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Post by admin on Aug 22, 2009 7:48:25 GMT -5
www.nypost.com/seven/08162009/postopinion/opedcolumnists/gops_best_medicine_184850.htmGOP'S BEST MEDICINE REPUBLICANS ALREADY HAVE A BETTER SOLUTION TO HEALTH CARE THAN OBAMA By RANDALL HOVEN "The health care system in America is broken. Costs are rising at an unacceptable rate -- more than doubling over the last 10 years, which is nearly four times the rate of wage growth. Too many patients feel trapped by healthcare decisions dictated by HMOs. Too many doctors are torn between practicing medicine and practicing insurance. And 47 million Americans worry what will happen to them or their children if they get sick." Who do you think said that? President Obama? Actually, those words were written by Republicans. They are part of the summary of the Patients' Choice Act, introduced this May by Rep. Paul Ryan (R-Wis.) in the House and by Sen. Tom Coburn (R-Okla.) in the Senate. To hear it from President Obama, the choice is simple: his plan or the status quo. He is wrong on both counts: he has no plan, and the Republicans do. In fact, Republicans have introduced meaningful health care reform for years. In the 1990s, Republicans tried to change Medicare into a defined-contribution model, more along the lines of the plan that federal employees enjoy. The Republican-controlled Congress passed such legislation in 1995, but President Clinton vetoed it. Seeing that Medicare costs were out of control, Clinton set up a bipartisan Medicare Commission headed by John Breaux (D-La.). The Breaux Commission came up with a similar plan in 1999. Democrats killed that too. When Republicans controlled Congress and the White House, from 2003-06, they provided Health Savings Accounts and prescription coverage under Medicare for the first time. With the Democrats regularly using Senate filibusters, those were significant achievements. Republican introduced precursors to the Patients' Choice Act in the House in July 2007, May 2008 and September 2008. All died in the Democrat-controlled House. There is also the Health Care Freedom, introduced in the Senate this June by Sen. Jim DeMint. The Patients' Choice Act addresses the concerns most of us have about health care. It will reduce costs. It will expand coverage. It will increase patient choice, moving decision-making away from government and corporations and toward individuals. When this country wanted to fight a hunger problem, it did not turn over the entire food production industry, from farmer to grocer, to the federal government. The federal government simply provided food stamps -- in effect, vouchers for food. Under the Patients' Choice Act, low-income Americans would receive vouchers for health care in the form of tax rebates to purchase health insurance: $2,300 for individuals and $5,700 for families. That is more than what a high-deductable, HSA-eligible plan costs today. Low-income families, those currently covered by Medicaid, would receive extra money to buy private insurance that best fits their needs. Participating insurers would be required to offer coverage to any individual, regardless of age or health history. Health insurance would be portable and patient-based, not employer-based. While PCA would not force individuals to have health insurance, it would incentivize participation financially and by providing enrollment opportunities through places of employment, emergency rooms, the DMV, etc. The Heritage Foundation estimated that Jim DeMint's plan, which, like the Patients' Choice Act, is based on vouchers, would insure an extra 22.4 million people -- more than the 16 million that the Congressional Budget Office estimates would be added to health insurance rolls by ObamaCare. The numbers for the PCA, which Heritage did not study, are likely similar. The PCA promises "no tax increases or new government spending." Generally, savings would be achieved by replacing byzantine rules and regulations with simpler incentive structures that foster patient choice and free-market competition. Notably, the CBO estimated that simply allowing individuals to purchase non-group health insurance coverage in any state would reduce the 2010-19 deficit by $7.4 billion and insure an additional 400,000 people by 2014. Instead of Medicare dictating reimbursement rates, the act would provide a mechanism for competitive bidding among insurance plans. CBO has estimated this could save $158 billion. Rather than dictate national tort laws, PCA would provide incentives to the states to reform their tort systems. Potential solutions range from specialized courts to handle medical malpractice cases to caps on damages, as successfully instituted in California and other states now. Tort reform could save perhaps $200 billion per year, according to a Pacific Research Institute study. If it saves only half that, or $1 trillion dollars over 10 years, it would save as much as ObamaCare would cost. Regarding President Obama's plan: he doesn't have one. What he insists on is a "public option," a sort of Medicare for non-seniors. That is curious, since the current Medicare system has been held together with chewing gum for years, and will go