Healthcare reform

[StrangeSox]

No one argues that the health care system in the US is great if you have a lot of money.

 

Also, nice sig. Glad to see that you hold educators in such high regard.

[Balta1701]

Link

Health-care spending in the United States grew last year despite a contracting economy, amounting to 17.3 percent of the gross domestic product, according to estimates released Wednesday.

 

The health-care sector's share of the economy grew 1.1 percent in 2009 compared with 2008, the largest one-year increase since at least 1960.

 

Spending growth by federal, state and local governments was 8.7 percent last year, nearly three times the rate for employers, insurance companies and individuals -- 3 percent.

[EvilMonkey]

Should the real headline have been changed to "Illegals bankrupt local public hospital"?

 

http://hosted.ap.org/dynamic/stories/U/US_...&SECTION=US

 

Feb 3, 4:21 PM EST

 

Cuts leave indigent dialysis patients in limbo

By KATE BRUMBACK

Associated Press Writer

 

 

ATLANTA (AP) -- Before she started receiving dialysis treatments at Atlanta's Grady Memorial Hospital, Bineet Kaur was so sick from kidney failure she could hardly walk. The memories of that pain came flooding back in September, when she received a letter saying the clinic was closing.

The treatment typically costs $40,000 to $50,000 a year, and Grady is just one of the struggling public hospitals cutting the service to reduce costs. Many indigent dialysis patients, including Kaur, are illegal immigrants, so facilities that give them routine treatments receive no federal money for their care.

Since the clinic closed in October, Kaur and other former clinic patients have been getting private dialysis treatments funded by Grady, which is struggling to find new providers for them and has even offered to buy them plane tickets to their home countries.

New patients who show up in Grady's emergency room in need of dialysis will get it only in life-or-death situations, and after they improve will be told that they must go elsewhere for regular care.

 

Kaur, a bubbly 26-year-old who studied nursing and once did an internship at Grady, said she doesn't know where she will get the treatment she needs to survive.

 

"I really hope God helps," the Indian native said on a recent morning. "Otherwise it's like having a death sentence."

Public hospitals are often the only option for illegal immigrants and others without health insurance because they will treat anyone. But many of those hospitals have severe funding problems, and several have given up dialysis treatment to control costs. Grady officials say its clinic was losing $2 million to $4 million a year.

Jackson Health System, the public hospital in Miami-Dade County, stopped paying for outpatient dialysis treatment for 175 indigent patients on Dec. 31. A month later, 40 patients - about half of them illegal immigrants - were still looking for alternate treatment. The hospital said it expects to save more than $4 million a year by stopping the payments.

 

The University Medical Center in Las Vegas has seen its budget strained as emergency room visits for dialysis more than doubled from December 2008 to December 2009, from 116 to 243. The Las Vegas hospital stopped paying for people to get private dialysis, but now spends about $700,000 a month on dialysis in its emergency room.

 

"You try to figure out what service lines to cut and that seemed like an easy one," said hospital spokesman Rick Plummer. "But it ended up just shifting the burden because now the dialysis patients show up very ill in the emergency room."

Larry Gage, president of the National Association of Public Hospitals and Health Systems, said many hospitals are rethinking the services they offer.

"It comes down to a decision about how to allocate scarce resources," Gage said. "As sad as some of the individual cases are, you really almost have to ask which services are the greatest number of uninsured patients going to benefit from, including uninsured immigrants."

Some argue that illegal immigrants are a burden that the nation's health care system should not have to shoulder.

"When you have long-term health conditions that need continuing care, the government needs to send these people back to their countries," said Ira Mehlman, spokesman for the Federation for American Immigration Reform, which favors tougher immigration enforcement. "They cannot expect the taxpayer is going to endlessly pick up the tab."

Medicare, the federal health insurance program for people 65 and older, covers routine dialysis for U.S. citizens regardless of their age, but illegal immigrants are ineligible.

 

Changes to the health care system being considered in Congress are unlikely to improve the situation. The current bills specifically exclude illegal immigrants.

 

Patients who need dialysis can't survive long without it. Hospitals can get reimbursed by Medicaid, the state-federal program that helps low-income people, when they provide emergency dialysis for illegal immigrants in life-or-death situations. But the reimbursement doesn't come close to covering what hospitals actually spend.

 

Emergency room dialysis is much more expensive than regular treatment, in part because patients are so sick they may need to be hospitalized until their conditions stabilize. But giving up routine dialysis still could help public facilities like Grady because at least some of their patients could end up in ERs at other hospitals.

 

"In communities that don't have a Grady, or other public hospital, all of the private providers pick up these patients," said hospital spokesman Matt Gove. He said that as long as other hospitals and clinics see Grady as the "solution" to providing dialysis for the uninsured, no one else will step in to help.

