Impeding changes to our Health Care system

[TheMercenary]

Originally Posted by Redux

The myth of government controlled health care is just nonsense.

What most Americans have, and will continue to have, and in some respects, see improved, at least in terms of coverage, is a system of privately administered health insurance w/ government regulation.

You can't have both.

[TheMercenary]

A letter Thursday to President Barack Obama and members of Congress signed by more than 130 economists predicted the legislation would discourage companies from hiring more workers and would cause reduced hours and wages for those already employed.

http://www.chicagobreakingbusiness.c...t-it-100m.html

I would like to see that letter and who signed it. Haven't found it yet.

[TheMercenary]

Medicare fix would push health care into the red

WASHINGTON (AP) -- Congressional budget scorekeepers say a Medicare fix that Democrats included in earlier versions of their health care bill would push it into the red.

The Congressional Budget Office said Friday that rolling back a programmed cut in Medicare fees to doctors would cost $208 billion over 10 years. If added back to the health care overhaul bill, it would wipe out all the deficit reduction, leaving the legislation $59 billion in the red.

The so-called doc fix was part of the original House bill. Because of its high cost, Democrats decided to pursue it separately. Republicans say the cost should not be ignored. Congress has usually waived the cuts to doctors year by year.

http://finance.yahoo.com/news/Medica....html?x=0&.v=2

Each year Congress votes to delay the cuts to Medicare. I wonder if they are finally going to do it or if they will feel the pain of making the cuts and risk their jobs and positions of power if they do finally make the cuts. Many Docs would end up closing up shop and office doors if the cuts go through.

[TheMercenary]

Here is a good opinion bit from the NYT on the actual costs, real and political, and some quotes about critical assessments of the CBO process and importance, which I have raised numerous times.

March 19, 2010

Checking the Math on Health Care

As the Economist once put it, “As a creature of Congress, the C.B.O. is required to pretend to believe many impossible things before breakfast.”

“The C.B.O. process has now been so thoroughly gamed that it’s useless,” writes Megan McArdle of the Atlantic. She’s concerned about how many of the costs have been pushed to the tail end of the budgeting period, and that the excise tax on so-called gold-plated insurance plans won’t take effect until 2018:

http://opinionator.blogs.nytimes.com...n-health-care/

[SamIam]

Originally Posted by TheMercenary

Each year Congress votes to delay the cuts to Medicare. I wonder if they are finally going to do it or if they will feel the pain of making the cuts and risk their jobs and positions of power if they do finally make the cuts. Many Docs would end up closing up shop and office doors if the cuts go through.

I don't see Docs as having to close up shop if the cuts go through. Many doctors right now refuse to accept Medicaid/Medicare patients and they are not going out of business by a long shot. I have to travel 10 miles to a rural clinic in the town adjacent to mine, because its the only outfit in this area that accepts Medicaid. Cuts to Medicare are going to hurt patients far more than they will doctors.

[TheMercenary]

Originally Posted by SamIam

I don't see Docs as having to close up shop if the cuts go through. Many doctors right now refuse to accept Medicaid/Medicare patients and they are not going out of business by a long shot. I have to travel 10 miles to a rural clinic in the town adjacent to mine, because its the only outfit in this area that accepts Medicaid. Cuts to Medicare are going to hurt patients far more than they will doctors.

I think it depends greatly on what we call payer mix. For the people who don't accept medicare it may have a minimal impact but it will impact them eventually. As goes medicare so goes a lot of insurance companies. Many of them follow their rates closely and adjust them accordingly. For those who struggle by on a shoestring budget it may not affect them either, because they are already barely making it by with little overhead. But they can't just add more and more people and make up the difference either, there is only so much time in the day and the FP's I know work pretty long hours already and most are not accepting any new medicare/caid patients at all, none. But for those with a more usual mix of patients, like 40/60, with the 60% being Medicare, they will take a huge hit in those cuts. Ideally to be profitable it is better to be 60/40 and no less because it is a money losing model. Time will tell. As I said back at the beginning of this mess, be careful what you wish for, I think there are going to be a lot of unintended consequences of this bill if it passes they way they are Rhaming it through on reconciliation and procedural by-pass.

[xoxoxoBruce]

[SamIam]

Palin's constituents strike again.

[piercehawkeye45]

Newsweek article of how different people will get affected by the bill:

http://photo.newsweek.com/2010/3/hea...rm.slide1.html


I am happy about this part:

Twenty-somethings account for a third of the uninsured population, but that will change soon. When new rules kick in in about six months, insurance companies will be required to extend coverage to all dependants below the age of 26 (typically now, insurance lapses after high school). Young adults who can't rely on a parent's plan will have to find their own insurance—or face a fine of $95, jumping to $325 in 2015 and $695 in 2016. Those who can't find affordable coverage—less than 8 percent of their income—will be exempt. It's not expected that too many will have to pay up. In Massachusetts, the only state where individuals are required to buy insurance, less than 1 percent of citizens pay a similar fine.

This may positively affect me in six months and almost all my jobless friends right now...

[glatt]

It will be awesome if healthy 20 somethings start paying in to the system more.

[skysidhe]

Thank you for that slide show pierce. It cleared up some questions I had.

[piercehawkeye45]

Originally Posted by glatt

It will be awesome if healthy 20 somethings start paying in to the system more.

It would be awesome if healthy 20 somethings didn't graduate college with a non-existent job market.

[glatt]

But even when there was a job market, there wasn't much motivation for 20 somethings to buy insurance. If their job gave it to them or their parents covered them, they would have it. But nobody would buy it on their own at that age. I didn't.

[Pie]

Originally Posted by TheMercenary

Then why support a bill that will not control the costs that insurance can charge in the form of co-pays and higher deductables? There are very few cost controls. Why support a bill that shifts more costs to taxpayers? Why support a bill that puts few controls on big Pharm for years?

Hear, hear! This is something no one wants to talk about. The real reason no one was interested in cost-controls for Pharma? They've bought enough congress people to keep that from happening.

And with all the fear-mongering about 'death panels' and 'cost benefit analysis' there will never be a way to convince the American public of any sort of rationality in this respect.

Preventative medicine. Vaccinations. Screening. Smoking cessation. Nutrition and weight management. Birth control. Generic, old-fashioned medications (like statins, aspirin, beta-blockers, ace inhibitors) to control the lion's share of age-related cardiac issues. This is where the money should be spent.

[classicman]

Originally Posted by Pie

Preventative medicine. Vaccinations. Screening. Smoking cessation. Nutrition and weight management. Birth control. Generic, old-fashioned medications (like statins, aspirin, beta-blockers, ace inhibitors) to control the lion's share of age-related cardiac issues. This is where the money should be spent.

Those people don't buy as many representatives as Big Pharma though.