broke in 2017. Even Obama paints the public vs. private option as a US Post Office vs. FedEx/UPS choice, and not in a good way for the public option. The plan being debated in town halls across the country is the Affordable Health Choices Act, introduced in the House by Rep. John Dingell (D-Mich.). This is the "Obama plan" only in the sense that it has a "public option" in it. The CBO did a cost analysis of ObamaCare and estimated it would cost $1 trillion over the next 10 years and insure an extra 16 million people (of 47 million estimated to be uninsured). Under ObamaCare, to insure an extra 5% of the population would cost more than $1 trillion dollars. On its very face, Obamacare fails ignominiously. Its reason for being was to save money, but it will cost a trillion dollars! And even after 10 years, it will cover only a third of the uninsured. (The math works out to $6,250 per additional person insured, or six times more than an HSA-qualified plan today.) Try this multiple-choice question: (a) Do nothing, for zero extra cost and 85% of the population insured. (b) ObamaCare, for a cost of $1 trillion and 90% insured in 2020. (c) A Republican plan, for no tax increases or new government spending, lower overall costs, and near-universal coverage. Don't believe the Administration's ultimatum. It's not Obama's way or nothing at all. There is an alternative, and the nation should rally behind it. Randall Hoven blogs at kulak.worldbreak.com
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Post by jefffriedman on Aug 23, 2009 9:05:44 GMT -5
To address all of the inaccuracies in the above would require too much time to properly research but I feel it is necessary to address a few:
1. "Republicans controlled Congress and the White House, from 2003-06, they provided Health Savings Accounts and prescription coverage under Medicare for the first time."
The HSA’s are a joke we don’t save for retirement or a rainy day. I wonder how many have been set up and used? The prescription coverage has been a costly bust by everyone’s account because there were no offsets to pay for it.
2. “When this country wanted to fight a hunger problem, it did not turn over the entire food production industry, from farmer to grocer, to the federal government. The federal government simply provided food stamps -- in effect, vouchers for food.”
This is not true both Roosevelt and Nixon imposed price controls on food which dictated prices by controlling the production costs. Additionally government has been heavily subsidizing farmers since the 1930. The government has done much more than simply provide food stamps.
3. “Under the Patients' Choice Act, low-income Americans would receive vouchers for health care in the form of tax rebates to purchase health insurance: $2,300 for individuals and $5,700 for families. That is more than what a high-deductable, HSA-eligible plan costs today. Low-income families, those currently covered by Medicaid, would receive extra money to buy private insurance that best fits their needs.”
This sounds real good but low income families don’t pay that much tax so a $5,700 tax credit is worthless. If they are presently covered by Medicare and they are given “extra money” I ask where is that extra money coming from?
3. “Participating insurers would be required to offer coverage to any individual, regardless of age or health history. Health insurance would be portable and patient-based, not employer-based.”
Who will require? What if no insures participate? What incentive do they have to participate? If the insurance companies did not participate would the author of the bill force insurance companies or would a public insurance company be created that does offer coverage to any individual, regardless of age or health history? If they force the insurance companies would that not be the government controlling business? If a public insurance company is set up is that not a “public option”?
4. "While PCA would not force individuals to have health insurance, it would incentivize participation financially and by providing enrollment opportunities through places of employment, emergency rooms, the DMV, etc.”
This is somewhat absurd, if it did not in some way force people to get insurance the insurance companies would never be able to insure people regardless of age or health history. I also can not imagine being provided an enrollment opportunity at an emergency room nor would I want my health insurance options explained to my by a DMV (MVC) employee. Etc maybe health insurance with that Big Mac please.
5. “The Heritage Foundation estimated that Jim DeMint's plan, which, like the Patients' Choice Act, is based on vouchers, would insure an extra 22.4 million people -- more than the 16 million that the Congressional Budget Office estimates would be added to health insurance rolls by ObamaCare. The numbers for the PCA, which Heritage did not study, are likely similar.”
The Heritage Foundation is not an independent non-partisan group; they add to the debate but should not be taken as gospel. If costs were not studied how can one claim that the cost would be similar? It should also be noted that later in the article he claims that this plan would have lower costs.
