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Old 08-13-2009, 06:45 PM   #241
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That's not correct.
I think you may need to coordinate with your party's talking heads and get your arguing points straight... they would disagree with you.


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Just to make myself clear, I wish to see that relationship ended with Americans free to buy their own insurance, which they can take from job to job, without the tax penalties they now suffer.
So you want to pay even more for insurance? Yeah, that's gonna work...

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Not to mention that under the Health Insurance Exchange the government will have complete control over who its competitors will be. At least that's how I read the legislation. Seems to be a stacked deck
So I'll ask once again since this question seems to keep getting ignored in here. Why are you fine with insurance companies being able to do this, but not government? You don't think insurance companies control everything right now? If you don't then I'm venturing a guess that you don't work in the medical field.
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Old 08-13-2009, 09:40 PM   #242
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The tax code must be changed to end the exemption for employer-based insurance and give a credit to those that buy insurance themselves. McCain got pilloried by the Obama campaign for proposing this but of course now democrats are floating the idea of taxing health benefits.

Can you provide me a link that shows that McCain advocated taxing health benefits. I just find it hard to believe that a Republican candidate (well any candidate really, but especially a Republican) would advocate taxing anything while running for office.

Why would it be a good thing to tax health benefits?

The public option becomes your insurance by default. If reform provisions state through mandates that all insurance policies must provide X, and the penalty not to do so is Y. What would you do, as an employer, if X is greater than Y? And as an employee, if your employer drops coverage you then have no other choice, other than looking for a another job, but to sign up for the public option.

Is that freedom?
Are your views predicated on the assumption that the Democrats and the president are trying to force the country into socialized medicine and since they can't bring it in the front door, they're trying to bring it in the back? Is this like the Conservative version of how liberals felt about the Iraq war, i.e. the president misleading the public to achieve policy goals he knows they'd never support if he told them outright?

Because if that's the case, then your reasoning makes sense. I haven't seen the evidence though that it will be cheaper for employers to pay the penalty than to provide X. And couldn't the employers just opt in to the public plan themselves and use that for their employeers. I mean we're assuming the public plan is going to somehow provide "more" than the other options, right?

And why would the president want to somehow get every one on the public plan?

I mean I hear what you're saying but I just don't see the pieces adding up.
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Old 08-13-2009, 09:42 PM   #243
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YouTube - Obama on single payer health insurance

Candidate Obama: "We might not get there immediately"...to single-payer. "First we got to take back the White House, and we got to take back the Senate, and we got take back the House."


And now we have this 1000+ page loaded House bill.

Transparency please.
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Old 08-13-2009, 09:43 PM   #244
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The public option will be cheaper...the government can tax or print more money to subsidize an individual's public option premium. Or simply short pay your doctor.

Not to mention that under the Health Insurance Exchange the government will have complete control over who its competitors will be. At least that's how I read the legislation. Seems to be a stacked deck

How the public option will be cheaper would be cause for concern if it means "printing more money" or short paying the doctor (isn't that what happens with Medicaid right now?). But that's not the only way the public option could be cheaper. If enough people are in the public plan, shouldn't that lower the price of premiums also?

As for the Health Insurance Exchange, I'm not sure I really understand how that will work.
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Old 08-13-2009, 09:55 PM   #245
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How the public option will be cheaper would be cause for concern if it means "printing more money" or short paying the doctor (isn't that what happens with Medicaid right now?)
Yes, you're right about Medicaid payments.
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Old 08-13-2009, 09:58 PM   #246
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YouTube - Obama on single payer health insurance

Candidate Obama: "We might not get there immediately"...to single-payer. "First we got to take back the White House, and we got to take back the Senate, and we got take back the House."


And now we have this 1000+ page loaded House bill.

Transparency please.
Well this right here is one of those moments where it's a politician being a politician. Sad but true, I don't like it anymore than you do...

Bush would speak to the NRA much differently than he would the public.

This video if I'm not mistaken was taken at a fundraiser with union groups.
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Old 08-13-2009, 10:02 PM   #247
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How the public option will be cheaper would be cause for concern if it means "printing more money" or short paying the doctor (isn't that what happens with Medicaid right now?). But that's not the only way the public option could be cheaper. If enough people are in the public plan, shouldn't that lower the price of premiums also?
Right now, Medicare pays something like .90 for every dollar, and Medicaid pays .84 for every dollar. And Private insurances are paying something like 1.10 for every dollar. Now I may not have the exact numbers but this is sorta the structure.
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Old 08-13-2009, 10:05 PM   #248
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As for the Health Insurance Exchange, I'm not sure I really understand how that will work.
It's laid out in the House legislation.

Page 19, 41, and 42.


http://docs.house.gov/edlabor/AAHCA-BillText-071409.pdf
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Old 08-13-2009, 10:16 PM   #249
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And why would the president want to somehow get every one on the public plan?
To secure VOTES ?
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Old 08-13-2009, 10:33 PM   #250
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But that's not the only way the public option could be cheaper. If enough people are in the public plan, shouldn't that lower the price of premiums also?
The public plan will be cheaper. I don't think the number of people will make a difference. The government will make the necessary adjustments.
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Old 08-13-2009, 10:36 PM   #251
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To secure VOTES ?
REALLY? If the polls are correct according to conservatives, he's surely going about that the wrong way...

