Author Topic: Talking Heads - Healthcare Reform (Read 102571 times)

nlhome · « **Reply #80 on:** July 06, 2009, 11:50:28 AM »

Talking Heads #6

"It occurred to me that nothing is more interesting than opinion when opinion is interesting..."
Herbert Bayard Swope, creator of the Op-Ed page.

A two week forum for opinions on anything in print: magazines, newspaper articles, online: bring your ideas and let's discuss.

Our Sixth Selection is:
Health Care Reform~! Are We on the Fast Track?

7 Ways Health Reform Is Going to Affect You
Newsweek June 10, 2009

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Janet, I saw that article also. Interesting. How will they resolve their problems?

There's always a "but" to these articles - why would this country adopt the problem areas of someone else's plan? If the USA plan is developed with thought, we can take the best of these other countries' plans and adapt them to suit our population. The devil will be in the details that will be fleshed out after Congress passes a basic plan.

We cannot continue as we are, because the costs, already higher than in other countries, are out of control now and we don't cover everyone. As more employers drop retiree plans and cut employees' benefits, the number of uninsured and underinsured will increase, and the costs to treat them in emergency rooms will increase, etc.

Something has to be done that addresses the high costs, both in care and in administration costs. I only hope Congress is up to the task. Unless our members of Congress lose their financial ties to the insurance industry, however, no meaningful reform will be impossible. That's why we need to educate ourselves and to constantly contact our representatives in Washington and challenge them to meet the needs of the population.

winsummm · « **Reply #81 on:** July 06, 2009, 08:56:09 PM »

jobs

why should health insurance be connected to employment? Universal health care, something like medicare has nothing to do with jobs. It has been convenient in the past but if we no longer have people who are not covered at all. . . . and may not have jobs at all . . . . what's the point. Universal heath care ceates lower costs since the pharmacies and the hospitals have to bid against the government for their contracts. It is said that they will go out of business that way.

they have been gouging us for decades. it's time the playing field is leveled.

claire

bellemere · « **Reply #82 on:** July 07, 2009, 09:22:00 AM »

As I understand it, health insurance became employer-linked during World War II when salarie increases were prohibited under wartime labor restrictions. So instead, employers could offer health insurance to compensate their workers.

Babi · « **Reply #83 on:** July 08, 2009, 08:17:25 AM »

Ah, that's an interesting bit of information, BELLEMERE. I didn't know that.
Makes sense. And of course, once we had it, we would be most reluctant
to let it go.

Steph · « **Reply #84 on:** July 08, 2009, 08:23:41 AM »

I suspect that part of the overwhelming costs have to do with improper usage.. I know in some countries, the doctors can opt out of the system and go private.. thereby setting up a side by side system. I know in our system, that number of people with no insurance use emergency rooms as their primary provider, thereby clogging up the system. My husband had to go through the emergency room in our local hospital in January. He had fallen at the gym and got quite a head cut, etc. and at 74, they whisked him off and rightfully so. When I went there to find him and find out what happened. I had to wait in the waiting area for maybe 20 minutes. I could not get over the number of people who wandered in at 5:30 am in the morning. Not one seemed to have any sort of emergency situation. One had a cold and couldnt sleep.. so the emergency room was a solution??? another had cut his hand maybe three days ago and decided on the sput of the moment, maybe it needed stitching?? Someone else had a headache.. on and on.. I just sat there amazed at why they were in the emergency room. There should be somewhere where these people could go for care or better triage..

nlhome · « **Reply #85 on:** July 08, 2009, 09:05:20 PM »

Steph, as a rule hospital emergency rooms cannot turn people away. So, people who do not have insurance and do not have money, and thus cannot get in to a doctor's office or clinic, go to the emergency room. If a community does not have a free or low cost clinic, they have no where else to turn.

Others, of course, abuse the emergency room, maybe because they don't want to miss work by taking time off to go to the doctor (or because they can't take off), or don't have a regular doctor, or any number of reasons. It's frustrating because most of us know what is appropriate for an ER, or think we do anyway, but it's hard to judge, also.

I agree, there should be some sort of clinic system that people can go to if they don't know where else to turn. My own health insurance has an on-call nurse, 24 hours a day, on the phone, that is a good initial source for deciding what needs to be addressed right away and what can wait. But, of course, that's part of my health plan, not available to the uninsured.

