with the

rest of the worlds' - who get better outcomes at lower costs. There are enough charts floating around - take a look at the #1 Greatest post if you are unclear as to how much out of whack Americans' expenditures on healthcare are.

I would be more than willing to pay whatever tax was deemed to be appropriate for my income in order to get a single payer system with 100% coverage and so should everyone else. Mandated coverage is a "tax" since it is demanded and enforced by the state - I would rather pay a real one rather than line the pockets of private interests who now have their MLR's engraved into law. Must be nice to have a "cost plus" contract signed with every citizen whether they like it or not.

I went ahead and answered your post even though I think anyone who uses the word "whining" doesn't deserve to be taken seriously as desiring any kind of real discussion since you lead with a perjorative.

[TreasonousBastard]

26. I'm well aware of of the problem we have of spending...

too much without proper results, and my key objection to most of the plans proposed is that they do little to solve the problem.

Here's an oft-quoted article about how we don't even have to go to Europe or Japan to learn about more efficient care:

http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande

I use the term "whining" purposely because I have seen too many people arguing for the moon. Regardless of whatever success Britain or Canada may have, the US will not see a single-payer plan any time soon. Like it or not, our entire history and the mindset of the population and politicians is to attempt to limit the scope of government, not give it complete control over our care. The current battle over a simple public option should give some clue how a real attempt at single payer would go.

Personally, I'm not sure I would want to see us go that route anyway. Given a choice between having my healthcare decided by Congress or by anyone else, I think I'd go for anyone else. Few advocating "Medicare for all" seem to realize that there are fewer and fewer providers accepting Medicare, and it does consist of four parts, some of which are those nasty insurance companies again. Medicare is also going broke, and has limited cost and fraud controls. ("If I can't get Medicare to pay for your Scooter, I'll pay for it myself")

Medicaid is not a health plan-- it is a medical loan and a scam brought to us by libertarians who believe our biggest problem is that poor people have too much money while the rich don't have enough. Not only is it more difficult to find a doctor than with Medicare, it must be repaid if and when you get back on your feet.

Other government plans, like the VA, Indian Health Service, SCHIP... have their own gotchas. The federal government is the largest insurer/provider of health care and it has not proven that it is the best, whether compared to priovate domestic plans or any foreign ones.

Universal, affordable care is the goal. Too many people have the one, only, absolute way to get there, and that's what I object to. If we get there by a government plan, expanded and regulated insurance companies, or the tooth fairy makes little difference to me as long as it works.

I would like to see a public option, since it looks like it would be needed, but I think using the states for test drives would be good idea, with a federal option as a backup for the backward ones who just won't do it. Massachussetts has started (with results being great or terrible depending on who you ask) and others are sticking a toe in.

[ima_sinnic]

5. I wonder how other countries manage?

you make it sound "impossible" to have affordable health care. People in Europe and Canada are laughing at us. Since nobody in the administration really addressed the myths about European and Canadian health care in "fierce advocacy" speeches, but instead let those myths grow and metastasize like cancer, we have the abomination of a bill we now have called "reform" as repukes threw around words like "socialism" and other wingnut misconceptions.
It's not a matter of giving up "movie rentals" (at $3 each! wow--that would buy so MUCH health care) and "ski trips" (something only people with disposable cash would even consider anyway--not average American working people) but of handing over obscene amounts of taxpayer dollars for insurance executives' yachts, multiple luxury homes, multiple luxury cars, and fine art collections.
It's working very well for them, isn't it? ("them" being the usual corporate highway robbers)

[ProSense]

7. "People in Europe and Canada are laughing at us." No they're not

They realize that it took them decades to get where they are, and now we're finally taking the first step.

[Phoebe Loosinhouse]

9. Yes, they are laughing at us.

or sighing in disbelief, or shaking their heads in amazment, or chuckling softly, or gasping, or doing whatever it is people do when they come up against unbelievable stupidity, complacency, corruption and a completely misplaced sense of superiority.

[ProSense]

11. No,

they're not.

[Phoebe Loosinhouse]

13. Oh well a single post by a single French person on DU is conclusive

proof that the rest of the world isn't looking at us like we have three heads when it comes to healthcare.

Well, let me ask you, if our system is so great - private for profit all but unregulated insurers,complimented by medical bankruptcies, why hasn't anyone else adopted it? Because they can see that it leads to fiscal insanity,and despair and poverty that's why.

