This sentence best describes the article - please read the whole thing - it is important.
"The question is: What are GOP candidates saying when they promise to repeal health care reform but are silent on health care and poverty?"
The article is: Don't Take Away America's Healthcare Lifeline.
Health Care reform has only just begun. We don't need to step back - we need to move forward and quickly. Steps have been put into place to address insurance coverage for most Americans - next we need to address costs. It really should have been done the other way around by addressing costs first - but people die while debates take place. Let's not repeal "Obamacare" - let's revise it. Let's take a good thing and make it better.
50 comments:
I've read the suggestion to take the middle man (the insurance company) out of the equation and make healthcare 100% out of pocket; a very radical idea.
Think about it though, you are not the main customer to your healthcare provider, it's your insurance provider who foots (most of) the bill. It's your insurance provider that determines what procedures it will allow. (If there was such a thing as a death panel, sarah palin, it's run by the insurance companies.). Since insurance pays for goods and services, most of us have no idea how ridiculous the prices are. Until i had a kidney stone this past year, i had no idea a shot of pain meds was $50, and another $20 for a nurse to administer the shot. Hell, i could've given myself the shot and saved $20 bucks. If we, as consumers, were paying out of pocket, we wouldn't stand for such prices. But because we're at the mercy of insurance companies, we have no bargaining power. I say let free market work here.
Thohea for President!
He just won my vote.
I've had kidney stones in the past too and I would have sold my mother to get out of that pain. I'm sure the hospital would have gladly accepted any amount I was willing to pay. So I guess supply and demand isn't quite so self correcting when it comes to healthcare.
However, I think we all agree the real problem is in costs and not necessarily insurance. The healthcare system is broken on almost every level starting with the the cost of education all the way to the cost of medical equipment and the $50 box of Kleenex. All of it conveniently covered by insurance companies as Thohea pointed out which enables the whole fiasco.
The entire system needs to be re-done. The first step has been started. We need to keep it going. Meanwhile - the GOP wants to take a step backward without any indication on what they would do instead.
Oh don't EVEN get me started on the insurance companies...I don't have the finger tips to type every thing we've gone through this past couple of years with them. Let's just say, we raised our premiums to the max and wow, what a difference. It costs more per month but it is better this year. I feel for anyone that doesn't have insurance or for those that DO have it and it doesn't cover squat.
Let's face it, we're humans, we get sick and we don't make it out alive in the end. Healthcare is a right, just like clean water, clean air and safe utilities.
Lisa
Thohea has hit the nail on the head.
When I was born 1962, my father, who was only 20 years old at the time and stocking shelves in a grocery store, was able to pay the entire hospital bill for my birth out of his pocket. Remember too, that this was at a time when delivering mothers typically spent a few days in the hospital, unlike today when they kick them out the door as quickly as possible. I think the entire bill came to just over $400!
Since the end of WWII almost every single service and commodity has dramatically decreased in price (relative to inflation) and become far more affordable to the great mass of consumers of all income levels. Health care is one of the few exceptions to that rule.
There are a number of reasons for this, but one of the primary ones is the near total separation of medical services and supplies from all consumer and market pressures.
Consumer and market pressures, which in almost all other areas, from automobiles to home electronics to clothes to air travel, have consistently forced prices down while at the same time increasing availability and quality.
For most of my childhood we were too poor to afford a color television. Today I can go to Walmart or Target (or countless other places) and buy a flat screen color TV far larger than anything even available when I was a kid, for the cost of a few bags of groceries!
If we had applied the same system to home electronics 50 years ago, that we did to health-care, that same TV, if it was even available, would probably retail for around $40,000!
I can't really disagree with that - but the fact remains that what we have now in health care is broken - badly. How do you - or your elected officials propose we fix it? Are we just supposed to end insurance? What about the person with a chronic illness? If your scenario were possible a person might be able to afford a baby out of pocket - but what about cancer? AIDS? Diabetes?
It's a nice thought but we need a real solution to price control.
Obviously the damage of 50 years can not be repaired overnight. It would have to be a gradual process of reform and transition.
Expanding the accessibility and use of Medical Savings Accounts (combined with a high deductible Catastrophic Insurance Policy) might be one place to start.