Steph · « **Reply #86 on:** July 10, 2009, 08:17:07 AM »

Yes, My AARP medigap has the nurse and she is really helpful to me.. I do know now that you can also call a help line at a lot of hospitals and get an answer about many probems..Since my husband was a patient of the MD Anderson Cancer center in Orlando, they provided us with so many souces of information and that was included. There is also in many areas, a visiting health nurse who have a hotline.. I still think that most areas would benefit from another area in the hospital that took on all who came in and triaged them into who needed help and who didnt. We have drop in clinics here in Florida, but I think you need insurance for them. Never been to one, so not sure.

bellemere · « **Reply #87 on:** July 10, 2009, 11:09:54 AM »

It seems a snag in the progress of health reform legislation is over "taxing health benefits." What is that? Who would pay that tax? Based on what? I am really confused. I know that this is something the President wants to back up his insistence that any reform plan be paid for. Can anybody enlightent me on this proposed tax on health benefits?

Janet · « **Reply #88 on:** July 10, 2009, 02:02:10 PM »

Comment removed.

bellemere · « **Reply #89 on:** July 10, 2009, 08:37:38 PM »

while I hate the idea, I guess it is a fair way to get this thing paid for. That is, the people who get the benefit pay the tax. But I thought it was paid by the employer. Thus weakening the incentvei to provide insurance for workers.
the two issues, access for all and cost control are almost mutually exclusive. If a bill passes that only guarantees access and does not control costs, it could wind up being worse than no bill at all. Rationing is a bad word, but can we guarantee everybody an additional heart transplant if they have already had one? Should every mother have the right to choose a more expensive Cesarian delivery if there is no medical justification for it? Should a 92 year old get a hip replacement? (Actually ;happened in a family I know. the woman lived eight months.) With a shortage of organ donations, who goes to the top of the waiting list? The child? The mother of a family? The war veteran? Should fertility treatments be covered for a single mother who already had a child or children? These are rationing decisions. But Americans want everything, and they want it now, and they want it paid for by someone else.

Janet · « **Reply #90 on:** July 11, 2009, 12:36:50 AM »

Comment removed.

bellemere · « **Reply #91 on:** July 11, 2009, 10:42:06 AM »

By far the largest share of current Medicare costs are incurred in the last six months of life. In the meantime, the cost of rehab for substance abuse, or mental illness, even in children is "capped" at predetermined amounts by most insurers. those people are not politically powerful, and can be safely ignored. Rationing is simply making decisions based on evidence that a given course of treatment is or is not effective. Health care today is rationed by a differnt method: political clout and money.

Janet · « **Reply #92 on:** July 11, 2009, 12:23:35 PM »

Comment removed.

nlhome · « **Reply #93 on:** July 11, 2009, 01:36:05 PM »

Janet, do you have the site that shows the quote by President Obama? I'd like to read that.

bellemere · « **Reply #94 on:** July 11, 2009, 01:55:46 PM »

I think I too would like to see that quote. I did not realize our President was commiting political suicide. He is, after all , a politician.

Steph · « **Reply #95 on:** July 11, 2009, 04:15:46 PM »

I think that Obama was referring to his grandmother.. She had some extensive stuff done in her last few months. In many areas, if you are refused treatment, you can acquire it privately.. Not saying it is right, but it makes sense to me. The use of statistics is a valid one.. We know someone who had a heart transplant.. He had always been bipolar and off and on suicidal. He recovered nicely from the transplant, but went completely off his head and spends his time in a nursing home on Medicaid.. Happily thinking he is about 12 and his Mommy is coming for him.. Such a waste of a heart.

Janet · « **Reply #96 on:** July 11, 2009, 07:07:38 PM »

Comment removed.

bellemere · « **Reply #97 on:** July 11, 2009, 08:57:03 PM »

It would be hard to make health policy for 200 million people based on each person's spirit. All a government can do is give guidelines based on proven effectiveness.
We seniors already use up a disproportionate share of health care resources. As the aging population increases with the baby boomers, that trend will accelerate. Costs will go up continually if each person demands that "everything possible" be done. We can't all have it all, even if we choose to. That's the message and it is a tough one to accept.

nlhome · « **Reply #98 on:** July 11, 2009, 09:16:59 PM »

Thank you, Janet. However, you say "Obama made no reference to the fact that under the proposed plan, a government appointed commission will be making those decisions. And that is what bothers me -- having some faceless bureaucratic gatekeeper, who does not know me or my health history, deciding that I am "too old" to have a certain procedure, based simply on my age."

Can you produce that plan that says that? Because as far as I know, nothing formal has actually been put up yet. There are bills that are being worked on, some being introduced, but I know of none that specify such rationing as you describe that are up for a vote. Our Congressman is still working on this topic and gathering information and stories from constituents, so I suspect a lot of work has to be done before any bill is introduced.

I have heard and read comments by people who are anti to any public involvement in health care raise that issue as a tactic to scare people, however.

