no public option

[CaP'N GRuNGe]

CNN says the Senate Finance Committee has just voted down the public option. Not sure if that means it's totally dead now or what.

[Perchoutofwater]

Thank goodness for small victories. It will be interesting to see if this means were are in for public option lite with co-ops, or if they are going to drop it entirely. Anyway, I guess we should be thankful for small victories.

[bpwallace49]

Health care cost to rise by (%, far outstripping wage increases

 

Anything passed by Congress has no effect materially on next year, and another whopping increase is likely.

 

Obviously the current bill is not the fix everyone wants, so what the heck is the answer? How long can these breakneck increases continue before reform actually happens?

 

perch I would LOVE to hear an option out of you besides "get rid of illegal aliens and eliminate all lawsuits". Those issues are NOT the sole reason health care keeps rising every single year.

 

Anyone?

[CaP'N GRuNGe]

Health care cost to rise by (%, far outstripping wage increases

 

Anything passed by Congress has no effect materially on next year, and another whopping increase is likely.

 

Obviously the current bill is not the fix everyone wants, so what the heck is the answer? How long can these breakneck increases continue before reform actually happens?

 

perch I would LOVE to hear an option out of you besides "get rid of illegal aliens and eliminate all lawsuits". Those issues are NOT the sole reason health care keeps rising every single year.

 

Anyone?

 

soylent green

[Big John]

soylent green

a prior Clubfoothead name.

[Perchoutofwater]

perch I would LOVE to hear an option out of you besides "get rid of illegal aliens and eliminate all lawsuits". Those issues are NOT the sole reason health care keeps rising every single year.

 

I agree they are not the sole reason health care keeps rising, still any health care reform that fails to address them is just lip service or redistribution.

 

My plan would be as follows (and I'm sure there are holes or problems I haven't thought of and would welcome any thoughts you might have) in no particular order::

 

1. Start enforcing our current immigration laws, do away with anchor baby laws, and deport any illegal alien that comes into a hospital (obviously give them help if it is life threatening, but deport them ASAP).

2. Do away with punitive damages in medical malpractice cases. If a doctor is negligent they should lose their license or face criminal charges for assault.

3. Raise the age people are eligible for medicare, and have medicare and medicaid pay what the services actually cost, instead of underpaying which requires hospitals and doctors to make up the difference by over charging insurance companies and by extension consumers.

4. Make insurance portable, break the tie between employment and insurance.

5. Make catastrophic insurance a requirement (I'm honestly not sure if this is constitutional. )

6. Do away with all the various state regulations on health insurance and aside from catastrophic insurance allow individuals and the free market decide what type of coverage are desired. (I'm pretty sure this is constitutional and may be one of the few items that legitimately falls under interstate commerce.)

7. Institute a sales tax on any items with a fat, sugar, cholesterol, and sodium contents above x% the only exception being whole non-processed foods such as meat, dairy, fruits, and vegetables).

8. Increase the sin tax on alcohol and tobacco.

9. Institute a 1% sales tax on any food bought through a drive through window or brought to you in your vehicle. (This one help curb carbon emissions as well )

 

Have the taxes in 7-9 help pay for truly indigent care and help medicare and medicaid pay a more appropriate rate.

 

These are just of the top of my head. I'm sure there are some problems with some of the suggestions, and I'm sure they could be fine tuned a bit, but I think they make more sense than what is currently being suggested and could probably be made into a 50 page bill that everyone would have time to read prior to voting on.

Edited September 29, 2009 by Perchoutofwater

[evil_gop_liars]

.....whaaa

 

I feel dumber after reading that.

[Furd]

2. Do away with punitive damages in medical malpractice cases. If a doctor is negligent they should lose their license or face criminal charges for assault.

 

I don't think that this will have any effect on health care costs:

 

1) Not all states allow punitive damages;

2) Most of those that do have pretty high burdens of proof (clear and convincing evidence of malicious conduct (or somesuch))

3) Given #1 and 2, I'm not sure how often that juries award punitive damages in medical malpractice cases. My guess is that its a rare occurrence.

4) Most states have caps on damage awards in medical malpractice actions and in most circumstances there has been no reduction in insurance premiums or health care costs.

[Perchoutofwater]

.....whaaa

 

I feel dumber after reading that.

 

I don't see you proposing anything. I don't mind the criticism, but it would be helpful if you actually took a point like Furd did and deconstruct it. Of course we know how good you are at actually arguing points, so just stick to the insults.

[Perchoutofwater]

I don't think that this will have any effect on health care costs:

 

1) Not all states allow punitive damages;

2) Most of those that do have pretty high burdens of proof (clear and convincing evidence of malicious conduct (or somesuch))

3) Given #1 and 2, I'm not sure how often that juries award punitive damages in medical malpractice cases. My guess is that its a rare occurrence.