People that can hardly pay for food are not going to be able to start a medical savings account or pay a high deductible. The GOP line of thinking always assumes everyone is at least comfortably wealthy. This is hardly ever the case. You must consider the working poor in your reasoning. Most people these days wouldn't even be able to afford a $400 baby.
"People that can hardly pay for food..."
We're not talking about the indigent, or the homeless, or the disabled, or the mentally ill, etc., etc. There will always be public and private social safety net/charity options for them.
We're talking about the overwhelming mass of Americans, who, if recent obesity statistics are accurate, suffer not from a lack of food but,if anything, far too much food (myself included, even with all my bike riding!).
The great thing about most Medical Savings Account plans is that you build up the balance in them (tax-free) over time. Most of the corresponding Catastrophic Insurance plans would probably have a 2k to 6k deductible, so it wouldn't take too long to build up that level of savings. Presumably, this option would be best for younger people, who commonly have few, if any, medical expenses through their early twenties. Obviously, other options would have to exist for people in more challenging situations, but the Medical Savings Account has never been put forward as some sort of one-size-fits-all solution, and I didn't suggest it as such. I was merely using it as an example of the type of thing that should be considered. Medical Savings Accounts would most likely be merely one component in a larger, more comprehensive, market-based reform strategy.
Remember, we're talking about long term structural changes, not some quick, over-night fix.
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"Most people these days wouldn't even be able to afford a $400 baby."
I'd bet that at least 70% to 80% would, especially when you consider the statistics that show how many "poor" Americans manage to afford big screen TV's, DVD players, computers, Air Jordans, and countless other material luxuries.
I believe I referred to the "working poor" like me who have had to put my 401k contributions on hold for the last 2 years so I can afford to pay my basic bills. But I do have a new TV! :) I financed it by not buying any new clothes (yet again). If it's Tuesday it must be that shirt. There simply isn't any extra money in my paycheck to put into any type of savings account.
But you are again addressing covering medical costs - not reducing medical costs. That is where this has to start.
"There simply isn't any extra money in my paycheck to put into any type of savings account."
A simple 2% payroll tax cut, that could only be used if it was rolled over into a MSA could take care of that problem relatively painlessly. There is probably lots of other ways to due it too (I could imagine Banks financing people's MSA's, where they would loan you the initial funds to cover the Catastrophic Policy deductible. It would be a safe bet for the banks, because the MSA fund could act as it's own collateral).
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"...reducing medical costs. That is where this has to start."
The only way to REDUCE medical costs is to bring the power of an open marketplace to bear upon it.
I'm sure when you were shopping for your new TV you didn't just go to the closest store and pick out the one you wanted without even asking what the price was, but if you had a "TV Insurance" policy, that is probably exactly what you would have done.
As Thohea correctly pointed out, when you have to open your wallet every time you go to the Doctors office or to the Hospital, you are going to be much more discerning about it, and there is no way in hell that most people are going to just pay $300 a pill for an aspirin!
When Doctors have to compete against each other to attract customers, prices will go down.
The only problem i have with a free market healthcare system is descrimination. Obviously, the more money you can afford, the better care you'll receive. The best doctors can charge more and only those who can afford their services will benefit. I'd hate to think my state of health could be directly related to my bank account.
Thohea - that's how the free market "works" I certainly would have bought a more expensive TV with more features if I could have afforded it. So in the freem market medical system you both suggest - only the rich will get quality care and the working poor and jobless will get substandard care or none at all.
Andre - I hope you also meant I would get a 2% raise to cover that 2% cut for my medical savings account. Otherwise I'll have 2% less food. Seems really difficult for Tea Party folks to understand that most of us are not making enough to pay for basics these days. Paycheck to paycheck isn't even covering it when I make 20% less than I did 2 years ago. Especially when costs have increased by at least that much too.
"Obviously, the more money you can afford, the better care you'll receive."
Obviously. That is what has been happening in countries like Canada and the UK that have fully socialized medicine: wealthy Brits avoid the long waits and sub-par care by going to hospitals in the Virgin Islands and wealthy Canadians go to hospitals in Boston and Baltimore.
