Healthcare going forward

[frankfrank]

Anything looking like that will never get to the House floor, because Ryan won't let it.

Republicans would rather add a new line in the budget that provides an annual $400 billion in subsidies for the homeless, than to continue subsidies to Planned Parenthood which amount to a sliver so tiny on the pie chart that it is nearly invisible.

 

[Benvolio]

Republicans would rather add a new line in the budget that provides an annual $400 billion in subsidies for the homeless, than to continue subsidies to Planned Parenthood which amount to a sliver so tiny on the pie chart that it is nearly invisible.

It is not a question of the money as such. We object to taxpayer being forced to pay for the slaughter of American babies. Yeah, yeah, they juggle the figures to claim the tax money is not used in the killing program. And they don't sell the baby parts, nudge, nudge, wink, wink.

 

[gsdx]

It is not a question of the money as such. We object to taxpayer being forced to pay for the slaughter of American babies.

But you're okay with the slaughter of old people and sick people and hungry children.

Got it.

 

[KaraBulut]

Another derail attempt since the federal funds that go to Planned Parenthood are for billable primary care Medicaid services- generally for women's well checkups, mammograms and birth control. These services were covered before the ACA. No federal funds go toward abortion services- the Hyde Amendment was signed by Bill Clinton in 1993 and was recodified by the the Stupak–Pitts Amendment to the ACA in 2010. Nice try, though.

 

[Kulindahr]

There is still a problem with the minimum wage, though since this does push more part-time workers into the expanded Medicaid program. The Medicaid program was intended to provide coverage for those who worked but did not work 32 hours or whose overall earnings were below the ACA's FPL guidelines. I don't think anyone expected that so many of the "working poor" would go onto Medicaid instead of into the individual market, though.

I look at the minimum wage from a business point of view. If large corporations insist on paying their employees so little thaat they can't make ends meet, they are essentially using the government to bolster their bottom line. Thus all the benefits provided to employees are actually benefits provided to the business. Conclusion: government should bill those companies the services rendered, i.e. the full amount of benefits paid to their employees.

No business would provide a service without billing for it. in this case, government is providing a service to business by making sure their employees have enough to survive on and thus be capable of working. Bill them for it.

 

[Kulindahr]

It is not a question of the money as such. We object to taxpayer being forced to pay for the slaughter of American babies. Yeah, yeah, they juggle the figures to claim the tax money is not used in the killing program. And they don't sell the baby parts, nudge, nudge, wink, wink.

Give up the lie.

Planned Parenthood does not spend government money on "the slaughter of American babies". Indeed, Planned Parenthood does not engage in "the slaughter of American babies".

So, give up both lies.

 

[Kulindahr]

Another derail attempt since the federal funds that go to Planned Parenthood are for billable primary care Medicaid services- generally for women's well checkups, mammograms and birth control. These services were covered before the ACA. No federal funds go toward abortion services- the Hyde Amendment was signed by Bill Clinton in 1993 and was recodified by the the Stupak–Pitts Amendment to the ACA in 2010. Nice try, though.

Why call it a "nice try"? Call it what it is: a deliberate lie he's repeated and then repeatedly been shown it's a lie.

 

[KaraBulut]

Why call it a "nice try"? Call it what it is: a deliberate lie he's repeated and then repeatedly been shown it's a lie.

I meant a nice try at derailing.

The pattern is when confronted with facts, change the subject to something inflammatory to garner more attention and responses.

 

[Stardreamer]

Despite the claims of some, the ACA is a conservative market-oriented approach to providing health care coverage. What the American experience is showing us is that health care is one of those things, like police, that simply cannot be done well in a free market and needs the government to regulate it properly. The problem is that the people who think you can do it with free markets are preventing the government from doing the regulation of that market properly. Can any of the opponents to government run health care point to an example in a country they would actually care to live in where a free market medical system actually works?

 

[kallipolis]

There is great value in private health care, and universal health care schemes working alongside one another...this being a reality in most, if not all European countries where national health care systems have been a fact of life from the immediate post war years.

Here in Greece there is a practicable working arrangement between the national health service, and private health care companies that ensures those who can afford to use, and choose to use private health clinics, physicians, dentists, and private hospitals can do so with part of the cost of their treatment met by the national health service.