 

Kaur and several of Grady's other illegal immigrant patients have not been able to find a hospital or clinic to take care of them once Grady stops paying for private treatment later this year.

 

"The only option I have is to go to the emergency room at Grady every time I feel sick," she said. "That's an option but it's not really an option because they can turn me away if they think I'm not critical."

 

Kaur came to the U.S. on a tourist visa in 2000 and applied for political asylum, saying she didn't feel safe in India as a single woman living alone. Her asylum request was denied, making her an illegal immigrant.

 

In 2003, she was diagnosed with kidney failure and told she needed dialysis, but she didn't get treatment because she had no insurance. After several years of extreme pain, she fainted while driving early last year, crashing her car into a pole. That landed her in a suburban hospital where she received dialysis treatment for a month. But hospital staff kept telling her she needed to return to India, where she says she no longer has family.

When she got sick again, she went to Grady and was treated at its outpatient clinic. She said her health improved dramatically, though she is weak on the days she gets treatment and relies on an aunt to take care of her.

 

Grady closed the clinic in October and has paid for its former patients to get treatment at private clinics for several months. The hospital has said it can't continue the payments indefinitely and has been trying to find placements for the patients, but many have not found another clinic that will take them.

About a dozen patients have accepted Grady's offer to return them to their home countries, but others don't want to leave their families in Georgia. They are also concerned because, in most cases, regular treatment is unreliable or unavailable in their home countries, said Dorothy Leone-Glasser, a patient advocate who has been helping the Grady patients.

 

A group of patients has sued Grady, claiming the hospital is abandoning them. A judge threw out the case in December but the patients are appealing.

[Rex Kickass]

Why not just rename it "Selfish Poor People Threaten to Die Without Expensive Healthcare Treatment"?

[Balta1701]

Should the real headline have been changed to "Illegals bankrupt local public hospital"?

This of course is another argument for why the immigration system needs fixed. Be nice if we had a working Senate that could have done that, either in 2007 or now.

[NorthSideSox72]

Obama conceding that the latest health care bill may not make it alive. Seems to me that, at this point, his best course of action is to say he's tabling the discussion until after the economy is a bit better, and focus on other things.

 

[kapkomet]

Obama conceding that the latest health care bill may not make it alive. Seems to me that, at this point, his best course of action is to say he's tabling the discussion until after the economy is a bit better, and focus on other things.

 

 

That's what he just did, without saying the words. You know, "FAILURE" and all.

[vandy125]

Very good article put out recently on the Wall Street Journal that talks about the wasted chance we had with Healthcare Reform. I've seen a lot about the "30 million new customers" for insurance companies, but without effective ways to push people into the program, you will have the healthy opting out and paying a fine instead of paying for the more expensive insurance that they can jump into when they get sick. This has been done before in other parts of the country:

 

Wall Street Journal Article

Take those states in turn. "In Maine, where guaranteed issue went into effect in 1993, there were 11 carriers in the individual market, and now there are two: Us, and another company that would not be called in any circle an equivalent health insurance company." In Kentucky, 45 insurers fled the state, with WellPoint the last one standing, until the state started in 1998 to repeal most of these regulations.

 

Depending on the plan, WellPoint's monthly premium for a 20-year-old in Indianapolis, where the company is based, ranges from $53 to $202. But the same young adult looking for similar coverage in Albany would face costs anywhere between $832 and $1,047. Obviously health costs vary across the country, Mrs. Braly says, but these disparities are almost entirely due to New York's regulatory mandates. In a state with 19 million people, 88 New Yorkers between the ages of 18 and 24—88!—have bought WellPoint's best-selling individual insurance product because insurance laws make it perfectly rational not to acquire costly coverage until people need it

 

 

[southsider2k5]

Very good article put out recently on the Wall Street Journal that talks about the wasted chance we had with Healthcare Reform. I've seen a lot about the "30 million new customers" for insurance companies, but without effective ways to push people into the program, you will have the healthy opting out and paying a fine instead of paying for the more expensive insurance that they can jump into when they get sick. This has been done before in other parts of the country:

 

Wall Street Journal Article

 

It also pretty well shows the the point that health care companies will leave the industry sooner than eat the brunt of paying for health care reform.

[mr_genius]

This of course is another argument for why the immigration system needs fixed.

 

Agreed. She should have been detained and sent to India when she was found to be an illegal alien.

 

Edited February 11, 2010 by mr_genius

[jasonxctf]

INDIANAPOLIS – Health insurer WellPoint blames the Great Recession and rising medical costs for its planned 39 percent rate increase for some California customers. To President Barack Obama, however, it's Exhibit A in his campaign to revive the health care overhaul.