6. "The PCA promises "no tax increases or new government spending." Generally, savings would be achieved by replacing byzantine rules and regulations with simpler incentive structures that foster patient choice and free-market competition."
This also sounds good but which rules and regulations would go; What does that really mean? One could equally argue that the criminal justice system would cost us less if we got rid of those pesky byzantine rules and regulations requiring due process.
7. "Tort reform could save perhaps $200 billion per year, according to a Pacific Research Institute study. If it saves only half that, or $1 trillion dollars over 10 years, it would save as much as ObamaCare would cost."
Perhaps, but perhaps not. Tort reform sounds fine in the abstract. Capping damages- When your wife, child, husband, parent, etc. is killed or permanently disabled due to malpractice then tell me what the cap should be. What is the low end dollar figure of a family members value to you?
8. "Try this multiple-choice question:
(a) Do nothing, for zero extra cost and 85% of the population insured.
(b) ObamaCare, for a cost of $1 trillion and 90% insured in 2020.
(c) A Republican plan, for no tax increases or new government spending, lower overall costs, and near-universal coverage."
This question is missing a few words C. should read “A Republican plan, for (perhaps or perhaps not) no tax increases or new government spending, (maybe or maybe not) lower overall costs, and (incentivize the possibility of) near-universal coverage (if you can afford it).
This artical does not add to the debate it misleades and prays on fear. As no final bill has been presented there is no "plan" yet. There are many different plans and the critics have can it both ways because there is no final plan yet.
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Post by fiberisgoodforyou on Aug 23, 2009 10:35:26 GMT -5
"there is no final plan yet"..., I believe the House Bill called HR320 is the proposed act of congrass, AKA "America's Affordable Health Choices Act of 2009"
You are correct, there is no final plan yet, because the plan proposed by the majority leadership of yhe 111th Congrass will never pass.
Congressman Chris Smith, a senior member of the House of Representatives long active on health care issues and legislation in Congress, supports reasonable health care reform but strongly opposes President Obama's national health care plan, also called H.R. 3200 and dubbed the "America's Affordable Health Choices Act of 2009." Congressman Smith issued the following responses to questions posed by the Asbury Park Press about the Obama healthcare plan. The following article ran in the Aug. 17 online edition of the Asbury Park Press, and a similar version ran in the Aug. 16 print edition of the paper.
EDITOR'S NOTE: Following up on our July 26 editorial on the need for further public discussion of the key issues in the health care reform debate, we invited Rep. Frank Pallone Jr., D-N.J., and Rep. Chris Smith, R-N.J., to respond to eight questions raised in the editorial. Pallone's responses appeared on the Aug. 2 op-ed page. Today, we are running Smith's responses.
Smith, dean of the New Jersey congressional delegation, says he supports reasonable health care reform but strongly opposes the so-called Obamacare plan for several reasons, "especially the sweeping new powers to manage an individual patient's care that would be vested in government bureaucrats as well as huge risks to patients inherent in the public plan."
Smith serves as co-chairman of the bipartisan Congressional Alzheimer's Task Force. He founded and serves as chairman of the Coalition for Autism Research and Education, the Spina Bifida Caucus and the Lyme Disease Caucus. He helped create a program to fund and significantly expand federal autism research, and wrote Title I of the Children's Health Act, which authorized a comprehensive surveillance project to learn what causes autism. He is the prime sponsor of numerous other comprehensive health care laws.
Q. Will the creation of a public plan drive private health insurance companies out of business? Private insurers say they will be unable to compete with the lower costs offered by the federal government, ultimately leading to a single-payer system.
A. There is a great deal of justified concern that the massive new public plan will unfairly benefit from numerous advantages over private insurance plans that, especially over time, will drive many private plans out of business. Notwithstanding claims to the contrary, the public plan will not compete on a level playing field with private insurance companies. A public plan will be empowered to force below-market payment rates to providers (with potential compromise in the quality of care), will not pay state premium and property taxes, will be insulated from lawsuits in state courts in favor of federal courts, will not be compelled to abide by state financial regulations, and will have reasonable assurance that U.S. taxpayers could be forced to cover any deficits.
