The future of Obamacare

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That's it? Our entire system must be remade because of the testimony of one insurance executive? What if another congressman conjures up a witness to testify how wonderful the big insurance companies are? Then what? For every position, you can find one to oppose it. Who is right? Sounds to me like the people are deciding that they prefer the status quo.

I gave you the evidence supporting the need for real reform.....

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Not from where I sit.... I am a non-affiliated independent, so I am listening carefully to both sides of the argument. Problem here is most of the "pro" side of the the slate have not even read the bill or simply choose not to disclose the facts, so I am only hearing from the opposition. It is my understanding that those who choose to remain with their current healthcare option, as I would do, can do so. What a lot of people fear is that it will become a single payer system, and as wonderful as that may sound, it will not fly with the majority of Americans. Rationing of healthcare is a simple economic reality under single payer. I did a paper in grad school on single payer systems - Canada and UK got very low ratings, by their own consumers. France seems to have a good system and it is an open choice system. Enroll in the government system or remain with private system. If I could be assured that I can remain with my current system, I will support the reform bill. But I don't trust the government to stay away from total single payer, especially when the decision makers refuse to come on board with it, but choose to remain in their own cushy coverage.

http://pleasecutthecrap.typepad.com/

http://healthcarereformmyths.org/HealthcareReformMyths.php

As a federal employee I have a BCBS PPO which seems to do the job quite well meeting the needs of me and my family. Congressman participate in FEHBP just like I do. (Its hardly "cushy" coverage.) I agree that France has the best model for future reform but we can look closer to home for ideas.(The VA is also a good model going forward.)

The U.S. already rations care. Rationing in U.S. health care is based on income: if you can afford care, you get it; if you can’t, you don’t. A recent study by the prestigious Institute of Medicine found that 18,000 Americans die every year because they don’t have health insurance. Many more skip treatments that their insurance company refuses to cover. That’s rationing. Other countries do not ration in this way.

If there is this much rationing, why don’t we hear about it? And if other countries ration less, why do we hear about them? The answer is that their systems are publicly accountable, and ours is not. Problems with their health care systems are aired in public; ours are not. For example, in Canada, when waits for care emerged in the 1990s, Parliament hotly debated the causes and solutions. Most provinces have also established formal reporting systems on waiting lists, with wait times for each hospital posted on the Internet. This public attention has led to recent falls in waits there.

http://www.pnhp.org/facts/singlepayer_faq.php#rationing

That's not to say that there's no room for profit within the American health-care system, but that it's time the discussion stopped focusing on how to preserve the interests of moneyed stakeholders and started asking how to deliver the best care, for the lowest cost, at the highest quality -- to every American. Such a system will probably still have private insurers (at least at the high end of care), pay enough to encourage pharmaceutical innovation, and allow for choice and competition and market pressures. But it will take as its guiding principle the health of the populace, rather than that of the providers. That, in the end, is what all the model health-care systems have in common. Except ours.

http://prospect.org/cs/articles?article=the_health_of_nations

We pay cadillac prices for a yugo type system.....i just want everyone to have at least a chevrolet level of coverage....

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Most recent polls show that the majority of Americans support a public option. Recent polling from Washington Post/ABC News, Time, and McClatchy all show more than 50 percent support for a public option; two Quinnipiac polls and a New York Times/CBS News poll show more than 60 percent support; and an NBC News/Wall Street Journal poll shows 46 percent support for a public option:

Quinnipiac: 62 percent support "public option."...

Washington Post/ABC News: 54 percent support a "government-run plan." ...

Time: 56 percent favor a "government-sponsored" option....

NY Times/CBS News: 66 percent favor a "government administered" plan....

McClatchy: 52 percent say "it is necessary to create a public health insurance plan." ...

NBC News/Wall Street Journal: 46 percent favor a plan "administered by the federal government." ...

Poll links available at http://www.dailykos.com/storyonly/20...-Public-Option

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Specializes in He who hesitates is probably right....
I gave you the evidence supporting the need for real reform.....

