Yeah, Barry and Congress are all about 'leveling the playing field', unless of course it applies to them. What page, paragraph and line stipulates that the Executive, Judicial and Legislative Branches of government and their families are EXEMPT from The Health Care Reform Act?

None of these fears would be an issue under a Single Payer System. Medicare for all would cover all low and high risk individuals for much less cost than what is being spent now in premiums, deductible and co-pays. Each of us who has coverage pays more to cover the 22,000 uninsured who still get sick and eventually, require more intensive, more expensive care because care was delayed.

Each of us who has coverage pays more to cover the 22,000 uninsured who still get sick and eventually, require more intensive, more expensive care because care was delayed.

Let's see--nutritionists can avoid amputations, right? No one here is buying this BS.

It's going to suck to be a pensioner. We're watching Soylent Green, 1984, Animal Farm, and Logan's Run -- all in real time. Since medical costs are heavily weighted to end-of-life issues, that's where the pressure to contain the enormous costs of Obamacare will focus. If you're young, that's your folks. If you're not, it's you. If I'm wrong about this, I'm only off by a generation. Maybe it will be your kids when they grow up.

The state can't possibly absorb the cost of healthcare for the entire country, and there are limits to how much in taxes the dwindling number of actual taxpayers will be willing to pay. Major cost savings have to come from somewhere, and that means old people. This ain't no sophomoric argument; it's going to happen, and you all know it.

I wonder if the plan will cover state-assisted suicide centers for old people, or whether the plan will be limited to Mandated Do-Not-Resucitate Orders and Mandated Palliative Care?

re: #2

Lets not forget all the "undocumented" non-citizens.

While chronic diseases like multiple sclerosis, severe psoriasis and rheumatoid arthritis are all expensive to treat, much more is spent in our current system to treat the effects of tobacco abuse, alcohol abuse and food abuse (morbid obesity). While its bad enough now, under a system that promises coverage for all, there will be no financial impact for folks with these self-created disorders. Nutritionists and even psych counseling imposed on a patient does no good. They have to want it, ask for it, even struggle a little to get it, if such therapy is going to have any lasting impact on their self-destructive behaviors.

Kinda like Obama supporters. They have to be directly affected by him before they consider changing their voting preferences, like the Cambridge Cops.

yeah let's not forget the 'undocumented' people who might be sitting next to you on the bus or subway and have undiagnosed, untreated tuberculosis or swine flu. Wouldn't it be better if we had a system where a person, any person, could go to a doctor if they were sick?

"Wouldn't it be better if we had a system where a person, any person, could go to a doctor if they were sick?"

It's called an Emergency Room.

As Epador said - a large part of the problem is getting people to take advantange of what is ALREADY available to them.

Wouldn't it be better if we didn't have 12 MILLION undocumented aliens in this country? You know, the border crashers who pay not income or healthcare taxes at all?

This kind of circular logic is making me all swimmy headed.

Jeezus.

See? I can't even spel good anymore...

#1 emergency room costs are among the highest in health care. not so for a family doctor or primary care doctor to treat the illness initially. ppl receiving primary care in ERs because they have no where else to go is a MAJOR part of the cost crisis
# 2 undocumented people are going to come, hell or high water, as would you or I if that were our only way to feed ourselves or our families. There but for the grace of God....etc...etc

Are we suppose to take care of the whole world? Ilegals should not be our problem, should not be in our country and our good for nothing politicans should do something about it.

Liberalism should be classified as a mental illness.

This is not about caring for individual health of patients. Its about controlling the cash cow slush fund created ( like Social Security ) if the Government creeps get thier greedy way..

Otherwise, they would be standing in line and waiting their turn with everybody else, instead of barging in front of the line and getting it for free on top of it.

They should have to live in the system to understand how to make it better. Y'know, pay as You go.

Since they are insulated and sheltered from it, they are incapable of anything but what they know best.. Stay in power and pay off the right People to do so at all costs.

progreat -

The folks who go to ERs when something goes wrong aren't likely to attend a doctor at any other time - even if it were available.

But just for grins, because I'm actually about 60% certain you'd reject any solution that doesn't fit your criteria - think about the following.

It costs about $70 to go to one of the little doc-in-a-box clinics in places like Walgreens, Walmart and CVS.

At the same places, $4 prescriptions are available.

What would you think about giving everyone under a predetermined income level (including unemployed and welfare/WIC/ADC users, but not folks otherwise covered under a health care program) a preloaded ATM card with $1000 - which would only be accepted by those (or equivalent) clinics and pharmacies and doctors which have chosen to participate in the program.