Rather than defeat an amendment offered by Rep. George Radanovich, R-Calif., requiring the government plan be subject to the same standards and business environment as private plans, the Democratic committee leadership should have accepted the proposal, creating a true level playing field between private insurers and the government-run plan. Like many consumers, I have, at times, been personally disappointed in the performance of private insurance plans. However, Obamacare puts patients — especially the chronically ill and very old — at greater risk of not getting necessary care because government bureaucrats may construe a patient's age, prognosis and medical outcome as factors precluding coverage of a vast array of services, from knee and hip replacements to expensive interventions to combat cancer.
By creating a massive new super-powerful government bureaucracy, I am deeply concerned that patients will encounter both unconscionable and life-threatening delays in addition to outright denials in service. Our health care system must be life-affirming and compassionate, and the patient's doctor must remain the quarterback — not a federal bureaucrat.
Q: Are there adequate incentives to keep employers who now offer health insurance to employees from dropping it because of the creation of a public plan?
A: No. Obamacare creates a new significant penalty on employers, 8 percent of payroll, for not providing what the bill calls "acceptable health coverage" — a set of health benefits designed and approved as "essential" by government bureaucrats. A fat new 8 percent tax can hardly be regarded as a benign "incentive" but it may cause some employers to retain their private plan. However, some employers — perhaps many — may conclude that just paying the new tax as opposed to paying for a private health insurance plan furthers their bottom line.
Q: For all the talk of dramatic reform, the legislation does not fundamentally alter the payment and reimbursement structure — a major driver of escalating health care costs. Why not devise a system that rewards providers for success in keeping people healthy — rather than for ordering more tests and procedures? The current system rewards inefficiency.
A: Under Obamacare, employers are not given the flexibility to attempt to control costs by varying employee health premiums based on participation in wellness programs, even though these programs are proven to significantly advance healthier living and lower costs.
The director of the non-partisan Congressional Budget Office, Douglas Elmendorf, testified before the Senate Budget Committee that none of the bills contained the "sort of fundamental changes that would be necessary to reduce the trajectory of federal health spending by a significant amount." Elmendorf's assessment included the House bill that will cost roughly $1.2 trillion, will raise taxes by $753 billion, will cut $563 billion from Medicare programs — with hospitals, nursing facilities and home care hit particularly hard — and will raise the budget deficit by $239 billion.
Rather than the administration's massive restructuring and expansion of federal control over health care, we should aggressively be moving forward to protect Medicare, which is projected to become insolvent by 2017, and make it a model for both responsiveness and efficiency.
Medical liability reform, including reasonable limits on pain and suffering awards with reduced payments to malpractice lawyers, was strongly pushed by President Ronald Reagan and under Republican control passed the House but failed in the Senate. Defensive medicine — ordering unnecessary tests and procedures to mitigate a possible malpractice lawsuit — imposes huge costs on both providers and patients. Sadly, Obamacare takes a pass on liability reform.
Q: Why does the legislation exempt federal officials from participation in the public plan, and why did Obama balk when asked whether he would enroll in the plan? If it is good enough for the general public, why isn't it good enough for our elected leaders?
A: Good question. Forcing millions of Americans out of private coverage into a public plan that the president apparently considers ill-suited for the First Family raises serious questions concerning the adequacy of the public plan for the rest of America.
In like manner, the Federal Employees Health Benefits Program provides private health care insurance — in all, no fewer than 283 private health plans nationwide — for all federal employees, including members of Congress. It is unfair and hypocritical to put millions of Americans currently enrolled in a private plan at risk of being forced into a public plan when federal officials are unwilling to subject themselves (ourselves) to the same, potentially substandard health care coverage.
On more than one occasion the Democratic committee leadership blocked or defeated Republican amendments that would have either allowed all Americans access to the exact same coverage plan as the FEHBP or would have required the president and vice president and all members of Congress to move to the government-run public plan. Meanwhile, an analysis by the independent Lewin Group estimated that under Obamacare more than 83 million people would lose their private insurance coverage and could be automatically enrolled in the public plan. As the spiral continues, the private insurance market will implode; Americans will have no choice in health insurance other than the public plan.
Q: Will the plan provide coverage for undocumented immigrants? If so, how will the government enforce the mandate for every individual to have health insurance?
