I agree with President Obama. You should not believe wild misrepresentations.
The health care bill does not mandate end-of-life counseling. Don't believe it when people say it does. The bill only allows Medicare to cover the same sort of end-of-life counseling that most people get already in one form or another, and it's entirely voluntary.
But there are other misrepresentations, too ... mostly from Obama and the Democrats.
Even though Obama insists otherwise, the health care bill does give government control over many peoples' insurance. It gives the government total control -- through the health insurance exchange -- over what individual health insurance options are available, as well as control over any services provided by the new "public option."
The health care bill MAY, in fact, force people to give up insurance they like, despite Obama's claim to the contrary. It's true that no existing health insurance coverage is explicitly killed by the plan, but significant changes (other than adding dependents) cannot be made to existing individual plans, such as to keep the coverage current with modern practices and treatments. And, of course, the public option and the exchange may force existing plans -- maybe one that you like -- out of business.
Therefore, further, it is also a misrepresentation for him to say that the public option will "hold down rates." It can only do so if it forces companies to lower their services to compete, or lower their rates and keep the same services ... and probably go out of business. Either the public option will cost as much as (or more than) existing plans, or it will undercut those plans and hurt them. There's no other two possibilities.
It is also a misrepresentation that if this bill does not pass, we are "doing nothing." If that's true, it's only because the Democrats want it to be true, since they could pass bipartisan health care reform that includes modest insurance regulations (like ending rescission), cost-cutting measures, tort reform, and so on. But they refuse to do it if it is not part of a far-left liberal takeover of a huge part of the health insurance sector.
And don't even get me started on Obama's misrepresentations on the cost of the plan.
Cross-posted on <pudge/*>.
Posted by pudge at August 11, 2009 03:10 PM | Email ThisWill the left/MSNBC say Obambam is inciting vilence by calling out the PO? What happens if someone "goes postal"?
He's a laugh riot....Oh its 56 million people now too...this guy just pulls numbers of his ass....
Posted by: Dengle on August 11, 2009 03:49 PMYou state that by not passing the bill doesn't mean no health care reform. If so, then why don't Republicans state this? Why don't that start by stating what parts of the bill they support?
For example, do they support the Medicare reforms contained in the package, in whole or in part. To me, this seems a good starting point for a bipartisan discussion. To assume that Medicare costs don't need to be addressed is, I believe, putting blinders on.
Another example is, if they don't believe in the public plan or health exchanges, how do they feel about the other insurance reforms in the package. If they disagree with those reforms, how do they address the preexisting conditions issue and some of the other items these reforms attempt to address.
In fact, the Republicans don't even bring up their standard line of tort reform. To me, I don't see any leadership on the issue from the Republicans. What I see is caving into the fringe groups. Couldn't they at least start by correcting those over 65 that believe the government is going to take over their Medicare insurance?
Posted by: tc on August 11, 2009 05:13 PMThe Republican bill (currently bottled up in committee, probably never to see the light of day) addresses most of your concerns. Do you think the Democrats will be bipartisan enough to actually let it come to debate?
Posted by: Shanghai Dan on August 11, 2009 06:19 PMtc: Republicans do state it. They've offered a bill. And some of them have said some parts they support. But the main goal is to defeat this bill, because it is a. on the table and b. very very very bad.
It is pointless to dwell on what we agree with in the bill when there's nothing we could do to this bill to make it palatable such that we could support it. What you're talking about is something the Dems should have done in the DRAFTING of the bill.
You're putting the blame in the wrong place. It's not the GOP's job to decide what bill is going to be voted on.
Posted by: pudge on August 11, 2009 06:27 PMI keep hearing claims about it does or does not do various things, but I don't thing ANYONE knows. And what differences are there between the House and Senate bills?
We have legislators trying to sell this thing and you can bet NONE of them have read it. Let alone understand it.
Posted by: Vince on August 11, 2009 06:32 PMA fringe libertarian like you must know, and hate, that government already has "total control" over insurance because it heavily regulates the insurance business -- in addition to directly controlling 35% of healthcare spending through Medicare, Medicaid, and the VA. Fortunately, most Americans (and non-Americans for that matter) have a more positive opinion of their elected representatives.
Posted by: Bruce on August 11, 2009 06:48 PMSpending through July of 2009 has increased by $530 billion... Medicaid spending has grown by a quarter and Medicare spending has increased by 11 percent.Posted by: Shanghai Dan on August 11, 2009 07:25 PMIn just one year, Medicaid is UP 25%, and Medicare is up 11%. Yet the Government options are going to save us by controlling cost - only double-digit increases to deal with! And we'll add 40% more people to those covered by this plan.