 

Health and Human Services Secretary Kathleen Sebelius, who received the company's explanation in a letter Thursday, said "it remains difficult to understand" how premium increases of that size by can be justified when WellPoint Inc. reported a $2.7 billion profit in the last quarter of 2009.

[vandy125]

INDIANAPOLIS – Health insurer WellPoint blames the Great Recession and rising medical costs for its planned 39 percent rate increase for some California customers. To President Barack Obama, however, it's Exhibit A in his campaign to revive the health care overhaul.

 

Health and Human Services Secretary Kathleen Sebelius, who received the company's explanation in a letter Thursday, said "it remains difficult to understand" how premium increases of that size by can be justified when WellPoint Inc. reported a $2.7 billion profit in the last quarter of 2009.

 

Yeah, not very good. The plans out there are still not attacking the issue though. Insurance companies are just the part that everyone sees because they deal with the patient payments directly. If nothing is done about unnecessary procedures and the rising costs of drugs and procedures, the patient payments will still go up and it doesn't matter whether the government or an insurance company is collecting.

Edited February 12, 2010 by vandy125

[Balta1701]

Yeah, not very good. The plans out there are still not attacking the issue though. Insurance companies are just the part that everyone sees because they deal with the patient payments directly. If nothing is done about unnecessary procedures and the rising costs of drugs and procedures, the patient payments will still go up and it doesn't matter whether the government or an insurance company is collecting.

And, according to more than a few analysts, the House and Senate Health care bills would, through a number of economic mechanisms (penalties for high payments, encouraging cheaper options like estate planning/death panels, etc.), have exactly that effect, esp. 10+ years out. The only thing that would make the Senate bill stronger is a strong public option, or even better, allowing everyone to buy into Medicare.

It's also worth noting this insurer's specific explanation for this rate increase:

Financial woes have pushed healthier people to drop coverage or buy cheaper plans, the company argued to Sebelius.

 

...."While this dynamic always exists, in a challenging economy it becomes more prevalent as individuals who are paying for coverage without a government or employer subsidy must choose to continue coverage or use the money for other necessities," wrote Brian A. Sassi, president and CEO of the consumer business unit at Wellpoint, Anthem's parent company.

 

....WellPoint said the increases relate only to the individual insurance market, less than 10 percent of its California members, and that a minority of its 800,000 individual policy holders will see 39 percent increases. The company said an independent actuarial firm concluded its rates were "sound and necessary."

This is of course exactly what some of us say is the inherent problem with a non-universal private system; there's a built-in death spiral. As costs go up, the healthy tend to leave the insurance pool, which pushes costs up even more. It's designed to break, and the end result is that no one except the very wealthy can afford insurance.

[vandy125]

And, according to more than a few analysts, the House and Senate Health care bills would, through a number of economic mechanisms (penalties for high payments, encouraging cheaper options like estate planning/death panels, etc.), have exactly that effect, esp. 10+ years out. The only thing that would make the Senate bill stronger is a strong public option, or even better, allowing everyone to buy into Medicare.

Encouraging cheaper options on top of other things seems to be a good way to go. However, I disagree with the public option as that would just lead to government taking over healthcare (maybe at a slow pace but takeover nonetheless). And, we will just disagree in that I see that as a bad thing. Medicare is already paying at a lower rate than what regular insurance companies are and is a bit of the cause in the rise of insurance costs due to cost-shifting. So, adding more people to that would again lead to higher prices and lead again towards the path of government taking over everything (again I don't see that as good). Also, I'm not sure how that would really lower costs overall.

 

It's also worth noting this insurer's specific explanation for this rate increase:

This is of course exactly what some of us say is the inherent problem with a non-universal private system; there's a built-in death spiral. As costs go up, the healthy tend to leave the insurance pool, which pushes costs up even more. It's designed to break, and the end result is that no one except the very wealthy can afford insurance.

So, how would you make sure that you push in the healthy into the insurance pool? I took a look at my pretty low insurance payments and compared it to the fines I would pay in both bills and saw that I would spend less if I just went with the fines. The push is pretty weak, the healthy will leave.

Edited February 12, 2010 by vandy125

[Brian]

Daily Show informs me more than any news channel sometimes. I had no clue that Hawaii had government run health care, and it seems neither did mose Republicans, including Rush Limbaugh.

[Balta1701]

If no health care overhaul passes Congress, health insurers may be in for a windfall -- and one far larger that most Americans probably realize.

