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Senate Majority Leader Harry Reid, center, accompanied by Senate Banking Committee Chairman Sen. Christopher Dodd, left, and others, speaks during a Democratic health care rally Tuesday on Capitol Hill in Washington. Associated Press photos
WASHINGTON – Americans will feel the pain before the gain from the health care overhaul Democrats are close to pushing through Congress.
Proposed taxes and fees on upper-income earners, insurers, even tanning parlors, take effect quickly. So would Medicare cuts.
Benefits, such as subsidies for lower middle-income households, consumer protections for all, eliminating the prescription coverage gap for seniors, come gradually. More here.
Hmm…taxes and fees take effect quickly. Coverage for the uninsured not likely ‘till 2013. See anything wrong with this picture?
Update: Exultant Senate Democrats pushed President Barack Obama‘s landmark health care overhaul past a final procedural hurdle Wednesday, setting up a Christmas Eve vote to pass the legislation extending coverage to 30 million Americans.
D.F. Oliveria is a columnist and blogger for The Spokesman-Review. Huckleberries Online was judged the best 2008 Idaho newspaper blog by the Idaho Press Club. And the best 2007 news blog in the Pacific Northwest by the Society for Professional Journalist. Print Huckleberries is a past winner of the Herb Caen Memorial Column contest by the National Association of Newspaper Columnists. The Readership Institute of Northwestern University cited this blog as a good example of online community journalism.
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hmoffsuite on December 23 at 8:37 a.m.
>> See anything wrong with this picture?
Absolutely. It’s creative accounting by Obama to make the bill appear to be deficit neutral. Smoke and mirrors. Just like I had mentioned yesterday. This is just plain a bad way to solve our health care problems and one can blame it all on the democrats. Sorry to say.
idawa on December 23 at 8:49 a.m.
at least Dems try to pay for their programs, unlike Medicare Part D which the Republicans basically used to buy votes of the elderly and put in on the old charge card while cutting taxes … Sure, the Dems will pay a price early, but as the full program rolls out and the nation learns that none of the lies that Republicans have been spinning come true (no death panels, million new insured, etc) that it will be the R that have a day of reckoning.
hmoffsuite on December 23 at 8:59 a.m.
Idawa. Here is a real problem that I have with this legislation: I would think you would agree that this health reform represents a very significant legislative opportunity for the Country. We need health reform and the sooner the better. But, due to its potential effect on our economy, wouldn’t you agree that it shoud be done right? The dems have said time and time again that ‘just getting something done is the most important thing’. Well, I disagree. Rushing behind closed doors to get something through congress is not the right thing to do. We should take our time, get differing opinions, think it through, and pass a bill that we have some assurance will be beneficial to the Country in the long run. Not one republican has signed off on this bill as it sits. Are their opinions and input not worthwhile? In this matter ALL opinions are valuable and MUST be considered. Why the big rush on this? Why stunts like a Christmas Eve session to get it through? The procedure is more concerning to me than anything else. This stinks the way it is being done. And, btw, to suggest our economy cannot recover without the passage of this bill is just plain stupid. I attribute that comment to Obama himself.
Phaedrus on December 23 at 9:18 a.m.
This is just plain a bad way to solve our health care problems and one can blame it all on the democrats—hmoffsuite
Sounds like somethings the R’s said back in the day when the Democrats where forcing Medicaid through Congress.
wheels on December 23 at 9:25 a.m.
HEY, take a look at the concessions (read PORK) the Dems gave members of their own party just to get them to sign on.Politicians make me ill.
Phaedrus on December 23 at 9:29 a.m.
Not one republican has signed off on this bill as it sits. Are their opinions and input not worthwhile?—hmoffsuite
The 2 nd sentence does not follow logically from the first. Not one Repub has signed onto this bill because it is the GOP political strategy to “Just Say No.” - if this was a bill to declare the sun rises in the east and sets in the west, the GOP wouldn’t sign off on it. As for GOP opinions and input, they have had it, they spent months as part of a 6 member subcommittee—3 Republicans, 3 Democrats, crafting the original Finance Committee version and many of the features missing from the bill, that are causing liberal organizations to oppose this legislation, are a direct result of GOP input. They still won’t support it. Remember what Sen Jim DeMint said, “If we’re able to stop Obama on this it will be his Waterloo. It will break him,” he said”*
This has nothing to do with ‘getting it right’, but everything to do with defeating Obama.
* http://www.politico.com/blogs/bensmith/0709/Health_reform_foes_plan_Obamas_Waterloo.html
idawa on December 23 at 9:30 a.m.
Phae - I think that is the R’s real fear. They have been so united in opposition to this, their only real hope is that everything bad that they have been trumpeting comes to pass … if this bill does good and the voters like it and appreciate it as they do medicare/medicaid and social security, then the R may have banished themselves to the hinterlands with the voter for a decade or so …
HMO - but other opinions have shaped the bill. The R’s united front in opposition has dramatically shaped the bill. I find it interesting that the far left feels the bill is worthless and does not do anything to fix the problem and yet the Republicans (the far right, there is no real centrist national Republican party left) believe that this bill will hasten the end of the USA. Since both sides of the spectrum are upset, its follows that the bill is a work of compromise.
hmoffsuite on December 23 at 9:36 a.m.
I ask the question once again. What is the hurry? Why must it be rushed through congress? Why the stunts and bribes to get it done? That all contributes to ones concern about the bill. And, of course, the fact that nobody really knows what is in the bill except Pelosi, Reid, Obama and Rham jam.
hmoffsuite on December 23 at 9:39 a.m.
idawa >> “HMO - but other opinions have shaped the bill”
Agreed. The most significant other opinions are the more centrist democats trying to tone down the far left liberals. Not the republicans being heard on the matter, imo.
Sisyphus on December 23 at 9:46 a.m.
Ofergodsake hmoff quit drinking the koolaid or at least offering it to us. This has been in the works for decades. There were open hearings where Republicans never even showed. They produced very little by way of their own plan to run on next time. Thus the only purpose of delay is to kill it. Don’t think that isn’t obvious to people while you’re slinging your drinks.