Let's cut spending by dramatically increasing the number of people covered and add them to a rapidly growing price plan - that's how to do it!
Mike Kreidler will never it. In my dealings with Mike and the OIC in general, he has been a very vocal proponent for socialized medicine for a long time. It was a relief a couple years ago when he addressed the insurance contingency and proposed that he would be lifting some regulations, but instead increased regulation not 2 months later to make it more difficult for anyone looking for individual insurance to purchase (this includes most small business owners).
Several years ago, Gregoire commissioned a "Blue Ribbon" panel to look at health care costs as they are currently structured. Insurance companies get a per member per month stipend (PMPM) in addition to reimbursement for services rendered. They found it was actually cheaper to have people on state programs to go to the emergency room for treatment with coupons than to continue the PMPM plus reimbusement.
So what happened? The Panel was loaded with Insurance CEO's that gave lots of money to her campaigns (i.e. Cheryl Scott was the leader of the group) and the report was buried quickly.
When Dems tell you that the insurance companies are all for the Reps, don't believe them for one minute. At least in this state, they are getting rich off the Dems reform.
Posted by: Ken on August 11, 2009 09:16 PMNow that the Stimulus has been shown to be a sham, more people have read this bill outside of Congress and realize how he contradicted himself on a number of occasions and also seemed to not remember correctly a number of key details - another snake oil pitch with smoke and mirrors. Geez, and he wonders why are people exaggerating wildly ? And he has only served less than 1/5 of his term.
Posted by: KDS on August 11, 2009 09:54 PMI wonder if we will be able tell the tale thirty years from now about how Medicare was saved? IMHO, the Medicare/Medicaid problems should be the secondary concern of Obama. The primary problem for Obama to fix is the recession! Ensuring that the entire United States population has health insurance is not the right fix and will not fix the recession either.
Posted by: Tim on August 11, 2009 09:55 PMYes, So much so that in this state we've gone down to only about five insurance companies ... the others were driven out by the government.
Fortunately, most Americans (and non-Americans for that matter) have a more positive opinion of their elected representatives.
Um. The first part has nothing to do with the second. I have a positive opinion of my doctor, but I don't want him in charge of my car repair.
Ken, yes, Kreidler is very dishonest, too, in his push to get socialized care. He flat-out lied when he said an initiative to put more requirements on insurers would not result in higher premiums. And his plan to have universal "catastrophic" care for Washington residents -- forcing people to have two different health care plans! -- was clearly a dishonest ploy to get people to BEG for single-payer (since once he got that through, and people hated it, he was counting on that they would ditch the private plans before ditching the universal plan).
In England, hospice is not covered by National Health. My mom's friend died of ovarian cancer because it was a 6 month wait to start chemo (the younger patients get higher priority).
If you are looking for facts on how well various state programs are doing, check out the Washington Policy Center website. In Washington state alone more people are now uninsured thanks to the "reforms" put in place and the prices are higher because most health insurance companies left.
And before the Obamacare loons get their panties in a wad, please note that there is a big difference between not having health insurance and not having access to health care. Also, check out who the uninsured really are. I work for a small business. We pay through the nose for health insurance but it is a priority for our business. There are ways to make insurance more affordable, but it involves things that don't call for tax increases so the democRats will never look at the sensible solutions.
And don't forget, Congress does not subject itself to the same health plan they want the rest of us to be on. Do you honestly think Teddy Kennedy is letting a penny pinching gate keeper determine who he sees and what treatment he receives? Get real!!!!
I would commend to you this article by Ezra Klien, Health Insurance Exchanges: The Most Important, Undernoticed Part of Health Reform. The concluding paragraph is excerpted below.
"To be sure, the exchange faces considerable difficulties. At the beginning, it's likely to be limited to individuals, the self-employed, and small businesses. Otherwise, experts worry -- probably correctly -- that only businesses with sick and expensive workers will buy in, and the costs of the exchange will start high. Instead, the hope is to get it on stable footing and then progressively open it to new groups. Its success isn't a sure thing. It's a theory. But it's arguably the best one we've got."
"So far I have been unable to find any example of a government run healthcare plan that has resulted in lower costs and world class care."
(a) Where have you looked?
(b) What is the cost of the health insurance you currently have for your family? per year?
(c) What does your current plan cover? Not cover?
(d) What are your criteria for care/coverage? Must haves?
Yes, it does.
