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July 17, 2011 in Nation/World
Controversial Medicare ideas may come back
Proposals to raise seniors’ medical bills gain traction
WASHINGTON – The heated debate over the federal deficit has pumped new life into controversial proposals for requiring Americans on Medicare to pay more for their health care, raising the possibility that seniors’ medical bills could jump hundreds, or even thousands of dollars.
It remains unclear if any of the proposals, which congressional Republicans have demanded to cut trillions of dollars from the federal budget, will be enacted this year, given the continued stalemate over government spending.
But the ideas, once considered politically toxic, have gained enough traction that many in Washington expect them to resurface, if not now, then after the 2012 elections.
“Over the long haul, beneficiaries will have to pay more and taxpayers will have to pay more,” warned Henry Aaron, a longtime health care expert at the Brookings Institution. “It’s just too darn expensive.”
That could mean higher co-pays, higher deductibles or higher premiums for many seniors.
Though the elderly are much better off financially than they were when Medicare was enacted, half of seniors subsist on incomes below $22,000 a year.
Raising costs for consumers would also represent a substantial shift in how the federal government has provided health insurance to the elderly for the last half-century.
Since Medicare’s creation in 1965, presidents and members of Congress from both parties have largely avoided transferring costs to seniors. Though the program began charging high-income seniors higher Medicare premiums in 2003, Washington leaders have mainly sought to control Medicare costs by regulating what hospitals, doctors and other providers could charge, a strategy employed again in the health overhaul that President Barack Obama signed last year.
Many health care experts believe this can drive improvements in quality and efficiency by rewarding medical providers that get good results and penalizing those that commit costly errors. That could yield savings in the long run.
But with the nation’s Medicare tab projected to nearly double over the next decade to almost $1 trillion, pressure is growing to restrain the program’s spending more quickly.
That is fueling renewed interest in charging beneficiaries more, a phenomenon that is already happening in the commercial insurance market.
Medicare, which now insures nearly 50 million elderly and disabled Americans, was designed to require enrollees to pay at least some of their own health care bills.
“What many people may not realize is that the Medicare benefit package is not actually very generous,” said Jonathan Oberlander, a University of North Carolina health policy professor who has written extensively about the program’s history.
On top of standard premiums of more than $141 a month, enrollees must pay a $1,132 deductible for every hospital stay, and hundreds of dollars a day more for long hospital stays.
Medicare beneficiaries are also responsible for 20 percent of the bills for medical equipment, such as wheelchairs, and non-hospital procedures, such as kidney dialysis, physical therapy or outpatient surgery.
Medicare also doesn’t cover long-term care in nursing homes. And unlike many private health plans, Medicare doesn’t offer catastrophic protection by capping how much beneficiaries have to pay out of pocket every year.
That can mean substantial health care tabs for some seniors. Medicare households on average spent $4,620 on health care in 2009, more than twice what non-Medicare households spent, according to the nonprofit Kaiser Family Foundation.
But millions of seniors protect themselves from even higher medical bills by buying supplemental health plans.
At the same time, some medical services covered by Medicare, such as lab work and home health care, still don’t require any co-payments, making them effectively free for beneficiaries.
How much more seniors can afford to pay continues to stoke intense debate, however, especially as Medicare beneficiaries are already projected to spend as much as a quarter of their income on health care in 2020, up from around a sixth now.
House Republicans faced a fierce backlash when they proposed replacing Medicare with a system of vouchers for private insurance. That plan would increase the average senior’s medical bill by $6,000 in 2022, according to the Congressional Budget Office.
Stocks plummet as outlook in Europe dims 
mikeln on July 17 at 8:56 a.m.
We should give nothing to these private health insurance companies, they are the one that keep driveing up the cost of health care in this country. It is time to get rid of them and have a single payer system that can keep health care costs down while paying the people that do the work a living wage. We should all be tired of our government bending over backwards to help a industry that has no place in a civilized world.
mrd on July 17 at 10:27 a.m.
Just give us the benefits that we pay for congress to receive.
gmorton on July 17 at 11:21 a.m.
mrd wrote,
“Just give us the benefits that we pay for congress to receive.”
Ah, yes. “Just give us … .”
Who do you expect to pay for these “gifts”?
The_Seer on July 17 at 11:40 a.m.
gmorton asked: “Who do you expect to pay for these “gifts”?”