4) Most states have caps on damage awards in medical malpractice actions and in most circumstances there has been no reduction in insurance premiums or health care costs.

 

If that is the case then why is malpractice insurance so high? While it might be true that few cases actually end up with punitive damages being accessed, how many are settled prior to verdict? How many are settled because it is in many cases cheaper to settle than to fight in court? How many are settled for fear of getting a sympathetic jury?

 

You may very well be correct, but if you are what would this provision hurt? If a doctor is negligent enough to deserve punitive damages under the current system, then throw his ass in jail, have the insurance pay actual damages (or whatever the legal term is that covers the medical bills and disability if relevant).

[bpwallace49]

If that is the case then why is malpractice insurance so high? While it might be true that few cases actually end up with punitive damages being accessed, how many are settled prior to verdict? How many are settled because it is in many cases cheaper to settle than to fight in court? How many are settled for fear of getting a sympathetic jury?

 

You may very well be correct, but if you are what would this provision hurt? If a doctor is negligent enough to deserve punitive damages under the current system, then throw his ass in jail, have the insurance pay actual damages (or whatever the legal term is that covers the medical bills and disability if relevant).

 

I am getting to your list . . . . but didnt Chavez pretty much soot most of this down with relevant footnotes and links? While it is an issue, it is by no means the giant boogeyman that it is made out to be . . . .

[Yukon Cornelius]

I am getting to your list . . . . but didnt Chavez pretty much soot most of this down with relevant footnotes and links? While it is an issue, it is by no means the giant boogeyman that it is made out to be . . . .

we need something for the sheep to be afraid of.

Edited September 29, 2009 by Yukon Cornelius

[Scooby]

having kept up too much with the health care plan, but how much would the premiums have been and furthermore how would the government have gone about collecting them?

[Perchoutofwater]

I am getting to your list . . . . but didnt Chavez pretty much soot most of this down with relevant footnotes and links? While it is an issue, it is by no means the giant boogeyman that it is made out to be . . . .

 

There are links and footnotes supporting both sides. I have in the past provided links to studies showing that it could cost as much as 10% of our health insurance premiums. I question if it is that high, but I also question if it is as insignificant as those on the left claim it to be. I'm not saying that tort reform is a silver bullet, but it is something that definitely should be incorporated into any medical care reform. If it is only 1% it would save a family of four $130 a year.

[Perchoutofwater]

we need something for the sheep to be afraid of.

 

Wow another nice substantive argument from the left.

[detlef]

I agree they are not the sole reason health care keeps rising, still any health care reform that fails to address them is just lip service or redistribution.

 

My plan would be as follows (and I'm sure there are holes or problems I haven't thought of and would welcome any thoughts you might have) in no particular order::

 

 

7. Institute a sales tax on any items with a fat, sugar, cholesterol, and sodium contents above x% the only exception being whole non-processed foods such as meat, dairy, fruits, and vegetables).

8. Increase the sin tax on alcohol and tobacco.

9. Institute a 1% sales tax on any food bought through a drive through window or brought to you in your vehicle. (This one help curb carbon emissions as well )

 

Have the taxes in 7-9 help pay for truly indigent care and help medicare and medicaid pay a more appropriate rate.

 

These are just of the top of my head. I'm sure there are some problems with some of the suggestions, and I'm sure they could be fine tuned a bit, but I think they make more sense than what is currently being suggested and could probably be made into a 50 page bill that everyone would have time to read prior to voting on.

Wasn't the notion of sin taxes derided as unethical in the thread about short term capital gains? Weren't you and WV saying that taxes should not be used to discourage behavior? Maybe it was just him. Honestly not sure.

Edited September 29, 2009 by detlef

[bpwallace49]

1. Start enforcing our current immigration laws, do away with anchor baby laws, and deport any illegal alien that comes into a hospital (obviously give them help if it is life threatening, but deport them ASAP). How do we fund/accomplish this? Have armed guards at every hospital along with detention cells? Not a bad idea, but seems to be problematic in implementation.

2. Do away with punitive damages in medical malpractice cases. If a doctor is negligent they should lose their license or face criminal charges for assault. What about loss of quality of life for the patient? Are you eliminating the need for compensation to real victims here? I dont know if I agree with that one . . .

3. Raise the age people are eligible for medicare, and have medicare and medicaid pay what the services actually cost, instead of underpaying which requires hospitals and doctors to make up the difference by over charging insurance companies and by extension consumers. I think we also have to re-examine what "services actually cost" as well. I remember you saying how many hospitals have wasted space and cosmetics built in. Make health care about HEALTH CARE. The age limits I agree with.