The wealthy also go to better restaurants, live in nicer homes, and drive fancier cars. It has always been that way, and it always will (irregardless of the political regime: the pharmacies in Cuba might have hardly any medicines on the shelves, but you can be sure that Fidel and his henchmen never want for anything).
What does any of that have to do with making health care in the US more affordable and accessible for all Americans?
Not much.
"...in the freem market medical system you both suggest - only the rich will get quality care and the working poor and jobless will get substandard care or none at all."
That is not what the history of health care in the United States would indicate. In the example I gave of my birth, my poor working class parents received excellent health care. Sure, a wealthy person might have been able to pay for a private room with a nicer view,and had fancy catered meals delivered, but there was absolutely nothing "sub-standard" about the health care my mother received in the maternity ward of the South Shore Hospital in the rough 'n tumble, blue collar town of Weymouth, MA in 1962. As a matter of fact, she had access to what was probably the finest health care available anywhere in the world at that time.
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"I hope you also meant I would get a 2% raise to cover that 2% cut for my medical savings account. Otherwise I'll have 2% less food."
No, you misunderstood the proposal. The 2% (or whatever it would be; that was just a number pulled out of the air for illustration purposes) would come from payroll taxes that you are already paying, so you would notice no difference in your take home pay.
However, a significant lowering of health-care costs, if such a thing were truly achievable, could have a noticeable positive impact in your take home pay, in that much of the labor cost savings to employers that is represented by health care premiums, in a competitive labor market, could be transferred to increased wage levels.
Here's where i differ from Andre and the GOP. I don't think healthcare is a luxury item or service. I understand that a private room might cost more, like a first class seat but you don't have better pilots flying planes for those first class customers.
I think congress should have the same healthcare options as the rest of us. That might give them an incentive to come up with a better system. Seeing as how they work for us, I can't believe we the people havent insisted on that or term limits at this point. Can't we at least insist on that?
By the way - when is the last time you got to go to the Dr. you really wanted to see? You all are suggesting that we can just go anywhere and everything is covered by insurance. Not so. My insurance company is the one doing the discerning shopping. They tell me where I can go, when, and how much they will cover. That's the only market controls we have right now and I'm not against it - however, it's the patients that get stuck because the costs just keep going up.
I also want to add that I have no problem with wealthy people getting their own higher standard of care - as long as EVERYONE else is also covered. That's why I believe a socialized system with a public option would indeed be a much better idea for this country.
"I believe a socialized system with a public option would indeed be a much better idea for this country."
You're just determined to have those $40,000 television sets, aren't you?
I know you would never dream of watching a documentary by Michael Moore but if you took the time to watch "Sicko" you would be enlightened to the reality that nationalized medicine does work in other countries and does address costs as well as coverage. Physicians make a comfortable salary but do not make millions. And again - the rich still have the option to have better care if they choose.
The definition of "Conservative" means resistant to change. It's interesting to me that you don't want a system with out of control costs which is exactly what we have. Something big needs to be done to change it - but it needs to be done in such a way that the working poor and very poor can get health care too. We need to take the "business" out of healthcare. It is a matter of human ethics to care for those in need - no matter who they are. In a "business" model only those with money get the services. That doesn't work with healthcare. Poor people get sick too - likely way more than wealthy people do. A poor person is no less worthy of healthcare - they are human beings too. Maybe not to the GOP but to the Democrats they are.
"It is a matter of human ethics to care for those in need - no matter who they are."
That's NOT what the debate is about.
The debate is about the best methods for a society to use in order for those ends to be achieved.
If you are advocating a free market solution to health care reform - you are, by default, excluding those who can't pay.
No, not at all. If that were true, then it wouldn't really be a "solution", would it?
Free-market reforms will lower the cost of medical care, making it financially more accessible to millions of lower income workers who cannot afford it on their own now.
Additionally, a combination of private charity and public safety net programs (partially funded by the savings to the public purse generated by these same free-market reforms) will be made available for those truly needy who can still not afford to pay for their own care.
We do something similar right now with the production and distribution of food in this country. An essentially free market (with relatively minor qualifications) produces a massive amount of what is, by world historical standards, incredibly inexpensive, varied, and safe food.