The wealth of the wealthiest nation ever. You know, all those riches the strivers accumulated in a vacuum. They are truly magical people, we are lucky to have such alchemists in our midst, ones who can transform luxuries like none ever witnessed out of the vast waste of the west.
If Cuba can “just give” their citizens better health care than the U.S., and at a fraction of the price, why can’t the U.S.?
Bagger, please.
IHike4Fun on July 17 at 12:33 p.m.
My neighbor finally turned the age where he could sign up for medicare. He said it is amazing what and how much they pay for compared to when he had to buy his own (company based) health insurance.
misjustice on July 17 at 12:56 p.m.
^ your neighbor is STILL paying for his health care, with co-pays and deductibles; didn’t you read the article about how much those under Medicare pay? Despite what many people think, Medicare isn’t free…
Albert on July 17 at 12:56 p.m.
gmorton these funds are derived from the Social Security Trust Funds and are NOT an entitlement. Over the years, abusive politicians from both sides of the aisles have “borrowed” these Trust Funds to pay the bills. The result attests that the “borrowed funds” are never to be repaid. I have been “assessed”, i.e. taxed for over 45 years on my earned income for this Trust account, thus when we come to obtain that which we have been duly taxed for, it now becomes and “entitlement”.
“Just give us…” is absolutely 100% correct. We paid for it, now please do give us what we paid for over our lifetime. Noting more - nothing less.
Diana on July 17 at 1:50 p.m.
I trust GMorton will have the courage of his convictions and turn down those socialist Medicare and Social Security programs when the time comes (if it hasn’t already).
Dazzeetrader11 on July 17 at 2:01 p.m.
No offense to anyone. What happens when you all realize the “bargain” forged by LBJ in 1965 is broken and is unsustainable. What if it wasn’t a executable contract at all?
Even Obama (who’s trying to break the bank) is the one who has the unenviable task of telling America that the deal’s off? He’s trying to do that now. More services demanded, move oldsters to demand services, longer lives ( by 10 years from back then), more union costs…and a host of new expenses…not the least of which is the ever expanding government to run and manage the program.
It’s not my solution to reduce the program. It is Ryan’s and now Obama understands the program ( no matter what he says to you) is unsustainable and must be cut by at least a full 1/3rd. This solution isn’t a solution The contract must be called off and new one must be worked out. It’s not something people want but even Mr Obama knows it. How he does this while trying to be re-elected is what all this is about. I don’t envy him..
Maybe there shouldn’t be a contract at all…..He’s in the process of wiping out the US economy AND with higher unemployment and decreasing US production, there is less money to solve the problem. It was a bad deal in the beginning. Unsustainable in 1965. Things are just catching up. Obamacare is not workable for similar reasons. Some think Obamacare is just reduced Medicare for eveyone. Do you see how this has worked out?
The message is clear. Obama’s trying to not be the messenger. US voters tend to blame the messenger…in this case it’s obama BUT he’s trying to make it look like it’s Bush and the republicans. It doesn’t really matter who the messenger is. The message is the same. SS and Medicare will be cut. They have to be. Sorry if this offends you.
USA scores again!!!!! 2-1 up on Japan.
hawken on July 17 at 2:19 p.m.
Medicare is soon to go bankrupt. What else do you need to know in order to make reforms now?
Reform now, save Medicare,,,, Or,,,, go bankrupt soon.
This is a no brainier, but for the liberal left.
gmorton on July 17 at 2:26 p.m.
The_Seer wrote,
“The wealth of the wealthiest nation ever.”
Oooh, your organic fallacy is showing.
Nations have no wealth. All of the wealth to be found in any nation is the wealth produced by particular people, whose wealth it is. “The nation” is merely a collective term for a number of autonomous, independent individuals who happen, by accident of birth, to occupy a common territory.
Collective terms do not denote “collective entities.” A gaggle (of geese) does not have feathers; only the geese who comprise it do. You’re trying to reify a verbal abstraction.
“They are truly magical people, we are lucky to have such alchemists in our midst, ones who can transform luxuries like none ever witnessed out of the vast waste of the west.”
Yes, we are lucky to have them. Such as all the alchemists (William Shockley, Robert Noyce, Jack Kilby, et al), who discovered how to transform beach sand into the microprocessors you are using to belittle them.
gmorton on July 17 at 2:30 p.m.
