Clinton unveils new health care plan

allnurses Guide · Sep 22, 2007

"For the first time, the word "no" would come into our system. Do you need open heart surgery? Are you a poor risk because of smoking or diabetes or age? No longer would the bureaucrat at the other end of the phone say "we won't pay for it" or "you don't need it" or "we can't fit you in at our facility." The answer would simply be no-even if you pay for it yourself, you may not have one. It is this type of coercion that drives Canadians over the border to the U.S. in search of medical options denied them at home under their socialized medical structure. Now it would operate on both sides of the border.. . ."

http://www.dickmorris.com/blog/

allnurses Guide · Sep 22, 2007

I did not mean to confuse anyone. I do not have brain cancer, but was using that as an illustration. The bottom line is that we need to remove for-profit corporations from the healthcare system. While the Clinton plan does not go straight to single-payer, it is an acceptable step in that direction for me.

I'm glad you don't have a brain tumor.

steph

allnurses Guide · Sep 22, 2007

and that is the reason she is against the big lobbyist for pharmeceuticals and insurance? not to mention her desire to rid medicare part d of the donut hole affect. did you happen to watch the presidential race debate that was on this past week? she identifies her weak points in the early ninties and goes on to give persistant, more defined thoughts on how to "pay "for this new healthcare system. she starts with the huge tax break the wealthiest are receiving, to budgeting the federal balance (again for all those who think she ran the country in the clinton years), to pointing out how solid ss was until 2045 until bush got his hands on that money to help subsidize current events. again, she is focused on domestic problems for the commonwealth of this nation. people can change their thinking and learn why. what appears to "hilary's" failure on her past healthcare package had direct interaction with the congress at the time. just my opinion. he article you sited was published before the debate date, so i have little value in the writer's piece.

i watched it - it was painful, especially john edwards. is he for real? it was like fingernails on a chalkboard to listen to his superficial answers.

as to hillary - i think she is wrong.

clinton's plan would force insurers to offer coverage at the same rates to everyone: smokers would pay no more than non-smokers; drug addicts and alcoholics would receive the same rates as the abstemious; obese people would pay the same as the physically fit -- even though all of these behaviors affect health and can be avoided. the consequence would be higher rates for those who choose to behave responsibly.

moreover, to pay for the estimated $110 billion cost of the new hillary care, clinton would raise taxes. first, she'd wipe out most of the bush tax cuts, and then she'd tax employer-provided health care plans themselves for those she deems "rich."

http://www.townhall.com/columnists/lindachavez/2007/09/21/hillarys_plan_wont_make_us_healthier

"senator clinton would require every american to purchase health insurance or face penalties."

rigmedic · Sep 22, 2007

There are certainly some entrenched special interests with DEEP pockets that will do their best to torpedo this thing. I will be very surprised if she can get it done in the first term, assuming she wins. If any of the Republicans win we can keep enriching Blue Cross and Blue Shield for another 4 years.

It will boil down to whether or not people are really fond of the for-profit insurance industry. After years and years of "preexisting conditions", "out of network providers", and repeated denials of care I think the insurance industry has cut its own throat.

The interesting thing is that all the Democrats are now for some form of nationalized healthcare. The Republicans are being forced to discuss healthcare and offer something other than just a tax cut, which is their universal cure-all. This tells me that the issue is resonating with the public and that we are moving toward reform. I still think it will take several years, though.

sharona97, BSN, RN · Sep 22, 2007

i watched it - it was painful, especially john edwards. is he for real? it was like fingernails on a chalkboard to listen to his superficial answers.
as to hillary - i think she is wrong.
clinton's plan would force insurers to offer coverage at the same rates to everyone: smokers would pay no more than non-smokers; drug addicts and alcoholics would receive the same rates as the abstemious; obese people would pay the same as the physically fit -- even though all of these behaviors affect health and can be avoided. the consequence would be higher rates for those who choose to behave responsibly.
moreover, to pay for the estimated $110 billion cost of the new hillary care, clinton would raise taxes. first, she'd wipe out most of the bush tax cuts, and then she'd tax employer-provided health care plans themselves for those she deems "rich."

http://www.townhall.com/columnists/lindachavez/2007/09/21/hillarys_plan_wont_make_us_healthier

"senator clinton would require every american to purchase health insurance or face penalties."