A: Obamacare would require millions of people to be "automatically enrolled" in Medicaid regardless of legal status. Specifically, Section 1802 of the bill requires that "the State shall accept without further determination the enrollment under the Medicaid program of an individual determined by the Commissioner to be a non-traditional Medicaid eligible individual." Nowhere in the legislation is the commissioner required to apply the existing citizenship and identity verification requirements that exist in current Medicaid statute. Again, the Democrats teamed up to defeat an amendment to improve the bill that was offered by Rep. Nathan Deal, R-Ga., to require proof of U.S. citizenship.
No one who is sick or injured should ever under any circumstance be denied needed medical care; however, providing care for a person in need — an unequivocal moral responsibility — is not the same as enrolling that person in a government-sponsored health program.
Q: The plan seems more concerned about covering the uninsured than the underinsured — those people whose medical bills far exceed the payout limits of their policies or whose health plans have unreasonable exemptions. To help Americans with costly long-term medical expenses, why not impose out-of-pocket caps?
A: While the House bill does limit annual cost sharing to $5,000 for individuals and to $10,000 for families, the plight of the uninsured raises an important issue — that insurance coverage does not equal access. For example, according to the non-profit, non-partisan National Center for Policy Analysis, five-year cancer survival rates in Great Britain are 53 percent for women and 45 percent for men, compared to 63 percent and 66 percent respectively in the U.S. Those discrepancies can be largely attributed to access issues — early diagnosis, time to treatment after referral and access to treatments, such as the newest cancer drugs.
As reported by the Heritage Foundation, access to cancer treatment became a major crisis in Britain when patients were having to wait a year or more after being diagnosed to begin chemotherapy, and the British government is spending a fortune to reduce the waiting time to three months by 2010 — a goal unlikely to be met.
Additionally, we should look behind the number of uninsured to develop solutions to providing access to quality health care for different subpopulations. When you break down the 47 million uninsured, 2007 Census data show that 9.1 million live in households making more than $75,000 and may be able to afford coverage; 9.7 million are not U.S. citizens; 18.3 million are young adults between 18 and 34; and a significant percentage were temporarily uninsured who regained their health coverage within several months. More than just having insurance, everyone should have timely access to high quality care, and different solutions may be more effective for different subpopulations.
Before totally disrupting the private insurance market and the 172 million people it covers in ways from which it may take many decades to recover, we should have positive answers to some basic questions: Will individuals be more satisfied? Will they have lower out-of-pocket costs, better access and higher quality care? Will they be able to see providers they like? Will they have a choice in selecting an insurance plan that matches their needs?
Q: Why not establish maximum allowable payments for various procedures, taking regional differences into account?
A: We should first look carefully at our ongoing experience with New Jersey hospitals regarding payment caps under diagnostic-related groupings (DRGs) for Medicare and Medicaid. Used in the U.S. since the 1980s, DRGs are supposed to fairly contain costs by setting maximum allowable payments. The net outcome for New Jersey, however, is that our hospitals currently are being reimbursed only 89 cents on the dollar of costs for Medicare patients and 66 cents on the dollar for Medicaid patients. Those loss rates also are a major reason that 15 operating hospitals in the state are on the watch list for being forced to shut their doors.
We need to be very cautious regarding maximum allowable payments to cover a much larger public plan base, much less to cover all insurers. Part of the concern is that payment caps could drive the quality of care toward the lowest common denominator, rather than toward excellence and innovation. Many New Jersey hospitals are justifiably proud of both their efficiency and their quality.
It is unavoidable that if reimbursement rates do not reflect real costs and thus systematically underpay providers, quality and access will be compromised, as evidenced now by the closure of hospitals and physicians refusing to take new Medicare patients.
Q: Health consumers often have no idea what the charges are for various procedures and tests, and typically don't care, unless the money is coming out of their pocket. Why not require complete transparency in billing from doctors and hospitals?
A: There needs to be more transparency than provided for in Obamacare. The President's plan does not go far enough in ensuring patients and doctors have the information they need to make the best health care decisions. Any reform should assist consumers as they shop for and choose the most appropriate health care provider and treatment for their particular needs, on a basis they choose, such as quality, costs or other considerations.
We all have been frustrated when we get confusing bills from doctors and hospitals. Requiring transparency in billing would be a significant step in helping consumers stay informed. Additional analyses and data by researchers and consumer-focused organizations, however, would go further in helping educate doctors and patients in healthcare options.
