Six in 10 people surveyed say they would be willing to repeal tax cuts to help pay for a health-care program that insures all Americans.
...
Most of the highest income group polled, those in households earning more than $100,000, support it. While more than eight in 10 Democrats say they like the plan, most Republicans oppose it.
Most of the highest income group polled, those in households earning more than $100,000, support it. While more than eight in 10 Democrats say they like the plan, most Republicans oppose it.
...
An agenda focused on health care and education spending would be better for the economy than returning money to taxpayers through tax cuts, she said: ``In the end it would cut costs.''
By 52 percent to 36 percent, Americans favored health and education spending as a better economic stimulus than tax cuts
I heard some interesting info on Fox News a few days ago,there was discussion regarding the lack of clarity in the Republican stance on health care reform. Those that were present in this discussion agreed that the Medical Savings Account was not feasable and should be benched. There was also agreement that the Republicans MUST come up with some SOLID ideas about healthcare, IF they are to have a chance of winning in 2008.
Fox transcripts lots of stuff on its site. Please cite this. I don't think MSA would work, ALONE, either.
Combine it with unhitching insurance from employment, and making insurance actually insurance instead of pre-paid healthcare - and it would do wonders.
I linked an article a few pages back. Come general election run, you are going to hear Dems saying that the Republican plan is TOO RADICAL A CHANGE, compared to what they are wanting to do. http://www.time.com/time/magazine/ar...682269,00.html
The free market is the true change from 60 yrs of financing failure. The gov't's manipulation and gaming of healthcare is why we have a mess now. I have no faith in its abilities to 'change its ways' if only we give it more reward for its current gluttony and sloth.
MSAs are but one link in the process of reform. It is a potent link, however, because it would RESTORE first payor healthcare: you paying the bills, you minding the store. Competition would do wonders for healthcare - JUST LIKE IT DOES, EVERYPLACE ELSE IT'S TRIED.
I think you write off the free market as an alternative much too quickly. The public wants change, that is true. Don't be too surprise that, when the options are explained to them, they don't rush right out and hand over their freedom to choose healthcare to Uncle Daddy. A change that doesn't involve taxes and DOES involve increased choice will compete quite well against the just fear of gov't bureaucracy. As much as you want to cite any current gov't restricted model, the downfalls in waiting and cut services are there to be pointed out, as well. "Access to a waiting list is NOT access to healthcare." - Canadian Supreme Court. Really?
the pnhp study link is explicitly debunked by don mccanne at pnhp:
although this study is presented under the guise of comparing administrative costs between medicare and the private insurance plans, it is important to note that zycher states that “a term perhaps more useful than ‘administrative’ costs might be ‘non-benefit’ costs.” thus, primarily for the medicare model, he includes much more than administrative costs.
let’s look at how he adjusts the explicit administrative costs of medicare. as an example, look at how he measures the amount of administration of justice in the medicare program. he notes that medicare spending ($356 billion for 2005) is 17.1 percent of federal non-defense spending ($2081 billion). thus, he concludes, because of the costs of investigating medicare fraud, medicare consumes a prorated 17.1 percent of the government costs of the administration of justice. the dollar amount involved in this calculation alone increases the administrative costs of medicare from 3.1 percent to 5.1 percent. considering dr. zycher’s training as an economist, stating that medicare consumes 17.1 percent of the government’s administrative costs for justice is not simply a distortion of the facts; it is a blatant lie.
comment: it was dishonest to post a link out of context from pnhp that appeared critical of medicare while it actually debunked a critical study. pnhp explicitly stated the problems with dr. zycher's work. i had stated that medicare operated at around a 5% administrative cost which was in fact an overstatement of medicare's administrative cost of 3%. i also gave private insurance the benefit of the doubt with the 15-25% administrative cost estimate. i am guessing that the real profit figure for private insurance is probably between 20-25% while administration costs range between 5-11%. the evidence to support efficiency advantages of the private health insurance system is just not there.
