Healthcare reform

[Balta1701]

Good. The more, the merrier. And it's happening on the other side as well. Just wait until the lawyers get their hands on the doctors who take orders from the government to cut tests and orders and have no recourse to lawsuits when they come back and say that they were ordered by the government to cut tests. You talk about a gigantic hole and payback to a certain group of assholes.

So let's see, you argue on one hand that the threat of malpractice suits is the main driver of increasing costs because it drives over-testing, and then on the other hand you argue that it'd be a terrible thing if the government cut back on testing and then prevented lawsuits associated with failing to do so.

[kapkomet]

So let's see, you argue on one hand that the threat of malpractice suits is the main driver of increasing costs because it drives over-testing, and then on the other hand you argue that it'd be a terrible thing if the government cut back on testing and then prevented lawsuits associated with failing to do so.

They will NOT prevent lawsuits related to that. That's my point.

 

[Balta1701]

They will NOT prevent lawsuits related to that. That's my point.

Except for the fact that 38 states already prevent that and that was one of the first concessions the President offered that the Republicans scoffed at...so basically except for 100% of the available evidence, I'd agree with you.

[kapkomet]

Except for the fact that 38 states already prevent that and that was one of the first concessions the President offered that the Republicans scoffed at...so basically except for 100% of the available evidence, I'd agree with you.

Really? And guess what... it works, where it's not watered down by a bunch of other crap. But it's not NEARLY enough to get the cost out of the system.

 

[StrangeSox]

http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/

 

http://www.amazon.com/exec/obidos/tg/detai...ER&v=glance

 

heard him on npr

 

(1) Americans are completely hung up on the mechanism by which we achieve a good health care system. Predictably, then, we completely lose sight of the goal: universal coverage at a reasonable price. There are lots of solutions that would fail at this, and probably more than one that would succeed. But there's only one proven failure, and that's the status quo. (The National Acadamy of Sciences estimates that 22,000 people die in America each year of preventable ailments because they could not get money for a doctor).

 

He points out the stupidity of this wrangling over whether it is the government or the private sector that will administer healthcare, given that many of the systems which perform better than our own are more private. They just don't allow big near-monopoly corporations to hold their government by the balls in those countries, and that goes for health insurance companies as well.

 

(2) It doesn't matter if hospitals are run for profit--Japan has a tremendously better healthcare system than the U.S., and they also have more for-profit hospitals than the U.S. All that matters is who pays, and whether the nature of health insurance coverage will be determined solely by a handful of giant corporate entities.

 

(3) The public hasn't gotten to see much detail about the things the Senate is considering, which is part of the cause of all the retardation from both sides that's been coming out at these town hall meetings; but regardless of what the details are of what the Senate is considering, there is no way that people who have a good health insurance situation right now will be threatened by a solution for the people who don't. Nothing has ever been mentioned by anyone in Washington to that effect. If you're good now, then nothing will change for you. Anyone who says or implies otherwise is fear-mongering.

 

(4) What will probably happen: the federal government will push through a half-assed reform or less, the Democrats will declare total victory, and the non-retarded states will start working on creating their own public options, which will actually be good because it will give us a lot of basis for comparison as to the best solution.

 

[Balta1701]

Really? And guess what... it works, where it's not watered down by a bunch of other crap. But it's not NEARLY enough to get the cost out of the system.

Yup, I should really go back and re-post that article where El Paso TX and the city right next to it are some of the highest and lowest per-capita health care cost cities in the country respectively, despite both sitting under Texas's highly restrictive malpractice lawsuit limits, because obviously the point wasn't made the first time the data was presented and the anecdotes continued to prevail.

[kapkomet]

Yup, I should really go back and re-post that article where El Paso TX and the city right next to it are some of the highest and lowest per-capita health care cost cities in the country respectively, despite both sitting under Texas's highly restrictive malpractice lawsuit limits, because obviously the point wasn't made the first time the data was presented and the anecdotes continued to prevail.

Yes, that would be McAllen. Different issue altogether. But it fits your argument, and it's liberal, and it's a way to prove that government is the only solution. You win.

