Dominoes

Jeffrey S. Flier: Health 'Reform' Gets a Failing Grade - WSJ.com

anyone with interest in massachusetts experience and our country's dilemna will want to read.

Bob

we are alone in industrialized nations in our lack of universal health care

cabythesea

Complicated issue - the article does hit some important HIGH points. Cost, access and quality need to be addressed:

"Our health-care system suffers from problems of cost, access and quality, and needs major reform.
Medicare and Medicaid drive spending without optimizing care.
Speeches and news reports can lead you to believe that proposed congressional legislation would tackle the problems of cost, access and quality. But that's not true. The various bills do deal with access by expanding Medicaid and mandating subsidized insurance at substantial cost—and thus addresses an important social goal. However, there are no provisions to substantively control the growth of costs or raise the quality of care.
The final legislation that will emerge from Congress will markedly accelerate national health-care spending rather than restrain it. Likewise, nearly all agree that the legislation would do little or nothing to improve quality or change health-care's dysfunctional delivery system. The system we have now promotes fragmented care and makes it more difficult than it should be to assess outcomes and patient satisfaction. The true costs of health care are disguised, competition based on price and quality are almost impossible, and patients lose their ability to be the ultimate judges of value.
Worse, currently proposed federal legislation would undermine any potential for real innovation in insurance and the provision of care. It would do so by overregulating the health-care system in the service of special interests such as insurance companies, hospitals, professional organizations and pharmaceutical companies, rather than the patients who should be our primary concern. "

30ashopper

I understand it's hard to see people suffer. But remember the reason why we are who we are is not because we followed everyone elses lead. This country exists today specifically because we wanted to do things differently.

Fishfood

Very convincing racial stereotypes. The doc is right- anyone with gold teeth and an R&B ringtone should bleed to death on the gurney! YEEHAW!

By the way, Massachussetts has mandates to buy private insurance but no public option which is precisely why its costs will continue to explode. Think about who put it in place and it all starts to make more sense.

Bob

your "existence" "anal"ogy should be checked for fecal matter. so socialized health care for the poor, the retired,the military vets, government workers, anyone who can survive the indigent wait in an emergency room, but no one else?

30ashopper

You personal insults are not appreciated. I've flagged your post.

We have safety nets in place for the poor. The retired wouldn't have any trouble paying for healthcare if the democrats hadn't robbed them of good income all these years, military vets are entitled to long term care for their sacrifice which should be (and I think is) provided through private providers, and government should treat its workers just like any other employer - coverage through a private policy.

Dominoes

It is outrageous that reposting a letter to the editor from a reputable newspaper written by a doctor about his own experience with the health care reform debate would be deleted by the moderators, but bob's insults at you 30-a were not deleted.

Dominoes

there is no mention of race in the post. that you thought of race when you read it just demonstrates that you stereotype based on behaviors. The Dean of Harvard Medical School warns this will limit access and destroy medical innovation. The Mayo Clinic and Cleveland Clinic, beacons of medical innovation and quality care, are against it. Your blind partisan support and that of your party's leader is exactly why John Boehnner will be Speaker of the House in 2010.

AlphaCrab

What a horrible and condescending statement. I'd be ashamed!
So our idea of "leadership" is to our deprive citizens!! Unbelievable.

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Abrupt and needed "change" is hard for anyone to deal with. We have to deal with new paradigms in a new world, but I think things are gradually getting better!

Fishfood

LOL. Sorry but that is a load of you know what. Of course there is no mention of race, then it would be easier to call it out for what it is. The subtext of that letter is obvious. This same "clever" code is used by the right wing time and time again.

kurt

Please provide a source or a link to your posts with material written by others, also use quote tags so we don't assume it wasn't written by you. Also include your own comments so we understand your point, or at least the reason for posting.


We normally don't delete insults, or at least stupid attempts at insults. 30Ashopper called him out on it and that is usually the best way to handle it.

Lynnie

OK, well reading this thread before the article is like reading the last page of the novel half way through.

I almost don't even need to read the article now. Yep, that was a stupid attempt at an insult.......well-stated. And, I don't like the word 'stupid.'

