July 29, 2009

Obama Care

Ok, as a man of the people, I have decided to listen to the readership, and create a post on the universal health care debate going on right now. Mainly so those of you interested in voicing an opinion on the matter can converse in the comments section of this post.

My main goal, as I have mentioned in previous posts regarding universal health care, is to lower the actual costs of care by improving price transparency in order to increase competition between health care providers.

What I find fascinating about this whole current debate is that the election of Obama has strangely convinced me how relatively conservative the nation is. I honestly didn't expect there to be that much outcry about this issue. Especially from Democrats on his own side. I mean, this is the best opportunity (with a fillibuster-proof majority in the Senate and unemployment causing the visibility of so many people without coverage) to pass universal coverage in our nation's history. And yet, it's getting held up.

Ok, have at it.


The Great I'm Not said...

I don't even think cost is the issue here. The issue is in claims. This deductible, out of pocket, lifetime maximum, exclusion bull is intentional setup to confuse people so they think they are paying for something that will cover an illness, or cancer, or pregnancy until they get a letter from the hospital saying "your insurance provider has refused payment". Congress needs to step up to the plate and require that all carriers cover people consistently.

The Great I'm Not said...

Tell me your opinion when someone with cancer calls you asking why the insurance company stopped paying for treatment. To which you have to explain that they've reached their lifetime maximum. "Sorry Ms. Jones you'll have to find another way to pay the doctors to keep you alive."

The Great I'm Not said...

Obama's current plan is weak. He needs to aggressively push for a Single Payer system. Most Americans support this.

Eric Olsen said...

so we're clear, what's your overarching belief in what the role of government in our country is?

Anonymous said...

Awesome piece of writing: http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande

Awesome excerpt from awesome piece of writing: Everyone agreed that something fundamental had changed since the days when health-care costs in McAllen were the same as those in El Paso and elsewhere. Yes, they had more technology. “But young doctors don’t think anymore,” the family physician said.

The surgeon gave me an example. General surgeons are often asked to see patients with pain from gallstones. If there aren’t any complications—and there usually aren’t—the pain goes away on its own or with pain medication. With instruction on eating a lower-fat diet, most patients experience no further difficulties. But some have recurrent episodes, and need surgery to remove their gallbladder.

Seeing a patient who has had uncomplicated, first-time gallstone pain requires some judgment. A surgeon has to provide reassurance (people are often scared and want to go straight to surgery), some education about gallstone disease and diet, perhaps a prescription for pain; in a few weeks, the surgeon might follow up. But increasingly, I was told, McAllen surgeons simply operate. The patient wasn’t going to moderate her diet, they tell themselves. The pain was just going to come back. And by operating they happen to make an extra seven hundred dollars.

Obama made this article mandatory reading for his staff. I think one (philosophical, anyway) way he's pushing to cut the cost of care is by encouraging an overhaul for the way physicians practice today. And I think THAT is scaring people, too. They hear "doctors should use more judgment and not rush to procedures and tests" and interpret "doctors won't be trying as hard anymore."

Eric Olsen said...

i can't imagine "trying" is what people are concerned with. perhaps more that the doctor is going to have a new incentive NOT to perform certain treatments.

The Great I'm Not said...

"so we're clear, what's your overarching belief in what the role of government in our country is?"

To protects its people from violence and fraud both foreign and domestic.

Eric Olsen said...

then i'm pretty sure you're overreaching.

The Great I'm Not said...


Bobby Teenager said...

I'm gonna have to agree with the Great one on this. I think you have it backwards a little bit. (Generalzing...bear with me). It does not matter what the provider charges or what their transparency is. I can start a clinic and put up giant billbpoards saying I charge $X for this service and so on. No one is going to come if I dont take their insuarance. So I have to charge what their insurance company allows me to (and I will b/c they have ALL the leverage). Then course the insuarnce company makes its profits on the diff btw premiums and claims. Thats the free market: the insurance company trying to win customers at the individual and business level with the best prices, and at the same time cut costs by denying more and more claims each year.

Right now I could choose not to accept medicare and maybe I'd be alright, maybe not, they tend to pay the least but have a huge population tend to provide the best coverage to the consumer.

You can argue the inefficiencies of government, but if I cant get my surgery paid for, I'd rather it be b/c there truly is no money available, not b/c my insurance company wants to boost their profits a quarter point this year.

"so we're clear, what's your overarching belief in what the role of government in our country is?"

"To protects its people from violence and fraud both foreign and domestic."

"then i'm pretty sure you're overreaching."

I dont think he is overreaching at all. And no offense, but to say so shows a little ignornace on how bad it really is out there for hard working people who think they have coverage and get screwed every single day.

The role of gov is to step in when the free market cannot do the job on its own without hurting or ignoring the people of this country (EPA, FDA, SEC, ATF, Medicare, Medicaid, etc.), and that is exactly what is happening right now.

I have to admit I am usually pretty conservative on most fiscal topics but I think it is gotten so ridiculous that something needs to be done.

