The 663 Million Dollar Question - page 2

Yet another argument for universal access and/or a single payer plan. Gov. Tim Pawlenty asked an interesting question recently: "How much would it cost to provide health insurance to every... Read More

  1. by   HM2VikingRN
    [quote=zashagalka]this cost only takes into account the cost of insuring those currently uninsured. and then, the law of unintended consequences occurs and significant percentages of both employers and employees stop spending their money on healthcare because the gov't will pick up the tab . . .

    inside of 3 yrs, your 700mn program will be a 5bn dollar program.

    and then the state's budget will totally unravel. they'll make up the costs by raising taxes, forcing business into bankruptcy or simply leaving.

    comment: both dishonest and inflammatory. if you take the time to follow the posted link to the full article there was a reference to how the state of maine was working towards allowing small employers to purchase coverage for employees through dingo care.

    the problem with runaway entitlement programs is that the bill will eventually be paid. when medicare collapses, it will be paid in the loss/curtailment of healthcare. when social security collapses, it will be paid by returns far more diminished then they already are. look at europe: everybody has great benefits, secure jobs, generous leaves and pensions. that is, if they're not one of the 20% unemployed as a result of paying for those programs. and the immigrant problems france and britain are having? the results of massive immigration programs to prop up their collapsing social system.

    comment: social security is off topic and off thread. i think that you are playing pretty fast and loose with your numbers re: britain and france. i refuse to take the thread off topic as the really important issues are related to making sure that everyone in society has access to affordable health care.

    what you are proposing is a pyramid scheme. it works great if you're one of the first into the system. not so great if you're the one holding the bag. . .rather then social systems based on 'get rich quick' schemes where effort is unrelated to benefit, our programs should be honest: if you work hard, you can get ahead. fortunately, this is the rule in america. but, only if you work hard.

    comment: the post was not an endorsement of a pyramid scheme. lets keep the focus of discussion where it belongs which is how to best care for our patients. i could go all day with documented resources showing how conservative government and social policy is harmful to the social contract but i am encouraging everyone to keep the discussion on topic and to make thoughtful respectful posts which are solution oriented.
  2. by   HM2VikingRN
    Quote from ZASHAGALKA
    That overhead they are talking about is YOUR salary. Once the gov't gets a monopoly on healthcare, there will be a nationwide 'collusion' to control nursing costs by setting the same standard everywhere.

    That's why teachers don't get paid squat: the gov't has a virtual monopoly on their salaries.

    No thanks.

    ~faith,
    Timothy.
    No, the overhead comes when a clinic or hospital needs to have multiple billing specialists who are defacto employees of the insurance companies who each have to know separate policies and coverage levels for insureds. This is a fear based communication which does nothing to advance the solution.
  3. by   pickledpepperRN
    Quote from HM2Viking
    No, the overhead comes when a clinic or hospital needs to have multiple billing specialists who are defacto employees of the insurance companies who each have to know separate policies and coverage levels for insureds. This is a fear based communication which does nothing to advance the solution.
    Yes those billing professionals are smart. Best they do useful productive work.
    And perhaps some of the insurance company employees will become caregivers.

    First we need to decide that everyone in the state deserves healthcare.
    Then figure out the best way to achieve what is morally right.
  4. by   HM2VikingRN
    Quote from spacenurse
    Yes those billing professionals are smart. Best they do useful productive work.
    And perhaps some of the insurance company employees will become caregivers.

    First we need to decide that everyone in the state deserves healthcare.
    Then figure out the best way to achieve what is morally right.
    Very well put!
  5. by   HM2VikingRN
    Quote from mjlrn97
    I maintain that the ONLY way to provide near-universal access to health care is to get the insurance industry and the federal government out of it. Get rid of this patchwork mess we call a "system"---it isn't a system, it's a nightmare, and we're paying more and more money for fewer and fewer services all the time.