... but market based incentives and process standardization.
All defined by bureaucrats and controlled by government. Start with the fact that ALL individual coverage will ONLY be offered as a part of the exchange. Now realize that ALL plans in the exchange can only cost what the government says they can cost; MUST offer a whole variety of undefined services the government dictates; MUST meet undefined federal requirements for doctor networks; and so on. Oh yeah, and if they make too much (undefined) profit, they must give it back to the consumer.
All -- and more -- controlled by the government.
Five insurance companies? I don't believe this is accurate. Are you stating in relation to what a private individual can obtain?
Here is the FEHB for Washington State Federal Employees.
Here is PEBB (State Employees).
Here is plans Virginia Mason accepts.
Here is UW Medicine.
Here is my family former pediatrics provider.
Yes, there are common ones: Group Health, Premera, Aetna, Cigna, First Choice, Uniformed Medical, but there are also others like Champus that I believe you are failing to count as an insurance plan. Shanghai Dan also has mention LifeWise (I believe that was the plan). I believe Unicare still operates in the state.
Now is there dozens. No. My guess would be under 20, and probably closer to 10 (than 20).
Some of this is due to insurance laws, but some of this is also due to consolidation nationwide of insurance providers. So, while those here want to keep their private health plans, they do need to realize that there isn't necessarily the competition on the private side that they envision. I would agree that this is one area Republican can and should address. I don't know if I agree with (I believe) McCain's proposal last fall of opening up insurance companies to compete across state lines (or whatever that one proposal was). I don't agree due to the huge disparity in what some states feel is mandatory in insurance plans where others don't. I would fear a situation similar to what has happened with credit cards (e.g., most credit card companies locating in the most regulation free states, like Delaware).
For our own state, I agree that Senn was a disaster. Kreidler is better and I haven't seen opposition yet that would improve the office over him, but this is one area locally where Republicans could also make an inroad.
Posted by: tc on August 12, 2009 07:42 AMThat's what I see when I listen to these town hall meetings, like this nut telling Arlen Specter yesterday "One day God will stand before you and judge you and your cronies on the Hill." I wonder what information this fellow actually has, because to me it sure sounds like good old fashioned ignorance.
I do agree that the Dems should be trying to include more of the Republicans' ideas in health care reform, but the Republicans are doing nothing but pandering in this case. They're just going limp and saying "Drag my dead weight along" rather than actually working with anyone, for the most part, and are simply trying to wheedle this into a flashpoint to translate into congressional election wins next year for their party.
I have to say, if I were President Obama, I would just let it be and wash my hands of it, and say, "Let the system break." That *will* happen -- so why bother, when there is such visceral nonsense and congressional representatives inciting their constituents to believe that somehow, their "freedom" is being taken away and the "commies" are coming for 'em? I wouldn't waste my time, personally.
It's simple economics. There are too many angles of profiteering based on your health, and when everyone's making a killing in our triangulated system of health care profits, it ain't about the "sick, the elderly, my son with Down's syndrome," etc., etc., etc. It's about the people who make an awful lot of money right now with the system just like it is, and they will never let it change.
So let the system break, I say, and then let's see what happens. It'll be fun! Might make for some good reality TV, too.
Posted by: Casual Observer on August 12, 2009 07:47 AMAnd very little of the drop has to do with consolidation. There literally are dozens of national companies offering in this country ... but only a few of them are available in this state.
And ANYONE honest would be an improvement over Kreidler.
"All defined by bureaucrats and controlled by government." is a phrase that could easily be applied to the NYSE or NASDAQ or FOREX. Each of these exchanges have inefficiencies and red tape, but I doubt there is a passable argument to be made that eliminating them would be a good thing.
I would appreciate it if your assertion "ALL plans in the exchange can only cost what the government says they can cost;" was backed up with a citation. Because in my reading, that is not at all what I find.
Regarding minimum requirements (or as you say "services the government dictates") for listing on the exchange, again - this sort of regulation is and has been common in our U.S. financial markets for years, and to good effect for all participants.
As I said previously, there are details that need to be worked out, but the concept is a positive innovation that conservatives would do well to get behind and involved with to ensure the first iteration is a big leap forward.
Posted by: MikeBoyScout on August 12, 2009 08:11 AMAs for my insurance plan at work, it is a top drawer plan because those of us in the office know what a difference it makes to have a PPO over a HMO. The out of pocket is higher, but if serious illness should occur, there will be no gatekeeper to decide what specialists can be seen or what medicine to take.