Bluer White I'm still curious as to why you haven't answered the question asked of you by a few of us...
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Old 08-14-2009, 03:45 AM   #252
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Correct me if I'm wrong but the form of socialized medicine we do have was signed into law by LBJ in 1965 or so.

And he was 'thanked' by his built-in electorate, when he was forced to not even be able to run for the Dem nomination in 1968.

So much for building his electorate by buying off the 'silver hairs'.

No, not directly apples to apples, LBJ's '68 candidacy was complicated by other factors (Vietnam, Civil Rights Act) but it just goes to show you that it's not a proven political ploy, in the least.

Truman (of the FDR cabinet and The New Deal) was booted out as well, right?
And that fucker won the war!!

Politics are too fickle to be as simple as this idea of buying votes having much weight. JMO.

If anything the Dems (effectively) steal votes every time some Republican douchebag opens up his mouth about Mexicans and immigration. Talk about a built-in electorate...but even then it's not that simple. They are mostly religious and never count out the Reps when the Jesus card is in play.
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Old 08-14-2009, 06:59 AM   #253
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Federal funds can currently be used for medical (rape, life of the mother complications) abortions only. Let's make the wording clear, either way, so that the American people understand, beforehand, what the bill does and doesn't cover.
That's a good idea everyone can agree on right?



oh, good. at least you're stating at the point that abortion is about punishing women and has nothing to do with female sexuality.

i appreciate the honesty.
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Old 08-14-2009, 07:00 AM   #254
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i didn't write this, but i wish i did:

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Dear Mr. President:

I am writing you today because I am outraged at the notion of involving government in healthcare decisions like they do in other countries. I believe healthcare decisions should be between myself and my doctor.

Well, that is not strictly true. I believe healthcare decisions should be between myself, my doctor, and my insurance company, which provides me a list of which doctors I can see, which specialists I can see, and has a strict policy outlining when I can and can't see those specialists, for what symptoms, and what tests my doctors can or cannot perform for a given set of symptoms. That seems fair, because the insurance company needs to make a profit; they're not in the business of just keeping people alive for free.

Oh, and also my employer. My employer decides what health insurance company and plans will be available to me in the first place. If I quit that job and find another, my heath insurance will be different, and I may or may not be able to see the same doctor as I had been seeing before, or receive the same treatments, or obtain the same medicines. So I believe my healthcare decisions should be between myself, the company I work for, my insurance company, and my doctor. Assuming I'm employed, which is a tough go in the current economy.

Hmm, but that's still a little simplistic. I suppose we should clarify.

I also believe my healthcare should depend on the form I fill out when I apply for that health insurance, which stipulates that any medical problems I ever had previously in my life won't be covered by that insurance, and so I am not allowed to seek further care for them, at least not at my insurance company's expense. That seems fair; otherwise my insurance company might be cheated by me knowing I needed healthcare for something in advance.

And if I didn't know about an existing condition I had, but I could have known about it, had someone discovered it, I suppose it doesn't make much sense for my insurance to cover that either.


But let us assume that all hurdles have been cleared and I am allowed to see my doctor, chosen from a list of available doctors, about a health problem, except health problems I have previously been treated for. After that, I believe my healthcare decisions should be between myself, my insurance company, my insurance plan, my employer, and my doctor.

Oh -- and the doctors at the insurance company, of course.

They will never actually meet me, or even speak to me on the phone, and in fact I couldn't tell you the name of a single one of them, or what state they were in, or whether or not they've just all been outsourced to a computer program somewhere in Asia at this point -- but they're in charge of determining which treatments might be "effective" for me, and which will be a waste of money, er, time. They do this by looking not at my case, which is individualistic and piffling and minor, but at the statistical panoply of treatments on the insurance company spreadsheet and their statistical cost vs. effectiveness. My doctor may think one treatment or another might be effective for me in a particular instance -- but he may be a little too closely involved with my personal case, and unable to make these decisions nearly as well as my less involved, more dispassionate insurance company can.

And then there's the claims office. When my doctor sends a bill to my insurance company, it must travel through a phalanx of people and departments and procedures in order to determine whether or not it is, in fact, a valid medical complaint to be treated for, done the right way, at the right time, by a doctor on the right list. If the paperwork is not done on time, or not done completely, or not done to the satisfaction of the right people, or if I did not receive the proper prior approval for the medical treatment administered, or if that approval expired, or if the insurance company rescinded the approval months after the fact, my medical care will not be covered. While my doctor has had to sometimes forgo payments because the 30-day window for receiving "all requested documentation" somehow slipped by, I myself have received notes from the insurance company denying coverage for treatments from twelve full months beforehand. It can't be helped: sometimes it takes twelve months for their computers to process the paperwork and determine that I owe them more money. They like to be thorough.