4. Make insurance portable, break the tie between employment and insurance. I could be wrong, but isnt that a main plan of the Obama plans? Breaking that link and making insurance portable? PS- I am ALL for this.

5. Make catastrophic insurance a requirement (I'm honestly not sure if this is constitutional. ) I dont see why not. Car insurance is mandatory in many states, and you HAVE to provide proof of insurance upon request.

6. Do away with all the various state regulations on health insurance and aside from catastrophic insurance allow individuals and the free market decide what type of coverage are desired. (I'm pretty sure this is constitutional and may be one of the few items that legitimately falls under interstate commerce.) Can you clarify this one? What if most consumers are sick of profit weilding corporate insurance and WANTS a single payer system or co-ops? I severly doubt DEregulation will benefit the average consumer, rather than just benefit insurance companies. But that is just me . . .

7. Institute a sales tax on any items with a fat, sugar, cholesterol, and sodium contents above x% the only exception being whole non-processed foods such as meat, dairy, fruits, and vegetables). I agree completely. Just like your sin taxes below. If you want to be 400 pound behemoth, I just dont want to fund it . . .

8. Increase the sin tax on alcohol and tobacco. Agreed!

9. Institute a 1% sales tax on any food bought through a drive through window or brought to you in your vehicle. (This one help curb carbon emissions as well ) Hey Sailor! New in town???? Is this for health reasons? What about of you go in the fast food place? Please clarify . . .

 

Have the taxes in 7-9 help pay for truly indigent care and help medicare and medicaid pay a more appropriate rate. I think part of the overhaul has to be a true cost analysis of what a doctors visit or an x-ray costs. You are in construction, right? So your business is ALL about your main controllable expense . . labor. . . with a lot fo your materials being somewhat fixed per job. Whats do we assign as a "per hour" cost for doctors? For their admin/nurses/etc? I would love to see a true cost analysis for what the REAL time of a visit/x-ray costs . . .

 

A lot of great ideas, but just like ANY bill passed by either side of the aisle there is no way that pork and earmarks will ever be completely eliminated. I REALLY admire the British system that up until recently, made public service truly SERVICE. This is the first generation that actually aspires to be politicians when they grow up instead of a different profession. Our politicians make a LOT of cash from special interest groups that contribute to them and make sure their special projects get passed/funded. We have a very broken system . . . .

[Perchoutofwater]

Wasn't the notion of sin taxes derided as unethical in the thread about short term capital gains? Weren't you and WV saying that taxes should not be used to discourage behavior?

 

I don't agree with government getting involved in health care at all, as I do not see it as something it was originally designed to do. If it is going to do it, and pay for any portion of it whether it be medicare, medicaid , or any other kind of funding, taxes are going to have to be used. I do not feel that income tax is fair, and question to some extent it's constitutionality as the ratification of it is questionable. I do not on the other hand question the fairness or the constitutionality of a sales tax. Also, I don't look at the sales tax as on these unhealthy items as a way to discourage behavior, but in this case as a way to pay for the consequences of that behavior.

[Savage Beatings]

I will be very surprised if the final bill doesn't include some kind of last minute ammendment that either outlines a public option (whether or not it is named as such), or at the very least will necessarily lead to one in the not too distant future.

[bpwallace49]

I don't agree with government getting involved in health care at all, as I do not see it as something it was originally designed to do. If it is going to do it, and pay for any portion of it whether it be medicare, medicaid , or any other kind of funding, taxes are going to have to be used. I do not feel that income tax is fair, and question to some extent it's constitutionality as the ratification of it is questionable. I do not on the other hand question the fairness or the constitutionality of a sales tax. Also, I don't look at the sales tax as on these unhealthy items as a way to discourage behavior, but in this case as a way to pay for the consequences of that behavior.

 

I would be very careful with "unhealthy items" in your last post perch. That argument could be extended to pretty much anything. Hell, GUNS can be considered "unhealthy" and a cause of health care costs to repair bullet wounds . . . .

 

Perch, I would LOVE to see you set aside what you think the founders intent was and focus on the actual health care question in front of us. Your aversion to the current administration is well documented (and often lamented), but you ahve some good points made above as it refers to health care in general. . . . can we stick to those? please?

[Furd]

If that is the case then why is malpractice insurance so high? While it might be true that few cases actually end up with punitive damages being accessed, how many are settled prior to verdict? How many are settled because it is in many cases cheaper to settle than to fight in court? How many are settled for fear of getting a sympathetic jury?