 

[kapkomet]

http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/

 

http://www.amazon.com/exec/obidos/tg/detai...ER&v=glance

 

heard him on npr

 

(1) Americans are completely hung up on the mechanism by which we achieve a good health care system. Predictably, then, we completely lose sight of the goal: universal coverage at a reasonable price. There are lots of solutions that would fail at this, and probably more than one that would succeed. But there's only one proven failure, and that's the status quo. (The National Acadamy of Sciences estimates that 22,000 people die in America each year of preventable ailments because they could not get money for a doctor).

 

He points out the stupidity of this wrangling over whether it is the government or the private sector that will administer healthcare, given that many of the systems which perform better than our own are more private. They just don't allow big near-monopoly corporations to hold their government by the balls in those countries, and that goes for health insurance companies as well.

 

(2) It doesn't matter if hospitals are run for profit--Japan has a tremendously better healthcare system than the U.S., and they also have more for-profit hospitals than the U.S. All that matters is who pays, and whether the nature of health insurance coverage will be determined solely by a handful of giant corporate entities.

 

(3) The public hasn't gotten to see much detail about the things the Senate is considering, which is part of the cause of all the retardation from both sides that's been coming out at these town hall meetings; but regardless of what the details are of what the Senate is considering, there is no way that people who have a good health insurance situation right now will be threatened by a solution for the people who don't. Nothing has ever been mentioned by anyone in Washington to that effect. If you're good now, then nothing will change for you. Anyone who says or implies otherwise is fear-mongering.

(4) What will probably happen: the federal government will push through a half-assed reform or less, the Democrats will declare total victory, and the non-retarded states will start working on creating their own public options, which will actually be good because it will give us a lot of basis for comparison as to the best solution.

My gawd that's BS. HB 3200 is where a lot of this comes from. So EVERY ARGUEMENT against health care is BS because no one knows what they want to do yet? That's mighty f***ing arrogant of you to then leap to then everyone (against this) is "fear mongering". When you subsidize "public option" and set pricing, it will kill the private industry. It just will. Which Obama himself admits that is what he wants.

[Balta1701]

Yes, that would be McAllen. Different issue altogether. But it fits your argument, and it's liberal, and it's a way to prove that government is the only solution. You win.

No, it's not proof, it's evidence, something you're not offering. You're sitting there repeating the claim that the biggest thing driving up health care costs is doctors ordering extra tests while worrying about malpractice suits. No one out there other than the far right believes that at all, even in the most restrictive states there hasn't been anything more than a percent cut in the growth of health care expenditures after those laws were passed, there is data out there saying that malpractice expensive have gone down significantly relative to inflation over the last 10 years, and the President was, correctly, more than willing to offer that up as the first concession to try to get the Republicans on board (which of course will never happen).

[DukeNukeEm]

So I've been thinking about drinking myself into a coma then hoping to wake up and this whole healthcare thing finally being over with. There is of course an ironic barrier to this plan.

[kapkomet]

No, it's not proof, it's evidence, something you're not offering. You're sitting there repeating the claim that the biggest thing driving up health care costs is doctors ordering extra tests while worrying about malpractice suits. No one out there other than the far right believes that at all, even in the most restrictive states there hasn't been anything more than a percent cut in the growth of health care expenditures after those laws were passed, there is data out there saying that malpractice expensive have gone down significantly relative to inflation over the last 10 years, and the President was, correctly, more than willing to offer that up as the first concession to try to get the Republicans on board (which of course will never happen).

It's not the BIGGEST thing, but it is a damn big component.

 

Honestly, you can't measure the truest of impacts of this for several reasons. One, out of court settlements that never even get to court. Two, defensive medicine is what's taught because that's what they have to do to avoid lawsuits. You'd have to retrain. Three, oh, so he offered it, but the only way he would keep it is if the Republicans gave him the public option free and clear. Come on. That's no real carrot, and you know it.

 

[StrangeSox]

My gawd that's BS. HB 3200 is where a lot of this comes from. So EVERY ARGUEMENT against health care is BS because no one knows what they want to do yet? That's mighty f***ing arrogant of you to then leap to then everyone (against this) is "fear mongering". When you subsidize "public option" and set pricing, it will kill the private industry. It just will. Which Obama himself admits that is what he wants.