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Post by fiberisgoodforyou on Aug 23, 2009 10:58:50 GMT -5
www.opencongress.org/bill/111-h3200/textOpenCongress Summary This is the House Democrats' big health care reform bill. Broadly, it seeks to expand health care coverage to the approximately 40 million Americans who are currently uninsured by lowering the cost of health care and making the system more efficient. To that end, it includes a new government-run insurance plan to compete with the private companies, a requirement that all Americans have health insurance, a prohibition on denying coverage because of pre-existing conditions and, to pay for it all, a surtax on households with an income above $350,000 www.opencongress.org/bill/111-h3200/textPLEASE READ THIS PDF FILE prepared by the House Ways and Means Committee edlabor.house.gov/documents/111/pdf/publications/AAHCA-BILLSUMMARY-071409.pdf
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Post by truthinesshurts on Aug 23, 2009 11:20:36 GMT -5
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Post by fiberisgoodforyou on Aug 23, 2009 11:22:31 GMT -5
www.opencongress.org/bill/111-h3200/textThis URL contains all 1100 (plus) pages... Here is a taste... DIVISION A--AFFORDABLE HEALTH CARE CHOICES TITLE I--PROTECTIONS AND STANDARDS FOR QUALIFIED HEALTH BENEFITS PLANS Subtitle A--General Standards Subtitle B--Standards Guaranteeing Access to Affordable Coverage Subtitle C--Standards Guaranteeing Access to Essential Benefits Subtitle D--Additional Consumer Protections Subtitle E--Governance Subtitle F--Relation to Other Requirements; Miscellaneous Subtitle G--Early Investments TITLE II--HEALTH INSURANCE EXCHANGE AND RELATED PROVISIONS Subtitle A--Health Insurance Exchange Subtitle B--Public Health Insurance Option Subtitle C--Individual Affordability Credits TITLE III--SHARED RESPONSIBILITY Subtitle A--Individual Responsibility Subtitle B--Employer Responsibility TITLE IV--AMENDMENTS TO INTERNAL REVENUE CODE OF 1986 Subtitle A--Shared Responsibility Subtitle B--Credit for Small Business Employee Health Coverage Expenses Subtitle C--Disclosures To Carry Out Health Insurance Exchange Subsidies Subtitle D--Other Revenue Provisions DIVISION B--MEDICARE AND MEDICAID IMPROVEMENTS TITLE I--IMPROVING HEALTH CARE VALUE Subtitle A--Provisions Related to Medicare Part A Subtitle B--Provisions Related to Part B Subtitle C--Provisions Related to Medicare Parts A and B Subtitle D--Medicare Advantage Reforms Subtitle E--Improvements to Medicare Part D Subtitle F--Medicare Rural Access Protections TITLE II--MEDICARE BENEFICIARY IMPROVEMENTS Subtitle A--Improving and Simplifying Financial Assistance for Low Income Medicare Beneficiaries Subtitle B--Reducing Health Disparities Subtitle C--Miscellaneous Improvements TITLE III--PROMOTING PRIMARY CARE, MENTAL HEALTH SERVICES, AND COORDINATED CARE TITLE IV--QUALITY Subtitle A--Comparative Effectiveness Research Subtitle B--Nursing Home Transparency Subtitle C--Quality Measurements Subtitle D--Physician Payments Sunshine Provision Subtitle E--Public Reporting on Health Care-Associated Infections TITLE V--MEDICARE GRADUATE MEDICAL EDUCATION TITLE VI--PROGRAM INTEGRITY Subtitle A--Increased Funding To Fight Waste, Fraud, and Abuse Subtitle B--Enhanced Penalties for Fraud and Abuse Subtitle C--Enhanced Program and Provider Protections Subtitle D--Access to Information Needed To Prevent Fraud, Waste, and Abuse TITLE VII--MEDICAID AND CHIP Subtitle A--Medicaid and Health Reform Subtitle B--Prevention Subtitle C--Access Subtitle D--Coverage Subtitle E--Financing Subtitle F--Waste, Fraud, and Abuse Subtitle G--Puerto Rico and the Territories Subtitle H--Miscellaneous TITLE VIII--REVENUE-RELATED PROVISIONS TITLE IX--MISCELLANEOUS PROVISIONS DIVISION C--PUBLIC HEALTH AND WORKFORCE DEVELOPMENT TITLE I--COMMUNITY HEALTH CENTERS TITLE II--WORKFORCE Subtitle A--Primary Care Workforce Subtitle B--Nursing Workforce Subtitle C--Public Health Workforce Subtitle D--Adapting Workforce to Evolving Health System Needs TITLE III--PREVENTION AND WELLNESS TITLE IV--QUALITY AND SURVEILLANCE TITLE V--OTHER PROVISIONS Subtitle A--Drug Discount for Rural and Other Hospitals Subtitle B--School-Based Health Clinics Subtitle C--National Medical Device Registry Subtitle D--Grants for Comprehensive Programs To Provide Education to Nurses and Create a Pipeline to Nursing Subtitle E--States Failing To Adhere to Certain Employment Obligations