Evidence from the left, which, apparently a lot of Americans don't agree with. Even my parents, who lean far enough left to fall off of the planet, are growing extremely wary of ObamaCare.

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The data is the data........

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The data is the data........

The data is only as good as its source. Data/statistics are always manipulated to suit the needs of the presenter, regardless of who that is. What has to be seen beyond the data that is presented, is who is presenting the data and why. In the case of the sources listed: Washington Post/ABC News, Time, Quinnipiac and New York Times/CBS News and NBC News/Wall Street Journal, these sources all heavily support Obama in the election. With one NBC personality even stating "It is my job to make sure Obama is successful." From that point on, can you really trust anything he says is actually accurate? Not to chose sides, but his data will be reflective of that statement...simply because he said that what he is going to do.

When polling, the questions are usually structured in such a way that support the interest funding the survey. Additionally, what was the demographic surveyed? If the surveys were conducted on an urban street corner as compared to say in front of a suburban grocery store, the result will be reflective of the audience. The numbers alone do not tell the complete story...they are only propaganda. Again, propaganda supporting whoever is presenting the data...regardless of who it is.

If statistics showed that a certain hospital was responsible for 10 accidental deaths and 100,000 healthy discharges, what number would the hospital present and what number would a lawsuit present? Both are correct and both would be manipulated to suit the needs of each side of the story.

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Interesting!

The majority of us in this country continue to hope that President Obama will demonstrate leadership by advocating for the elimination of private, for-profit insurers and replace them with a single payer system. Actually we already have a single payer system of health care that works in this country: Medicare. We need to improve it and expand it to cover everybody. The system will allow us to end the inhumane and uncivilized practice of denying medically necessary preventative and restorative care to those in need. The care would still be provided by our current system of non-profit, for-profit, and public hospitals and providers, so we're not talking about nationalizing the whole system, just the payment for the care. The savings that result from eliminating the waste of the insurance company bureaucracy, (read bonuses, marketing, advertising, dividends to shareholders, and overhead), is enough to pay for the system.

I was unaware that 1) a majority of Americans support socialized medicine and 2) that medicare is a successfully run government program. I wouldn't be too suprised about #1, but doubt that #2 is true.

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Specializes in burn, geriatric, rehab, wound care, ER.
That's it? Our entire system must be remade because of the testimony of one insurance executive? What if another congressman conjures up a witness to testify how wonderful the big insurance companies are? Then what? For every position, you can find one to oppose it. Who is right? Sounds to me like the people are deciding that they prefer the status quo.

I find it puzzling that you can't accept the sworn testimony, to Congress of an insurance executive with 20 years in the business as evidence of the problems with our health insurance system. Do you have the same approach to evidence based medicine/nursing care?

Perhaps Ezra Klein of the Washington Post can back me up

"The Truth About the Insurance Industry

Insurers often complain that their critics don't understand their business practices. It would be hard to say that about Wendell Potter. Potter, whose name sounds like that of a character in a Frank Capra movie, worked in the health insurance industry for more than 20 years. He rose to be a senior executive at Cigna. He was on their calls, at their board meetings, in their books. And today, at a hearing before Sen. Jay Rockefeller's Commerce Committee, he testified against them.

What drove Potter from the health insurance business was, well, the health insurance business. The industry, Potter says, is driven by "two key figures: earnings per share and the medical-loss ratio, or medical-benefit ratio, as the industry now terms it. That is the ratio between what the company actually pays out in claims and what it has left over to cover sales, marketing, underwriting and other administrative expenses and, of course, profits."

Think about that term for a moment: The industry literally has a term for how much money it "loses" paying for health care.

The best way to drive down "medical-loss," explains Potter, is to stop insuring unhealthy people. You won't, after all, have to spend very much of a healthy person's dollar on medical care because he or she won't need much medical care. And the insurance industry accomplishes this through two main policies. "One is policy rescission," says Potter. "They look carefully to see if a sick policyholder may have omitted a minor illness, a pre-existing condition, when applying for coverage, and then they use that as justification to cancel the policy, even if the enrollee has never missed a premium payment."