This would give the recipient 10 visits to the doctor at $70 each, and a year's worth of 6 prescriptions. ER stuff would still be handled the way it is now for indigents.

Would that be a satisfactory solution for you? Why, or why not?

mag: illegals are not your problem, but they come from Mexico; whereas the freedom of the Iraqi people was a problem that warranted spending hundreds of billions of dollars and thousands of Iraqi and American lives--got it. Nice that you're consistent in your moral isolationism.

JLawson
Not a bad idea but would need tweaks for:
Preventative care (saves money later)
Dental care (poor dental care, of course, turns into heart disease eventually = more medications, more medical needs, more cost)
Prenatal care
Pediatric care (we have 111,000 uninsured children in Ohio)
Docs-in-a-box are not equipped or funded to deal with even a limited list like this but they do serve the public in minor ways that do cut down on the number or ER visits.
So do public health nurses, licensed nurse practitioners, midwives, etc etc
Docs-in-a-box could fill a small, but still important niche in providing some basic health care.
Of course, the system breaks down again when the person being seen at Walgreen's has undiagnosed disease that needs follow-up not under the practice guidelines of the average docs-in-boxes ie untreated hypertension that has affected the kidneys, previously undiagnosed diabetes, breast, pelvic or abdominal masses that need follow-up, even though MOST of the time they turn out to be benign, the masses still need to be followed up, the list goes on and on. That's the whole point of 'preventative care.' But $1000 is not going to cover those costs and those kind of clinical findings happen multiple times a day in tens of thousands of practitioners' offices.
Why not have all of us covered by a single payer plan like Medicare that functions VERY WELL on 3-5% overhead. That amount could be, and eventually, will be tweaked, but will still beat the 20-30% profit margins being paid to the insurance industry right now. We would all pay a small portion of higher taxes but it is possible to cover everyone, to save spending down the road, to prevent expensive disease later.

Progreat -

"Preventative care" - the vast majority of people DO NOT think about 'preventative care'. They wait for something to go wrong, then go to the doctor. This would take care of the doctor visit. You can't force someone to go to the doctor for 'preventative care' - and in the case of vaccines and such, those can be gotten for free usually from county health offices.

And then you start the laundry list...

(Shakes head.)

You missed the "... doctors which have chosen to participate in the program."

Which can include pediatricians, GPs, dentists and the like. All they have to do is follow government charging guidelines. $70 a visit. (Some multiple might be charged for dental work.)

As far as children go - dependents EACH get their own card, if they've got a social security number. So each child has 10 visits, w/associated prescriptions.

"undiagnosed disease that needs follow-up not under the practice guidelines of the average docs-in-boxes ie untreated"

That's what the 10 visits is/are for. And each year of the program, the card gets refreshed back up to $1000.

Heavy duty stuff (amputations, organ transplants, ect) fall outside the scope of this proposal.

"Why not have all of us covered by a single payer plan like Medicare that functions VERY WELL on 3-5% overhead."

Possibly because of the hundreds of billions of dollars of fraud and waste currently in the system?

Tell you what - do the math, Progreat - 45 million 'uncovered people. $1000 each. Figure $5 billion for administrative overhead.

How many times could you fund this from the supposed $300 billion fraud and waste inside Medicare?

"the vast majority of people DO NOT think about 'preventative care'. They wait for something to go wrong, then go to the doctor."

Bullshit. Prove it.

Prove most people think about 'preventative care'.

Some folks think about flu shots. Some about tetanus shots. Haven't seen many people go "You know, I'm wondering how my liver is working... guess I'll go to the doctor for a checkup."

Well, you're the one challenging the statement, so you're the one who's got to come up with a counter example. But I'll give you this much...