 

 

"The SENATE"

 

"HOUSE Bill 3200"

 

 

eta:: also, at least read my f***ing post. Your avatar is highly appropriate and saves me the time of posting it again and again. Its might f***ing arrogant of you to say I said things I did not.

Edited August 31, 2009 by StrangeSox

[kapkomet]

"The SENATE"

 

"HOUSE Bill 3200"

But you just blended the two and people are "fear mongering"... they aren't fear mongering about crap the senate's doing. They are just pissed off and want left alone. I'm not sure why "liberals" don't understand that concept. If you're mentioning people "fear mongering" they aren't about the Senate, so why did you bring it up?

 

Edited August 31, 2009 by kapkomet

[Balta1701]

It's not the BIGGEST thing, but it is a damn big component.

 

Honestly, you can't measure the truest of impacts of this for several reasons. One, out of court settlements that never even get to court. Two, defensive medicine is what's taught because that's what they have to do to avoid lawsuits. You'd have to retrain. Three, oh, so he offered it, but the only way he would keep it is if the Republicans gave him the public option free and clear. Come on. That's no real carrot, and you know it.

So basically your argument is that Obama made the biggest concession he could make, something that would make a huge difference, and it wasn't nearly enough, so the Republicans should give him nothing in return. I love negotiating with you guys. "As soon as you give up everything you want, you can have a vote or two".

 

This Factcheck piece from a few years ago IMO does a good job of compiling the responses to your claim that it's even a remotely significant part.

The President was relying on a paper issued last year by an assistant secretary of HHS which said “The litigation and malpractice insurance problem raids the wallet of every American.”

 

The HHS report put the cost of malpractice insurance to doctors alone at $6.3 billion in 2002, but said much larger costs come from "defensive medicine":

 

HHS: Defensive medicine that is caused by unlimited and unpredictable liability awards not only increases patients’ risk but it also adds costs. The leading study estimates that limiting unreasonable awards for non-economic damages could reduce health care costs by 5-9% without adversely affecting quality of care. This would save $60-108 billion in health care costs each year. These savings would lower the cost of health insurance and permit an additional 2.4-4.3 million Americans to obtain insurance.

 

That “leading study” was a 1996 paper by Stanford economists Daniel P. Kessler and Mark McClellan. McClellan – who is both an economist and a physician – served more recently as President Bush’s senior White House policy director for health care, and is now the head of the Food and Drug Administration.

 

The Kessler-McClellan study is one of the few academic studies that has ever attempted to measure the cost of “defensive medicine” attributable to lawsuits. It did so by examining the cost of treating hospitalized heart patients in states that have caps on damage awards and other restrictions on malpractice suits, and comparing them with the costs of treating similar patients in states without such limits on lawsuits.

 

The Kessler-McClellan conclusion:

 

Kessler-McClellan: We find that malpractice reforms that directly reduce provider liability pressure lead to reductions of 5 to 9 percent in medical expenditures without substantial effects on mortality or medical complications. We conclude that liability reforms can reduce defensive medical practices.

 

The Kessler-McClellan study won the 1997 American Economics Association’s award in health economics.

 

However, a fact not mentioned in the Bush HHS paper is that several other studies of defensive medicine failed to find anywhere near such large costs. A 1990 study by the Harvard University School of Public Health “did not find a strong relationship between the threat of litigation and medical costs,” CBO said. And a 1999 study in the Journal of Health Economics found only tiny savings – less than three-tenths of one percent – when studying the cost of Caesarian sections in states with limits on lawsuits, compared to states without limits.

 

Finally, a 1994 study by the congressional Office of Technology Assessment found some added costs (under $54 million total) due to defensive radiology in children with head injuries and defensive Caesarian sections in certain women with difficult pregnancies. But the OTA study concluded: “it is impossible in the final analysis to draw any conclusions about the overall extent or cost of defensive medicine.”

 

What GAO and CBO Said

 

CBO and GAO both question whether the results Kessler and McClellan observed in hospitalized heart patients can be applied to patients in cancer wards, nursing homes, doctors’ offices, maternity wards and elsewhere.

 

In 1999 a GAO study said the evidence Kessler and McClellan cited was too narrow to provide a basis for estimating overall costs of defensive medicine:

 

GAO: Because this study was focused on only one condition and on a hospital setting, it cannot be extrapolated to the larger practice of medicine. Given the limited evidence, reliable cost savings estimates cannot be developed.