here is a link to a reputable researcher who calculated administrative costs honestly. (i strongly suspect that the cafi study was funded by the insurance companies.):
9. private administrative costs are taken from national health expenditure data, available at
www.cms.hhs.gov/nationalhealthex-penddata/downloads/nhe2004.zip. administrative and net costs of private health insurance (including profits) were 14.4% of private insurance payments in 2004. medicare's administrative costs are calculated from tables ii.b1 and iii.b1 of the 2006 medicare trustees report, available at www.cms.hhs.gov/reportstrustfunds/downloads/tr2006.pdf. the estimate includes "administrative expenses" from table ii.b1 ($6.1 billion) and "fraud and abuse control" costs from table iii.b1 ($1.1 billion)—which sum to administrative costs of 2.1% of expenditures ($336.4 billion).
I witnessed this firsthand, while I was working as a Case Manager for a major HMO several years ago. Our CEO netted a cool $32 million in bonuses from a merger with another insurance company...just as my requisition for a new stapler had been denied, and our workforce reduced to the point where it was becoming next to impossible to take care of our Members. I quit after that, no longer willing to be associated with this mindless Corporate greed. :angryfire
Thats the free market, corporate greed reigns supremo
"Fortunately, there is a solution to the predicament (gov't interference in the financing of healthcare). The key is recognizing exactly what is driving spending through the roof. While many conditions have contributed to the spending explosion, one stands out as the fundamental problem with the U.S. health care system today: the consumer, the patient, has been cut out of the decisionmaking loop.
ZASHAGALKA:
I came into nursing to care for PATIENTS ,not consumers .The fallacy of people who advocate consumer awareness , as a way of controlling healtcare costs , Is that most of us do not plan our illnesses . When we get sick we don't always have time to research our options re. the financial aspect of our care . Also I don't see many Healthcare providers (on the net, or elsewhere)advertising the cost of non-elective procedures so how am I able to comparison shop for the procedures I know I am to have .
Even in the case of non elective care , we are all human so there may be a course of treatment prescribed for the condition , but again each body reacts differently to the treatment , therefore the care I receive will be adjusted to that , so how can I predict the costs I am looking at.
There should be a greater emphasis in patient care upon excellence of nursing / procedural care , than upon things administrative staff can quantify eg ,how many pillows you have , or how often your nurse asks what you want ( in preference to attending to a patient in need )
"Fortunately, there is a solution to the predicament (gov't interference in the financing of healthcare). The key is recognizing exactly what is driving spending through the roof. While many conditions have contributed to the spending explosion, one stands out as the fundamental problem with the U.S. health care system today: the consumer, the patient, has been cut out of the decisionmaking loop.
ZASHAGALKA:
I came into nursing to care for PATIENTS ,not consumers .The fallacy of people who advocate consumer awareness , as a way of controlling healtcare costs , Is that most of us do not plan our illnesses . When we get sick we don't always have time to research our options re. the financial aspect of our care . Also I don't see many Healthcare providers (on the net, or elsewhere)advertising the cost of non-elective procedures so how am I able to comparison shop for the procedures I know I am to have .
Even in the case of non elective care , we are all human so there may be a course of treatment prescribed for the condition , but again each body reacts differently to the treatment , therefore the care I receive will be adjusted to that , so how can I predict the costs I am looking at.
There should be a greater emphasis in patient care upon excellence of nursing / procedural care , than upon things administrative staff can quantify eg ,how many pillows you have , or how often your nurse asks what you want ( in preference to attending to a patient in need )
I linked an article a few pages back. Come general election run, you are going to hear Dems saying that the Republican plan is TOO RADICAL A CHANGE, compared to what they are wanting to do. http://www.time.com/time/magazine/ar...682269,00.html
~faith,
Timothy.