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Post by fiberisgoodforyou on Aug 23, 2009 11:24:49 GMT -5
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Post by jefffriedman on Aug 23, 2009 12:05:25 GMT -5
Fiberisgoodforyou said
""there is no final plan yet"..., I believe the House Bill called HR320 is the proposed act of congress, AKA "America's Affordable Health Choices Act of 2009"
You are correct, there is no final plan yet, because the plan proposed by the majority leadership of yhe 111th Congrass will never pass."
I retort,
If anyone believes that the members who wrote that proposal (HR320) believed that that would be the final version, they not understand the legislative process.
Is it quite possible that that bill as written is a "wish list" of some members of congress, or a starting point in a bargaining position with the knowledge that there would be opposition to any proposal and that any proposal would be changed during the process?
I think it is not only possible but the reality.
When one is selling a house would one tell the potential buyer "I want 600k but I am hard up and will take 300k"-I think not.
The republicans also have their bill which is an equally impassable "wish list." These impossible to pass wish list bills will get mangled together to form a bill that will get votes to pass.
I strongly believe that these attacks on the character and intentions of people one disagrees with is why our system is stalled. It is not Obamacare it is the American health care system, to use shorthand labels limits constructive conversation.
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Post by fiberisgoodforyou on Aug 23, 2009 14:20:01 GMT -5
Can we agree that good reform MUST contain effective incentives for employers, insurers and the insured (as well as under and un insured too)...., and not harmful, costly government mandates.
One needs only to look at the VA, and wonder how the overall long term quality of care provided to our veterans has so much room for improvement, I do have the unpleasant experiance of the rationed care and denial of care that impacted the mortality of my father. This flavor of Government mandated health care (the VA) is a fair and reasonable measure of the potential collapse of histories greatest provider-nation of health care that, that government mandated social engineering will distroy.
The world looks to the USA as the gold standard..., developer of methods and best practices, innovations and the health sciences. Whatever we do to improve greater access to ALL Americans, we must make solid assurances that these efforts preserve and improve one of our national treasures..., health services and GREAT HEALTH FOR ALL OF OUR CITIZENS.
I have been in touch with Congressman's Smiths office, and expressed my concern that the current plan, detailed in HR-3200 causes more harm than good, and issued a few suggestions based on incentives, rather than mandates. Look at our NJ schools, and you can see how unfunded mandates are very BAD, end up to be failed social experiments, and end up costing more to fix!
Small employers must be able to offered affordable health insurance plans, these employers and insurance companies need incentives to offer health coverage, balanced with good family wellness initiatives.
Most people who have no coverage are people working for the small to medium size employers who can NOT afford the $1,500.00 a month premiums. One such solution can be developing a market for small to medium size companies to outsource HR functions, and expand on theses services to include Health Insurance POOLS through the private sector, not government mandated agencies and oversight.
Using ADP as an example, if they were to expand their services beyond payroll services....., One company that kind'a establishes these services is a firm called Administaff...
We have a problem, many Americans are in the midst of the crisis. When the appropriate incentives are designed effectively and honestly, the free market can impliment the positive, permanent solution America needs.