 

And on Jan. 8, 2004 , the Congressional Budget Office also said the Kessler-McClellan study wasn’t a valid basis for projecting total costs of defensive medicine.

 

CBO: When CBO applied the methods used in the study of Medicare patients hospitalized for two types of heart disease to a broader set of ailments, it found no evidence that restrictions on tort liability reduce medical spending. Moreover, using a different set of data, CBO found no statistically significant difference in per capita health care spending between states with and without limits on malpractice torts.

 

Worth noting: The nonpartisan CBO is now headed by Douglas Holtz-Eakin, who previously was chief economist for President Bush's Council of Economic Advisers.

[StrangeSox]

But you just blended the two and people are "fear mongering"... they aren't fear mongering about crap the senate's doing. They are just pissed off and want left alone. I'm not sure why "liberals" don't understand that concept. If you're mentioning people "fear mongering" they aren't about the Senate, so why did you bring it up?

 

Most of what they're ranting about isn't in any piece of legislation. Its made-up fear mongering bulls***, such as the only new option is the public option, DEATH SQUADS!, and illegals are guaranteed coverage. I'm not sure why you don't understand that concept.

[kapkomet]

Why should there be "anything" in return? He asked if tort reform would be put in, that they would go all in on the public option. WTF would they do that for when that's the point of the Democrat's bill? At that point, it's a dead issue.

 

And this article pretty much says what I just said - it's almost impossible to understand the true cost, but for me, it's almost common sense. There's so much stuff done, and paid, by CPT coding and bundling that it would have to be an enormous cost. But then again, I've worked in the medical indistry, so I'm stupid, I guess. It's just what my own two eyes saw.

 

 

[kapkomet]

Most of what they're ranting about isn't in any piece of legislation. Its made-up fear mongering bulls***, such as the only new option is the public option, DEATH SQUADS!, and illegals are guaranteed coverage. I'm not sure why you don't understand that concept.

Well, ok, what the hell are you (or I) missing? Under the HOUSE bill (yes, I understand your point about the Senate...) the only insurance you can get if you change is the public option, DEATH SQAUDS are called for (although honestly, that's just a stupid argument, imo, holy s***, it's called end of life preparation, I guess living wills are death sqaud sessions now - although if the GOVERNMENT forces that, it's BS...), and illegals WILL RECIEVE (please do not get hung up on "guaranteed"... come on, you're smarter then that, and it's ignorant to think otherwise that they won't get the coverage, which drives up the costs even more to the taxpayer - more then even now) health care coverage. So what's wrong with the rants again?

[Balta1701]

But then again, I've worked in the medical indistry, so I'm stupid, I guess. It's just what my own two eyes saw.

As I told Y2HH, the plural of anecdote is not "Data".

[StrangeSox]

Well, ok, what the hell are you (or I) missing? Under the HOUSE bill (yes, I understand your point about the Senate...) the only insurance you can get if you change is the public option,

 

I asked for your source on this. As far as I'm aware, it is not in the bill. Another poster pointed out a section they thought you might be referring to, but I don't remember you following up.

 

DEATH SQAUDS are called for (although honestly, that's just a stupid argument, imo, holy s***, it's called end of life preparation, I guess living wills are death sqaud sessions now - although if the GOVERNMENT forces that, it's BS...),

 

That's not the 'DEATH SQUADS' idiots are all worked up about. Palin talked specifically about some government panel killing her DS baby, not "end of life counseling" provided by her doctor if she wants it. Its not forced, its not mandated. Its simply more made-up bulls***.

 

and illegals WILL RECIEVE (please do not get hung up on "guaranteed"... come on, you're smarter then that, and it's ignorant to think otherwise that they won't get the coverage, which drives up the costs even more to the taxpayer - more then even now) health care coverage.

 

Why wouldn't I get hung up on "guaranteed" since that's the retarded fear-mongering bulls*** part? They're eligible to buy a plan in the HCE. Just like they're eligible to purchase bread at the grocery store.

 

Its illogical to make conclusions based on unsupported premises, like illegals being guaranteed coverage. I'm still waiting for something indicating that illegals WILL RECEIVE health care free-of-charge, because complaining that they'll be able to pay for coverage is just too ridiculous to address.