And quit lying to people.
http://tpmdc.talkingpointsmemo.com/2009/11/reid-unveils-text-of-senate-health-care-bill.php
Sisyphus on December 23 at 9:49 a.m.
“The most significant other opinions are the more centrist democats trying to tone down the far left liberals”—that’s pretty funny since by far the most popular aspect of the House reform bill is the public option. You can label it liberal if you want but its the best way to cut costs. It does the job for workers comp rates in Idaho, it can work here too.
The centrists positions are almost all insurance giveaways and will end up being the most unpopular aspects of the bill.
hmoffsuite on December 23 at 10:04 a.m.
Sis. >> “Thus the only purpose of delay is to kill it.”
Kill this bill, perhaps, but the TRUE purpose of any delay is to simply make sure to get it right. I happen to think we should start over with it and kill the bill but that isn’t the true objective. Health reform is extremely important to all of us. We MUST get it right, not just get it through. Why the back room antics? The stunts? The bribes? You craft ‘spin’ as good as any, Sis, but this particular bill is of such importance, I don’t think it can be spun away.
ShoshoneConservative on December 23 at 10:05 a.m.
The main problem I see with the bill, which is where the outrage SHOULD be, is the individual insurance mandate, i.e., buy insurance (which, if you could afford it, you’d have anyway) or be fined.
Yeah, they say it’ll be waived, or there’ll be subsidies, if you can’t afford it, or whatever - but rarely, if ever, can the working lower middle class afford half of what the government SAYS they “can afford.”
So, the choice is: Make the house payment, make the mandatory health insurance payment, pay the fine, or buy food. Hardly “good” for the common person. To me, all of the other problems with the bill are secondary. THIS is what the Republicans should be yelling and screaming about.
Phaedrus on December 23 at 10:44 a.m.
the TRUE purpose of any delay is to simply make sure to get it right.
I couldn’t disagree more. Delay is simply for the sake of delay and defeat. They do not want any health care legislation, of any kind. In the true definition of conservative, they simply want to maintain the status quo. If they were interested in “getting it right” they would have done so after the defeat of the Cklinto health care proposal, during the 12 years they controlled Congress. But they did nothing. It took another Democratic Administration to once again start the ball rolling on health care reform.
keithincda on December 23 at 10:48 a.m.
Pheadrus>>>”It took another Democratic Administration to once again start the ball rolling on health care reform.”
Except it is rolling backward not forward.
Sisyphus on December 23 at 10:49 a.m.
“the TRUE purpose of any delay is to simply make sure to get it right.”—your gullibility knows no bounds. The people delaying have no plan of their own and refused to participate in this one. They’ve done nothing on HCR for decades. Why they are listened to at all is a wonder.
keithincda on December 23 at 10:54 a.m.
this is health care reform? No, this is an absolutely corrupt process that serves NOTHING to reform healthcare.
It took this crap added to it to get the votes:
Sen. Ben Nelson (D., Neb.)
—$1.2 billion over ten years for a permanent exemption from Nebraska’s share of the Medicaid expansion. The only state so exempted under the bill.
Exemption for Nebraska from an excise tax on non-profit insurers.
Sen. Carl Levin (D., Mich.), Sen. Debbie Stabenow (D., Mich.)
—Exemption from the non-profit excise tax for Michigan insurers.
Michigan and Nebraska were the only two states so exempted.
Sen. Bernie Sanders (I., Vt.), Sen. Patrick Leahy (D., Vt.)
—$10 billion for “community health centers”.
—Protections from cuts to Medicare Advantage beneficiaries in Vermont.
—$250 million over six years in expanded federal Medicaid funding.
Sen. Mary Landrieu (D., La.)
—$300 million increase in Medicaid funding in Louisiana.
Sen. John Kerry (D., Mass.), Sen. Paul Kirk (D., Mass).
—Three years of expanded federal Medicaid funding.
Sen. Chuck Schumer (D., N.Y.), Sen. Kirsten Gillibrand (D., N.Y.), Sen. Bob Casey (D., Pa.), Sen. Arlen Specter (D., Pa.), Sen. Bill Nelson (D., Fla.)
—Special treatment for Medicare Advantage beneficiaries in New York, Pennsylvania, and Florida.
Sen. Daniel Inouye (D., Hawaii), Sen. Daniel Akaka (D., Hawaii)
—billions in new funding for something called “Disproportionate Share Hospital” (DSH) payments (financed, in large part, by $18.5 billion in cuts to DSH payments in other states).
Sen. Max Baucus (D., Mont.), Sen. Jon Tester (D., Mont.), Sen. Kent Conrad (D., N.D.), Sen. Byron Dorgan (D., N.D.), Sen. Tim Johnson (D., S.D.)
—Higher federal Medicare reimbursement rates for low-population “frontier” states (also qualifying under the bill’s definition of frontier states are Utah and Wyoming, represented in the Senate by Republicans).
hmoffsuite on December 23 at 10:57 a.m.
Sis and Phaedrus. If I were the only one holding the opinions that I have expressed on this thread, I would kindly accept all of your words. Problem is, tho, that the majority of Americans share my thinking and DON’T want this bill passed. You both read the polls. The manner in which the democrats are trying to get the bill done is just not acceptable.
idawa on December 23 at 11:05 a.m.
Keith - I suppose you could at least credit the National Review for your collection of facts.
Just saying …
Cabbage Boy on December 23 at 11:08 a.m.
Holy pork fest. Thanks for the post Keith.
Yeah, it is all about them evil GOP senators trying to block “meaningful reform”.
hmoffsuite on December 23 at 11:09 a.m.
The latest Rasmussen Reports weekly tracking update shows that 41% of voters nationwide favor the bill and 55% are opposed.
http://www.rasmussenreports.com/public_content/politics/current_events/healthcare/september_2009/health_care_reform
nic on December 23 at 11:10 a.m.
@ hmo RE: “Health reform is extremely important to all of us.”
Are your sure about that? Speak for yourself, there’s a few Republicans that don’t agree with you.