If you want to cut costs in this state, tell your beloved Governor Clueless to reduce the number of mandates (there are over 50) and get rid of the requirement that companies over a certain size must offer an HMO in addition to any other plan. And, no, HMOs aren't cheaper than PPOs when similar plans are compared.
As for Medicare, again get off your duff and do some research. Medicare is just a bare bones plan and the quality of care an individual receives depends on the supplement they have. Supplements vary greatly in cost and so do the services covered. You can start with the Medicare website.
Posted by: Burdabee on August 12, 2009 08:22 AMWhy should my choice in health insurance plans be restricted?
Simple question, and yes, it will definitely be limited as I am a single individual, buying individual insurance. I do not qualify for the business exemptions; right now per HR3200 my choices go from ~60 plans offered by ~10 carriers in this State, to ~3: one being my current plan, the second being Medicaid, the 3rd being the new, as-yet-defined public plan.
So why should my choice in health insurance plans be restricted?
Posted by: Shanghai Dan on August 12, 2009 08:52 AMUm.
You're kidding, right?
How is "mandatory" bad? Because it is mandatory! In a free country, I should not need to say anything more: requiring a free person to do something IS BAD. Especially when that person may be requiring me to be counseled to end my life. That makes it not just bad, but damned evil.
Now, even if it is not mandatory, there huge potential for wrongdoing here. We know, for a fact, that sometimes senile elderly people are convinced to allow themselves to die, because family or friends or -- yes -- even medical professionals think they are a burden. I am not against optional counseling being covered by insurance, but that counseling must have very strict controls to make sure that such extraordinary power over another life is not abused.
Sorry, but I work in health care policy, and it's very complicated
There is nothing at all complicated about MANDATORY counseling being wrong. It's wrong, period. When we had a kid, someone tried to come in and counsel us on having a new baby. They told us they had to. We told them to get bent. And as free people we don't need a reason other than: we are free, and we say no. End of story.
what I thought I knew, before I had been immersed in this for years, amounted to doodley squat, and I had thought I was pretty well informed.
And if you want to actually identify what you think we believe that amounts to "doodley squat," and why, feel free. Otherwise this just looks like a veiled attempt at an appeal to authority fallacy. And I've seen a ton of ignorance and misrepresentations (as I mentioned up top) coming from the left, too.
I do agree that the Dems should be trying to include more of the Republicans' ideas in health care reform, but the Republicans are doing nothing but pandering in this case.
That's dishonest. The Republicans are against this plan, and THEREFORE are trying to kill it. That is a GOOD THING in a democratic system. You call it pandering; I call it trying to kill a terrible bill. Something tells me that if the Republicans were in control and offering a bill YOU hated, and the Democrats rose in opposition to it as the Republicans have, then you'd have no problem with it.
They're just going limp and saying "Drag my dead weight along" rather than actually working with anyone
Good! They want to KILL the plan because it is, to them, a VERY BAD plan. Why should they work with the Democrats on a plan they want to kill? That makes no sense, especially when they have a good chance to kill the bill.
Let's do an exercise here. Say there's a bill that says, "all pet cats shall be killed at the age of one year old if they have no black markings." This bill looks like it might pass. You hate the bill, and rise in opposition to it. Should I condemn you for not "actually working with anyone"?
Granted, there are more dissimilarities than similarities between that, and the health care bill before us. But the point is that I am not going to spend my energy making better a bill that I simply want to kill.
for the most part, and are simply trying to wheedle this into a flashpoint to translate into congressional election wins next year for their party.
When God (or the Democrats) gives you lemons ... you cannot honestly think that the Republicans should not try to take advantage of a bad Democratic bill to improve the number of seats they have, do you?
there is such visceral nonsense and congressional representatives inciting their constituents to believe that somehow, their "freedom" is being taken away
You pretend that's not true. It absolutely is. The problem is that you have no problem with freedom being taken away, as you said up front when you see nothing bad about forcing old people to receive end-of-life counseling. Now, that's not in the bill, but many other things are: our options in individual insurance will be significantly reduced due to the new regulations and introduction of an anti-competitive public option; our ability to do business as insurers will be significantly hampered for the same reasons; our MONEY will be taken from us to make this all work due to the extraordinarily high costs.
Those are obvious ways our freedoms are taken away by this bill; and there's a lot more.
It's simple economics.
Yes, it is: this bill does NOTHING significant to cut costs, so insurance will keep getting more expensive, either directly or indirectly through subsidies paid for by our taxes. If for no other reason, the bill should fail for that reason alone.