[ProSense]

15. No, it's not conclusive, but neither is an opinion posted here.

"Well, let me ask you, if our system is so great - private for profit all but unregulated insurers,complimented by medical bankruptcies, why hasn't anyone else adopted it? "

Are you talking about the current system? Why would they. If you're talking about the system under reform, they cannot adopt a system that hasn't been implemented, nor would they as it is the first step for this country.




edited for clarification.

[Armstead]

21. I heard Bernie Sanders use an interesting example the other day

He said a while back Taiwan decided to set up a new health coverage system, and did extensive research into all of the systems in the world to find a model to base it on.

They decided that the best model for healgthcare in the world was US Medicare.They used that as the basis for their new system, BUT expanded it to other age groups.

And yet, we can;t even see our way clear to slightly expand access to Medicare by a few years, and instead we mandate private rip-off insurance?

Something is wrong with this picture.

[Phoebe Loosinhouse]

22. Fascinating. And yet we're too damn dumb to expand an existing

program that works very well and is effective and efficient and would be even better if drug prices were negotiated. How sad is that? - That another country would base it's healthcare on the sole single payer component of our morass and we have our heads stuck up our collective asses?

I've said it before, the only thing left for me to work towards is not a politician or a party but a movement until we finally have the single payer system that we deserve to have - that will save lives and fortunes and eliminate the bribery of at least a couple of industries in our highly corrupted system.

[Captain Hilts]

28. I spend a LOT of time in Canada. Yes, they think we, and our system, are absurd.

What an ignorant tool you are.

[TreasonousBastard]

27. It's not impossible, but I wonder how many would...

accept what it would take.

Treating for outcome, rather than the way we have of just treating forever, would mean you can't walk into your doctor and say you need that pill you just saw on a TV ad. Malpractice suits would be limited, since your doctor will have more control over your treatment-- he is the expert, not you. If the doctor says she can't do any more for you, nothing more will be done. (On the upside, treating for outcome means you stand a better chance of being cured of what ails you)

In Japan, the government sets the prices for everything from office visits to hospital stays. And sets them very low. Not many US doctors would work for what Japanese doctors work for.

In Germany, smokers don't get treated for lung cancer. (That's something I heard, and haven't checked to see if it's true-- but if it is, that's being responsible for you own health!)

More realistically, here's an oft-quoted article about how we can learn about cost effective treatment from ourselves:

http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande

[NashVegas]

2. You Know What? That Actually Doesn't Look Bad

You can't have it both ways.

I see so many progressives who want European-style health care and education opportunities and try to completely ignore the fact that Europeans pay taxes up the ying-yang for these services!

It's not that the taxes are awful; 50% of your income for affordable shelter, public transportation and medical services and higher education is a pretty freaking good deal, IMO.

You just can't wrap your head around finding and staying with an argument that will convince conservatives to go along with it.

[ProSense]

10. Exactly, this chart should be seen by everyone. n/t

[harun]

12. Agree, our high income taxes (albeit not as high as Europe) are

diverted for war. They can end the wars, raise my taxes and give me education, health care and public transit any time they want.

[NashVegas]

18. Good Point, That

The war tax, indeed.

[Armstead]

20. The "argument" for it gets stifled by our own friggin party

I heard Dennis Kucinich (yes him) on an interview program one day a few years ago discussing univerasl health care in detail. He had figures and logic that indicated that people would be paying less for better coverage in a system that would be more cost effective overall.

It was a very compelling case.

However the Denmocratic Party Elites refuse to even get behind anything that would be a small start in that direction or any kind of demonstration of how it would work for people.

INSTEAD they run away from any consideration or promotion of it like scared chickens, and instead turn the wheel over to stooges of the private insurance industry like Max Baucus to ram through c rap that is designed to perpetuate the monopoly of those corproations.

[TwilightGardener]

3. This is worst case scenario costs, for people who don't have employer coverage, correct?

Expensive, but better than what they would have now.

[Phoebe Loosinhouse]

6. Wasn't divorcing healthcare from employment one of the major reasons for reform in the 1st place?!!!

AAARRRRRGGGGHHHHHH!!!!!

Don't you get that that hasn't happened and you just proved it with your statement? How long do you think employers will be able to hold up their ends even if they want to?

[TwilightGardener]

14. I'm not sure what you're saying--are you saying that employers won't

cover health insurance anymore? I think they have to, by law, if they're of a certain size. And according to this chart, the price of an individual policy will be lower than it is now, so if one becomes unemployed or self-employed, it's not as dire a situation as it used to be--especially if you're covered by an employer, have a pre-existing condition, and then you lose your job. It's not a monumental improvement (at least for the upper income range folks)--just a modest one.