The overwhelming majority of people in this country are able to afford an adequate food supply for themselves and their families, but even so, many options, from Food Stamps to church run dining halls exist to help the relatively tiny minority of Americans who are unable to provide enough food for themselves through their own labor.
I don't think that is a very reasonable comparison. Food is much cheaper than medical care will ever get even with full reform.
But, I give you and thohea credit for actually presenting an alternative idea - which is more than I can say for ANY of the presidential candidates.
Thanks, but let's be fair (and accurate)...just because the MSM doesn't talk about something, that doesn't mean that it doesn't exist; apart from "Romney-care", a number of the other current candidates also have a history of working on this issue:
Michele Bachmann has authored legislation that would make all health-care expenses 100% cash deductible for all Americans.
From her website:
"Under current law, health insurance is tax-free for those who receive it through their employers. My bill (H.R.502) would give this same tax benefit to people who buy their own health insurance or pay for medical care “out-of-pocket.” This would give all Americans the freedom to purchase the health plan of their choice, to pick their preferred doctors and to make their own medical decisions.
Additionally, I support the expansion of Health Savings Accounts (HSAs) which currently allow Americans to save a limited amount of money for medical expenses tax-free. I also advocate the creation of Association Health Plans (AHPs), which would allow small businesses to band together through trade associations to purchase health insurance for their employees at a lower cost. Finally, the flood of frivolous lawsuits in our nation must be addressed to curb the rising cost of health care. Frivolous lawsuits impose extremely high costs on physicians, causing doctors to abandon certain areas of practice or even leave certain regions, making health care less accessible."
And Newt...geesh...just try to get him to shut up about this topic (or any other topic for that matter):
http://www.healthtransformation.net/cs/library/video_library/videos_2009/newt_gingrich_talks_about_healthcare_reform_on_nbcs_today_show
He founded the Center for Health Transformation in 1999, which deals with nothing else but trying to provide new solutions to the nation's health care problems:
http://www.healthtransformation.net/cs/about_the_center
Also, speaking of frivolous lawsuits; Texas, in recent years, has become a medical center (and research) powerhouse, largely due to medical related legal reforms, signed into law by Gov. Perry.
Scratch the surface a little, and you will find that among the Republican candidates, there is much substance on this issue in the form of both proposed new ideas (some good, some bad) and actual accomplishments (mostly good).
Andre - you sure like to blame the MSM for all the GOP troubles. The FACT is that I've been watching all the debates myself! All I've heard - with great force - is repeal "Obamacare". There has been no alternatives mentioned. Now I see why. The alternatives you mention are ridiculous for reasons I mentioned earlier. Americans - especially right now - don't want to hear about medical savings accounts when we don't have enough money for our current lives. Plus, once again - this addresses coverage and not costs. And I love (or rather despise) the term "frivolous lawsuits". Once again we have the GOP trying to protect business and strip the people of needed protections. We have a serious problem with outrageous settlements, that's true for sure - but the lawsuits are likely not frivolous if they passed a jury trial. If a patient gets the wrong leg amputated - they sure a heck deserve the right to sue the people responsible!
Well Andre - I tried to re-post your comments but it wouldn't let me because it said it was too long. LOL
Anyway my point is this:
If a presidential candidate has what they believe is a better way to handle health care reform (or other issues) - why would they spend their entire debate time bashing President Obama's plan rather than presenting their own? Why not even mention that they have a plan and the details are on their website? If their proposed plans are not already public knowledge then it is hardly the fault of the MSM - it is the fault of the candidates.
"...why would they spend their entire debate time bashing President Obama's plan rather than presenting their own?"
First of all, it is simply incorrect to say that they haven't presented any alternative ideas. That is just not true. I haven't watched every minute of every debate, but even so, I have heard alternate ideas put forward by a number of the candidates.
Aside from that though, the fact remains that most of the Republican candidates agree that the single greatest obstacle to meaningful reform of health-care today IS Obama-care (I can use that term now, because a few months ago the President said that he is "proud" of that label), and any positive reform must begin with it's repeal.