“I urge everyone to spend every bit of capital and energy you have to stop this health care reform. The Democrats have accused us of trying to delay, stall, slow down and stop this bill. They are right. We do want to delay, stall, slow down and ultimately stop them.” Republican National Committee Chair Michael Steele
“Our goal is to make this as difficult as possible to vote for it (HCR)” House Republican Leader John Boehner.
“It’s clear that the Senate Republican leadership doesn’t know how to deal with this in the health care fight… I know that it’s gotta be stopped, and whatever parliamentary steps are available to people who do know what they are should have been taken, every blocking tactic they had at this.” Rush Limbaugh
FOUNDATION FOR THE MINORITY PARTY’S RIGHTS IN THE SENATE is a two page document (distributed by New Hampshire Senator Judd Gregg to GOP members of Senate) that details how to use parliamentary maneuvers to impede and possibly stop any health care legislation.
Sisyphus on December 23 at 11:22 a.m.
Holy cow, lets hijack the thread to talk about all the opportunities wasted by Republicans in the last ten years to correct the abuses inherent in out legislative process. How much did they increase our debt under Bush? And what do we have to show for it? Seems it was all spent overseas, certainly not in Now Orleans. Good? Bad? Its an accomplishment.
So Kieth what have Risch and Crapo done for Idaho besides a lot of empty rhetoric.
And hmoff as I informed you yesterday, when people are polled on the actual provisions on HCR the poll numbers flip. And check the trend lines on the CNN poll.
http://politicalticker.blogs.cnn.com/2009/12/21/cnn-poll-6-point-jump-in-support-for-health-care-bill/
hmoffsuite on December 23 at 11:28 a.m.
Sis. As taken from your link. If I had posted it, I would have been ridiculed. You successfully supported my argument. Thanks.
The CNN/Opinion Research Corporation survey, released Monday, also indicates that President Barack Obama’s approval rating has experienced a similar six-point rise.
According to the poll, 42 percent of Americans, based on what they’ve read or heard about the bill, support Senate Democrat’s legislation. That’s up from 36 percent in a poll conducted December 2-3. Nonetheless, a majority of people questioned in the survey, 56 percent, oppose the bill.
Sisyphus on December 23 at 11:38 a.m.
hmoff, I take it from your response the term ‘trend lines’ mean nothing to you. A big portion of the unpopularity of which you cite is from Democrats because of what was left on the cutting room floor and their frustration for all the time its taking. When this passes it will be over the 50% mark and resemble the polls which show its individual provisions to be popular.
hmoffsuite on December 23 at 11:43 a.m.
The thing about trend lines, Sis, is that they change. Don’t they? I suspect when more real information is leaked on this bill, the trend will reverse. However, even given the improvement in the ‘trend’, the result is still that the majority of American oppose the bill. Nice attempt to spin that, tho.
LarrySpencer on December 23 at 11:47 a.m.
Hey, sis, you never answered my question about what part of the Constitution gives Congress the power to require individuals to purchase something they don’t want from a private company.
Got an answer?
Sisyphus on December 23 at 11:56 a.m.
Larry, its bad enough that I have to write like a three year old to walk hmoff through polling data. But as I told you before I’m not your lawyer or your law professor. The jurisprudence on the commerce clause is replete. Have at it. You always keep your own counsel in any event, you surely don’t need mine. Besides I wouldn’t want to deprive Starr or any other hungry attorney from the opportunity you provide as a paying customer. And remember, you get what you pay for. Make sure Brannon knows.
hmoffsuite on December 23 at 12:01 p.m.
Sis >> Larry, its bad enough that I have to write like a three year old to walk hmoff through polling data.
I think I made my point quite clearly with regard to the polling data. Your comment merely shows your frustration with your posting your own data that proves my point. Walking me through it lke a three year old? C’mon, you can do better than that.
LarrySpencer on December 23 at 12:07 p.m.
“…you can do better than that.”
Not so much, really. We are talking about Sis, here. If he can’t win based on the facts, he doesn’t want to play. Perhaps that is why the other Dems are avoiding this thread like the plague.
Sisyphus on December 23 at 12:17 p.m.
“Perhaps that is why the other Dems are avoiding this thread like the plague.”—no, its because its a microcosm of what’s going on nationally. Dems seeking dialogue on how to rationally approach the serious issues of the day in order to solve them and Republicans making irrelevant comments, irrational allusions, misleading characterizations, and false assumptions. There’s simply no use in trying to engage. Which is why no Republicans will be part of the solution. All they know how to do is throw rocks.
Soaf on December 23 at 12:20 p.m.
***All they know how to do is throw rocks.***
________________________________________________
LarrySpencer 101.
hmoffsuite on December 23 at 12:23 p.m.
That last post must have come from your blog. Word tracks for the ‘foot soldiers’? This part was good …
“Republicans making irrelevant comments, irrational allusions, misleading characterizations, and false assumptions. There’s simply no use in trying to engage. Which is why no Republicans will be part of the solution. All they know how to do is throw rocks.”
Great liberal blog stuff. Pass it around.
Phaedrus on December 23 at 12:29 p.m.
LarrySpencer you wouldn’t know a fact if it dressed up like a 2000 Toyota Landcruiser and ran you down.
Phaedrus on December 23 at 12:30 p.m.
hmoffsuite why just another irrelevant comment instead of addressing the fact that Repubs are making the “irrational allusions, misleading characterizations, and false assumptions” Death Panels, anyone?
LarrySpencer on December 23 at 12:43 p.m.
It is a simple question. The the news media around the nation is now raising the Constitutional question- it isn’t a fringe thing you are trying to sell it as.
All I hear you say is “D—m the Constitution- full speed ahead!”
Cindy_H on December 23 at 12:44 p.m.
Abortion issue still a stumbling block: http://news.yahoo.com/s/ap/20091223/ap_on_bi_ge/us_health_care_abortion
keithincda on December 23 at 12:57 p.m.
It is already looking like it may implode on it’s own merit’s (or lack thereof)…
http://www.atg.wa.gov/pressrelease.aspx?id=24914
LarrySpencer on December 23 at 1:00 p.m.