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Who is Lynnie?? ~~~~~~~Signed, All Y'all

middlesister

I was reading this with interest. So many different opinions. 30ashopper is so right when they talk about why our country is different. I have friends/family way left to way right. Nobody I know would ever want someone to suffer because they could not afford healthcare. This is such a complicated issue. I work in the medical field and am a provider of health care. Most governmental agencies we work with are extremely disorganized, do not have efficient systems in place and hold us to a standard they would never be able to adhere to. I live in a wonderful city and there are so many resources for people that they are not aware of. Mobile, free mammography, free clinic, low cost dental clinic, social service programs. Isn't is interesting that in the last week new "guidelines" for breast cancer and cervical cancer screening have come out. Who published those guidelines??? Could it possibly be a precursor to new guidelines so that when health care reform is enacted they can save money by loosening the screening parameters? Health care does not come cheap. I do not think there is enough focus on capping litigation. Health care costs have soared because of personal injury litigation. I have no doubt that everyone who is weighing in on this subject here is a good person. I hope you are all doing some small thing to make a difference for a better life for someone in your community. I am fairly new here and am wondering why there are all these annoying, smiley faces on the right of this screen??? Have a wonderful weekend to all of you who are down in my beloved 30A. That water, sand and air are like no other.

30ashopper

It's not horrible or condescending, it's historical in nature. I'm not ashamed at all.

Deprive our citizens of what exactly? It's certainly not opportunity or incentive. What is it? FYI, you want to deprive them, you just don't have a grasp of how you'll inadvertently do it. I'd suggest spending some time studying the principals this great country of ours was founded upon.

Winnie

Could you point out a small example? I don't perceive anything racist at all in the article. Not even when I re-read it looking for the elusive "clever code" that the right wing purportedly uses.


I also don't see how a public option brings health care costs down. It's a government run (subsidized) insurance plan isn't it? Maybe it brings insurance plan costs down for those who become subsidized, but how does that decrease the cost of medicine, treatment, or office visits? Healthcare costs money no matter who ends up footing the bill. I think it costs too much, but insuring people only raises the prices because it artificially raises the amount people are willing to pay for services.

I read that the Senate proposal will assure 94% of people are insured - up from the 83% currently insured. I don't think that's much bang for the buck or for the re-working of the entire system.

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They’re all for diversity in everything but thought.
George Will

Fishfood

Example: reagan talking about a "welfare queen from the south side of chicago". No mention of skin color. Clear intent.

But hey if you want to be disingenuous that's fine. Even if I were to grant that there is no racial subtext to the letter whatsoever (there is, especially considering the audience it was intended for), it's pretty clear the image being used is there for a reason. It's because it stirs contempt in certain types of people who want to put an "undeserving" face on those who will be helped by serious reform.

And it's funny because the subject of the letter gets medicaid, and will no matter whether reform passes or not. So why is he even bringing it up? It seems to me reform is aimed at better coverage for the self-employed and the middle class and those with pre-existsing conditions. So the example is misleading at best.

Quote: I read that the Senate proposal will assure 94% of people are insured - up from the 83% currently insured. I don't think that's much bang for the buck or for the re-working of the entire system.

Maybe this is part of your problem, because I bet that 11% feels like it's pretty worthwhile.

30ashopper

Why would anybody complain about getting a government check?

I don't see why we can't have valuable reform without all the free hand outs. I'd be willing to accept medicaid expansion to 150% of the poverty line as long we couple it with fraud prevention and healthy living initiatives, but subsidizing private insurance payments up to 90K a year for families? I mean really, what the heck is congress thinking.

Winnie

I think you must be talking about something other than the opinion article written by the dean of the Harvard Medical School referenced in the first post of this thread. There is no mention of Reagan or welfare or anything else that by any stretch of imagination could be racist. The audience of the Wall Street Journal is predominately people interested in business and finance, I believe. The image is of a man getting a shot.

As to my wanting to be disingenuous - I am always frank on this board. I absolutely believe there is no hint of racism in the article.

I think that the 11% will be comprised of many people who currently don't want to allocate so much money to health insurance. I do not equate health insurance to good health nor to health care. They aren't at all the same things. The article states, and I agree:

I believe the current proposals are going to decrease access to and the quality of health care while increasing the costs enormously. We need reform in our health care system, not just to buy everyone health insurance. If it were really a good bill (the Senate version), there would be no need to rush it through nor to bribe Senators to vote for it.

__________________
They’re all for diversity in everything but thought.
George Will

Fishfood

Winnie, I see the problem here. The post I was talkig about was deleted (probably by the moderator for the racial subtext it contained). This happened after I made my first post about underlying racism. I just assumed the post was still in the thread, so likely having not read the post in question, you were not being disingenuos. I can see why there would be massive confusion about why I would find racism in the original article- I certainly don't find a thing racist about that. Dominoes posted something that is no longer here.

So we are arguing about two completely different things and are therefore both right imo. (Except about health care policy, where only one of us is right and I suppose we can guess who each of us thinks it is).

Dominoes

For those of you who wish to read the deleted letter that I had posted, here is the link snopes.com: Dr. Starner Jones
You can see what kurt was trying to suppress.