You of course may disagree completely with that appraisal, but the relevant point in response to your criticism is that if a candidate truly believed that Obama-care was a disastrously ill-conceived approach to health care reform, then there would be absolutely nothing illogical about those candidates making it's repeal the first step in any reform program. That, in a nutshell, is the answer to your question about why they talk about it so much (that, and also because it is just good politics, since poll after poll after poll shows that the majority of likely voters in the country continue to be opposed to Obamacare....it is actually less popular today than it was a year ago).
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"If their proposed plans are not already public knowledge then it is hardly the fault of the MSM - it is the fault of the candidates."
Can't disagree with you at all on that one. Any Republican entering any election race just about anywhere has to know going in that the MSM will do everything it can to help his Democrat opponent. They will get absolutely zero help at all promoting their ideas from the MSM, so it is up to them to communicate their ideas directly to the voting public.
I have no sympathy at all for Republican candidates who cry on and on about how they are being treated unfairly by the MSM. That's like crying about the fact that the sky is blue. It's fine to point it out once or twice, or at particularly egregious examples of it; that should be pointed out, but then they have to stop whining about it , and just go out and find other ways to get their message out to the voters.
Am I to understand from your comments that Fox News is not also the Mainstream Media? How is that possible?!
I know this is off topic but Fox News has the top 13 out of 20 cable news shows. I think it's hilarious that they don't consider themselves MSM.
The term "Main Stream Media" has a specific meaning and history. It should have been obvious from the context that I was using it in that commonly accepted sense. The fact that Fox has been so successfully capturing market share from the MSM in recent years does not in any way change the meaning or history of that term.
If you want to give the term a new and personal definition; such that any news outlet automatically is given the label "MSM" solely by virtue of achieving some minimal amount of market share, and nothing else, then you should at least have enough good sense to realize that in so doing you are not in any way challenging or refuting the traditional Conservative critique of the "MSM".
I'm well aware of what Fox News, who started the term, means when they say MSM. But you have to admit if it continues to dominate in the ratings, eventually it will have to consider itself "mainstream".
By the way, i only watch fox news for televised "news" but turn to the internet for real reporting. Fox and Friends is on in my house from 6am to 7:15am. In that time period i hear all about the GOP candidates, what Donald Trump thinks about them, how Obama is financially destroying the country financially according to Stuart Varney, how some organization wants to take Christ out of Christmas or asks someone to take down the American flag, a story how Obama care will ruin your life. That's the formula every
morning. It's not news at all, its propaganda.
Forgive my little rant... Back to the topic at hand.
"most of the Republican candidates agree that the single greatest obstacle to meaningful reform of health-care today IS Obama-care"
This one goes down in the "duh" category. It has been quite obvious from the beginning that the GOP doesn't like nationalized healthcare. So again, why spend your expensive air time continuing to tell their own voters what they all already know? Many of these voters have pre-existing conditions, how will the new candidates plan handle that? In my opinion there is nothing more important to talk about than that. The time to bash Obama is in a debate with Obama. The voters need to know who they are choosing - not who they already know they don't like.
That would be like the Captain of the Titanic turning to his First Mate and saying "Yes, I realize that we are only moments away from smashing into that enormous ice-berg that lies right front of us, but rather than discussing how we might avoid it and save our ship and the lives of all those upon it, I think we should instead be spending our last few moments discussing how the scheduling of our voyage has put us in this position by having us cross the North Atlantic during the peak of ice-berg season."
"Forgive my little rant..."
OK, you are forgiven.
I don't watch FOX News myself, so I will have to take your word on "Fox and Friends" (never seen it).
I don't know what relevance this has or not, but I found it interesting to note that the womanizing story that helped end the Cain campaign was first broke by a FOX News station in Atlanta.
Also, last weeks Bret Baier interview with Mitt Romney has been a big story on the Conservative blogs because of how poorly Mitt handled Brett's tough (but fair) questioning. Apparently Romney gave a little too much credence to the Leftist meme that FOX News is a shill and apologist for the Republican Party, and was rather upset to find out that wasn't the case!
What?!
It would be more like, "Captain Obama put us on this course. He is an incompetent, bleeding-heart landlubber. But instead of telling the crew and passengers exactly how we're going to avoid the iceberg and get out of this mess, let's tell you again how bad a captain Obama has been."