It's about the people who make an awful lot of money right now with the system just like it is ...
Straw man fallacy: no one here is in favor of the status quo. But we will not be bullied into accepting a bad plan just because we want change. In fact, Obama himself has often said that it is wrong to give people false choices: that if you don't do one thing, there's only other option. He said there's always other ways. Funny, but he is being a damned hypocrite about that right now, isn't he?
"..and Canada. All three countries have had to ration care and are struggling to deal with the rising costs."
Hmmm. I guess it would surprise you to find out that price is the rationing mechanism in all supply and demand markets? :-D
Of course there is rationing there and there is rationing here - so, not a valid comparison point until you get to what is rationed. sorry bub.
You didn't answer my question as to what your coverage costs, and my guess is you probably have very little idea what you employer pays to purchase and administer the program. And as you brought up Canada... In British Columbia the max a family pays is $180 month. Dollars to doughnuts, your employer pays considerably more than that.
Non fact based assertions of "bare bones" don't advance any argument. The cost of Medicare in 2009 is 1.45% on all earnings.
If the level of Medicare coverage is insufficient for you, there are dozens of Medicare supplemental insurance programs you buy for yourself on the open market. Nothing in HR 3200 or Obama's proposal shall prevent you or me from purchasing supplemental insurance.
OK. Sec. 113(a), "In General- The premium rate charged for an insured qualified health benefits plan may not vary except as follows. ..."
Regarding minimum requirements (or as you say "services the government dictates") for listing on the exchange, again - this sort of regulation is and has been common in our U.S. financial markets for years, and to good effect for all participants.
Except for the participants who wind up paying for services they don't want!
As I said previously, there are details that need to be worked out, but the concept is a positive innovation ...
No, it's not. It is all about government control and LESS choices. It's bad.
"That's the reason people are so frightened and enraged about the proposed measure that would allow Medicare to pay for end-of-life counseling. If the government says it has to control health-care costs and then offers to pay doctors to give advice about hospice care, citizens are not delusional to conclude that the goal is to reduce end-of-life spending. "
Do you liberals get it yet? The government is going to control costs by encouraging old people to just go away. And yes, I understand the words, "Death Panel" do not appear in the text of the bill.
Section 113 does not define cost, but identifies how cost categories may be pooled. Of course, this has an impact on the price of coverage, but I think you would be more upset to find an insurance provider who (without the regulations identified in Section 113) decided to price MA raised developers who blogged in a higher price category. The specific restrictions in Section 113 are: Age, Area, and Family (composition) - which I hope you are not going to argue is unreasonable.
However... I would love to hear what other categories you think should be permitted to have higher premiums for health insurance?
"It is all about government control and LESS choices."
In another post, I would love to hear of the choices you have now in your health insurance and which specifically are being removed in HR 3200.
"So why should my choice in health insurance plans be restricted?"
It is a stupid question Dan, because:
First, your choice is restricted today, and unless you are already are on Medicare, they have always been restricted by law.
Second, your choice is restricted (rationed!!) but the fact that you can't afford to pay health insurers to build any plan of your choice.
I understand that there are no choice restrictions in Somalia. Look forward to reading your blog from there. :-D
It's right there in the Constitution. Once the feds seize it, it's over.
Posted by: Gary on August 12, 2009 09:56 AMLeadership by example, not directive...what a concept
Posted by: Rick D. on August 12, 2009 10:02 AMIn WA state, I know a big issue, at least on the right, is the controls put in place by the Insurance Commissioner, which is currently Mike Kreidler. Therefore, to argue Dan's point, there could be more competition with a change in Insurance Commissioners. Now whether someone who would relax the current restrictions could get elected in this state is a separate question. My point is with the current private market it is regulated and controlled by the state, and this fact could be changed. With National regulation, however, it would be a lot harder to open up flexibility to allow more "players."
I think for you to debate the issue, you would need to counter the argument that the reduction of private insurance providers is not due to regulations put in place by the Legislature and/or Insurance Commissioner.
Posted by: tc on August 12, 2009 10:06 AMNo. It explicitly states that the premium rate within each category will be defined by government. What part of "may not vary" do you not get? Yes, there are some explicit ways in which they may vary, but even in those they are controlled within certain limits (such as requiring that the highest rate cannot be more than twice the lowest, in age categories).
Please do not tell me the prices are not controlled, because that is exactly what this does. It does not DEFINE what the prices will be ... that is TBD. But it gives the government control over those prices.
You might think that's a good thing, but don't tell me it's not what the bill does.