The whole point of the letter is not the racial stereotype it is the failure of an individial to make good decisions. The left cannot get past it seeming like a racist image, when the point is look at what this individual has chosen to spend my money on with the check they got from Uncle Sam. Whether this individual is causasian, asian, afr-am., indian, etc. their life choices are horrible and I should not be paying for it.

the cost of a new gold tooth : 200-2000 depending on who made it. the cost of a new cell phone yearly: 500-2000 depending on type the cost of smoking and drinking regularly: 2000 a year
the cost of the tattoos: 200-1000 per tattoo depending on quality

the cost of a single woman to have good health insurance with BCBS: $3000 per year.

The point is that this woman has spent our money on non-necessities that could have paid for her own health insurance.

Your point about Medicaid is flawed because both the House and Senate bills raise the income threshhold for Medicaid eligibility and is going to increase medicaid enrollment substantially. Medicaid is a state program that is being given an unfunded federal mandate in these bills and the states will have to raise taxes to pay for the additional enrollees. It is the genius behind making the plans "deficit neutral" for the federal budget. It is not deficit neutral for the individual states.

steyou

We do not need UHC. Just a tweak in our current policies. Do you need more information Bob or do u want to stay on the left with Obama. Simple question. How is the change so far for you.

Fishfood

How much do R&B ringtones cost dominoes? Why was that information important then? And how does the doc know the woman in question smokes a pack a day and has plenty of money for beer? Either you are being disingenuous or you're just willingly blind.

But all that aside, should we simply let all people who make bad decisions die? Your argument probably flies with many in America where the almighty buck is king, but most of the civilized world is beyond this type of thinking and for good reason. You're rationalizing why some people are not worthy of medical treatment and health care is simply a commodity. I view things differently.

A woman spends maybe 1500 bucks on non essentials over who knows how many years and you are outraged that she gets your tax dollars. Our governent spends hundreds of billions on pre-emptive war and I reckon you hardly bat an eye. No one likes waste and abuse- but it's a reality of social safety nets. For better or worse, we've decided that such things have a place in America.

kurt

As I stated above - it was deleted because you posted a part of the letter without reference or link. Without external reference or an explanation of what it was, it didn't look like an external doc, it looked like something you wrote and nothing but a troll post.

Now that I see the context it is obvious that none of us want to pay for tattoos, cigarettes, gold teeth, etc. no matter who the person is or what their skin color. In a society where we decide to take care of each other there are going to be some who take advantage. The system needs to be fixed so that people who actually need health care get it. And that it is fair for everyone. Our education and values have shrunk so much that it may not be possible to eliminate cheaters and users.

Isn't health care a moral issue? Don't both sides claim the moral high ground? Aren't both immoral if they don't take care of the people who elected them?

Dominoes

Its called a medical history. You ask the patient if they smoke and drink and do illicit drugs. Any good clinician asks those questions. The doctor may even ask what brand and types of alcohol they use.

National defense is an obvious role of government, health care is not. Please find somewhere in the constitution where health care is a right. What is your profession? I am sure you would like it if the government found it to be a right and not a commodity. I am sure the folks at our local pizza joint would be thrilled to give away pizza for free to all if the government mandated it. They could just let those who chose to pay be nice enough to pay $20 a slice subsidize the dining of the freeloaders. After all isn't food a more primary need than health care???

Dominoes

There is an article in today's Panama City News Herald about Medicaid, quoting our state Senator Don Gaetz. Now he who is the most thoughtful, intelligent elected official I have ever had the pleasure to meet, went to Washington concerned about the unfunded mandate about to be placed on our state and they tag him as a proponent of doing away with Medicaid... unbelievable!!! He has been an advocate for Medicaid and was crucial in preventing cuts in the program this year when every other part of the state budget was cut due to the state budget crisis.

Anyone in this debate who brings up the fact that the costs are going to spiral out of control and quality of care will have to decline to prevent that is labelled as uncaring for the poor and needy. Somebody will have to pay for this new entitlement spending and our government needs to get out of health care and focus on reviving small business or we are going to be stuck at 12% unemployment for the next decade.

Winnie

I see.

Since Dominoes re-posted a link, I read the letter. It sounds to me like the point of the letter was the doctors frustration with irresponsible behavior. I prefer to give people the benefit of any doubt.

__________________
They’re all for diversity in everything but thought.
George Will

scooterbug44

Sorry to burst your bubble, but I don't have any gold teeth or tattoos, my cell phone is the cheapest plan available w/ the default ringtone, I don't smoke, rarely drink beer, and my sneakers were cheap when I bought them on sale at the outlet store.

And I'm white.