Analogy wars...I love it!
Let's torture the analogy some more:
Obamacare IS the ice-berg.
The priority is to avoid the ice-berg right in front of you that is about to send your ship to the bottom.
Only afterwards can you deal with the larger problem of navigating successfully through treacherous waters.
How about the iceburg being the current healthcare system that the GOP can't seem to avoid running into head-on with Obamacare being the rescue ship on its way that won't (fully) make it to the scene until most of the passengers are dead.
Oh, forgot to add....
The rescue boats are full of GOP and it's base who can afford to bribe the crew, with plenty of room for more but they wouldn't dare rescue those in steerage.
:-)
"How about the iceburg being the current healthcare system..."
That does not work as well as an analogy for the simple reason that the present health care system (pre-Obamacare) for all it's weaknesses and failings, does not, in and of itself, have the potential to "sink the ship" of our economy, whereas there are many thoughtful analysts who believe that Obamacare, if fully implemented, does have that potential.
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"...Obamacare being the rescue ship on its way that won't (fully) make it to the scene until most of the passengers are dead."
At the risk of veering even further off the original topic(?), your reference to "dead passengers" reminded my of a news item from a few days ago (and this seems as good a place as any to mention it);
The soon to be retiring Barney Frank has stated that one of his main goals before leaving office is to get the "death panels" removed from Obama-care.
A noble endeavor, to be sure, and one at which I wish him full and complete success. However, I could not fail to notice that his mention of "death panels" went all but completely uncommented upon by the MSM. The exact seem MSM that raked Palin over the coals for talking about the exact same panel.
So does that mean that Sarah was right after all, or does mean that Barney Frank is as looney-tunes as Sarah Palin?
There are no Death Panels in "Obamacare". There are also no publicly funded abortions in "Obamacare". Those are complete lies by the GOP to get their base fired up. And it worked for them.
But even if they were there, what is their alternative options. Not mentioned in the debates. Just gripes not solutions.
So now you are calling Barney Frank a liar?
How did he suddenly become a propagandist for the Republicans?
Isn't it more likely that Sarah Palin was on to something real and truthful after all?
I think you owe her an apology.
I think you owe me an apology for once again veering off topic.
Wait - Sara Palin actually does belong on this topic because she is another whiner about "Obamacare" without any other options mentioned. But she is totally irrelevant anyway.
I thought that perhaps Barney's example might inspire you to do the stand up thing and admit to perhaps having been a little unfair to Palin on this one point, at least.
It's not too late to do the right thing.
I have been neither fair or unfair to Sara Palin. I think she is a total crazy bitch - is that fair enough? She has never said anything intelligent in her entire political career - such as it was. I know that sounds harsh but it is absolutely my real opinion of Mrs. Palin.
Barney Frank was never a presidential candidate so he is irrelevant to this discussion. However, I would like to point out that he was a great career politician who championed causes for middle class Americans and the poor. I don't agree with all of his views but I can say he always had the best intentions. We need more liberal politicians like Mr. Frank.
It's still not too late to do the right thing.
"Many of these voters have pre-existing conditions, how will the new candidates plan handle that? In my opinion there is nothing more important to talk about than that."
Newt's already thought about that, and he's been talking about it for a long time:
"4. Cover the sickest with a High Risk Pool set up by each state to cover the uninsured who have become too sick to buy health insurance.
5.Protect consumers by reinforcing laws which prohibit insurers from cancelling or charging discriminatory rate increases to those who become sick while insured."
Check out his full plan for Health Care reform at :
http://www.newt.org/solutions/healthcare
Newt's site is blocked from where I am right now. LOL
#4 Sounds kinda "socialist" but doesn't address how much the sickest will have to pay to be covered or how this risk pool will be funded. Remember that people who are this sick are likely not able to work and will likely be on a very fixed income - possibly government supported. So no matter how much they are forced to pay to be covered - it will likely be government funds paying for it. This boils down to nationalized healthcare to high risk groups.
#5. The health care system before President Obama's reform did not offer these protections. Does Newt agree with President Obama's plan?
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