thanks for the articles, again their is a huge deficit not caused ny the clintons, no matter how much money she has spent. she has something to show for it and it's compassion. there is no doubt, the healthcare issue (debate) could go on forever. i think of our soldiers and the conditions they have been sent home too, and i think of "the wealthiest" not always being of a business, but as individuals who should be responsible as well. i.e. smokers, different tax laws for them. and as far as immigration goes, i believe our current president took that issue by the horns. after all, all his kronies to help "fix" katrina were substancially hispanic. there is nothing wrong with the culture, but just like many posts on this site, would'nt you aspire to improve yourself? 1993 was 1993. it's 2007 with a president on his last term. with that said, i hope to see change. i agree with you on edwards comments. "he's used to winning not only for political aspirations in my opinion. and the govenor of new mexico? was he chewing food while speaking? very hard to understand. i'm not lookink down my nose at anyone, i feel good about a change a comin, who that will be , don't know. but do realize that the issues here at home need to be addressed as well as over seas.

peace!

sharona97, BSN, RN · Sep 22, 2007

There are certainly some entrenched special interests with DEEP pockets that will do their best to torpedo this thing. I will be very surprised if she can get it done in the first term, assuming she wins. If any of the Republicans win we can keep enriching Blue Cross and Blue Shield for another 4 years.
It will boil down to whether or not people are really fond of the for-profit insurance industry. After years and years of "preexisting conditions", "out of network providers", and repeated denials of care I think the insurance industry has cut its own throat.
The interesting thing is that all the Democrats are now for some form of nationalized healthcare. The Republicans are being forced to discuss healthcare and offer something other than just a tax cut, which is their universal cure-all. This tells me that the issue is resonating with the public and that we are moving toward reform. I still think it will take several years, though.

I agree with the exception of "all democrats" wanting a nationalized healthcare. I'm not so sure we've even begun to see their points of view.

rigmedic · Sep 22, 2007

don't ya just love it when they put profits ahead of people?????

by charles duhigg

published: september 23, 2007

habana health care center, a 150-bed nursing home in tampa, fla., was struggling when a group of large private investment firms purchased it and 48 other nursing homes in 2002.

skip to next paragraph

alice garcia, with her granddaughter jacqualynn hewitt in 1995. mrs. garcia, who had alzheimer's disease, died in 2003 after a bedsore became infected at habana health care center in tampa, fla.

golden opportunities

a lucrative maze articles in this series are examining how businesses and investors seek to profit from the soaring number of older americans, in ways helpful and harmful.

previous articles in the series »

multimedia

interactive graphic layers of ownership

enlarge this image

ozier muhammad/the new york times

confronting a nursing home

"i feel so guilty," said vivian hewitt, who is suing habana over her mother's death. "but there was no way for me to find out how bad that place really was."

the facility's managers quickly cut costs. within months, the number of clinical registered nurses at the home was half what it had been a year earlier, records collected by the centers for medicare and medicaid services indicate. budgets for nursing supplies, resident activities and other services also fell, according to florida's agency for health care administration.

the investors and operators were soon earning millions of dollars a year from their 49 homes.

residents fared less well. over three years, 15 at habana died from what their families contend was negligent care in lawsuits filed in state court. regulators repeatedly warned the home that staff levels were below mandatory minimums. when regulators visited, they found malfunctioning fire doors, unhygienic kitchens and a resident using a leg brace that was broken.

"they've created a hellhole," said vivian hewitt, who sued habana in 2004 when her mother died after a large bedsore became infected by feces.

habana is one of thousands of nursing homes across the nation that large wall street investment companies have bought or agreed to acquire in recent years.

those investors include prominent private equity firms like warburg pincus and the carlyle group, better known for buying companies like dunkin' donuts.

as such investors have acquired nursing homes, they have often reduced costs, increased profits and quickly resold facilities for significant gains.

but by many regulatory benchmarks, residents at those nursing homes are worse off, on average, than they were under previous owners, according to an analysis by the new york times of data collected by government agencies from 2000 to 2006.

the times analysis shows that, as at habana, managers at many other nursing homes acquired by large private investors have cut expenses and staff, sometimes below minimum legal requirements.

regulators say residents at these homes have suffered. at facilities owned by private investment firms, residents on average have fared more poorly than occupants of other homes in common problems like depression, loss of mobility and loss of ability to dress and bathe themselves, according to data collected by the centers for medicare and medicaid services.

the typical nursing home acquired by a large investment company before 2006 scored worse than national rates in 12 of 14 indicators that regulators use to track ailments of long-term residents. those ailments include bedsores and easily preventable infections, as well as the need to be restrained. before they were acquired by private investors, many of those homes scored at or above national averages in similar measurements.

in the past, residents' families often responded to such declines in care by suing, and regulators levied heavy fines against nursing home chains where understaffing led to lapses in care.

but private investment companies have made it very difficult for plaintiffs to succeed in court and for regulators to levy chainwide fines by creating complex corporate structures that obscure who controls their nursing homes.

by contrast, publicly owned nursing home chains are essentially required to disclose who controls their facilities in securities filings and other regulatory documents.

the byzantine structures established at homes owned by private investment firms also make it harder for regulators to know if one company is responsible for multiple centers. and the structures help managers bypass rules that require them to report when they, in effect, pay themselves from programs like medicare and medicaid.

investors in these homes say such structures are common in other businesses and have helped them revive an industry that was on the brink of widespread bankruptcy.