Only to the people, Cindy H, the Dems just want to pass this, come heck or high water.
Ram it through!
moveon.stupid/backlash/watchemcrash
idawa on December 23 at 1:04 p.m.
The trade offs that have been made between the States do bring up some real equal protection/treatment issues … should be interesting to see what the State AGs come up with.
LarrySpencer on December 23 at 1:04 p.m.
From keith’s link
““The arrangement that requires Washington state taxpayers, and those around the country, to permanently pay Nebraska’s additional Medicaid costs carries a price tag of untold millions,” McKenna said. “It raises key constitutional questions about whether residents of certain states should receive special privileges, based on the deal-making skills of their senators. I look forward to working with Attorney General Henry McMaster and other colleagues in researching the constitutionality of such a provision.”
If Washington State AG is questioning the constitutionality, is there a question?
Not to the rabid left, there isn’t!
Sisyphus on December 23 at 1:05 p.m.
“it isn’t a fringe thing you are trying to sell it as.”—LOL, of course it is. You know as little about the media as you do about the constitution or makes of cars. The Republicans are now trotting out their last ditch efforts by utilizing yet another procedural rule for delay by making a point of order motion that HCR is unconstitutional. The very fact that they’re only raising the issue now shows their desperation. The media loves controversy just like Dave here. But just cause its on TV doesn’t make it true, balloon boy. And since Republicans don’t know their commerce clause from a bill of attainder, their assertions on constitutionality should carry as much weight as their feeble attempt at ACORN de-funding.
Try again Cindy. Erica Werner has been drip drip dripping stories about how bad HCR is since last summer. No doubt this will come up again but only as Ben Nelson used it, a red herring to get what he wants.
ShoshoneConservative on December 23 at 1:07 p.m.
“Hey, sis, you never answered my question about what part of the Constitution gives Congress the power to require individuals to purchase something they don’t want from a private company.”
Not just what they might not want, but what they can’t afford even if they did want it. As I said in my post above that everyone blew over, if the GOP would start banging the drum about the insurance mandates, support for this healthcare bill would be in the single digits. But, they drone on about “big government” and “cost,” so those in the middle just tune it out to “there go the big business Republicans again…”
“The jurisprudence on the commerce clause is replete. Have at it.”
Actually, and I believe this was even in a CBO report for an earlier healthcare proposal, I think from when Clinton was still in, to require individuals to purchase something like this is entirely unprecedented. Car insurance isn’t even a good comparison. If you can’t afford car insurance, don’t drive (and a lot of people don’t, for that reason). But, if you can’t afford health insurance, don’t qualify for the subsidies, and can’t afford the fine, what do you do? It amounts to a HIGHLY regressive tax on the working class. I thought the Democrats were supposed to be against that sort of thing?
Sisyphus on December 23 at 1:08 p.m.
“The trade offs that have been made between the States do bring up some real equal protection/treatment issues”—agreed idawa. Probably why he got it.
spokelooneh on December 23 at 1:13 p.m.
” … The program of Assisted Health Insurance is designed to cover everyone not offered coverage under Employee Health Insurance or Medicare, including the unemployed, the disabled, the self-employed, and those with low incomes. In addition, persons with higher incomes could also obtain Assisted Health Insurance if they cannot otherwise get coverage at reasonable rates. Included in this latter group might be persons whose health status or type of work puts them in high-risk insurance categories.
Assisted Health Insurance would thus fill many of the gaps in our present health insurance system and would ensure that for the first time in our Nation’s history, all Americans would have financial access to health protection regardless of income or circumstances. … ”
President Richard M. Nixon
Feb. 6, 1974
Soaf on December 23 at 1:18 p.m.
Spencer, you’re here crying about the “Federal WelFare” Nebraska is getting from other staes. Why aren’t you whinning about all the “Federal WelFare” Idaho gets?
Is it because you think it might affect the monies Idaho already receives from the rest of the country? In other words, it’s ok for Idaho to be a Federal Welfare state but no one else huh Spencer?
spokelooneh on December 23 at 1:29 p.m.
“”In 2017, as you know, when we have to start phasing back from 100 percent, and going down to 98 percent, they are going to say, ‘Wait, there is one state that stays at 100?’ And every governor in the country is going to say, ‘Why doesn’t our state stay there?’” Harkin said. “When you look at it, I thought well, god, good, it is going to be the impetus for all the states to stay at 100 percent. So he might have done all of us a favor.”
http://www.politico.com/livepulse/1209/Harkin_Nelson_did_us_a_favor_.html
What’s going to happen is that the vast discrepancies among the States regarding Medicare eligibility and coverage are going to go away. No more niggardly state programs that don’t provide adequate coverage for the destitute and working poor.
spokelooneh on December 23 at 1:30 p.m.
Excuse me, MEDICAID coverage in the states…
Phaedrus on December 23 at 1:33 p.m.
The the news media around the nation is now raising the Constitutional question-
Interesting how that works in todays’ media age;
A blogger, for this example, a right wing blogger, or a larrySpencer type guy, raises the ‘constitutional question” then a Drudge type site picks it up, and then another and another, now there is buzz, the right wingers start to email Fox News, or the Washington Times and say “Hey. congress doesn’t have the constitutional authority to do that!” Fox begins to report it so the networks start reporting that Fox is reporting and yada, yada, yada.
LarrySpencer how is the election lawsuit against the city coming along, any updates?
spokelooneh on December 23 at 1:35 p.m.
We know Spencer wants to force all the destitute who are on Medicaid out of Idaho, breaking up their extended families and forcing native Idahoans to completely pull up stakes and move in order to access life-saving health care services.
Merry Frickin Christmas. Get the hell out.
LarrySpencer on December 23 at 1:42 p.m.
You left wing guys are really foaming at the mouth in your desperate push to ram this through.
I am so totally going to enjoy watching your party implode this coming year.
:-)
Sisyphus on December 23 at 1:49 p.m.
