What ObamaCare might mean for you

[finknottle]

Your "actual cost" numbers are pretty off...particularly end-of-life care. I've read somewhere that 80% of a person's lifetime health care costs come in the last two weeks of life...so if we could only not pay for the last two weeks (since they're going to kick in two weeks anyway), health care would be fixed. Great idea...if you could identify those two weeks.

 

I made the numbers up on the fly - my intention is only to get people to go through the exercise of costing out what they consume, in actual services rather than annual premiums. All the congressional jiggery-pokery in the world won't change the fact that if you go see a doctor, you consume a very expensive man-hour plus overhead. When you have emergency surgery, there are a team of doctors, nurses, and technicians that must be paid, as well as the facilities and tests. All too often people who complain about rates complain *not* in the sense of what they pay versus what they expect to consume, but rather what they pay versus what they think they have a right to pay.

 

We can argue about whether we over-consume, whether middlemen and paperpushers are jacking the costs up, or whether prices are subsidizing free-loaders, but at the end of the day we are buying specialized services that are intrinsically very expensive. And it is foolish to believe that the core expense can be significantly reduced without limiting the services we consume.

[ExiledInIllinois]

Like the Chef and most of us who have employer coverage, there is a worry that our sweet deal may get affected by health reform. However, the bigger worry that we should have is losing our coverage due to job loss or a major health issue.

 

 

And that what it really it really boils to for people and why I am not holding my breath that ANY (even if I don't like the reform that happens) any reform will be made. Good luck getting ANYTHING done.

[KD in CA]

If Republicans supported spending more money on funding clinics like you suggest, that would have been done years and would have alleviated part of the problem. Why have they never supported that alternative?

 

What do you need Republicans for when the executive and legislature are controled by the Dems? Why are they not proposing this instead of blowing up the entire system at a cost of untold billions?

[ExiledInIllinois]

I made the numbers up on the fly - my intention is only to get people to go through the exercise of costing out what they consume, in actual services rather than annual premiums. All the congressional jiggery-pokery in the world won't change the fact that if you go see a doctor, you consume a very expensive man-hour plus overhead. When you have emergency surgery, there are a team of doctors, nurses, and technicians that must be paid, as well as the facilities and tests. All too often people who complain about rates complain *not* in the sense of what they pay versus what they expect to consume, but rather what they pay versus what they think they have a right to pay.

 

We can argue about whether we over-consume, whether middlemen and paperpushers are jacking the costs up, or whether prices are subsidizing free-loaders, but at the end of the day we are buying specialized services that are intrinsically very expensive. And it is foolish to believe that the core expense can be significantly reduced without limiting the services we consume.

 

 

Why the expensive overhead? If the a laborer is too start out at say Ford to today (if that is even posible), I ensure you they will not be making over 15 bucks an hour.

 

I brought up the salary issues in the health care profession? Should somebody be making 100k a year to take my temperature and blood pressure and file some papers? Of course I am throwing it right back in the industry's face and I am half sarcastic. But that is the way the rest of the world thinks outside of the health care profession...

[Pine Barrens Mafia]

Why the expensive overhead? If the a laborer is too start out at say Ford to today (if that is even posible), I ensure you they will not be making over 15 bucks an hour.

 

I brought up the salary issues in the health care profession? Should somebody be making 100k a year to take my temperature and blood pressure and file some papers? Of course I am throwing it right back in the industry's face and I am half sarcastic. But that is the way the rest of the world thinks outside of the health care profession...

 

They have to pay for malpractice ins.

[KD in CA]

If the a laborer is too start out at say Ford to today (if that is even posible), I ensure you they will not be making over 15 bucks an hour.

 

Are you drunk?

 

 

p.s. don't forget to add in that 'time and a half cause it's after 2 pm', jobs playing solitare, zero healthcare contributions, and the rest when you add up that per hour rate that the taxpayers are funding.

[KD in CA]

They have to pay for malpractice ins.

 

Oh, no, I'm sure that Obama and pals are taking a very serious look at malpractice reform as part of this overhaul.

[ExiledInIllinois]

Are you drunk?

 

 

p.s. don't forget to add in that 'time and a half cause it's after 2 pm', jobs playing solitare, zero healthcare contributions, and the rest when you add up that per hour rate that the taxpayers are funding.

 

 

No. Just my typing sucks... It always does. Home the last few days, I got less time on my hands to concentrate on my typing!

 

A Ford worker gets to play solitare on the assembly line?

 

With regard to my job and taxpayers:

 

Time and a half? Zero health care contributions? OT is parsed out in my job more miserly than Scrooge would do... They just change your shift and re-schedule... Off shifts you get shift differental (7% 4-12, 10% midnights, and time and half for Sundays) Health contributuons? I pay 20%, the Corps pays 80% (over 200 bucks every two weeks). Now solitare/internet... When I am in the office pushing buttons.

[finknottle]

Why the expensive overhead? If the a laborer is too start out at say Ford to today (if that is even posible), I ensure you they will not be making over 15 bucks an hour.