 

So what's wrong with the rants again?

 

They're retarded.

 

[StrangeSox]

Kap, I fully recognize that there are legitimate practical criticisms of this bill (how do they plan on paying for it?) as well as ideological criticisms I simply do not agree with.

 

What I frequently argue against are what I see as ridiculous and just generally unsupportable criticisms.

[mr_genius]

They're eligible to buy a plan in the HCE. Just like they're eligible to purchase bread at the grocery store.

 

Its illogical to make conclusions based on unsupported premises, like illegals being guaranteed coverage. I'm still waiting for something indicating that illegals WILL RECEIVE health care free-of-charge, because complaining that they'll be able to pay for coverage is just too ridiculous to address.

 

This program will not be able pay for itself with premiums paid in. I think we all realize that paying into this program is not like buying a loaf of bread.

Edited August 31, 2009 by mr_genius

[kapkomet]

As I told Y2HH, the plural of anecdote is not "Data".

So there's nothing without data? That's nice to know. Just remember for all of your "data", there's plenty of room for manipulation. You should know that... but I think there's times where you get so wrapped up in a position, that it can't possibly be wrong, huh?

 

 

[Balta1701]

You should know that... but I think there's times where you get so wrapped up in a position, that it can't possibly be wrong, huh?

And I'm the only one????

[kapkomet]

I asked for your source on this. As far as I'm aware, it is not in the bill. Another poster pointed out a section they thought you might be referring to, but I don't remember you following up.

 

 

 

That's not the 'DEATH SQUADS' idiots are all worked up about. Palin talked specifically about some government panel killing her DS baby, not "end of life counseling" provided by her doctor if she wants it. Its not forced, its not mandated. Its simply more made-up bulls***.

 

 

 

Why wouldn't I get hung up on "guaranteed" since that's the retarded fear-mongering bulls*** part? They're eligible to buy a plan in the HCE. Just like they're eligible to purchase bread at the grocery store.

 

Its illogical to make conclusions based on unsupported premises, like illegals being guaranteed coverage. I'm still waiting for something indicating that illegals WILL RECEIVE health care free-of-charge, because complaining that they'll be able to pay for coverage is just too ridiculous to address.

 

 

 

They're retarded.

The point is right now illegals are not eligible for insurance because they can't legally obtain work. That's honestly the way it should be. So they go to the ER, get treated with world class care (compared to the rest of the world - no it's no perfect, no one says it is) and we the taxpayer pony up or it gets written off. The issue becomes, under this plan, just like you say, they can go purchase insurance like it's bread in a store. "Purchase"... whatever the hell that is. Anyway, that's wrong. If you're not a citizen, you should not be able to pick up insurance like it's bread in a store. What the hell comparision is that? So I'll say it another way, which is the semantics game you're playing. Insurance is guaranteed to be available to them. That's FACT. And it's wrong. Jose Illegal (stereotyped) just got the same "rights" I just got as a citizen, and that's just wrong.

 

Then there's this: Ezekiel Emanual, who is pretty much running the show for this push, has said a hell of a lot regarding "death panels, old people care" and the rest.

 

http://online.wsj.com/article/SB1000142405...3280098676.html

 

Ezekiel said this s***, and that's where a lot of the ammunition is coming from. It's not what's in a bill, it's the positions in which these people take that piss people off. Yet, they will forgo this crap? You actually trust these assbags to do the "right thing" for America? No way.

 

[kapkomet]

And I'm the only one????

Sure. Because the "other side" is obviously lying, right? Ok, all BS aside, seriously, that's how it comes off. People can see and experience things, and it doesn't matter, because there's not "data". But yet, "data" can be manipulated to say whatever you want it to say. So, because it supports a position you want it to, you're going to believe it more then you would something I would post. I'm using that as an example. Then you'll post counter after counterpoint talking about how my stuff is junk, because this that and the other is supporting your position.

 

I'm not defending a dissertation when I post stuff - but I guess that tends to be my downfall. All I know is, there's a line between government intervention in MY life versus simply taking my property, and all Kaperbole ™ aside, that's where I draw the line, and apparently a lot of "fear mongering" Americans agree with me.