“if the GOP would start banging the drum about the insurance mandates, “—LOL ShoCon. Keep asking yourself why they’re not screaming about it and you’ll eventually find that its because this was something they were touting and got when they helped write the legislation. Mandates are one of a few things the insurance industry loves about HCR. The left has been screaming about it since it came out of the gang of six (for hmoff’s benefit— the gang of six is the group from the senate finance committee that drafted the senate bill, three democrats and three republicans) largely because of the huge pool of new insurance subscribers required to be included.
Mandates actually work in Massachusetts. But I’m not convinced yet. There’s much good in the bill but there’s also massive giveaways to the insurance industry.
Phaedrus on December 23 at 1:53 p.m.
(for hmoff’s benefit— the gang of six is the group from the senate finance committee that drafted the senate bill, three democrats and three republicans)—Sisyphus
Save your pixels, I’ve provided this information to hmoffsuite on multiple occasions, but since it doesn’t fit the narrative of his talking points he just skips this fact.
LarrySpencer on December 23 at 2:00 p.m.
Ummm….
Phaedrus, your “gang of six” didn’t craft the bill. They tried to figure out if it could be done as a bi-partisan effort. They found it could not be, and ALL three Republicans are voting against the final product.
But don’t let facts stop your great little heartwarming story.
Phaedrus on December 23 at 2:01 p.m.
LarrySpencer you say “facts” I say Toyota Landcruiser.
spokelooneh on December 23 at 2:03 p.m.
” …
For the average family, it is clear that without adequate insurance, even normal care can ‘be a financial burden while a catastrophic illness can mean catastrophic debt.
Beyond the question of the prices of health care, our present system of health care insurance suffers from two major flaws :
First, even though more Americans carry health insurance than ever before, the 25 million Americans who remain uninsured often need it the most and are most unlikely to obtain it. They include many who work in seasonal or transient occupations, high-risk cases, and those who are ineligible for Medicaid despite low incomes.
Second, those Americans who do carry health insurance often lack coverage which is balanced, comprehensive and fully protective: … ”
President Richard M. Nixon
Feb. 6, 1974
http://www.kaiserhealthnews.org/Stories/2009/September/03/nixon-proposal.aspx
LarrySpencer on December 23 at 2:17 p.m.
“For the average family, it is clear that without adequate insurance, even normal care can ‘be a financial burden ….”
WRONG! And I don’t care who said it.
What is clear is that health insurance and the HUGE cost associated with billing the insurance providers is perhaps the most moronic waste of funds spent by Americans today.
The insurance cost add-on to basic medical insurance is the reason America’s health care cost is so expensive. Insurance itself, when covering “normal care” is the real burden.
Insurance should never have become responsible for paying “part” of a $6 perscription that if not for the cost of insurance might only have cost $3.
Sisyphus on December 23 at 2:30 p.m.
I know Phaedrus and I keep rolling the rock. He keeps repeating the Republican Noise Machine and I keep correcting him. While frustratingly futile, I don’t write for him. He’s a useful foil even though his mind is as closed as a liquor store in Provo on a Sunday. Its a perverse and lopsided symbiosis but its a catharsis of sorts from the drivel in the trad med.
Sisyphus on December 23 at 2:32 p.m.
“The insurance cost add-on to basic medical insurance is the reason America’s health care cost is so expensive. Insurance itself, when covering “normal care” is the real burden.”—what’s your plan Larry. The public option would correct this using market forces. So why do Republicans oppose it?
spokelooneh on December 23 at 2:36 p.m.
” … —Forty percent of those who are insured are not covered for visits to physicians on an out-patient basis, a gap that creates powerful incentives toward high cost care in hospitals;
—Few people have the option of selecting care through prepaid arrangements offered by Health Maintenance Organizations so the system at large does not benefit from the free choice and creative competition this would offer;
—Very few private policies cover preventive services;
—Most health plans do not contain built-in incentives to reduce waste and inefficiency. The extra costs of wasteful practices are passed on, of course, to consumers; and
—Fewer than half of our citizens under 65—and almost none over 65—have major medical coverage which pays for the cost of catastrophic illness.
These gaps in health protection can have tragic consequences. They can cause people to delay seeking medical attention until it is too late. Then a medical crisis ensues, followed by huge medical bills—or worse. Delays in treatment can end in death or lifelong disability. … “
-President Richard M. Nixon
Ibid
LarrySpencer on December 23 at 2:37 p.m.
And since you opened up the topic a bit wider …see, you shouldn’t have done that! ;-)
Let’s look at why insurance has become the customer and the patient is just along for the ride.
Think about it. Medical practice is geared toward insurance reimbursment instead of making decisions based on what is best for the patient.
How did we as a society ever let the insurance company take the place of the patient as the consumer that treatment should be centered around?
And why are we unwilling to demand otherwise? This bill forces the patients to lose and the insurance companies to be declared the king by Congress! Why did the Dems support this?
spokelooneh on December 23 at 2:42 p.m.
Nixon was a crook, liar, megalomaniac, paraniod, and a mass-murderer (ah, Christmas Bombing, the good old days, WWJD?) but he promoted a very good program of health care reform.
Had that reform started back then, by now we’d have universal single payer health care with patient outcomes the envy of the world and reasonable costs.
LarrySpencer on December 23 at 2:44 p.m.
For those of you wondering what Nixon was pushing, it was a plan that would not pay until a family paid $150 (around $1500 in todays dollars) each year as a deductable.
He wasn’t thinking that one day insurance would be billed and expected to pay part of a $6 refill at the drugstore.
spokelooneh on December 23 at 2:45 p.m.
“Why did the Dems support this?”
The insurance kleptocracy has a (financial) gun to their heads.
hmoffsuite on December 23 at 2:49 p.m.
“Senior Dem: Kill the Senate health reform bill and start over”
It’s worth the read.
http://thehill.com/blogs/blog-briefing-room/news/73493-senior-dem-kill-the-healthcare-bill-and-start-over
spokelooneh on December 23 at 2:54 p.m.