 

I brought up the salary issues in the health care profession? Should somebody be making 100k a year to take my temperature and blood pressure and file some papers? Of course I am throwing it right back in the industry's face and I am half sarcastic. But that is the way the rest of the world thinks outside of the health care profession...

 

Fair question.

 

By overhead I am refering primarily to the cost of the facilities, equipment, and the costs of running a business (compliance, insurance, etc). These are particularly significant in the medical business.

 

But let's look at your flunky. It may look like they are only taking your temperature, but they are actually trained, as are the people taking your blood and so forth. Because we want a highly regulated medical world, they must be accrediated and not (like your laborer) someone off of the street - that drives their salaries up. And let's not forget that take home pay is not the real cost to the business. A practice employing a nurse has to pay payroll taxes, medical benefits, and ensure that nurse against malpractice. So at the end of the day, that nurses time probably *does* cost the practice $50+ an hour.

 

Interestingly enough, the market for nurses is more like the free market than that for doctors (who limit the supply). If they were making too much money, there would be plenty of people going into it - and yet we have a shortage!

[ExiledInIllinois]

Fair question.

 

By overhead I am refering primarily to the cost of the facilities, equipment, and the costs of running a business (compliance, insurance, etc). These are particularly significant in the medical business.

 

But let's look at your flunky. It may look like they are only taking your temperature, but they are actually trained, as are the people taking your blood and so forth. Because we want a highly regulated medical world, they must be accrediated and not (like your laborer) someone off of the street - that drives their salaries up. And let's not forget that take home pay is not the real cost to the business. A practice employing a nurse has to pay payroll taxes, medical benefits, and ensure that nurse against malpractice. So at the end of the day, that nurses time probably *does* cost the practice $50+ an hour.

 

Interestingly enough, the market for nurses is more like the free market than that for doctors (who limit the supply). If they were making too much money, there would be plenty of people going into it - and yet we have a shortage!

 

Interesting and I see what you are saying... I also forgot about the mal ins like you and Joe said.

 

Also... Do workers in the health care industry get free medical? If anything they should have to pay into the system too!

[ExiledInIllinois]

Oh... I forgot to mention about medical facilities. Do they have to be so elaborate? Like the new Children's hospital (If I recall it is Children's) they are building in Chicago. Granted I like to see the nice things, but man! The thing even has a "winter garden" on one of the high rise floors... The thing is an architectural marvel.

 

Arne't we building the "new cathedrals" of the 21st century... Of course it doesn't revolve around religion but in the modern case science has become what religion used to occupy in people's lives.

[IDBillzFan]

Oh, no, I'm sure that Obama and pals are taking a very serious look at malpractice reform as part of this overhaul.

It's such a critical part of reform, and yet I don't see it discussed in any of the current bills. I understand how costs are high because doctors run an inordinate amount of tests, but I also understand that doctors may run inordinate amount of tests to cover their asses in case they get sued.

 

I simply can not imagine reforming health care without tort reform. Unfortuntely, them lawyers...they have some serious lobbying cash.

[ExiledInIllinois]

It's such a critical part of reform, and yet I don't see it discussed in any of the current bills. I understand how costs are high because doctors run an inordinate amount of tests, but I also understand that doctors may run inordinate amount of tests to cover their asses in case they get sued.

 

I simply can not imagine reforming health care without tort reform. Unfortuntely, them lawyers...they have some serious lobbying cash.

 

 

Or just run an inordinate amount of tests to get more money and say it because they fear getting sued. Tug on the patients irrational fear. I am sure there is no limits to who use cop outs. Look what some vets do and they don't get sued if they kill your pet... Reminds me of that King of the Hill episode where hank gets stuck with the cat from the veteran.

[IDBillzFan]

Or just run an inordinate amount of tests to get more money and say it because they fear getting sued. Tug on the patients irrational fear. I am sure there is no limits to who use cop outs. Look what some vets do and they don't get sued if they kill your pet... Reminds me of that King of the Hill episode where hank gets stuck with the cat from the veteran.

If it's a problem on both sides, and it contributes to the high costs, then maybe addressing THAT problem will help reduce costs. But to address health care reform without tort reform of some sort seems kind of stupid to me.

[ExiledInIllinois]

If it's a problem on both sides, and it contributes to the high costs, then maybe addressing THAT problem will help reduce costs. But to address health care reform without tort reform of some sort seems kind of stupid to me.

 

 

I agree. Can we remain at the staus quo? I hate to rhyme, but I don't know.

[Booster4324]

If it's a problem on both sides, and it contributes to the high costs, then maybe addressing THAT problem will help reduce costs. But to address health care reform without tort reform of some sort seems kind of stupid to me.

 

I haven't read up on it ages and your point about testing might be a valid one. However, I was under the impression the actual insurance for malpractice was a fairly low percentage. If testing is to become part of preventative health care (supposedly lowering costs), wouldn't that help keep the cost of the insurance down? At least then we would know why the tests are being performed (preventative vs precautionary). Just a thought.