 

[Stardreamer]

There is great value in private health care, and universal health care schemes working alongside one another...this being a reality in most, if not all European countries where national health care systems have been a fact of life from the immediate post war years.

Here in Greece there is a practicable working arrangement between the national health service, and private health care companies that ensures those who can afford to use, and choose to use private health clinics, physicians, dentists, and private hospitals can do so with part of the cost of their treatment met by the national health service.

Yes and this to me is the best approach.

 

[Kulindahr]

Despite the claims of some, the ACA is a conservative market-oriented approach to providing health care coverage. What the American experience is showing us is that health care is one of those things, like police, that simply cannot be done well in a free market and needs the government to regulate it properly. The problem is that the people who think you can do it with free markets are preventing the government from doing the regulation of that market properly. Can any of the opponents to government run health care point to an example in a country they would actually care to live in where a free market medical system actually works?

Free-market police would work if everyone were as intelligent as a B- -level college graduate, honest, and fair, but I don't think free-market medicine would work even then. So long as medicine was small-scale and community-based plus patient-oriented, the free market worked okay, but with the advent of extremely high-tech gadgets (thanks primarily to the space program) and so many necessary specialties, that became impossible if for no other reason than that when a variety of specialists are required for something guild economics come into play and prices go up, and when high-tech instrumentation becomes necessary then prices are to a great extent in the hands of companies able to manufacture them.

If we had a society where everyone took seriously the vastly-neglected Christian ethic set down by St. Paul, that we are to consider everyone else as more important than ourselves, free-market medicine would almost certainly work, but then it wouldn't be free-market as we understand it because no one would be pursuing profit, only the welfare of everyone else.

 

[Sausy]

I like where Kuli goes a lot of the time but ultimately the corporate interest is in maximizing profits, not the individual health and welfare of the public. The Republicans who are so set on a "free market" approach to health care never seem to be motivated by true Christian ethics, though they are the first ones to want to interject their version of "Christianity" into public life. It is ironic though that the "socialist" ACA is really just a version of Mitt Romney's plan enacted when he was Massachusetts governor which was heavily influenced by the Heritage Foundation... not exactly known as a socialist organization but a pretty damn conservative one. The ACA was deeply flawed in many respects BECAUSE it still made the basic bedrock of our public health care dependent on private insurance providers.

 

[gsdx]

^ Up here in Canada, there are some things our healthcare system will not cover. We have a few insurance companies around which take up the slack. They are not our major source of healthcare coverage.

 

[thewiz]

It is not a question of the money as such. We object to taxpayer being forced to pay for the slaughter of American babies. Yeah, yeah, they juggle the figures to claim the tax money is not used in the killing program. And they don't sell the baby parts, nudge, nudge, wink, wink.

The Republican mantra, much like used in the past by such notables as Joseph Goebbels, Baghdad Bob and others, is to repeat the lie over and over until it becomes "the truth." Planned Parenthood provides primary care to women and others for which it is reimbursed -- just like any health clinic or doctor. Funds for abortions are not paid by the federal government and haven't since 1992 when Bill Clinton signed the Hyde Act. But the 30 second sound bite is ripe for the "Right to Birth" crowd.

 

[KaraBulut]

^ Up here in Canada, there are some things our healthcare system will not cover. We have a few insurance companies around which take up the slack. They are not our major source of healthcare coverage.

And that's a very common scenario (similar also to Greece as kallipolis described it).

In other countries that I've dealt with, there's a guaranteed level of services- particularly preventative and diagnostic services- that the public health system covers either free or at a minimal cost, similar to a copay. If you want additional services (which can be an elective procedure or in some cases if you want a more luxurious private hospital room), there's a private healthcare system and private insurance that is available.

What gets presented to Americans by conservatives is a "government takeover of healthcare" with substandard care, long wait times and poor outcomes. The reality is that most socialized systems are equivalent to a public health system but that does not necessarily negate the availability of private healthcare for those who can afford it. And in developed countries, the public health system provides quality care, usually with better outcomes that the American system- primarily because the socialized systems focus more on preventative care- preventing illness which keeps acute care costs low.

 

[rareboy]

^ Up here in Canada, there are some things our healthcare system will not cover. We have a few insurance companies around which take up the slack. They are not our major source of healthcare coverage.