In another post, I would love to hear of the choices you have now in your health insurance and which specifically are being removed in HR 3200.
Dude, we DO NOT KNOW because it is NOT IN THE BILL. It is left TBD by the government bureaucrats. It is CONTROL. And worse, you continue to fall prey to the fallacy that forced restrictions by govt are equal to restrictions by private companies. That's similar to saying that it is OK for govt to ban Alphabet, Jensen, and Amused from speaking just because I do it on my posts.
Posted by: pudge on August 12, 2009 10:27 AMI'm a liberal, socialist, communist, ... business person who is getting killed by the current system.
Posted by: MikeBoyScout on August 12, 2009 10:30 AMAlso your assertion that a family in BC only pays a max of $180 is only looking at part of the program, not at what other tax revenues are used to prop up a broken system. A system that spend 10-11% GDP on health care cannot do so only on the "$180 max" for a family.
And, yes, I do know exactly what it costs for my health insurance. I have also had to pay for insurance out of my own pocket.
As for what is rationed, these countries do it through a "wait and see" approach and scaling back other services. On the east coast there is a booming business for some US hospitals to handle high risk infants from Eastern Canada because of the lack of facilities and specialists. Another tactic is to use only low cost medications, so if coumadin doesn't work for you, tough beans.
Regarding rationing here, I would like you to list some examples that a)don't involve someone who doesn't want to pay or b)don't involve a managed health plan.
And since you are a kind hearted soul who thinks everyone should be covered (even those who deliberately chose not to be), then may I suggest you and your like minded friends contact Children's Hospital or Harborview and make a generous donation to their uncompensated care funds. Or better yet, volunteer at Harborview. They can use the help.
Posted by: Burdabee on August 12, 2009 10:40 AMHowever this is someone that is creating policy for Obambam. Who you assoiciate with does matter!
Dr. Ezekial Emanuel is a key health care advisor to President Obama and the brother of White House Chief of Staff Rahm Emanuel. Earlier this year, Dr. Emanuel wrote an article that advocated what he called "the complete lives system" as a method for rationing health care. You can read it here.
The system advocated by Dr. Emanuel would allocate health care based on the government's perception of the societal worth of the patients. Accordingly, the very young and the very old would receive less care since the former have received less societal investment and the latter have less left to contribute.
"Forstall[ing] the Concern that Disproportionate Amounts of Resources
Will be Directed to Young People with Poor Prognosis"
"The Complete Lives System" would also consider the prognosis of the individual.
Quoting Dr. Emanuel: "A young person with a poor prognosis has had few life-years but lacks the potential to live a complete life. Considering prognosis forestalls the concern that disproportionately large amounts of resources will be directed to young people with poor prognosis."
When fully implemented, Dr. Emanuel's system, in his words, "produces a priority curve on which individuals aged between roughly 15 and 40 years get the most substantial chance, whereas the youngest and oldest people get chances that are attenuated."
"Chances that are attenuated" is a nice way of saying the young and the old are considered less worthy of health care and, under this system, will get less.
This sounds awesome doesn't it. Way to go Obambam...another fishy statement. I wonder if you mail server is being overloaded by folks telling him his own statements are fishy. Waaahahahaha!
Dingell:
"there will be no payment of taxpayer funds for abortion,"
Lofgren:
"Abortion will be covered as a benefit by one or more of the healthcare plans available to Americans, and I think it should be,"
Do they *both* know what the bill will do?
Posted by: Gary on August 12, 2009 12:42 PM"Global warming creates volatility. I feel it when I'm flying. The storms are more volatile. We are paying the price in more hurricanes and tornadoes."
-
You want to hand your health care over to this person?
Folks, please. Congress is an embarrassment.
Posted by: Gary on August 12, 2009 02:32 PMI do want to clarify my point about potentially mandatory counseling on end-of-life care options; what I'm saying is there is no mandate for you to *choose* any of those options. That's an important distinction.
End-of-life care, and long-term care in general, are largely misunderstood. That's part of the "doodley squat" knowledge I referred to that people tend to have (or not have), because most folks only think to learn about it when the need has already snuck up and bit them. Ask people that have had to go through it and they'll confirm this, or ask 40 or 50-somethings who've found themselves with mom or dad all of a sudden unable to care for themselves on their own.
If there were any "mandatory" decision you had to choose, like foregoing curative treatment and accepting palliative care against your will, that's outright wrong and, I wholeheartedly agree, straight up evil. Mandatory counseling (and, I should point out, HR 3200 only creates an *option* for receiving counseling, which already has existed in Medicare as a payable benefit to a hospice physician for certain patients since 2004) would just try to make sure people are informed of what their choices are.