 

According to a study by a pro-health reform group published Thursday, the nation's largest five health insurance companies posted a 56 percent gain in 2009 profits over 2008. The insurers including Wellpoint, UnitedHealth, Cigna, Aetna and Humana, which cover the majority of Americans with insurance.

 

The insurers' hefty profit gains came even as 2.7 million more Americans lost their insurance coverage due to the declining economy.

Link

[kapkomet]

Link

 

 

Evil mother f***ers.

 

Now, ask yourself why this happened.

 

Oh wait, there's no convincing of you otherwise. Evil mother f***ers.

 

And, what's the % overall, not the "% profit gained", which is misleading.

[Balta1701]

I figured that'd get you riled up. The opportunity to defend big business. Wouldn't matter if they were denying health insurance to someone or bringing down the global financial system and then being bailed out by the government...as long as they're profitable, they're worth of a strong defense.

[kapkomet]

I figured that'd get you riled up. The opportunity to bash big business. Wouldn't matter if they were forced to give out health insurance to someone below cost or going out of business because they will not be subsidized and then being forced to close down by the government...as long as they're unprofitable, what's what we want, those capitalist pigs. Government needs to step into everything because capitalism has left me wanting everyone on equal footing.

[Balta1701]

Can you cite for me any bit of evidence suggesting anything other than a negative correlation between Health Care outcomes and increasing insurance company profitability? If, hypothetically, I were to reject the contention that profitability for its own sake is the greatest good possible and instead were to believe that the goal of the medical industry was health care, and the free market system actually worked in this industry, then you should have no problem demonstrating that to me.

 

If insurers are more profitable and the system is working, then either they should be improving efficiency, expanding coverage, or producing overall better health care outcomes.

 

If insurers are more profitable and the system is fundamentally broken, then they may be less efficient, contracting coverage, and producing worse overall health care outcomes.

[southsider2k5]

Can you cite for me any bit of evidence suggesting anything other than a negative correlation between Health Care outcomes and increasing insurance company profitability? If, hypothetically, I were to reject the contention that profitability for its own sake is the greatest good possible and instead were to believe that the goal of the medical industry was health care, and the free market system actually worked in this industry, then you should have no problem demonstrating that to me.

 

If insurers are more profitable and the system is working, then either they should be improving efficiency, expanding coverage, or producing overall better health care outcomes.

 

If insurers are more profitable and the system is fundamentally broken, then they may be less efficient, contracting coverage, and producing worse overall health care outcomes.

 

Hilarious that you can even post the last line with a straight face, and then recommend that the federal government get involved. The Kings of running fundamentally flawed, inefficient, contracting coverage and worse productive plans across the spectrum.

[Balta1701]

Hilarious that you can even post the last line with a straight face, and then recommend that the federal government get involved. The Kings of running fundamentally flawed, inefficient, contracting coverage and worse productive plans across the spectrum.

Except in the case of health care, where the private providers dominate the Feds in those categories.

[Y2HH]

Except in the case of health care, where the private providers dominate the Feds in those categories.

 

Because the feds haven't had a chance yet.

 

And before you try to say how wonderful medicare is, it's not. So just don't.

 

Same goes for the VA. Just don't go there, because it'd show you have no clue what you're talking about.

 

It's amazing how little people actually know about the health care industry, yet everyone's an expert at fixing all of it's woes, and they all end in the government running it when the government is bankrupt in 48 out of 50 states and overall beyond bankrupt on a national scale. 2+2 doesn't equal 5 no matter how hard you all try.

 

Again.

 

I repeat.

 

Hospitals send the bills.

 

Insurance companies pay them.

 

In no way am I saying ignore the insurance companies, as there ARE things that can be done, however...they are NOT the primary target. If you want lower insurance rates, tell the f***ing hospitals to stop sending insane bills for insane procedures that shouldn't cost what they do to the insurance companies.

 

Instead, what you will do, is again ignore what I just said and fall back on blaming the insurance companies for everything.

 

It's old.

Edited February 17, 2010 by Y2HH

[southsider2k5]

Because the feds haven't had a chance yet.

 

And before you try to say how wonderful medicare is, it's not. So just don't.

 

Same goes for the VA. Just don't go there, because it'd show you have no clue what you're talking about.

 

I can go there in two words. Agent. Orange.

 

Talk about the mother of all pre-existing conditions.

[Y2HH]

I can go there in two words. Agent. Orange.

 

Talk about the mother of all pre-existing conditions.

 

My father was in Nam and exposed to agent orange, so let's say I have a unique perspective on this.

 

Do you know what he'd have to go through to collect on that? His friends did...and it's so red-tape filled that by the time you start collecting you're probably dead or dying...that's how awesomely efficient the VA is.

Edited February 17, 2010 by Y2HH