[IDBillzFan]

I agree. Can we remain at the staus quo? I hate to rhyme, but I don't know.

I don't think anyone honestly believes the status quo is the way to go. My only concern, as I have mentioned previously, is that doing something simply to avoid doing nothing doesn't mean that what you're doing is the right thing. Which is why rushing these bills has bad written all over it...as is evidenced by the original link in this thread.

[ExiledInIllinois]

I don't think anyone honestly believes the status quo is the way to go. My only concern, as I have mentioned previously, is that doing something simply to avoid doing nothing doesn't mean that what you're doing is the right thing. Which is why rushing these bills has bad written all over it...as is evidenced by the original link in this thread.

 

 

Ya, I see what you are saying... But how int he hell is anything going to get done in a cluster phuck system like we have. What you are basically saying IS that things will remain the staus quo.

 

On another front... As much as I hated the Bush years and the war choices... Dynamics have changed which I respect.

 

You heard it first here guys!

 

[IDBillzFan]

Ya, I see what you are saying... But how int he hell is anything going to get done in a cluster phuck system like we have. What you are basically saying IS that things will remain the staus quo.

Not really. I give Obama tremendous credit for pushing this issue, and especially for setting a deadline, as unrealistic as it is. Now, when pressed for why his is pushing for such a rough deadline, his answer has, essentially, been, "because without deadlines, nothing gets done in DC." And while most people paying attention know that's not the real reason, it's still a very good reason. (Except for the immensly rudimentary management mistake that once you set a precedent for casually brushing off a missed deadline, your future deadlines carry no weight, but that's a different issue.) People are working around the clock to find answers right now. This is great in that while we may not be seeing formidable bills being produced, the ball is rolling. In fact, NOT meeting the August deadline means America will have a chance to really find out what is going on in these bills, and elected officials are going to hear from their constituents. As a result, health care reform may actually take place, and that will be a good thing for everyone provided they take the time to get it as right as possible out of the gate.

 

No status quo there.

[Magox]

http://www.washingtonpost.com/wp-dyn/conte...9072701905.html

 

Obama's Plan Isn't the Answer

For the 85 percent of Americans who already have health insurance, the Obama health plan is bad news. It means higher taxes, less health care and no protection if they lose their current insurance because of unemployment or early retirement.

 

President Obama's primary goal is to extend formal health insurance to those low-income individuals who are currently uninsured despite the nearly $300-billion-a-year Medicaid program. Doing so the Obama way would cost more than $1 trillion over the next 10 years. There surely must be better and less costly ways to improve the health and health care of that low-income group.

 

Although the president claims he can finance the enormous increase in costs by raising taxes only on high-income individuals, tax experts know that this won't work. Experience shows that raising the top income-tax rate from 35 percent today to more than 45 percent -- the effect of adding the proposed health surcharge to the increase resulting from letting the Bush tax cuts expire for high-income taxpayers -- would change the behavior of high-income individuals in ways that would shrink their taxable incomes and therefore produce less revenue. The result would be larger deficits and higher taxes on the middle class. Because of the unprecedented deficits forecast for the next decade, this is definitely not a time to start a major new spending program.

 

A second key goal of the Obama health plan is to slow the growth of health-care spending. The president's budget calls explicitly for cutting Medicare to help pay for the expanded benefits for low-income individuals. But the administration's goal is bigger than that. It is to cut dramatically the amount of health care that we all consume.

 

 

A recent report by the White House Council of Economic Advisers claims that the government can cut the projected level of health spending by 15 percent over the next decade and by 30 percent over the next 20 years. Although the reduced spending would result from fewer services rather than lower payments to providers, we are told that this can be done without lowering the quality of care or diminishing our health. I don't believe it.

 

To support their claim that costs can be radically reduced without adverse effects, the health planners point to the fact that about half of all hospital costs are for patients in the last year of life. I don't find that persuasive. Do doctors really know which of their very ill patients will benefit from expensive care and which will die regardless of the care they receive? In a world of uncertainty, many of us will want to hope that care will help.

 

We are also often told that patients in Minnesota receive many fewer dollars of care per capita than patients in New York and California without adverse health effects. When I hear that, I wonder whether we should cut back on care, as these experts advocate, move to Minnesota, or wish we had the genetic stock of Minnesotans.

 

The administration's health planners believe that the new "cost effectiveness research" will allow officials to eliminate wasteful spending by defining the "appropriate" care that will be paid for by the government and by private insurance. Such a constrained, one-size-fits-all form of medicine may be necessary in some European health programs in which the government pays all the bills. But Americans have shown that we prefer to retain a diversity of options and the ability to choose among doctors, hospitals and standards of care.

 

At a time when medical science offers the hope of major improvements in the treatment of a wide range of dread diseases, should Washington be limiting the available care and, in the process, discouraging medical researchers from developing new procedures and products? Although health care is much more expensive than it was 30 years ago, who today would settle for the health care of the 1970s?