Albert wrote,
“gmorton these funds are derived from the Social Security Trust Funds and are NOT an entitlement.”
That is false in the case of Medicare, Albert. The Medicare payroll tax covers about 60% of Medicare costs; a percentage which declines every year. Other taxpayers eat the rest.
What you said does apply in the case of Social Security, however.
mikeln on July 17 at 2:45 p.m.
If we had full employment with living wage jobs we would be self insured for old age, something these crimminal health insurance companies fear most of all. If these crooked polititians had left these funds alone instead of giving them to thier buddies in return for money to be re-elected, we would be fine. If……
RaulBloodworth on July 17 at 2:52 p.m.
We need to completely end government involvement in all forms of health care and social security.
Everyone should buy their own health insurance and not expect the government or their employer to pay for it. Buy your own just like you do car insurance and homeoowner or renters insurance.
Also end social security now. People should save for their own retirement and not expect taxpayers to pay for it.
Get the government out of both and costs for healthcare would drop and people would take care of their retirement themselves.
dataxman on July 17 at 3:28 p.m.
Albert & gmorton - you both are incorrect. Social Security is an entitlement and there is no ‘trust fund’ - hasn’t been since the Johnson (D) administration and the adaption of the unified budget. Social Security is a tax - you have no claim to that money (don’t believe me - try leaving your ‘trust fund balance’ to your heirs) any more than to the monthly excise tax you paid on your phone bill.
If people were financially literate they would have rose up against medicare/social security years ago, but the promise of someone taking care of you is just too much for people to turn down. The fact they pay income tax on the social security/medicare taxes withheld from wages - then pay income tax on 85% of their benefits (up from 50% thanks to Clinton and the Democrat party) - 35% of which you have already paid income tax. Then you realize your medicare premiums are not deducted from your taxable social security benefits, so you get to pay income tax on your medicare premiums…
Pigrobin on July 17 at 5:08 p.m.
Anyone who actually believes they would get better health care in Cuba is smoking some very good stuff. If you’ve ever set foot in a country ruled by a communist dictatorship, you would never make such a foolish statement. What a limited view of the world, it certainly takes all kinds.
oneanddone on July 17 at 5:15 p.m.
Raul&Taxman are more of the same sort of conservative schleps who weigh down the right wing. SS is NOT a tax. It’s an agreement made by the full faith and credit of the USA - no different than their promise to pay China back what they’ve borrowed. They’ve taken MY money and they’ve AGREED to pay what’s been formulated. It’s like a bank (something conservatives pray to every night) taking a deposit and promising to pay the principle back plus interest. I can guarantee all politicians one very simple thing. The day the govt stops paying SS is the day there will no longer be a govt.
Traveler on July 17 at 5:24 p.m.
Well, my privatized, for-outrageous-profit medical insurance costs me more than $115 a week, and that’s with a whole slew of $1,000+ deductibles. My Medicare tax costs $16 a week. Granted, I’m not old enough to get it yet, but if the government were to increase it sixfold or so to cover me and every other American, it’d still be a better deal. So where do I sign up for socialized health insurance (not, as you cons keep wrongly asserting, HEALTH CARE)?
dataxman on July 17 at 5:48 p.m.
oneanddone - there is no guarantee that you will ever receive a penny from the social security taxes you pay. Congress can means test it (as has been discussed along with Medicare), lower the amount you receive or eliminate it all together. In Helvering v. Davis (1937), the Court had ruled that Social Security was not an insurance program: “The proceeds of both the employee and employer taxes are to be paid into the Treasury like any other internal revenue generally, and are not earmarked in any way.” In Flemming v. Nestor (1960) “To engraft upon the Social Security system a concept of accrued property rights would deprive it of the flexibility and boldness in adjustment to ever changing conditions which it demands.”
As I said earlier, a taxpayer has no claim on the taxes they pay. When you die, your estate becomes the owner of your bank account. Die without a spouse or a minor child, and a $250 death benefit is all your estate will receive.
I realize it is easier to name call then actually do a bit of research, but try to open your mind to the idea that a different point of view of yours is not automatically wrong…
gmorton on July 17 at 6:08 p.m.
dataxman wrote,
“Albert & gmorton - you both are incorrect. Social Security is an entitlement and there is no ‘trust fund’ - hasn’t been since the Johnson (D) administration and the adaption of the unified budget.”