“For those of you wondering what Nixon was pushing, it was a plan that would not pay until a family paid $150 (around $1500 in todays dollars) each year as a deductable.”
Well Spencer, as another well known Republican used to say, “There you go again” as in lying.
$150 in 1974 dollars would be about $650 in 2009 dollars.
Or as GWB used to say, “The math doesn’t work!”
Phaedrus on December 23 at 3:05 p.m.
“Senior Dem: Kill the Senate health reform bill and start over”
Her reasons are a lack of a public option and restrictions on abortion; are you saying you want those to items in a “new” bill? Or that a new bill with those items in it will have bipartisan support? Or that killing the bill is the ultimate goul regardless of the reason?
Sisyphus on December 23 at 3:07 p.m.
Larry @ 2:37. Damn buddy, you’re confusing me a might. That’s liberal talk. You are bringing up the points for a single payer system which no conservative would endorse including those in the Democratic Party like Minnick. It never got to the negotiating table let alone to legislation. If you can get me twenty Republican senators who would be willing to cut out the insurance industry, I can get you enough Democrats to make it happen. And I would endorse hmoff’s plan to kill this bill and start over.
LarrySpencer on December 23 at 3:11 p.m.
“$150 in 1974 dollars would be about $650 in 2009 dollars.”
If you used the cpi, yes. But medical inflation is another story. from the Nixon speech….
“—Across the Nation, the average cost of a day of hospital care now exceeds $110.
—The average cost of delivering a baby and providing postnatal care approaches $1,000.
—The average cost of health care for terminal cancer now exceeds $20,000.”
Are you willing to say that the cost of delivering a baby and providing postnatal care in 2009 is $4400? try 10K or so.
Do you think a day of care in a hospital in 2009 costs less than $500??
The math does work, Spoke. But keep calling me names if it makes you think your arguement is stronger because of it.
Sisyphus on December 23 at 3:14 p.m.
While that’s a fresh article, its old news hmoff. Liberals are plenty pissed at what the senate legislation doesn’t do and there’s probably going to be some kerfuffle in reconciliation. Lieberman is in the catbird’s seat and his main constituency is Connecticut’s formidable insurance industry. He’s already killed the public option in the senate legislation and I’m sure he’ll be willing to do it again for them. But he makes 60 so his gun pointed at our heads is loaded.
One plan I saw out there was to pass it in stages, take out what he doesn’t like then pass the rest on a straight 59-41, reconciliation vote.
Phaedrus on December 23 at 3:14 p.m.
LarrySpencer are you just making those numbers up? I think the only one who might believe you is mike_s! LOL!
LarrySpencer on December 23 at 3:25 p.m.
Sis, I want to see great medical care at reasonable cost. Running every nickel past an insurance company so they can pay part just drives the cost through the roof.
It is like buying insurance for your tires so when they wear out, you are not hit with the cost of replacing them.
Well, actually, it is stupider than that, because the insurance billing, statements, and overhead cost get added on, so you actualy end up paying twice as much for the insurance as you would have if you just bought the tires yourself.
Seriously, people, can we not afford to pay for our own $3 refill instead of paying an insurance company to help us with these unexpected costs?
But if y’all feel safer with a $5 co-pay…
:-(
LarrySpencer on December 23 at 3:28 p.m.
Phaedrus, the numbers are from the speech that Spoke posted a link to.
IdahoDad on December 23 at 3:39 p.m.
LarrySpencer, I’m kind of curious. What do you pay each month for health insurance or medical savings? What can you recommend to me personally as an alternative that works for you?
idawa on December 23 at 3:45 p.m.
Spencer - “How did we as a society ever let the insurance company take the place of the patient as the consumer that treatment should be centered around?”
Because of a failure of the free markets. At the turn of the century (1900) there was no real medical industry. Dr could manage pain and mask symptoms, but they couldn’t cure or prevent illness. Hospitals were really just places where the indigent went to die. On the upside, healthcare was really cheap. The average person spend about $5 a year (~$100 today) on healthcare.
But, in 1909 the first drug ever to cure an illness was invented (Syphilis, btw, or should I say Sisyphus, ha!). Then medicine took off, Drs were expected to have gone to school, customer expected you to cure things … and hospitals radically changed to look more like what we know. The downside, it got terribly expensive, fast. Then, in the great depression, most people just stopped going to hospitals or seeing Dr unless they have no choice.
At Baylor U Hospital, no one was using the hospital, in fact, Baylor noticed that people would spend more on cosmetics than healthcare. So, Baylor started offering a deal to public school teachers that if they spend a small monthly amount they would give them a number of hospital visits. Since few teacher would get sick, this turned out to be a good deal for Baylor. As the depression hit, other hospital copied the deal, and insurance was born (specifically blue cross was born) …
This is, in a nutshell, what got us here … oh, and in WWII since employer couldn’t increase wages they turned to insurance plans to lure new employees and this was exacerbated at some point when the IRS found that health insurance was not a taxable benefit and employer provided insurance was boon for the tax break. Then, congress accepted that IRS ruling and made it law … thus, we have a system today where people don’t pay for health insurance directly and lost control of their own care - all because the market could not figure out how medicine itself to people without insurance.
spokelooneh on December 23 at 3:45 p.m.
Point taken, Spencer, however I’d say that had a version of Nixon’s plan been enacted, and other subsequent reforms, the rate of medical inflation would have been much smaller than it is.
Sisyphus on December 23 at 3:55 p.m.
Larry I completely agree with you except of course for the numbers. The mark up is more like 10-12% although I’ve heard as high as 30%. Your party does not agree with you on any level.
Look at these charts on per capita expenditures for health care. We come no where even close to those countries who have cradle to grave public coverage and we’re not on top of either infant mortality or life expectancy.
http://wolafen.wordpress.com/2009/01/11/life-expectancy-versus-health-care-cost-per-capita/
http://www.oecd.org/document/14/0,3343,en_2649_37407_44216846_1_1_1_1,00.html
Cuba does better than we do.
hmoffsuite on December 23 at 4:07 p.m.