[Phoebe Loosinhouse]

16. If costs keep running amok without mechanisms in place to control costs

and there are no mechanisms for that (people point at Medical Loss Ratios without realizing that they just pass through costs, they do not contain them) then at every increase some employers will have to pull the plug on employer provided benefits. The costs will rise so fast that more and more people will be on so-called "cadillac plans", not because the plans have improved but strictly because of the inflationary cost spiral. The tax on those plans to the employer is 40%!!! You will see your precious employer provided benefits eroded away and with great and greater percentages passed onto you because basically your employer will not have any other choice if they want to stay in business.

I laugh cynically, because you and other people who are saying "it's not that bad" are only saying that because right at this moment you are not feeling the rain because you are huddled under your employer's umbrella. Those figures in that chart are astronomical on BOTH sides, just less so one. But you don't care, because you think it doesn't effect you . . . YET.

Let me say once again, reform was supposed to provide AFFORDABLE healthcare to everyone that was supposed to be divorced from the workplace and portable. This has not happened. Spending a quarter of your income on healthcare because you happen to be one of the many unemployed, underemployed, or self-employed is simply not doable.

It always amazes me how completely unconcerned many people are for others if their ox isn't being gored.

[TwilightGardener]

17. The point of mandates is that if more healthy (low cost) people are

paying in to make up for the sick people who are having claims paid, then the price of insurance should go down across the board, for everyone. Plus, the number of uninsured going down SHOULD have a cost-saving impact on hospitals, who lose money on people that don't pay and supposedly use that as an excuse to raise their prices. So I am interested to see if that principle will work--it did seem to work for car insurance, in various places where I've lived. The 85% MLR, I am undecided about, as well--what is it now, for private insurers? Is that 85% supposed to be actual claims payout, or does it also include administration and business costs? I don't know if there's a mechanism in place to prevent this scenario: The insurer can only stand to make at most 15% profit, so it encourages the driving-up of health care provider prices (more for tests, nursing care, doctor fees, etc.), which gets passed on to the consumer--so that instead of the insurer making a 15% profit on a hospital stay worth $20,000 today, it will make 15% on a hospital stay that suddenly jumps to $30,000 or $40,000--with the patient (or the government) paying for that increase. That is a valid concern--UNLESS there is a strict and reasonable limit to what patients/government can be charged (sort of like Medicare reimbursements now), and the insurance co. has to eat the rest if it doesn't find a way to control prices and reimbursements.

[eridani]

25. Insurance costs will be whatever the insurance companies can screw out of us

They are useless sociopathic parasites.

[harun]

19. It should have been but it clearly was not. Obama and other leading

Dem's came out of the gate saying the employer based system would remain intact.

If we got a Public Option started I would be ok with that. If they are just going to institutionalize the for-profit health insurance model then that isn't what people wanted.

[Captain Hilts]

31. We MUST decouple access to insurance from employment. nt

[inna]

8. More numbers here:

http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=389x7338574

And... K&R!

[quiller4]

23. I supported the Senate Bill before I saw this chart --now my support is stronger

We are a family of 2 and we are older but the calculations I found online show that our total income at risk will drop from 56% of our income to 23% and our out of pocket max will be cut in half. Those with lower incomes will be helped more.

When I look at this chart I fail to understand all the complaining.

[TheKentuckian]

24. Probably because you're looking at it and see savings

while others see they still won't be able to afford treatment while being forced to pay significant premiums. Broke is broke is broke. 6K is a lot less than 17K but if you can't afford even a thousand then who gives a crap about "savings"?

People are stretched to the fucking limit and even many that are covered now cannot aford to use it.

Its funded by screwing over union-folk who have been a tremendous group of strong allies for the party.

Most of all the bill fails to fix any of the longstanding problems and the regulations are weak as water and depend on chumpass state regulators to enforce what loophole ridden stuff is there. Are you going to argue that an industry left an anti-trust exemption is fixing to be strictly regulated because if you are I've got Arizona beachfront property for days to sell ya.

I'll be glad for any this helps but it is a real stretch that there is going to be a huge improvement in access, controling a vampire industry, or general affordability. A lot of good people that worked to get Democrats in office are going to take a hit.

[quiller4]

29. You may have "chumpass state regulators" . I know little about

Kentucky state politics. In the West, in Washington state in particular, we have had very strong insurance commissioners. They have forced a number of insurance companies out of the state for their offensive practices. That hasn't necessarily brought our rates down and it has reduced competition but it has protected us from some of the more outrageous pratices about which others complain.

[Captain Hilts]

30. Kentucky doesn't believe in government or regulation. They elect folks that reinforce the idea that

you wouldn't want them running anything.