Well, there never was a “trust fund” in the usual sense of the word, i.e, a dedicated account for each participant. It was a program trust fund, which means only that the payroll taxes were held in a separate account.
And that trust fund still exists, on paper. When the government “borrows” from it, it places an IOU in the account books. The unified budget did not change that; it merely lumped the two acccounts together for reporting purposes.
gmorton on July 17 at 6:15 p.m.
I should have added (if it was not clear) that dataxman is right that there is no “property right” in one’s SS account.
Dazzeetrader11 on July 17 at 6:35 p.m.
Don’t know why the people think they should give money to the government for SS or Medicare. I also don’t know why you shouldn’t keep your own money and build a nestegg. The government obviously in now a failure in both ways ( SS and Medicare).
I suspect the “glory” years are getting over. Perhaps the contract should be ended. The government is ending it now…they just won’t say it. Obama’s structure and his spending can’t hold up their end of the bargain anyway.
Nothing personal but you will all be broke if you depend on Obama and the future governments. I’d make good on the people in the system now but I’d seriously think about phasing out both. Government will NOT save you. Just eliminating the sections that administer Medicare, Obamcare and SS would save trillions.
A few things are clear….the biggest is that the “contributions” the government allegedlymakes cannot go on if they’re out of money…which they are. US Gov takes in $179 billion every month but it spends $300 billion per month. Something’s got to go. Can’t borrow that difference anymore. I, like many of you, depended on SS and Medicare….until I saw the data and actually read Obamacare as a plan. It’s worse than Medicare by far. I’d rather pay for my healthcare on my own.
As far as Cuban medicine goes…nobody who had options would endorse it. It’s just terrible. Years back, I spent 1 month at our Havana Mission on my way to Grand Cayman….wow…awful care. Filthy hospitals….terrible outcomes. You wouldn’t want it. Cuba’s a lot worse off than they let you know.
meadman on July 17 at 6:43 p.m.
take all the old folks who (due to making bad decisions like getting sick, injured, unable to find a job etc.) don’t have any money to buy heatlh insurance and just LET THEM STARVE…. they’re probably all Democrats anyway so what is the loss. Ship’em all off to some island somewhere so we don’t have to look at them as they lay in the gutter with their blanket and cup of beans. That’s the American way if you are a wealthy Republican. We are a great nation and can do anything – as long as those pesky losers don’t clutter things up. We don’t need any safety nets — it is a cruel world: get used to it.
Dazzeetrader11 on July 17 at 7:08 p.m.
http://www.realclearpolitics.com/video/2011/07/17/budget_director_wont_answer_if_wh_would_prioritize_social_security_payments.htm
It’s a tough question from CNN. Budget Director says no all things will be paid…wouldn’t quaranteed SS or Medicare payments…Not good but it’s real..tsk tsk tsk Obama…bet you wish you had the $7 + Trillion ( Fed transfers $4 trillion and all his other “programs= $3.7 trillion).
Obama is a HUGE problem. BUT the bigger program is the program itself. Just not affordable as it sits now. Ryan’s plan would work….not a fun option but it would work if the insurance companies lock their plans as they are now.
DickAdams on July 17 at 7:12 p.m.
I perused all the comments and after reading all of them, including; Cuba`s health care plan, lol, it seems to me that a few of the posters should put a tooth under their pillow.
misjustice on July 17 at 7:31 p.m.
@ meadman, in response to your 6:43 p.m.post: Soylent Green!
misjustice on July 17 at 7:39 p.m.
Oh, The Seer isn’t off base about Cuba.
“The scope of Cuba’s success has been validated through the authors’ study of Cuba over many years (JMK: Over 65 visits to Cuba since 1976, written or coedited 13 books on Cuba; EBC: Cuban physician/epidemiologist/medical historian living and working in Cuba; JMK, NEM, BH and EBC: Personal observation of the Cuban health care system).”
“To illustrate this success, we chose to compare Cuban data with data from the United States and Canada (because these were readily available) to clearly show what Cuba has been able to achieve.The experience of the United States has shown that more money for health care does not translate automatically into better health.”