Let me give you a similar example. If you want to pay for long-term care, one way to do that is to get what's called a "reverse mortgage." This is a fairly complex concept and structure for a mortgage and is, by almost anyone you speak to about it, just not understood. I've researched them myself and there's plenty I don't even understand about them. Anyway, before you get a reverse mortgage, it is mandatory that you receive certain counseling about what you're going to do. Seniors are signed up for some loans and other financial "products" that prey on them, which I'm sure you know.
Beyond that, there are sure a lot of mandatory things put upon you in this "free" country...like in most states, should you wish to drive a car, it's mandatory that you have certain minimum insurance in good standing or you'll be fined and penalized. We could go on about mandatory stuff that you must do and I'm sure you don't like, in many cases.
To sum up: if we force you to make any certain particular decision in the case of long-term or end-of-life care (or many other instances that are clearly your own personal, private perogative), I would join you and call that evil. If we're just making it possible for you to get all the info if you like, or even in some cases if we make you get all the information, I don't think that's harmful at all.
There's a lot of misunderstanding out there concerning things like hospice and "aggressive" exhaustive ICU end-of-life treatment, and everything in between. Spend some time with some hospice nurses or volunteers or, better yet, patients, and see what they have to say. Start by looking up Art Buchwald, maybe...great guy.
Posted by: Casual Observer on August 12, 2009 02:38 PM
But I was not talking about that. You said mandatory counseling, and that is what I spoke to. If you had said there was a mandate to choose an option, I would have spoken to that.
End-of-life care, and long-term care in general, are largely misunderstood.
But what is NOT misunderstood is that mandating counseling is anti-liberty and unconstitutional.
You have no right to force me to accept any counseling of any kind, unless you've gone through due process to strip me of my rights.
Mandatory counseling ... would just try to make sure people are informed of what their choices are.
And you have NO RIGHT to force me into counseling. Not in a free country. Not where I have due process rights.
You apparently think it is no big deal. Fine, you can opt into counseling. And maybe someday I'll choose to. But it will be MY CHOICE. (And yes, in the bill, it is not mandatory.)
... before you get a reverse mortgage, it is mandatory that you receive certain counseling about what you're going to do.
First, that's stupid. I don't care how complicated it is: it's stupid to require it of anyone. Second, this is not a similar example at all. I choose whether or not to enter into a contract such as a reverse mortgage. I do not choose whether to get old. You can say, as part of a legal agreement, that certain mandates are part of the agreement. You CANNOT say, that as part of AGING, that I must accept counseling.
should you wish to drive a car, it's mandatory that you have certain minimum insurance...
I could choose to not drive.
We could go on about mandatory stuff that you must do and I'm sure you don't like, in many cases.
No, you couldn't, because with the exception of Massachusetts' mandatory health insurance -- a tax on being alive, essentially -- you will be extremely hard-pressed to find mandates for simply existing.
There are a few more, such as mandatory schooling, which is extraordinarily evil. In this state we even require people who opt out of the system to be overseen by the government. Evil. Of course, there's also selective service and the draft. Also evil.
Note that in none of these cases am I against the thing being mandated, I am against THAT it is mandated. I support and went to public school and fully support having an educated populace, I support military service and have many relatives and friends who served, I think health insurance is a good thing, and I have no problem with counseling.
But forcing a free people to do any of these things contradicts the principles our country was founded on. Government mandates for being alive are wrong and evil.
If we're just making it possible for you to get all the info if you like, or even in some cases if we make you get all the information, I don't think that's harmful at all.
You're not. In the scenario we are discussing, you are FORCING me to receive that information from you. That is not "making it possible," it is "requiring."
I ignored most of what you said about how good counseling is because it has nothing to do with the point I am making, which is about mandating it. It could be the best thing in the world and it is still wrong to mandate it.
Mike @ 36: you didn't answer the question. Why should choice be restricted? Saying that it is today is irrelevant; I want to know why choice should be restricted. What's the reason?
And to all HR 3200 supporters: Medicaid is up 25% this year (over last); what parts of HR 3200 will actually REDUCE Medicaid costs? We're going to add tens of millions more people to Medicaid; we cannot just slow the growth, it must be reversed or it WILL blow out the budget.
So how to we SHRINK dollars spent on Medicaid? An annual 25% increase in costs is simply unsustainable for even 5 years, let alone 10...