The Preventive Medicine Con | The Doctor Is In

When we talk about preventive medicine, we are generally speaking of two general areas: the screening and early detection of diseases, and lifestyle changes and therapy to reduce long-term medical risk. Screening and early detection of diseases is appealing concept, but devilishly difficult in practice. The idea sounds wonderful: do a simple, inexpensive test; detect the disease earlier, when it is simpler and less expensive to treat; and you will be healthier in the future, requiring far fewer health resources. The problem lies, as I have discussed elsewhere, in the malignant mathematics and sickening statistics of applying medical screening to large populations. Simply put, no screening test is perfect, and all such tests generate both false positives -- telling you that you have a disease, when you do not -- and false negatives -- telling you you're fine when you really have the disease. Even with an extraordinarily accurate test the problem lies in applying it to large populations. If you have a cancer screening test with a 1% false positive rate (an extraordinarily low number in the screening business), and have a disease which occurs in one patient out of every 10,000, applying the test to 10,000 patients will generate 100 false alarms (false positives) for every patient with the disease. These false positives all require additional testing or procedures to determine whether in fact the abnormal test really means you have the disease. And herein lies the economic trap: you will in fact spend an extraordinary amount of money on patients without the disease for every patient detected who does have the disease. This phenomenon has been well demonstrated in almost every study of screening -- to wit: screening actually increases rather than reduces medical costs.

Of course many simple screening tests and procedures are used every day in medicine. When you go to the doctor, your blood pressure is checked, your cholesterol is measured, you stand on the scale and are weighed, and asked whether or not you smoke. If your blood pressure is high, you will likely be started on medication, and it is also likely that you will need to stay on this medication indefinitely. If your cholesterol is elevated, will be encouraged to exercise, make dietary changes, and lose weight (most of which you won't do), but will also likely will be started on cholesterol-reducing medication, likely for the long-term. Of course, we recognize that this is appropriate for the reduction of risk from high blood pressure or high cholesterol. What may not be recognized, is that many people with high blood pressure or high cholesterol, unrecognized and untreated, may not have significant problems from these disorders for many years, if ever.

Suppose that 100 people with high cholesterol levels take statins, a common treatment for high cholesterol. Of them, about 93 wouldn't have had heart attacks even if they had not taking the medication. Five people, on the other hand, will have heart attacks despite taking the statin. Only the remaining two out of the original 100 avoided a heart attack by taking the daily pills. In the end, 100 people needed to be treated to avoid two heart attacks during the study period--so, the number of people who must get the treatment for a single person to benefit is 50. This is known as the "number needed to treat" -- and is a common way in which health researchers determine the cost and effectiveness of preventive therapy. Ideally, we will get better at selecting those patients at the front end who actually will benefit from taking the drug, and therefore avoid administering it in those who ultimately will not need it. But such health forecasting is far, far from perfect, and there will always be a need to treat patients perceived to be at risk even though time will ultimately find them not to be at risk at all. The human organism in health and disease is far too complex to eliminate this reality.

Problems such as these arise in every aspect of preventive medicine. It also goes without saying that implementing lifestyle changes, such as weight reduction, regular exercise, smoking cessation, and dietary modifications, is largely a fool's pursuit. We humans love our addictions, and rarely overcome them even when they threaten our health and well-being.

The myth of the economic benefits of preventive medicine dies hard, however, and the pending changes in the health care system are placing a very large bet on this loser's hand. The systemic manifestation of this crap shoot is the glorification and indemnification of primary care as the solution to all of our health care woes, economic or otherwise. Although the final details of the pending reforms of health care are still far from complete, it is clear that there will be a heavy emphasis on steering patients toward primary care physicians and away from specialists.

JLawson
Let me just say that after reading Dr. Bob's opinions and short bio, I would not choose him for a personal physician. Be that as it may, let's cut to the basics.

US 42nd in life expectancy per the Kaiser Foundation, the Commonwealth Fund, the WHO etc etc. US spends twice as much per patient for health care than nations with a national plan but has poorer outcomes. For the world's industrialized nations, the US has the largest disparity between rich and poor in health care distribution.
Surely we can do better than that. It's time to try some new methods, JLawson. The 1st baby boomer just cashed her social security check last year. Thousands of baby boomers are going to be stricken with the diseases associated with aging long before they are due to receive Medicare. Cancer, heart disease, stroke, diabetes will affect all of us eventually. Only a tiny number of baby boomers will be lucky enough to go to sleep one night and just not wake up. The majority will become patients, some sooner than others. It's time now to change this system of piracy and profiteering. United Health posted a 150% increase in their 2nd quarter profits last week. At the same time, someone with a guilty conscience at United posted an internal memo instructing managers how to eliminate an additional 10% of their high-risk clients in order to boost additional profits.
It's time to stop this.

"Well, you're the one challenging the statement, so you're the one who's got to come up with a counter example."

That makes no sense. You alleged that "the vast majority of people DO NOT think about 'preventative care'." It's your responsibility to back up that statement.

But are you really using THAT link to back up that statement? If so, I'll mark you down as unserious. Thanks for playing.