Clearly, right now we have faceless heads of insurance companies deciding whether procedures are being covered and whether people are even able to get insurance, and we have rationing in the form of leaving out substantial numbers of people from coverage. In fact, it seems the people who have the least restrictions and best coverage are those on Medicare, which is a single payer universal coverage, government system.

bellemere · « **Reply #99 on:** July 12, 2009, 01:48:55 PM »

That is exactly right. the hip replacements we talked about must have been paid by Medicare, a single payer goverment program. It would be interesting to know what a private insurere might rule about a hip replacement for a very elderly person.
Nobody likes the idea of rationing. but it seems that The Almighty in combination with Science has dealt us seniours a rather tricky hand. Longer and longer life spans combined with more and more health problems for which there may be at least possible solutions. What's missing is the means to pay for it all.
'

Steph · « **Reply #100 on:** July 13, 2009, 08:11:24 AM »

I had a mother in law with Alzeimers.. When she was 97... she stopped eating and the nursing home wanted us to have a surgery implant to feed her.. We talked to the doctor and he was a very nice man, he said he would not do it to his own mother.. We didnt. She drank liquids by herself and lived several more months.. but she was at the stage where she knew noone, could not walk or talk or anything. She just lay and slept mostly.. There is a stage where there is no quality of life at all.. Very hard time for MDH

nlhome · « **Reply #101 on:** July 13, 2009, 09:01:22 AM »

Steph, that must have been a hard time.

We all should consider a healthcare power of attorney and living will. Hard to do, sometimes, but vital if we want our wishes to be followed.

bellemere · « **Reply #102 on:** July 13, 2009, 10:21:40 AM »

How awful for you to see a loved one in that position. My own mother was lucid until just a day or so before she slipped into a coma and died. On one of those last days she said to me ;"Honey, this dying business is for the birds." How do you answer something like that? I just couldn't think of anything.

maryz · « **Reply #103 on:** July 13, 2009, 11:53:55 AM »

John's dad has Alz., too. Definitely not a fun way to go - at least for the family.

Bellemere, the answer to the question is: "You're d...ed right!"

Steph · « **Reply #104 on:** July 14, 2009, 08:10:06 AM »

My mother in law would not consider that she might get ill or die. so she had nothing except for an old will.. After all we went through with her and going to court,etc. We made sure that we have medical powers of attorney,durable powers.. wills, trusts, everything that will help us and our sons cope. We also prepaid a cremation service, etc. Both of our boys got upset since we have provided them with copies of the cremation, etc and they are aware as to where to find all assets and medical stuff if both of us go at once.. Neve again would I want to put anyone through what we did.. There is nothing worse than having a total stranger being able to ask personal questions so that we could pay her bills with her money. Whew..

bellemere · « **Reply #105 on:** July 15, 2009, 09:31:14 AM »

there are rumors that the President will order Congress to stay in session after August 1 until they pass a Health Care Bill. Can he legally do that? How will they survive if they cannot decamp to Martha's Vineyard or Lake Tahoe or wherever. Maybe he should lock them in a room with no food until they reach a good consensus.

Babi · « **Reply #106 on:** July 16, 2009, 08:18:46 AM »

Good question, BELLEMERE. I've always been under the impression that the
President could extend the Congressional session, but I'm not sure whether
that is a Presidential legal right. In may simply be that if the President asks you
to do something, not many people are going to say 'No'.

Steph · « **Reply #107 on:** July 16, 2009, 05:23:54 PM »

Actually given our congress they say no all the time.. I think Teddy Kennedy will have a lot of influence on them staying in session. He is highly respected in the Senate. Not my favorite human, but he has been a good senator over the years.

bellemere · « **Reply #108 on:** July 16, 2009, 08:32:37 PM »

I think I have figured out what "taxing health benefits" means. If your employer pays a portion of your premiums, that amount would be considered income to you, and would become part of your taxable income. It is , actually, so I guess it would be fair.

Steph · « **Reply #109 on:** July 17, 2009, 09:39:17 AM »

Makes sense to me to tax the benefits. I know that when we had a car supplied by MDH company, we were taxed on that.. Reading the paper and laughing over the doctors yelling about the MRI's and Ct's in the offices. I did that only once and it was double what the hospital charged.. and I have no idea who read the results. From then on I specified hospital or independent. Doctors just see that sort of thing as a profit center. I knew a doctor who did Mammos and read them himself..Now there was a real risk

bellemere · « **Reply #110 on:** July 17, 2009, 12:04:42 PM »

It seems that taxing the health benefits would meet the cost control goals of the President, yet he has not gone on record for it. Unions are against it. But those benefits have been exempt from taxation from a very different time: World War II, when salarie increases were prohibited. Now is a differnt time. I am tring to find out who in Congress is in favor of this. anybody seen anything about the identity of the proponents? They are probably being castigated by union lobbies. I have always been a firm advocate of health care reform, but if it is passed withoug some cost control, it will be a disaster.
Has some doctor really got an MRI in his office? When they wre firest being acquired by hospitals they had to be in a special room with very thick lead-lined walls to prevent " scatter. Not your typical office building. Maybe the docs have managed to get that requiremtn dropped.