We used to pay about $150 to $200 per month per employees for their health insurance until I just told them to take the money and buy it themselves...or not, as they chose. It would cover extended dental, meds, eye nonsense, physio and massage therapy and upgraded inpatient accommodation.

 

[Sausy]

I thought the Canadian system was like the European systems... a tiered system seems to leave room for skimping. Your public system doesn't cover eye, dental, meds all that well?

The key words in Kara Balut's summation is "for those who can afford it". Prevention is of course all well and good, but if you have a heart attack, stroke, get cancer, get into a major accident... why should it be the super rich can be able to get coverage to their hearts content, but those with limited means get bupkis. People shouldn't have to face huge bills for being sick... why the fuck would I want to recover if I faced thousands upon thousands of dollars in bills?

 

[rareboy]

No, the only way that the Canadian public system really works is to use the money for the big ticket diseases and conditions and care, from primary care through quaternary specialists.

After a certain age, eye exams are covered and after 65, so is just about the full cost of prescription meds and each province has its own separate income tested drug benefits plan (remember that health is provincial administered here). The other services, like physio, massage and even some dental is covered under OHIP, but private insurance gives you more range of options. Ophthamology, by the way, is covered...it is only optometry that is out of pocket because the cost of glasses is pretty variable

And that is why we don't have a tiered medical system that allows the rich to buy better care than anyone else. Certainly, if you do have money, being sick is easier.....but you get no different treatment by the doctors or in the Emergency department or even in the cancer care facilities. And when it comes to private room coverage...the feeling is that if you want one just because you are rich, then you can pay for the privilege....private rooms are really reserved for the cases that require more intensive care and isolation any more. So even those with money are likely to find themselves in a semi-private room.

After a lifetime with Ontario's Health services, I still am firmly opposed to a two stream system. And the federal government is too, even though many attempts have been made by 'for-profit' providers trying to create a parallel system.

I would also note that because of managed care providers are shifting to the wellness and prevention paradigm and trying to ensure that people aren't over-hospitalized or subjected to diagnostic or treatment procedures that may not be needed or particularly good for them.

It is an ongoing struggle and subject to constant pressures from all sides.

But it has kept me alive for decades now, whereas with a private care system. I probably would have been dead.

 

[KaraBulut]

...The key words in Kara Balut's summation is "for those who can afford it".

No, the only way that the Canadian public system really works is to use the money for the big ticket diseases and conditions and care, from primary care through quaternary specialists.

And to clarify what I meant by "for those who can afford it"...

The US consumer has come to expect more that just good healthcare- the ability to be see any doctor at any time, TVs in hospital rooms with lots of cable channels, private rooms,etc. On the extreme end of the scale, I have worked with hospitals in the US that had concierge service where you could call and ask for special food anytime of the day, higher thread count sheets, comforters, etc.

In a socialized system, there are basic levels of healthcare that you are entitled to and your taxes/fees make that system free or available for a smaller fee. If you don't have an emergency or urgent condition, there may be a wait of a couple of weeks to see a provider and a similar wait for elective surgeries. If you want that extra level of service beyond what the social system offers, you can have private insurance. A 20 year old college student might be happy to be in a semi-private hospital room in exchange for free care. On the other hand, a 50 year old with a well-paying job might want the private room and they can afford the private insurance that will cover those items.

Keep in mind, that if you're on Medicare, it doesn't cover dental, vision or things like hearing aids. The same is true of most US group health plans- dental, vision and long-term care require additional insurance.

In the H&W forum, I'm offering advice to people in a lot of different countries. There's a big contrast in- for example, providing advice on getting an STD test in the UK, where I can just tell the person to make an appointment with the genito-urinary (GUM) clinic where they don't have to worry about the cost versus trying to find a place to send someone in the US who will have to pay $150 for a physician visit and another $200-300 for STD testing.

I used to refer people in the to Planned Parenthood because they have a LGBT program with sliding scale fees but this crowd in Washington seems determined to defund those programs in order to punish Planned Parenthood...but I digress...

This is really the underlying issue- that we also have two health systems in the US: one for those who have health insurance and another (underfunded) system for those who don't. What the ACA was trying to do was make it so that everyone had some form of health insurance and there was a basic level of service that everyone could depend upon.