“Indeed, while the United States has the highest health spending per capita (7), it does not have the healthiest population in the world (Table 1) (7-9). In contrast, Cuba, with much fewer resources, has managed to bring about the elimination of polio and good control of tuberculosis, and can claim the lowest rate of HIV in Latin America (0.05% in 2004 according to the Joint United Nations Programme on HIV/AIDS (UNAIDS) [10]).”
“Cuba also has a better infant mortality rate than the United States as well as the same life expectancy at birth (8). Cuba’s health achievements have been attained with only a fraction of the resources available in the United States and in other Organisation for Economic Co-operation and Development (OECD) countries. According to the World Bank (7), Cuba spends 7.5% of its gross domestic product on health expenditure, compared with 9.6% in Canada, 14.6% in the US, and the OECD average of 8.6% in 2003 (Table 1) (7,9). Of note, the overall annual per capita income of the Cuban population is only $1,170 compared with $28,390 in Canada and $41,400 in the United States in 2004 (8).”
Continues, but it’s all, like, sciencey and stuff…so many won’t follow this link to learn more… *sigh*
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2095081/
johnclarke on July 17 at 7:43 p.m.
Yeah well laugh it up about Cuba I suppose, because they were actually ranked 39th, as compared to the richest nation on the planet which is 37th.
misjustice on July 17 at 8:11 p.m.
Oh, and about the “controversial” Medicare ideas coming back…of course they are. The regressives have been trying to gut the program ever since LBJ signed it into law. Just like they have been itching to dismantle SS ever since FDR enacted that program.
I mean, DUH!
gmorton on July 17 at 8:30 p.m.
misjustice wrote,
“Oh, The Seer isn’t off base about Cuba.”
Oh, yes he is. Cuba is a totalitarian State, and rigorously controls the information it makes available to outsiders. There are no publicly accessible databases whose data can be readily verified, on the ground, by any interested person. Outside observers, such as the authors of your paper, will see only what the Cuban goons want them to see, and speak only with persons the goons have approved. Any report released by the Cuban government on health conditions (or on any other matter) can be dismissed *prima facie* as propaganda.
“According to Katharine Hirschfeld, criticizing the government is a crime in Cuba, and penalties are severe. She noted that ‘Formally eliciting critical narratives about health care would be viewed as a criminal act both for me as a researcher, and for people who spoke openly with me’. According to Hirschfeld the Cuban Ministry of Health (MINSAP) sets statistical targets that are viewed as production quotas. The most guarded is infant mortality rate. The doctor is pressured to abort the pregnancy whenever screening shows that quotas are in danger. Once a doctor decides to guard his quotas, patients have no right to refuse abortion.
“According to previous research about other socialist countries such as the Soviet Union and the People’s Republic of China, Marxist ‘revolutionary’ efforts have included such practices as ‘deliberate manipulation of health statistics, aggressive political intrusion into health care, decision-making, criminalizing dissent, and other forms of authoritarian policing of the health sector designed to insure health changes reflect the (often utopian) predictions of Marxist theory’. These practices are well documented for the former Soviet Union and China. Their existence was virtually unknown in the West during the Soviet era and Western social scientists cited favorable the health statistics supplied by the regimes in the USSR and China. Social scientists did not look critically at the ways they were created and maintained by state power.
“Many Cubans complain about politics in medical treatment and health care decision-making. There is no right to privacy, patient’s informed consent, or right to protest for malpractice. The patient has no right to refuse the treatment, including for religious or ethical reasons. For example, Jehovah’s Witnesses cannot refuse blood transfusions and a Rastafarian cannot refuse an amputation on the grounds that it goes against Rastafari biblical teachings (Rastafari teaches that the body must be whole in order for it to resurrected on Judgement Day). As a result, the experience can be dehumanizing.”
“After spending nine months in Cuban clinics, Katherine Hirschfeld asserted in her paper ‘My increased awareness of Cuba’s criminalization of dissent raised a very provocative question: to what extent is the favorable international image of the Cuban health care system maintained by the state’s practice of suppressing dissent and covertly intimidating or imprisoning would-be critics?’”
http://www.miscelaneasdecuba.net/media/pdf/Article-Hirschfeld-Press.pdf
Dazzeetrader11 on July 17 at 8:47 p.m.
J…you preach like you actually KNOW something. Well you don’t know much and you don’t know enough.