In order to perhaps get a more balanced and better thought out plan, I think we really need some checks and balances in government. Right now, there are none and Obama is taking advantage of it to a fault. When EITHER party has total control, its not healthy for the Country. If the repubs had control of either the Senate OR the house, something might get worked out. Even when Kennedy was there, for example. deals got made and some good things came out of it. Compromises will have to be made by both sides, nobody will get or should get all they want.
spokelooneh on December 23 at 4:17 p.m.
LOL, HMO, Obama can’t get at 7 or 8 Dem Senators to go along with the majority of Dem senators, same deal in the House. Because of the filibuster, the Republicans and DINOS control the Senate, in that they can stop quite a bit of legislation and have done so at an unprecedented rate.
Sisyphus on December 23 at 4:17 p.m.
ohfergodsake again hmoff. When did Republicans ever put this on their agenda in the last three decades? Your party out of power is the ONLY reason we’re even talking about it.
hmoffsuite on December 23 at 4:31 p.m.
Sis. >> ” When did Republicans ever put this on their agenda in the last three decades?”
Sis. I can’t argue about that. Things should have been done a long time ago. But, that was then, this is now. Just because it hasn’t happened with previous administrations, is no reason that if it gets done this time, that it isn’t done right. It is a big deal for the Country.
LarrySpencer on December 23 at 4:32 p.m.
“Larry I completely agree with you except of course for the numbers. The mark up is more like 10-12% although I’ve heard as high as 30%.”
Sis, you are counting only the “overhead” and/or profit of the insurance company. The rest of the cost is the HUGE cost of billing and keeping up with the insurance regulations and procedures. This hidden cost is covered by the doctor raising his fee to cover it, and it adds up to a large part of what the bill comes to.
IdahoDad, when I go see my doctor, I pay just $63.00, and that covers fifteen minutes of actual doctor time. The reason he charges so little? He doesn’t bill insurance, so his overhead is less and he can spend more time with his patients.
Consider carrying major medical for a few hundred a month for your family, and use the savings to cover the much less expensive non-insurance billing doctor visits. Then you can use the rest of the money you save to pay for your kids college tuition.
LarrySpencer on December 23 at 4:43 p.m.
Points that Spoke, Sis and I agree on. (I think)
1. Medical inflation is out of control.
2. Insurance companies are much to blame.
What we don’t agree on is the solution. The Dems want government to take over the system, and I think the system’s cost would be cut in half or more if people were the customer instead of an insurance company.
The free market system works best in nearly every market, as long as you don’t allow people to be suckered into thinking that insurance is needed to cover every single ortion of helth care.
Tell the Big Pharma and the insurance industry to go screw themselves and rethink the proper roll of insurance and we just might end up with the most cost effective patient oriented system in the world.
hmoffsuite on December 23 at 4:46 p.m.
For Their Next Trick …
The latest example of violating principles of transparency and accountability in the single-minded pursuit of legislative
http://online.wsj.com/article/SB10001424052748704254604574614183270356274.html
This is exactly the type of thing that is causing the parties to harden their position.
lastdemoinidaho on December 23 at 4:53 p.m.
Here is one progressive person (won’t call myself a demo right now, and can’t change my handle easily) who says dump this bill unless and until it includes a reasonable likeness of a public option.
As far as those who oppose mandatory health insurance buyin, I would like an explanation of who will pay the costs of those thousands of young bucks and does when they crunch their cycles, or fall from the cliff, drive drunk up H95, or wack a tree going 60 down the ski hill…. My guess is that 99 percent of these young people do not have the cash or family fortune to fully pay for hospital, chopper, doctor and Rx costs associated with such adventures. Not to mention the risk of cancer or other extremely costly maladies just lurking over the corner.
If case you don’t know, when one of these insurance-less people ends up in KMC, the county and/or all the insurance-covered folks (like me) end up paying, through direct taxes or in higher premiums next year.
The only sound, long-term way to deal with this issue is a single-payer, public option where everyone is covered (read 100percent), and those who can’t afford it are somehow factored in. No exceptions. Then, only then, will we have true health coverage. That’s why I hope one or two progessive Democratic senators have the guts to say “NO” when the vote comes tomorrow.
As far as “how do we pay for this”, once we have a program we will figure out how to finance it, Some higher taxes are a reality, for both this program and to finance our costly wars and military spending. That is a fact. I will gladly pay my fair share. Will you?
OrangeTV on December 23 at 4:55 p.m.
It is truly a Christmas miracle. Larry Spencer is making a fair amount of sense and Sis, Spoke, and myself all seem to be in agreement with him about something. I’m all warm and fuzzy and it’s not just from the double-shot eggnogs…
mike_s on December 23 at 5:04 p.m.
OTV, shhh don’t tell Phaedrus. He might lose his sense of purpose.
spokelooneh on December 23 at 5:35 p.m.
Spencer is quite correct in noting the high cost of insurance overhead, especially when a practice has to deal with multiple insurers with their own various rules. I believe the last time I looked at this, the “average” doc was spending 15-18% of his/her dealing with insurance BS, and the “average” RN was spending 40% of his/her time. This is absolutely ridiculous and unsustainable. And the private insurance companies have done nothing but make this burden worse, year after year, decade after decade.
Despite many flaws in Medicaid and Medicare, Docs, Nurses, and Practice Administrators say they have much less trouble dealing with these public bureaucracies than they do with the private insurance bureaucracies.Dealing with ONE bureaucracy would significantly reduce overhead costs for providers.
As would, I’ll grant you, dealing mostly in cash payments. But that still doesn’t do much to reform the system in total when it’s still the big ticket operations and ongoing care for chronic diseases that are the huge cost drivers and almost always have to paid for by third party payers. Sure reducing the costs of routine office visits for minor problems would be a good thing, but its very small potatoes in the scheme of things.
LarrySpencer on December 23 at 5:51 p.m.
It might be small, but it would serve to open the eyes of the public.
Think about it. If one day the patient woke up and decided that he and his doctor should be in charge of his care. So, he wants to know what a procedure will cost and what it’s sucess rate is. Then, he wants to ask about other options that might cost less or work better.