    I say leave it up to the states to decide how to craft programs; they know best what the needs are in their individual areas. Get rid of Medicare/Medicaid and put that money back into the pot along with the money that individuals and businesses would otherwise be paying to health insurance companies so their CEOs can enjoy the good life. Appoint a panel of medical people (including nurses!), financial experts, and ordinary citizens to administer the program and decide what services will be covered and which won't. Offer a basic plan to all that provides preventive care, mental health services and all necessary medications and treatments; as always, those who can afford cosmetic surgeries and other 'extras' can buy them if they so choose. Now, how tough is that??
    This almost sounds like the Canadian Provincial Health Care system(s).
  6. by   HM2VikingRN
    From the Commonwealth Fund:

    While the costs of expanding coverage are significant, so are the costs of leaving so many people without health insurance. The Institute of Medicine estimates that lack of health insurance leads to 18,000 excess deaths each year. And a recent Fund study shows that health problems among working-age Americans and their families cost an estimated $260 billion in lost productivity each year.
  7. by   azhiker96
    Quote from HM2Viking
    Social Security is off topic and off thread. The central issue of the original article was:
    1. How much would it cost to achieve universal coverage/access for the uninsured in MN?
    2. The number of uninsured patients in MN is approximately 5-7%.
    Oops, sorry for getting off topic and off thread. I'll get back on topic then. Um, apparently the people in MN who know their system and have studied this say it's $663M. I don't have any special insight into their healthcare system so I guess the answer is $663M. There you have it! :spin:
  8. by   ZASHAGALKA
    Quote from HM2Viking
    Comment: Both dishonest and inflammatory. If you take the time to follow the posted link to the full article there was a reference to how the state of Maine was working towards allowing small employers to purchase coverage for employees through Dingo Care.
    I think it neither dishonest nor inflammatory. Just because I disagree that the program CAN be contained in the way it's envisioned doesn't mean that I'm being 'inflammatory'.

    And, runaway entitlement programs DO have a history of being, runaway. I wasn't going off subject by mentioning medicare and SS. They are ON POINT examples of how such programs become budget monsters.

    The Fed gov't can shift and shunt more to hide the true costs of their handouts. A smaller sized state: once they begin to play the Federal game of all benefits, all the time, it WILL, very rapidly, crash their budgets. This is especially true since most States (and prob this one too, but I didn't check specifically) require their budgets to be balanced.

    They simply can't borrow the 6 BILLION dollars this program will costs. The result: raise taxes, cut spending in other key State sponsored areas, like public schools, etc.

    If you don't want to examine the pitfalls of unlimited entitlements, then don't bring them up. But don't accuse me of being 'inaccurate and inflammatory' because I point out valid and known drawbacks to such programs.

    I think that you are playing pretty fast and loose with your numbers re: Britain and France. I refuse to take the thread off topic as the really important issues are related to making sure that everyone in society has access to affordable health care.
    It's not off thread; it's on point. Comparing the damage done to other nations by unfunded liabilities is certainly on point - if we are proposing yet more unfunded liabilities here. In the last 3 yrs, the U.S. has had more job growth than all the other G7 nations, combined!

    Ok, I reread a few articles, the overall unemployment rate in W. Europe is about 9%, but the unemployment rates for young and unskilled workers, the same type of workers we are referring to in the provision of universal coverages, IS approx 20%. This was the root cause of the riots in France last year. 20 -somethings with no jobs. My point remains valid.

    And the squeeze on the State budget created by this type of program will translate into a squeeze on businesses which translates into them not hiring as many young and unskilled workers.

    So, this group might now have some form of universal coverage (that will itself be subject to massive paring to meet budget goals), but now they don't have a job.

    This is simply how macro-economics work. There's no such thing as a free lunch.

    Comment: The post was not an endorsement of a pyramid scheme. Lets keep the focus of discussion where it belongs which is how to best care for our patients. I could go all day with documented resources showing how conservative government and social policy is harmful to the social contract but I am encouraging everyone to keep the discussion on topic and to make thoughtful respectful posts which are solution oriented.
    I disagree, making promises without regard to how they are eventually paid IS consistent with pyramids scheme policy. 1. Unfunded liabilities, and 2. Underestimating the ultimate costs of those schemes by orders of magnitude, IS an endorsement of pyramid scheme policies. It's bait and switch. You are selling a program by misrepresenting the cost/benefit ratios by billions of dollars.

    You claim that, if adopted, such a program will ultimately save money. In fact, that is not likely the case. I find it skeptical when anybody promises something for nothing. In this case, it's even worse: the promise is something and savings for nothing. This program promises more healthcare for less money. Simply put, once the 'more healthcare' comes online, the fact that it costs billions will be of little concern for those advocating the program. As such, it is tantamount to 'bait and switch'.