Steph · « **Reply #111 on:** July 18, 2009, 08:33:29 AM »

No, what the doctors do is rent a space in a medical building.. They generally go together on that sort of equipment.. They buy it and then all plege to send all of their patients to it.. They also do the same with labs for blood, etc.. There are way too many tax advisors who get doctors to invest in this sort of profit center. Same for kidney dialysis. Since it is always paid for by the government,, a number of foreign doctors love this..

Babi · « **Reply #112 on:** July 18, 2009, 10:02:07 AM »

I do know,..and benefited from the knowledge...that a patient cannot be billed for services that not to the benefit of the patient.
I once broke a bone in my elbow. The x-ray was read by the young
intern on duty, and my arm was casted based on his reading. The
fracture did not heal, and I had to have surgery and another six weeks
in a cast.
Somewhere along in here I got a bill from the radiologists. You know, the
group that reads all the hospitals x-rays as a safety back-up. I sent them
a letter that I owed them nothing, as I had received no benefit from their
services. The treatment I received was based on the reading done by the
doctor on duty, and the treatment had not been successful. The reading
done by the radiologists was solely for the benefit and protection of the
hospital. I didn't hear from them again.

Steph · « **Reply #113 on:** July 19, 2009, 07:27:17 PM »

Ah Babi, you have cleared up a puzzle of mine. When I had surgery about 15 years ago, I was not yet on medicare and had private insurance.. I was extremely careful to call and verify each and every doctor and the hospital before the surgery. Then to my amazement, I got a bill from a totally unknown medical service. I called them and asked them what they had done for me.. They hemmed and hawed and never answered meto my satisfaction. I sat down and wrote a note to the insurance company telling them of the puzzle. They did not pay the bill and I was never billed again. Still have no idea who the people were or what they did..

Babi · « **Reply #114 on:** July 20, 2009, 08:26:53 AM »

It is standard practice, STEPH, for a hospital to have all x-rays reviewed by a
group of radiologists. This is for their own protection, really, ...a quality control
mechanism. It can also be a help to in-patients, as the specialists may catch something that was missed before the paient leaves. For the most part, tho', it's so the hospital can prove a specialist reviewed the films, in case of a
lawsuit.

Steph · « **Reply #115 on:** July 20, 2009, 08:43:24 AM »

The last mammogram I had done, I was recalled and I know that they had all of the previous one and then did a new type that really hurt. But the good thing with that I was told on the spot that all was well.. So sometimes xrays can help with a lot of nervous results.

Janet · « **Reply #116 on:** July 21, 2009, 01:45:39 PM »

Comment removed.

Steph · « **Reply #117 on:** July 21, 2009, 03:30:32 PM »

ah,but the bill as original and the bill as law will be quite different.. Always is..

Janet · « **Reply #118 on:** July 21, 2009, 04:26:06 PM »

Comment removed.

bellemere · « **Reply #119 on:** July 21, 2009, 10:03:32 PM »

wow, this is tough reading for a layperson. I particularly studied the passage relating to keeping one's current plan. I am interested because I have a Medicare Advantage Plan, founded by Tufts University and it has been fine. i should add that we have no seriuos health problems so far. As far as I can tell, the individual can keep a Medicare Advantage plan, but the plan may not market itself to new members after the passage of the bill, which is designed to have every plan meet certain standards. I couldn't find anytthin about a Medicare Advantage plan being forced to carry prenatal benefits for its members. Hello? why would senious need that ? And it cannot insure members' children at all. I know that I was very surprised when my monthlypremium went DOWN a couple of years ago. Evidently the plans were awarded a huge government subsidy, which the reform bill woudl remove, and our premiums would go up again. But I expect it to anyway.
I am really having a tough time figuring this bill out. But I am not giving up.
I was disgusted to hear that a congressional rep was gloating that "this will be Obama's Waterloo" as if the entire point of opposing the bill was to deal the President a blow, not to find a better way for the american people.

News:

Author Topic: Talking Heads - Healthcare Reform (Read 102571 times)