 

You may very well be correct, but if you are what would this provision hurt? If a doctor is negligent enough to deserve punitive damages under the current system, then throw his ass in jail, have the insurance pay actual damages (or whatever the legal term is that covers the medical bills and disability if relevant).

 

One of the biggest frauds being perpetrated on the American people (thanks to insurance companies and their politician shills) is that high insurance premiums are caused by "trial lawyers."

 

Its the market. Insurance companies make their $$$ from investments. When the market is good, premiums hold steady or drop, as insurance companies compete for $$$ to invest. The amount of the premium isn't all that important, its the potential from the investment. When the market is bad, insurers need those premiums to pay the light bill, so they go up.

 

Most states have enacted caps on medical malpractice damage awards. I bet you that medical malpractice case filings are down in just about every state. They have plummeted in Michigan due to "tort reform" and to an activist judiciary that has curtailed medical malpractice cases and has just about eliminated automobile negligence, premises liability and products liability lawsuits. I have see numbers that show that in Michigan, the 2008 medical malpractice case filings are less a 1/4 of the number that were filed in 1986 (from 3,629 to 847 in 2007 - Michigan has a population of 10 million). How much do you think medical malpractice insurance rates or automobile insurance rates have dropped in that time, as a result? They haven't.

 

Show me where insurance premiums have gone down in a hard market due to tort reform, and maybe I'll change my tune somewhat. The market is cyclical. Tort reform is not. If tort reform worked to reduce premiums, you should see a pattern somewhere, shouldn't you?

 

Im my experience, lawyers in Michigan do not file cases for a "quick settlement." It just does not happen. A good friend of mine called me after his grandmother, just a nice old lady as you'll ever meet, tripped on a curb at a casino and smashed her face into the pavement. I wrote a letter on her behalf, I got a call a couple of days later. "We're not going to pay her a dime. We'll give her some tickets to the buffet." No sh*t. I'm telling you, it ain't worth anyone's time to pursue a case without merit. You have to remember, most PI attorneys take fees on a contingent basis. In MI, the max is one-third. So say that you come to me with a case that is worth, objectively, about $30,000. That means that the most that I'm going to get, if we settle the case without any costs, is $10,000. Every hour I spend on that case diminshes my return. Every dollar spent on costs diminishes my return. So lets say case the settles for that 30,000 after I put 100 hours worth of time and 3,000 in costs. I get $9,000 - about $90.00 per hour. I get less with more time and more costs. And I may get nothing if the insurance company digs in its heels and tries the case. So who is going to waste their time on frivolous cases? Certainly not many people working on a contingency.

 

I have good friends and colleagues who practice medical malpractice and personal injury law. Or who did, as many are doing divorce work or whatever else comes in the door. A medmal lawyer in these parts is probably not going to take your case unless your damages are about $200k. That means if your doc botches your surgery, you need another, but recover quickly, you're SOL. You only needed another surgery, why should you be compensated for that? I know that I enjoy undergoing needless surgery.

 

Who does tort reform hurt? The injured person and his/her family. Who does it help? Insurance companies. It doesn't help a doctor one whit. it doesn't help the public one whit.

 

As I see it, a doctor is just a pawn. In many cases, a rich pawn, but a pawn nevertheless.

Edited September 29, 2009 by Furd

[westvirginia]

Wasn't the notion of sin taxes derided as unethical in the thread about short term capital gains? Weren't you and WV saying that taxes should not be used to discourage behavior? Maybe it was just him. Honestly not sure.

 

That was probably me, but I don't remember saying it with respect to this. I have said that the government is no arbiter of morality. If it is, then it should be able to stop unprotected sex, premarital sex, smoking, drinking etc. And none of you guys (me included) would stand for that. I don't think I should have to pay for anyone else's HC either, but you guys say I'm cold and heartless like that. I sure as hell don't want to give fedgov control over it. They do NOTHING right.

[untateve]

Obviously the current bill is not the fix everyone wants, so what the heck is the answer? How long can these breakneck increases continue before reform actually happens?

 

 

Real reform will begin as more and more small businesses (like mine) find that they can no longer afford health insurance and no longer offer it to their employees.

[bpwallace49]

Furd . . . . . that was an AWESOME post! Well done and well reasoned.

 

[bpwallace49]

That was probably me, but I don't remember saying it with respect to this. I have said that the government is no arbiter of morality. If it is, then it should be able to stop unprotected sex, premarital sex, smoking, drinking etc.

 

It isnt stopping those things, just making the cost to engage in those things higher as a deterrent.

 

Just like a speeding ticket. if it was only 10 bucks and didnt affect my insrsnce, I would have a ticket a week. But considering the cost of the ticket and resulting insurance premium is high, I decide to not engage in risky behavior as a result.