Then, with his doctor, he questions why a procedure that doesn’t work very often or for very long is used. Turns out that the machine that helps the procedure was purchased and needs to be paid for. And insurance always pays for it, so that is the route that gets taken. This doesn’t sit well with our patient or his doctor, so they look for a better way to solve the problem.
Then health care changes direction and starts to get more efficient and results oriented.
And we, the patients, win.
hmoffsuite on December 23 at 6:02 p.m.
Spoke >> “Despite many flaws in Medicaid and Medicare, Docs, Nurses, and Practice Administrators say they have much less trouble dealing with these public bureaucracies than they do with the private insurance bureaucracies.”
If I had made that post, you guys would have been all over me for giving opinions with no facts behind them. Challenging my intelligence and all that. I won’t make any comments like Phead or Sis would, but just where did that statement come from? My experiences is dealing with any government vs. any independent business, that has not been the case.
LarrySpencer on December 23 at 6:08 p.m.
It comes down to the patient having a stake in the cost. Who would care how much something costs or how well it works if it is free and then you try something else if it doesn’t work.
If the patient becomes the customer, he demands results and wants to know why the two asprin the nurse is bringing him get billed to his insurance (or him) at $24.50. Until he becomes the customer, he doesn’t ever wonder what the asprin costs.
PS if you think I am making up that $24.50 figure, ask someone at the hospital how much an asprin costs, but be ready to be shocked at the answer.
OrangeTV on December 23 at 6:09 p.m.
The arguments on both sides of this issue seem to be “deja vu all over again” as George Carlin would say, with nothing accomplished and no new thoughts on the matter.
I just had to throw in a comment which accomplishes nothing and presents no new thoughts on the matter. Carry on.
LarrySpencer on December 23 at 6:16 p.m.
Merry Christmas, OTV. :-)
hmoffsuite on December 23 at 6:21 p.m.
Thanks, Otv. I had actually thought that Yogi Berra first used the deja vu all over again line.
OrangeTV on December 23 at 6:22 p.m.
Hey Larry, you as well. Hope Santa brings you lots of hair gel, brushes and blow dryers! ;-)
OrangeTV on December 23 at 6:25 p.m.
Hmo, I stand corrected! George Carlin was the one who said “vujà dé” - when it feels like something has never happened before. Got them mixed up in the old brain…time for another hot buttered rum, I think.
spokelooneh on December 23 at 6:31 p.m.
“My experiences is dealing with any government vs. any independent business, that has not been the case.”
Classic example of personal bias, assuming your experience is representative with the usual “gubmint bad, private good”, damn the facts.
I studied up on this last time we had a big debate about health care and found several articles.
Here’s a recent example from the Medical Group Management: Association, the preeminent organization in the field:
“Yesterday at the MGMA 2009 conference, the group unveiled statistics suggesting that—counter to what you might believe—Medicare seems to be doing a relatively good job of satisfying doctors. In fact, a new MGMA study concludes that Medicare Part B ranks higher in total satisfaction with payers than any other national plan.
The study ranked seven national payers, including Medicare Part B, Aetna, CIGNA, Coventry, Humana, Anthem and UnitedHealthcare, on various aspects of how well they satisfied medical groups. Medicare’s top-ranked score was only a 3.59, meaning that doctors were somewhere between “neutral” and “moderately satisfied,” but that still put it at the top of the pile. Closely following was Aetna, with a score of 3.14 and CIGNA, with 3.11.
http://www.fiercehealthcare.com/story/mgma2009-medicare-b-ranks-above-private-payers-satsfaction/2009-10-13#ixzz0aZLif3RE
Also most surveys of patients rate better satisfaction with Medicare than with private insurance ghouls.
hmoffsuite on December 23 at 6:48 p.m.
Spoke. Here is a source that doesn’t exactly agree with your argument.
http://www.heritage.org/research/healthcare/wm2505.cfm
spokelooneh on December 23 at 6:50 p.m.
“PS if you think I am making up that $24.50 figure, ask someone at the hospital how much an asprin costs, but be ready to be shocked at the answer.”
Am well aware of the insane costs and huge amount of waste that goes on in hospitals, and have personally seen it from both sides, as a patient and a contractor.
I sliced my hand up pretty bad once and the ER doc fixed it up with medical superglue. I asked him if it was the same as superglue sold at retail, and he said, it was, as far as he knew. I said I bet it’s far more expensive and he said of that I have no doubt.
Was originally billed $48 for it, can buy three tubes for a dollar at the Dollar Store, which I did as the original application came off 36 hours later. By then the throbbing had stopped and was able to “self-medicate” and glue it back together myself.
spokelooneh on December 23 at 7:03 p.m.
“hmoffsuite on December 23 at 6:48 p.m.
Spoke. Here is a source that doesn’t exactly agree with your argument.
http://www.heritage.org/research/he”
Stick to the subject, I was talking about Provider satisfaction with Medicare and patient satisfaction compared to private insurance company parasites. You questioned my assertion and I backed it up with surveys of Doctors from an authoritative medical industry organization, not some lefty blog or something.
You linked to a right wing thinktank screed about administrative costs, I saw nothing in that propaganda related to Provider satisfaction or patient satisfaction.
Me on December 23 at 7:17 p.m.
Ok - just going to chime in and then quickly leave because I KNOW it’s anecdotal and just because it is my experience doesn’t mean its everyone’s and on and on. Last year my sister hurt herself - so bad she was out of work - so then lost her insurance. She got by, family and friends helped and she got back to work and has paid off her hospital and Dr bills. My Son got hurt this year Memorial weekend. Broke his upper arm - snapped. It was an ambulance ride, the emergency room and Dr visits after that. He was 21 - no insurance. He is paying all those bills.
I know there are people who don’t pay - but some do. It is hugely expensive I know - and no one wants to do it but people do. My Son (who is one of those statistics - the ones who chose NOT to buy insurance even when it was available to him and he could afford it) now has insurance. And I think my sister has now purchased short term disability insurance after what happened to her.
Not every single person without insurance just bails.