So that's getting a bit more complete. I believe my healthcare decisions should be between me, my insurance company plan, my statement of preexisting conditions, the claims adjusters at my insurance company, my insurance company's doctors, my employer, and myself.

And the separate claims review team that will be looking over my treatment.

My health insurer might have flagged me as someone who needs a lot of healthcare, and who is therefore costing the company money. Needing to use the insurance you paid for is naturally a suspicious activity: that means that a special review team will look over my paperwork, seeing if there is any vaguely plausible reason for the company to be rid of me. They will look for loopholes in my application, irregularities in the paperwork my doctor filled out or any other situations which, like magic, mean that all the money I have paid for health insurance premiums was in fact irrelevant, null and void, and they don't have to pay a single cent of claims because I defrauded them by neglecting to remember that I had chicken pox in sixth grade, not fifth, or that what I presumed was a bad cold in 1997 was in fact maybe-possibly-bronchitis, and I can't possibly expect to be covered for any lung-related complaints since then. I suppose I cannot complain too much; after all, this is a crack squadron of employees whose pay is determined by how much they can reduce the healthcare costs incurred by the company. It would be irresponsible for them to not look for such loopholes.

And then there is the board of directors at the insurance company, of course. My personal healthcare is irrelevant, when considered in the abstract; a health insurance company exists to make a profit, and the pay of every executive in the company and every board member is dependent on squeezing out the maximal amount of profits from every dollar.

This is where "experimental" and/or "preventative" treatments come in. New-fangled treatments, things that have only been around for a decade or two, are usually the most expensive. For example, when I complained of chest pains I could have had an CT scan to determine the state of the arteries around my heart, and it would have shown exactly where the problems, if any, lie. This is what the specialist recommended -- but using a CT scan in this way is considered "preventative" treatment, not "diagnostic" treatment, so it is not covered, and I am not allowed to have one. Instead, less accurate tests were used to get a "feel" for what the arteries might look like; these tests are covered. Problem solved; as it turned out, my chest pains were probably a preexisting condition, most likely caused by me having bones. And if it's not, I suppose we'll find out in another ten years or so, when no doubt I am covered by another insurance company and not this one.

These may seem like arbitrary determinations, but they are not. They are based on a rigorous study of how well the treatment works, how much it costs, and how likely it is that the company will have its corporate ass sued off if they do not provide it. This is weighed against the desired profit announcements for the insurance company during that quarter in order to determine how much care must be denied to customers, in aggregate, in order to meet the appropriate financial goals.

Let us not forget the obligations to the stockholders, after all. Of every dollar paid in premiums, currently eighty cents it paid back out for actual medical claims; the rest is administration and profit-taking. Fifteen years ago the number was 95 cents: in other words, the insurance companies themselves have gone from taking five cents of every healthcare dollar to taking twenty cents of every dollar, all since the Clinton presidency.

The stockholders require healthy profits. The executives require personal profits for providing those profits. And since people for some reason aren't getting any healthier, those profits can only come from one place -- reducing what the company pays out when people do become sick.


I recently heard a radio interview with a health insurance company whistleblower; he was describing his trips on the company jet. Gourmet meals were served on china, and the forks were gold plated.

I was pondering this, while looking over the letter from my insurance company informing me that they were switching the coverage of my most expensive monthly medication -- those expensive allergy/asthma shots now count as a "procedure", not as "medicine", and so therefore those vials are not covered by my pharmaceutical plan anymore. It must be very difficult to balance all the tasks of an insurance company CEO. If the corporate jet has inferior place settings, imagine the corporate shame. If a new medication or treatment is no longer considered "experimental", or a treatment classified as actually useful, as opposed to "preventative" nonsense, consider how many millions of dollars the company would have to pay out to give people that treatment. It seems reasonable indeed for the president of my insurance company to have personally pocketed a few hundreds of millions here or there -- I cannot imagine the stress of keeping up with proper utensil etiquette during a time when those you insure are doing you the constant insult of actually getting sick.

So, Mr. President, I write to you with this demand: we are not a socialist country, one which believes the health of its citizens should come without the proper profit-loss determinations. I believe that my healthcare decisions should be between me, my insurance company plan, my insurance company's list of approved doctors I am allowed to see and treatments I am allowed to get, my insurance company's claims department, the insurance company doctors who have never met me, spoken to me or even personally looked at my files, my own preexisting conditions, my insurance company's crack cost-review and retroactive cancellation and denial squads, my insurance company's executives and board of directors, my insurance company's profit requirements, the shareholders, my employer, and my doctor.

Anything else would be insulting.
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Old 08-14-2009, 08:20 AM   #255
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The public option will be cheaper...the government can tax or print more money to subsidize an individual's public option premium. Or simply short pay your doctor.
I am a little baffled as to why people feel this need to protect the profit-making ability of insurance companies as if it's their God-given right. If there is one villain in this entire story, it has been the insurers, but you have half the country fighting on their behalf like they're taking up some noble cause.
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