Well, this Dem thinks a radical change would be a step in the right direction.
this may not shock anybody, but a new paper from health affairs finds that consumer-driven care -- also known as the republican party's answer to universal health care -- "would probably widen socioeconomic disparities in care and redistribute wealth in 'reverse robin hood' fashion, from the working poor and middle classes to the well-off. racial and ethnic disparities in care would also probably worsen."
the reasons for this are largely issues we've talked through in the past. health savings accounts and their ilk are attractive to the healthy, unattractive to the sick, and thus worsen "risk segmentation" in the market. without healthy individuals subsidizing sick folks, more sick folks will be priced out of care. it's possible that attracting health individuals would actually lead to a net increase in those with something called "coverage." but the losses would be concentrated among those who most need health insurance.
the paper also brings up a finding from the rand health care experiment. cost-sharing didn't affect the health outcomes of most participants. but among the poor, higher cost sharing resulted in "elevated death rates, worse control of hypertension, and other inferior health outcomes."
consumer driven health care is no panacaea. the only way to leverage costs down is through a single large national pool. providers need to get back in the habit of competing for customers. i can cite one local example of anticompetitive behaviors in a health care market that (if allowed to happen) would actually drive up costs.
immanuel st joseph's hospital in mankato mn is controlled by the mayo health system. there are 2 clinics attached to the hospital. isj is owned by mayo, mankato clinic is a clinic owned by local doctors. isj charges mankato clinic more for surgical equipment sterilization than it charges isj clinic. (i have a friend who works in the department so i have the inside information.) because of these and other price gouging behaviors mankato clinic has submitted a proposal to build a second hospital. what is the net result duplication of services such as additional ct machines which will lead to additional (and probably unnecessary) tests. this will drive health care expenditures up rather than down for the local area. these shenanigans can be prevented with a well designed single payer system. mayo should not be able to favor its own clinic through these kinds of anticompetitive behaviors. if it charges x dollars for a service. it should charge the same price to competitors.
insurance reimbursements for state employees at isj are at a level 4 (more expensive). mankato clinic is level 2. (less expensive). because there are large groups of state employees in mankato more employees are mankato clinic patients. because of cost shifting by the mayo system mankato clinic proposed changing to a level 3 clinic. the advantage health plan stopped this price increase. these are concrete examples of how large groups can act to restrain costs and also foster patient choice.
Ezra Klein debunks the Radical Republican argument at:
The Republicans plans don't offer that. But Ramesh knows they need to seem like they do. So he writes, for instance, of Bush's plan will "make it possible, for example, for [people] to keep their policies when they switch jobs." Yes, Bush's plan makes it possible, but not likely. Conversely, the Democrats' plans actually allow you to keep your policy when you switch jobs.
I thought of leaving my response there , but even if CR did a report on healthcare costs , it would be a general report , which would not enable me to a ) know what my individual healthcare provider would charge for a single procedure , or enable me to negotiate with my provider for that single procedure ,as I am sure my provider would point out that the CR report was not relevant to the market I live in .
robin hood didn't steal from the rich and give to the poor. he stold from the rich and gave back to the taxpayers...
from ezra klein:
this may not shock anybody, but a new paper from health affairs finds that consumer-driven care -- also known as the republican party's answer to universal health care -- "would probably widen socioeconomic disparities in care and redistribute wealth in 'reverse robin hood' fashion, from the working poor and middle classes to the well-off. racial and ethnic disparities in care would also probably worsen."
the reasons for this are largely issues we've talked through in the past. health savings accounts and their ilk are attractive to the healthy, unattractive to the sick, and thus worsen "risk segmentation" in the market. without healthy individuals subsidizing sick folks, more sick folks will be priced out of care. it's possible that attracting health individuals would actually lead to a net increase in those with something called "coverage." but the losses would be concentrated among those who most need health insurance.
the paper also brings up a finding from the rand health care experiment. cost-sharing didn't affect the health outcomes of most participants. but among the poor, higher cost sharing resulted in "elevated death rates, worse control of hypertension, and other inferior health outcomes."