The infant mortality rate is low in Cuba because if a child dies in the first 48 hrs of birth, they don’t count it. We at NIH knew that going in. The data Cuba presents is washed up and scrubbe dlike crazy to PROVE ( lol) the communist system is better that the capitalist systems.
And if you don’t follow the party like ( like the “MD” you cite, you won’t be getting soup for dinner. You might be in jail or one of your family members are….or let out early ,etc ,etc.
The fellow in the video link I posted is OBAMA’S guy….did you not watch what he said??? He is the director of the budget. Geez girl…..wake up. US is in trouble because of misinformed stupidity. The system is failing…Obam’s worse than Bush by far. He’s got no job so tax generation monies will be low. And yet, he wants to continue spending…heck he hasn’t even produced a single budget since he’s been in the WH. Not one…why? He’s spend the money in odd channels where he doesn’t need the COngress.
Obama and his crew are much better understood if you understand that what they say isn’t true..it’s just part of the truth. They hide the rest. But to the poin…Obama knows nothing about economics..he just gives the nice speeches. He won’t take questions because he couldn’t answer. He knows nothing but spending. Never managed a single thing in his entire life. Not one thing.
gmorton on July 17 at 8:51 p.m.
misjustice,
More on Cuban health care:
http://www.youtube.com/watch?v=o6ZH1ps20WA
(Stossel interviewing Michael Moore)
PlanB on July 17 at 10:37 p.m.
I’ve been paying into it for more than three decades, so I expect it to be there when I need it.
greenlibertarian on July 17 at 10:50 p.m.
Couldn’t be two more ignorant losers than John Stossel and Michael Moore.
Really, that’s a basis for debate?
pathetic.
misjustice on July 18 at 7:03 a.m.
g posted, “Outside observers, such as the authors of your paper, will see only what the Cuban goons want them to see, and speak only with persons the goons have approved.”
The same could be said about our health insurance system; in that regressives will only see what the corporate insurance goons want them to see…yadda, yadda, yadda…
We have the best health insurance system that money can buy!
gmorton on July 18 at 7:42 a.m.
misjustice wrote,
“The same could be said about our health insurance system; in that regressives will only see what the corporate insurance goons want them to see…yadda, yadda, yadda…”
Now, now. You know better than that. Anyone who wishes to investigate American health care can visit any hospital, clinic or pharmacy he wishes and talk to any providers or patients he wishes, whenever he wishes. No government approval is necessary and it can do nothing to prevent it. Corporate goons may be able to hide or falsify or selectively release their own records, if they wish to risk the wrath of state auditors, but they can’t hide what’s on the ground.
The_Seer on July 18 at 9:54 a.m.
oooo, I’m sooooooooooooooooooo afraid of those totalitarian goon Cubans.. they are coming to roast our children in spits!
Hugo Chavez could get cancer treatment anywhere in the world. He chose Cuba.
I think wikileaks has shown how our own government decides what we should know. And those documents aren’t even top secret.
gmorton wrote: “Now, now…” Could you please be more patronizing and paternalistic? Please? If corporate goons can’t “hide what’s on the ground” explain why Grace Mining in Libby knew of the presence of cancer causing fibers in their product and didn’t inform workers for decades? I could go on and on, and you know it.
misjustice on July 18 at 10:06 a.m.
g, you know damn well that I did not reference hospitals or health care providers; I targeted the CEOs of health insurance companies. You know, the ones mandating the rationing of health care because to pay claims would mean that their corporations could not pay them the millions that they suck from their customers premium payments. Delay and Deny!
gmorton on July 18 at 10:28 a.m.
misjustice wrote,
“g, you know damn well that I did not reference hospitals or health care providers . . .”
You sure did. The topic, after all, was the comparative quality of health care in the US v. Cuba, not the behavior of insurance companies, which have little to do with the quality of care.
“You know, the ones mandating the rationing of health care because to pay claims would mean that their corporations could not pay them the millions that they suck from their customers premium payments.”
Insurance companies deny about 3% of all claims. Medicare, BTW, denies 4%.
http://www.fundmasteryblog.com/2009/10/07/denied-medical-insurance-claims/
gmorton on July 18 at 10:35 a.m.
The_Seer wrote,
” …explain why Grace Mining in Libby knew of the presence of cancer causing fibers in their product and didn’t inform workers for decades?”