Posted by: Shanghai Dan on August 12, 2009 10:21 PMI have never heard of such as thing as a doctor refusing to answer a question.
Posted by: pbj on August 13, 2009 09:26 AMI have not said that I was a single-payer supporter, because, frankly, we historically have had a employer-based system in this country, with private insurers, and for us to transition to a system like that, I believe, would be too disruptive.
He must have "misremembered" then.
http://www.youtube.com/watch?v=fpAyan1fXCE&eurl=http%3A%2F%
It is foolish to believe that his plan is not an indirect way of driving the country to single payer by default.
Posted by: Palouse on August 13, 2009 09:41 AMLiberals are so gullible.
Posted by: Gary on August 13, 2009 09:42 AMhttp://www.huffingtonpost.com/2009/08/13/internal-memo-confirms-bi_n_258285.html
I love this part at the end:
"Opponents of the deal with PhRMA hope that Obama is playing a multilayered game, making a deal in order to keep the drug makers in his camp for now, but planning to double-cross them in the end if he needs to in order to pass his signature initiative."
These people actually expect their President to be a double-crosser.
His "signature initiative"? He hasn't even crafted a bill.
Thanks for reminding me what the biggest difference between the political left and the political right are: The left expects their elected officials to lie, steal and cheat. The right expects ours to simply be honest and straightforward.
What shocks me is that the left is now willing to fully admit it in print and in public. They are feeling so powerful now that these types of transgressions are now considered completely normal. Who's to disagree? And if they do . . .
Posted by: G Jiggy on August 13, 2009 02:15 PMThis is in addition to the American College of Surgeons also objecting to his assertions.
Who is advising this man? Will he snitch on himself?
Doctors don't know what the cost is; clearly they are unqualified to speak on the subject. Listen to the Obamassiah, he will lead you towards the promised land!
HOPE AND CHANGE!
Posted by: Shanghai Dan on August 13, 2009 07:30 PMThese people we're dealing with are *incredibly* dishonest. They are, by their own wall posters, Marxists.
I eagerly await the defense of this by the liberals here.
"In a free society, if people absolutely insist on not being covered, that's ultimately going to be their choice."
Uh... wrong. Read the damn bill, Senator! (is it really asking too much?)
I eagerly await the defense of this by the liberals here.
by your logic, the poster of your idol jane fonda in your office makes you... a woman?
Posted by: mike on August 14, 2009 12:47 PMAnd how does this apply to people in this country illegally? I've asked many times. Does anybody know? Do you?
Will people in this country illegally *not* have to buy insurance, and yet still get medical care?
Why should choice be restricted?
Posted by: Shanghai Dan on August 14, 2009 02:44 PMIf person #1 would rather have $500 than consume a scarce resource, while person #2 would rather have the scarce resource than $1,000, is there any reason why the allocation of the resource should favor person #1? Person #2 could give person #1 $750 for the privilege of consuming the resource, thus leaving both himself and person #1 at least $250 better off than they would be if person #1 had consumed it.
The effect of socialized medicine (or socialized anything, for that matter) is to cause resources to be allocated to some people who value them less and denied to some people who value them more. The effect of this will be to make fewer resources available to people who would value them more.
Posted by: supercat on August 14, 2009 04:16 PM
THE PRESIDENT: I don't have to explain to you that nearly 46 million Americans don't have health insurance coverage today. In the wealthiest nation on Earth, 46 million of our fellow citizens have no coverage. They are just vulnerable. If something happens, they go bankrupt, or they don't get the care they need.
But of those 45.7 million people:
* 6.4 million are enrolled in Medicaid or S-CHIP and just gave the Census taker the wrong answer. I'm serious. This is called the Medicaid undercount.
* Another 4.3 million are eligible for Medicaid or S-CHIP and have not enrolled. If they need care, the hospital or clinic generally enrolls them. They are protected against risk even though they don't show up on the rolls as insured.
* Another 9.3 million are non-citizens. Different people come to different conclusions about what portion of this group should receive taxpayer-subsidized health insurance.
* Another 10.1 million have income more than three times the poverty line.
* Leaving about 15.6 million remaining uninsured, of whom about 5 million are childless adults.
The 46 million figure is technically correct, but it dramatically overstates the size of the population that many Americans would conclude is deserving of additional taxpayer subsidies.
We know this, right? So why doesn't the President?
Or is he... do I dare say it... is he, maybe, ly... I can't say it.
Posted by: Gary on August 14, 2009 09:46 PM