consumer driven health care is no panacaea. the only way to leverage costs down is through a single large national pool. providers need to get back in the habit of competing for customers. i can cite one local example of anticompetitive behaviors in a health care market that (if allowed to happen) would actually drive up costs.
immanuel st joseph's hospital in mankato mn is controlled by the mayo health system. there are 2 clinics attached to the hospital. isj is owned by mayo, mankato clinic is a clinic owned by local doctors. isj charges mankato clinic more for surgical equipment sterilization than it charges isj clinic. (i have a friend who works in the department so i have the inside information.) because of these and other price gouging behaviors mankato clinic has submitted a proposal to build a second hospital. what is the net result duplication of services such as additional ct machines which will lead to additional (and probably unnecessary) tests. this will drive health care expenditures up rather than down for the local area. these shenanigans can be prevented with a well designed single payer system. mayo should not be able to favor its own clinic through these kinds of anticompetitive behaviors. if it charges x dollars for a service. it should charge the same price to competitors.
insurance reimbursements for state employees at isj are at a level 4 (more expensive). mankato clinic is level 2. (less expensive). because there are large groups of state employees in mankato more employees are mankato clinic patients. because of cost shifting by the mayo system mankato clinic proposed changing to a level 3 clinic. the advantage health plan stopped this price increase. these are concrete examples of how large groups can act to restrain costs and also foster patient choice.
Thats the free market, corporate greed reigns supremo
NO. Motivated self-interested, under the pressure of competition, is the best situation for all parties involved. Always has been.
Insurance companies are shielded by gov't from having to compete directly for your business - that isn't the free market. (The gov't created the financing scheme that makes it advantageous for employers to provide you insurance while at the same time making it too expensive for you to pay for, yourself.)
The problem here is the gov't.
Or, to steal Roy's quote: "If I had a nickel for everytime the free market was blamed for the acts of government; I'd BE the government."
Big Insurance, Inc., isn't competitive because the gov't protects them. When you remove competition from the free market, you no longer HAVE a free market. What you have is what we have now: a failed gov't financing scheme for healthcare. But do. Let's trust them even more.
After all. How much worse could they screw it up than they already have? Oh, yeah. Right. I forgot. This is the gov't we're talking about.
Have fun with some future Dick Cheney deciding if you should have surgery or rather, if he should fund his war. Choices, choices.
ZASHAGALKA, RN
3,322 Posts
Fox transcripts lots of stuff on its site. Please cite this. I don't think MSA would work, ALONE, either.
Combine it with unhitching insurance from employment, and making insurance actually insurance instead of pre-paid healthcare - and it would do wonders.
I linked an article a few pages back. Come general election run, you are going to hear Dems saying that the Republican plan is TOO RADICAL A CHANGE, compared to what they are wanting to do. http://www.time.com/time/magazine/ar...682269,00.html
The free market is the true change from 60 yrs of financing failure. The gov't's manipulation and gaming of healthcare is why we have a mess now. I have no faith in its abilities to 'change its ways' if only we give it more reward for its current gluttony and sloth.
MSAs are but one link in the process of reform. It is a potent link, however, because it would RESTORE first payor healthcare: you paying the bills, you minding the store. Competition would do wonders for healthcare - JUST LIKE IT DOES, EVERYPLACE ELSE IT'S TRIED.
I think you write off the free market as an alternative much too quickly. The public wants change, that is true. Don't be too surprise that, when the options are explained to them, they don't rush right out and hand over their freedom to choose healthcare to Uncle Daddy. A change that doesn't involve taxes and DOES involve increased choice will compete quite well against the just fear of gov't bureaucracy. As much as you want to cite any current gov't restricted model, the downfalls in waiting and cut services are there to be pointed out, as well. "Access to a waiting list is NOT access to healthcare." - Canadian Supreme Court. Really?
~faith,
Timothy.