And don't be fooled: rescission is important to the business model. Last week, at a hearing before the House Subcommittee on Oversight and Investigation, Rep. Bart Stupak, the committee chairman, asked three insurance industry executives if they would commit to ending rescission except in cases of intentional fraud. "No," they each said.

Potter also emphasized the practice known as "purging." This is where insurers rid themselves of unprofitable accounts by slapping them with "intentionally unrealistic rate increases." One famous example came when Cigna decided to drive the Entertainment Industry Group Insurance Trust in California and New Jersey off of its books. It hit them with a rate increase that would have left some family plans costing more than $44,000 a year, and it gave them three months to come up with the cash.

The issue isn't that insurance companies are evil. It's that they need to be profitable. They have a fiduciary responsibility to maximize profit for shareholders. And as Potter explains, he's watched an insurer's stock price fall by more than 20 percent in a single day because the first-quarter medical-loss ratio had increased from 77.9 percent to 79.4 percent.

The reason we generally like markets is that the profit incentive spurs useful innovations. But in some markets, that's not the case. We don't allow a bustling market in heroin, for instance, because we don't want a lot of innovation in heroin creation, packaging and advertising. Are we really sure we want a bustling market in how to cleverly revoke the insurance of people who prove to be sickly?"

By Ezra Klein | June 24, 2009; 6:29 PM ET

http://voices.washingtonpost.com/ezra-klein/2009/06/the_truth_about_the_insurance.html

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Specializes in He who hesitates is probably right....
I find it puzzling that you can't accept the sworn testimony, to Congress of an insurance executive with 20 years in the business as evidence of the problems with our health insurance system. Do you have the same approach to evidence based medicine/nursing care?

No actually, I do a fine job as an RN, according to my manager. I find it odd that you would question my professional ability because I don't agree with your political viewpoint. That aside, you are giving ONE example by ONE executive at ONE hearing, and condemning the entire system. I have had problems with insurance companies in the past, but I would expect even bigger problems from the government. I can always find another insurance company if I don't like the way I'm being treated. The government? I'm pretty much powerless to give them their walking papers.

BTW, I inquired in a previous post why you had left the UK to work in a place as horrible and unjust as the US?

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Specializes in burn, geriatric, rehab, wound care, ER.
No actually, I do a fine job as an RN, according to my manager. I find it odd that you would question my professional ability because I don't agree with your political viewpoint.

You have misconstrued my response. I did not question your professional ability. I apologize for any offense caused -it was not my intent. Your response reminded me of a situation I came across some years ago as a wound care specialist for home health. I had contacted a doctor regarding a patient of his that had a chronic non-healing wound. Part of the MD's treatment regime included cleansing the wound with betadine -which numerous studies had shown delayed wound healing. I had faxed him a reference list citing such sources attached to my recommendations for wound care. On speaking to the doctor about this particular case he told me that he was going to continue with betadine because he did not believe the research. I was flabbergasted!

Healthcare should not be regarded as a right-wing or left-wing issue but a human issue. Your political viewpoint is your own business. I would appreciate discussion of facts and not feelings without demonization of opposing views.

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Specializes in burn, geriatric, rehab, wound care, ER.

Coincidently Mr Wendell Potter " began his trip from health care spokesperson to reform advocate while back home in Tennessee. Potter attended a "health care expedition," a makeshift health clinic set up at a fairgrounds, and he tells Bill Moyers, "It was absolutely stunning. When I walked through the fairground gates, I saw hundreds of people lined up, in the rain. It was raining that day. Lined up, waiting to get care, in animal stalls. Animal stalls."

http://www.pbs.org/moyers/journal/07102009/profile.html

The health care expedition he referenced is "Remote Area Medical" a volunteer group.

http://www.ramusa.org/

I say coincidentally as they are holding a week long event in Inglewood, Ca from August 11-18 to provide free medical, vision and dental services to the uninsured, underinsured, unemployed and those unable to pay.

http://www.ramusa.org/expeditions/2009/ramla2009.htm

I was surprised to learn that Los Angeles is considered a "remote area" -who knew!

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