So NOW what is the excuse du jour for denying me affordable medical care?

P.S. I also exercise daily, grow some of my own food, and haven't missed a preventative gyno, dental, annual, innoculation, vision check in my life. And I have been working since I was 12. PUCK IT!

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"I hate to break it to you, but this year (and probably the next few) was going to suck even if Jesus himself was president. These problems were not created overnight and they aren't going away overnight." -Jdarg

Dominoes

If what you post is true, I am pretty sure you can afford coverage. $3600 a year for average white female age 40 with BCBS of florida. THis is a plan with low copays and rx coverage. My employees pay an average of $1500 out of pocket while I pay $2500 per employee. Without a federal mandate, I provide coverage to all those who contribute to the success of my business.

I really don't think your race is a factor in the debate. Perhaps a 2nd job, better paying job, or one with a better benefits package would work out for you.

The vitriole in your last line is hardly appropriate.

scooterbug44

Actually, I find it very appropriate - I am REALLY tired of everyone who wants health care reform or who can't get health insurance being depicted as a deadbeat crack whore or an illegal alien.

All of the comments I posted were direct responses to YOUR link.

Not saying the current proposal is the solution, but there is a SEVERE need for reform.

__________________
"I hate to break it to you, but this year (and probably the next few) was going to suck even if Jesus himself was president. These problems were not created overnight and they aren't going away overnight." -Jdarg

Fishfood

I'm sure you do.

Winnie

In his letter, the doctor didn't depict anyone who supports health care reform or can't get health insurance as a deadbeat crack whore or an illegal alien. That is coming from you, not him.

The letter is deriding the President for wanting responsible people to pay for the health care of those irresponsible with their health and their money.

I agree with you that the system needs reform. We do need to help those who can't help themselves. We also need to create lower costs so people can sustain themselves.

But, I also think it is important that poor choices be discouraged not rewarded. I think it is bad for individuals and for society, to allow able people to lose their self-worth.

__________________
They’re all for diversity in everything but thought.
George Will

Lynnie

Good letter and this is a concern of mine as well as many fiscally responsible people I know both left and right. It does not mean that we are without compassion, but we recognize that our social systems are abused by some and we don't want to pay for them any longer.

Not everyone will be able to or can currently afford the 'Bentley' plan and that is why there are the 'Hyundai' plans, which provide catastrophic coverage as well as certain state mandates.

I know not one person who isn't for reform. I know many, many people who are vehemently opposed to socializing (gov't run) our health care system.

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Who is Lynnie?? ~~~~~~~Signed, All Y'all

Dominoes

You failed to answer the question, how is it that you currently can't afford coverage? If you work, don't indulge in non-necessities, and don't have a pre-existing condition, then $300 a month for a great BCBS plan seems pretty affordable to me?

Also, how does HB 3962 help you. If you work, then you are unlikely to qualify for the expansion in medicaid. So you will now be mandated to have insurance and penalized by a new tax if you don't get covered. Since the public option is not tied to medicare but negotiated with providers in your area, most project that it will cost about what a private insurer will be charging. The funny thing is that much of the left-blinded populace has no idea how this bill will affect you. Those not blinded are the 58% that have learned about what is in the bill and now oppose it.

I am actually in a unique position to be in a win-win situation with this plan. Politically, I believe in free markets and am right-leaning. So I will be happy if the bill fails. Professionally, if we get an additional 30 million insured Americans and $300 billion earmarked for physicians in HB3961, which is the companion bill to HB 3962, I will make more money and be happy too.

You are fooling yourselves if you think this bill will make care more affordable or accessible. It will decrease both and put more control in the hand of the government and more money into the pockets of health care providers and administrators.

30ashopper

Hopfully at some point the long term costs of the Senate bill will be discussed in the media. Can you say "unsustainable"?

(If this chart doesn't scare the heck out of people, I don't know what will.)

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The path to hell is paved with good intentions.

Winnie

Another nice chart 30ashopper!

I have given up on many people ever understanding the magnitude of trillion. Much less the consequences of costs at these levels. Million, billion, trillion, - all just numbers. Some people think there is little difference in real terms.

__________________
They’re all for diversity in everything but thought.
George Will

Lynnie

I agree and I've given up on some understanding the cost of this administration.

__________________
Who is Lynnie?? ~~~~~~~Signed, All Y'all

30A Skunkape

Right, so, gold teeth and such aside, I heard this excellent piece on the house and senate bills on NPR this evening. A good 'compare and contrast' job in about 4 minutes, or, roughly 1000 pages per minute (whew). Interesting conclusion regarding what the consumer might find regarding value toward the end of the piece. Senate, House Health Bills Have Much In Common : NPR

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