    It's simply not inflammatory to point that out. You can rail about 'administrative costs' all you like. In fact, the rise in health costs is because new technology is causing healthcare to rise at mulitiples of the inflation rate. EVEN IF YOU GOT A 30% TOTAL REDUCTION IN HEALTHCARE COST (and I doubt this is possible), the costs related to technological advances would catch up and surpass the current costs, factored against inflation, within a decade. And that will translate into an unfunded liability far greater than 663 million.

    All I'm pointing out is that a little reality is in order. The thread is mistitled. This is not a '663 million dollar question'. It's a 6 BILLION dollar question. And that's being, if you'll excuse the pun, conservative.

    ~faith,
    Timothy.
    Last edit by ZASHAGALKA on Aug 20, '06
  9. by   StNeotser
    Would the above poster like to explain to me why the economies of France, Canada, Australia et al are NOT collapsing?

    Why after fifty years or so of universal healthcare have their economies not collapsed?
  10. by   ZASHAGALKA
    Quote from StNeotser
    Would the above poster like to explain to me why the economies of France, Canada, Australia et al are NOT collapsing?

    Why after fifty years or so of universal healthcare have their economies not collapsed?
    At the moment, because they are being propped up with massive immigration. And that creates a whole other range of problems. Not immigration itself, but immigration at a rate that surpasses the ability to integrate and assimilate that immigration. This is why French immigrants riot due to lack of jobs and British immigrants plan to blow up airplanes. The RATE of immigration is itself leading to disenfrachisement.

    But their economies ARE bearing the strains of such unfunded liabilities. From an economic perspective, the U.S. is far better positioned to manage our economy in the next 50 yrs, EVEN WITH THE TWIN PROBLEMS OF MEDICARE AND SS looming, then Europe because their economies have far worse unfunded liabilities looming.

    It's a matter of degrees. Instead of following them down this path, we should be reigning in this path. We should be moving towards LESS unfunded liabilities, not more.

    There is no such thing as a free lunch.

    ~faith,
    Timothy.
    Last edit by ZASHAGALKA on Aug 20, '06
  11. by   HM2VikingRN
    Please explain to me how you arrived at a figure of 6 BN dollars from 663 million. I fully recognize that there is no free lunch but I also think that the real difference between our viewpoints is that it is far too expensive for our society to continue doing nothing to address uninsured patients. The reality of most of the state government sponsored insurance plans (Minnesota Care, Badger Care etc.) is that enrollees do pay premiums on a sliding scale which hardly is an entitlement program. (entitlement almost by definition involves something for nothing.) One of the goals of a Universal Access program is to break the cycle of the "benefits" handcuffs. Jefferson often wrote about the idea of a nation of small farmers and shopkeepers. Our current system of employer provided health benefits gets in the way of this ideal.
    Last edit by HM2VikingRN on Aug 21, '06
  12. by   StNeotser
    Quote from ZASHAGALKA
    There is no such thing as a free lunch.

    ~faith,
    Timothy.
    No there isn't. Consider that my family has been paying healthcare premiums for 7 years in the USA, current cost paid by both family and employer is $7000 per annum. We've had about four school check ups and five well woman check ups for that money.

    Man who just got insured by company a couple of months ago needs a CABG. He's paid all of $800 to be insured for that. Unfair system, no?

    Why do you say that European economies are being propped up by massive immigration? By the way, it was not the Eastern European or Chinese immigrants in Europe rioting or blowing up airplanes. That is another problem altogether, not linked to healthcare.

    I must say, for a country that has no class system the ruling classes have you worker bees well controlled, don't they?
  13. by   wjf00
    Quote from ZASHAGALKA



    It's not off thread; it's on point. Comparing the damage done to other nations by unfunded liabilities is certainly on point - if we are proposing yet more unfunded liabilities here. In the last 3 yrs, the U.S. has had more job growth than all the other G7 nations, combined!

    ~faith,
    Timothy.
    Job growth at Walmart and Mc Donalds hardly address the need for healthcare when GMC, Ford And Boeing are laying off benfited workers.
    Last edit by wjf00 on Aug 20, '06

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