What does that have to do with the comparative quality of US v. Cuban health care, or the ability of insurance companies to manipulate information about US health care?
misjustice on July 18 at 11:27 a.m.
The rate of denials, by corporate health insurance, is unknowable. The health insurance industry is not mandated to report such numbers, except in California. Any reporting of their denial rates are likely low balled.
The_Seer on July 18 at 1:22 p.m.
John Stossel… .lmao!
That video is packed with disaffected Cuban expatriates with an axe to grind. I especially liked the doctor who claimed to have performed 70-80 abortions a day in order to improve their infant mortality rates, rates he previously admits are manipulated by the government. The contradictions abound, thanks gmorton.
Plus, if a two tiered system exists in Cuba it’s not all that different from the U.S. where those who can afford better care receive better care.
gmorton on July 18 at 6:09 p.m.
misjustice wrote,
“Any reporting of their denial rates are likely low balled.”
Well, that’s possible, but until some evidence is produced it must remain speculative. The AMA seems to be happy with the stats.
http://www.politifact.com/truth-o-meter/statements/2009/sep/18/health-care-america-now/tv-ad-overstates-health-insurance-denials/
More important that the rate of denials is the reasons for them. The denial rate could be 50%, and if every denial was for a valid reason, such as that the claim is not covered by the insurance contract (pre-existing condition, condition or treatment not covered, policy limit exceeded, etc.) – then the patient has no grounds for complaint.
Many of them think they do, of course, because they have become convinced that they have a “right” to health care, and that the evil insurance companies are violating their rights if they refuse to pay for any claim the patient might submit. It doesn’t occur to them that the companies are obligated only for the specific coverages they have contracted for.
gmorton on July 18 at 6:19 p.m.
The_Seer wrote,
“Plus, if a two tiered system exists in Cuba it’s not all that different from the U.S. where those who can afford better care receive better care.”
Oh, it’s quite different, Seer. In the US you can get the quality of care you can pay for, which is largely up to you. In Cuba, the quality of care you get depends upon your status within the political pecking order.
Traveler on July 18 at 6:43 p.m.
Cuba is not the best example of a first-world economy, or even a second-world one, thanks in large part to the 51-year-old U.S. embargo — most of ‘em are still driving 60-year-old cars, for heaven’s sake. In a country where the average monthly wage is $20, do you think their hospitals are going to be state of the art? Even so, they do pretty well.
How ‘bout considering a socialized medical system in a country that’s fairly prosperous, like Canada? I trust Canadians to have a fairly sophisticated view of medical care, and according to Wikipedia, (http://en.wikipedia.org/wiki/Socialized_medicine#Canada), “85.2% of Canadians reported that they were “satisfied” or “very satisfied” with the way health care services are provided in their country and an even higher number (89.8%) rated their physician in the same way though slightly lower ratings were awarded to hospitals (79.9% being “satisfied” or “very satisfied”).[65]”
gmorton on July 18 at 7:28 p.m.
56traveler wrote,
” … thanks in large part to the 51-year-old U.S. embargo . . .”
Of all the specious rationalizations trotted out by lefties to explain away Cuba’s poverty, that is surely the favorite, and most specious.
The US embargo has nothing to do with Cuba’s plight. An embargo is not a blockade. Cuba is free to trade will all of the rest of the world. They can’t, however, because they have nothing to trade. They have nothing to trade because they produce nothing. They produce nothing because they don’t have a real economy; they have a Marx-inspired, State-run pseudo-economy which performs as well as all the other Marxist pseudo-economies which popped up like neoplasms in the late 20th century, such as those in N. Korea, pre-enlightenment China, Eastern Europe, and the late, unlamented USSR.
I agree the embargo should be lifted, though. It would nullify that excuse and make things a bit easier for Cuba’s black-marketeers, who are the most resourceful segment of Cuba’s prostrate economy.
Traveler on July 18 at 7:31 p.m.
Wow, way to strain at a gnat.
My point was that Cuba’s medical system is not even remotely comparable to America’s, due to the vast difference in economies, and that Canada’s is a much better example.
That’s what I’d like you to discuss.
Traveler on July 18 at 7:45 p.m.