"lawyers were convincing nursing home residents to sue over almost anything," said arnold m. whitman, a principal with the fund that bought habana in 2002, formation properties i.

homes were closing because of ballooning litigation costs, he said. so investors like mr. whitman created corporate structures that insulated them from costly lawsuits, according to his company.

"we should be recognized for supporting this industry when almost everyone else was running away," mr. whitman said in an interview.

some families of residents say those structures unjustly protect investors who profit while care declines.

when mrs. hewitt sued habana over her mother's death, for example, she found that its owners and managers had spread control of habana among 15 companies and five layers of firms.

as a result, mrs. hewitt's lawyer, like many others confronting privately owned homes, has been unable to establish definitively who was responsible for her mother's care.

Geo125 · Sep 23, 2007

All I have to say is see the movie "Sicko"... it'll turn your stomach and make you feel embarrassed that we've got where we are.

Geo

Jolie, BSN · Sep 23, 2007

All I have to say is see the movie "Sicko"... it'll turn your stomach and make you feel embarrassed that we've got where we are.
Geo

Yeah, it makes me embarrassed that we've got Michael Moore here :)

Katnip, RN · Sep 23, 2007

I'm not talking about refusal of medical care. I am talking about the conscious and voluntary decision made by many healthy young people to opt out of health insurance. It's not a choice I would make, but I do believe it ought to be an individual's personal choice how to spend their money.

Then who pays for their healthcare when they have an accident or become ill?

CHATSDALE · Sep 23, 2007

problem with some of these plans if you are going to be universally covered due to some overwhelming taxes why, are some going to pay for insurance

will all doctors/hospitals/nursing homes be required to accept what is offered or can they pick and choose their patients?

what about elective surgery, bariactic, fertility treatments, plastic surgery,

if we have universal coverage will car insurance go down due to the fact that medical tx would be provided elsewhere

we have found in our state that home health is more beneficial to pt than ltc placement.would visiting nurses be covered

HM2VikingRN, RN · Sep 23, 2007

"for the first time, the word "no" would come into our system. do you need open heart surgery? are you a poor risk because of smoking or diabetes or age? no longer would the bureaucrat at the other end of the phone say "we won't pay for it" or "you don't need it" or "we can't fit you in at our facility." the answer would simply be no-even if you pay for it yourself, you may not have one. it is this type of coercion that drives canadians over the border to the u.s. in search of medical options denied them at home under their socialized medical structure. now it would operate on both sides of the border.. . ."
http://www.dickmorris.com/blog/

see:

americans with above-average incomes have more access problems

than patients in canada, the united kingdom, australia, and new zealand

(figure 1) (15).

...

the ncpa report raises the specter of rationing by government-run programs,

then focuses on minorities of the populations in britain, canada, australia, and

new zealand who seek private care outside publicly financed services. these

are mainly patients not wanting to wait for elective or non-urgent care within

the system, who gain access to private care through either private insurance or

out-of-pocket payments. no evidence is presented that waiting times within

the system adversely affect clinical outcomes, and no distinction is made

between "need" and "desire" on the part of patients who bypass waiting lists.

at http://pnhp.org/facts/myths_memes.pdf for a rather thorough debunking of this myth about access problems.

canada has had some access problems related to funding issues but many of these issues have been resolved. us single payer advocates do not argue for a reduction of funding levels but do argue for reallocating excessive administrative costs to patient care.

see:

though admittedly the canadian system is underfunded, and extended waits

for some elective services may be a problem in some parts of the country,

these problems are often exaggerated by its detractors based on unreliable

self-reported data. in 1998, fewer than 1 percent of canadians were on waiting

lists, with fewer than 10 percent of these waiting longer than four months

(19). waiting times in the united states, even for the privately insured, are

now increasing for checkups as well as for sick visits (20).

comprehensive and reliable provincial databases on waiting times show that

in recent years, waiting times have decreased while services have increased.

for example, coronary bypass surgery increased by 66 percent between

1991 and 1997 in manitoba, while waiting times were reduced for that

procedure and also shortened for five other elective procedures--carotid

endarterectomy, cholecystectomy, hernia repair, tonsillectomy, and transurethral

resection of the prostate (21).

* although there is a widespread myth that many canadians seek medical

care in the united states, a three-state study reported in 2002 found that

this number is very low for either outpatient or hospital care, and largely

due to these canadians needing medical care while traveling in the united

states (22).

at http://pnhp.org/facts/myths_memes.pdf .

there is a huge difference between "need" and "want." frankly i think the whiners about having to wait for elective procedures have a huge case of brattism going on.