Eric Olsen said...

don't play the "if you don't want universal health care, you must hate poor people" game.

simply because i don't believe in the same solution as you does not mean that i do not empathize with or understand the severity of the situation.

i was pointing out what i believed to be an inconsistency in his own belief system. not judging the belief at all.

bob, your example points out the fact that this "private system" we're currently under is really corporate-run and government managed.

RP gives a brief 4:00 summary here. http://www.youtube.com/watch?v=sjuEdJ0DAGc

it's not a broad enough response to address all the things we're talking about here, but it's interesting.

Bobby Teenager said...

I dont really see how I said that. I said that everybody is getting screwed. Someone making $100K a year can have an injury or get an illness, lose their job, lose their insurance, or get claims denied, (you can pick any combination from above), and owe tens or hundreds of thousands in medical bills and be forced into bankruptcy.

I'm still unclear too what your idea is on free market and payer transparency, how specifically would you set it up so that we dont have the same problems that exist today?

Eric Olsen said...

i think i misread both bob and erik's comments. you were both stating that the fraud/deception of the insurance providers needs to be dealt with by the government, right? that's fair.

i think all of these plans being tossed around now are going way beyond that though.

i want insurance to be what it is in every other industry. insurance against a cataclysmic event. separate the insurance/job relation. people pay cash for the rest.

now, we still have the problem about what you do for the diabetic family, or kids w/ cancer treatments that could bankrupt a family.

if so many are willing to pay higher taxes to make sure those people aren't left behind, then we needn't wait until we are coerced to make it happen, right? St. Jude's, etc.

brent said...

we have a society full of people who think paying $60 a month for 36 months is a great deal for a 32" tv and ps3. we're really that dumb--how do you expect us to understand what a deductible is? decisions made by an elite few are our only hope.

Eric Olsen said...

lol brent. Amen to the first part. No-men to the second.

Arcane Rest said...

it comes down to 2 things in my view: do you think that health insurance is a right?

if so, how do we cover everyone without bankrupting the nation?

if not, welcome to america where we are given the freedom to choose to live with or without things.

I hate the fact that the both government and nongovernment health insurance companies are so inefficient that they drive up costs of healthcare. We cannot allow a government to be our health care payer. The reason is 3 fold: 1. what happens when they start not paying for all those things that should be, i.e. hip replacement for 80 y.o., because is isn't worth the money for the productivity gained, 2. what happens if the health insurance really is poor we cant just switch to another plan as a company or individual, but have to GO TO ANOTHER COUNTRY to get 'better' care, 3. who has and what is the incentive for govt paid healthcare (or even Obamacare)? the govt has the incentive to keep costs down by most likely not covering procedures for groups of people (i.e. obese and/or elderly). case in point, British healthcare determined that an individual cannot have surgery for cataract correction (a fairly routine surgery) until the patient was completely blind. OR impacting the amount that healthcare employees can make, just like they did with the CEOs because the health care workers will not be paid by the government.

The intended unintended consequences that will exist from this will be great.

Sure we need to fix something in our system, we need to make insurance simpler but the reason it got so dang messed up is from none other than Government intervention both state and federal.

Arcane Rest said...

my last comment"OR impacting the amount that healthcare employees can make, just like they did with the CEOs because the health care workers will [correction: now] be paid by the government."

The Great I'm Not said...

in response to Arcane's comments. What happens when govt run health care fails to keep us happy and healthy. We stage massive protests and vote administrations out of office until its fixed. I also see no problem with limiting what healthcare workers make, or at least requiring that treatment be fair and consistent across the board. Its not right that you can see 5 different doctors who recommend 5 different treatments for the same ailment just because a few of those doctors want to give you more aggressive treatment to make a few more bucks. I don't see a problem with regulating the health care system more.

The Great I'm Not said...

and arcane rest, you can't tell me that you don't see billing fraud everyday in your field.

Kat said...

Great I'm Not- It sounded to me like arcane rest was recognizing fraud in both government and nongovernment insurance providers.
Do you think that regulating salaries of health care workers would have an effect on the number of individuals seeking a career in healthcare?

Arcane Rest said...

The biggest cases of fraud occur when people are least likely to be caught. These senarios espeically exist for GOVERMENT PROGRAMS, i.e. the debit card for people after Katrina hit. The problems I see/hear about most are those that occur with MediCare for the reason that only about 3% of charts are audited and the typical recourse is only repayment of funds. This could happen over and over because ~97% of the time you are getting paid. So it is not in our best interest to allow the government to handle all healthcare dollars because it will only encourage people to do fraud.

The fraud and cost of fraud cases does indeed drive up costs and people are less likely to perfrom deviant deeds if they are watched closely, work comp and GOOD case managers for example.

All in all, healthcare limits every one's freedom, increases cost, which will decrease the disposable income, and will drive some skillful people out of the medical business because of the "income of a medical professional."

Answers to healthcare:
Transparency of coverage somehow with insurance
SALARY all doctors to limit fee for service
Possible increase Whistleblower reward
and some more things I am sure

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