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Post by fiberisgoodforyou on Aug 23, 2009 14:36:40 GMT -5
Great, thanks... I was looking at Pallones website, did not see his Q&A response to the APP there (or on the APP), can you find the Pallone URL, I;d like to see balance in this thread. Thanks FIGFY |
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Post by admin on Aug 25, 2009 7:56:52 GMT -5
www.nypost.com/seven/08242009/postopinion/editorials/obamacare_on_life_support_186200.htmOBAMACARE ON LIFE SUPPORT The more Americans hear about President Obama's health-care agenda, it seems, the sicker they get. A Washington Post-ABC News poll Friday shows that fully 50 percent of Americans dislike Obama's handling of health care -- 42 percent, strongly so -- the highest either number has been. Support for a "public option" to compete with private health insurers is down 10 points in less than two months. And only 19 percent of Americans think ObamaCare would improve their health care or lower expenses. No surprise, though: Obama and congressional Democrats have yet to explain, say, how they plan to control costs without widespread rationing of care. Or how the heavily subsidized public option wouldn't crowd out private plans, leading to de facto nationalization. Most likely, that's because they can't. So it's just as unsurprising that the Democrats are resorting to tactics befitting a schoolyard bully. Rep. Henry Waxman (D-Calif.), chairman of the powerful House Energy and Commerce Committee, last week sent letters to 50 of the nation's largest health insurers, demanding detailed information on how much they spend on executive salaries and corporate junkets. Surely it's just a coincidence that Democratic talking points now stress the need to bash insurance companies in order to save ObamaCare. The president, meanwhile, was taking Republicans to task for not being "bipartisan" -- though his biggest problem has always been skeptical Democrats. Meanwhile, Senate Dems were reportedly scheming to pass the most radical parts of the plan with a parliamentary trick that would avoid the need for a filibuster-proof, 60-vote majority. Better they ditch the desperate moves -- and try to figure out what all the opposition is trying to tell them.
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Post by admin on Aug 25, 2009 8:59:25 GMT -5
I let this thread hang for a few days before I have decided to come back to it. The contributions from both Jeff and Fiber are very good and exactly what we need to continue seeing more of in this country.
If there is any one point that I believe has to be made, it is that the dialog must continue everywhere, it is too vital for all of us. I think all people can agree that, yes, there is a need for health care reform. I believe there are lessons to be learned from this health care issue we are seeing and the social security dialog a few years ago. Remember that? Then president Bush took on the tough topic of social security. In the end he got his clock cleaned for it, but he was right to bring it up, (just as President Obama is right to bring up health care.) The failure of that issues is that dialog has stopped on social security. It is still a program destined to go bust. We the people have lost in the end with social security because we still have to find solutions. I just read recently that starting in 2010, COLA payments will stop for a brief period of time. Seniors will be screaming! Lets not have a repeat of this with health care.
In the bigger picture, we are seeing the battle of two different philosophies playing out, those who believe that Federal government can make good changes and those who are very skeptical. This is nothing new and we saw it in the social security mess as well as how people responded to Hurricane Katrina.
And yes, Katrina was an example of the two ways of thinking and how they reacted. Remember all those people who were appalled at the Federal response? And then there were those of us who were not at all surprised and considered it par for the course when the non government entity, the Red Cross, came in and dollar for dollar out performed the Feds ( Fema) and helped out more people.
Getting back to health care, there is plenty of reason for the public to be very skeptical of federal intervention. I for one do not believe that the Federal government should be involved with health care, marriage, education, or baseball steroids. And contrary to what some legislatures and courts may have said, I am also of the opinion that none of those things are rights. They are sacred institutions to be supported and honored. (Yes, I include baseball steroids, it is male bonding at its best.)
I like the backlash with the tea parties and town hall meetings we are seeing against Obamacare. It is a grassroots effort that is playing a massive role in educating people. The more people find out about it, the more support the Democrats in congress are losing. The Democrats are being lead by the loony left and not the centrists. They way they went about it with arrogance and lack of transparency shows the true colors of the party elite. Even the Blue Dog Democrats have largely been silenced.
But, as Jeff very rightfully pointed out, the GOP is very deficient as well. There are very good reasons why they are the minority. They have failed to deliver ideas or get out any coherent message. The GOP is going to have to pick up the pace and get its act together. If not, they will only ride the coat tails of Democrat failure, which will ensure that we the people lose out again.
Yes, America must keep the dialog going and not come to a standstill. And all voices count.
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