And while I certainly won’t defend Cuba’s Marxism or central-run economy — that is the main reason for its economic woes, certainly — but not being able to sell anything to the richest country in the world that’s only 75 miles away has got to have an influence.
And, btw, Cuba is about the size of Tennessee, with a population of about 11 million, putting them 73rd on the list (http://en.wikipedia.org/wiki/List_of_countries_by_population_in_2005). Most of their neighbors on the list are also third-world, like Zambia, Senegal, etc., or in Europe, like Greece, Portugal and Belgium. I think one big difference between those two classes is who they can trade with. How rich do you think Cuba should be if its nearest trading partners are Mexico and the northern countries of South America?
Traveler on July 18 at 7:55 p.m.
The wife’s home:
Traveler out!
gmorton on July 18 at 7:59 p.m.
56traveler wrote,
” …Canada’s is a much better example.”
Try this:
http://www.youtube.com/watch?v=6EEN-kb2Czs
The rest of the program is worth watching also. Six parts.
gmorton on July 18 at 8:05 p.m.
56traveler wrote,
“How rich do you think Cuba should be if its nearest trading partners are Mexico and the northern countries of South America?”
At least as rich as Australia and New Zealand, whose trading partners are much further away than Cuba’s.
That argument is a non-starter.
Traveler on July 18 at 9:18 p.m.
gmorton,
OK, I watched the video, and it seems to me that the biggest problem in Canada is that supply can’t keep up with demand. Stossel even admits that’s the problem in America; why isn’t that same claim valid in Canada?
And comparing free ice cream or beef or even gasoline to free medical care seems like a specious argument to me. Which of these is not like the others?
Traveler on July 18 at 9:36 p.m.
My point wasn’t about proximity of trading partners so much as quality, but after a little research I found that Cuba’s biggest partners are the Netherlands and Canada, so I was wrong about that.
And I’ve already admitted Cuba has a crappy economy, mostly because of its communist/Marxist government, even though I still maintain that the embargo has played a role — I just shouldn’t have said it was a “large” role.
And you were certainly right when you said a big problem is that they don’t make anything lots of people want.
So your points about Cuba’s economic state being its own fault are conceded.
I was wrong in my claims, but in my defense, I was only trying to say that its medical system wasn’t equal to ours, because of their poor economy.
gmorton on July 18 at 10:34 p.m.
56traveler write,
“And comparing free ice cream or beef or even gasoline to free medical care seems like a specious argument to me. Which of these is not like the others?”
They are all alike in one respect – they are all subject to the Law of Supply and Demand. As the price of any desired item approaches zero, the demand increases to infinity. So whoever is actually paying for this “free” health care is forced to ration.
In a market economy consumers “self-ration” – they consider whether the benefit they expect to realize from a good justifies its price. For example, if your doc sends you to the lab with an order for a dozen tests, and you are paying for those yourself, you’ll press him to tell you exactly what each of those tests will reveal, and how useful that information will be in determining how to treat you. You may also check around before heading for the lab to see what other labs charge for them. If some third party is paying, you don’t ask those questions. Why do you care how much they cost?
These two segments of Stossel’s program deals with the 3rd party payer issue:
http://www.youtube.com/watch?v=UvCqXomvWd8&feature=related
http://www.youtube.com/watch?v=7wyTi2WK8d8&feature=related
Traveler on July 18 at 11:01 p.m.
Well, I don’t think demand infinity will be a problem with health care — at least not on the same scale as gasoline — because not everybody needs a new hip, or artery surgery, or whatever. Aside from basic checkups, as you meet the higher-level needs of patients, the demand will drop, or at least level off with population growth. And the more people you give checkups to, the fewer who will need the higher-level services.
But people will always want free ice cream or gasoline, as much as they can get, and the demand will only increase with population growth. That need can never be met, and putting a personal price on it is the only way to regulate the demand.
According to Wikipedia, in 2006, (http://en.wikipedia.org/wiki/Comparison_of_the_health_care_systems_in_Canada_and_the_United_States), the U.S. spent about 15.3 percent of its GDP on health care — about $6,700 per person. Canada spent about 10 percent of its GDP — about $3,600 per person. If Canada were to increase its GDP percentage by 50 percent, or nearly double its per-person spending, to match America’s, I’m sure the supply would be much closer to the demand.
Traveler on July 19 at 10:09 a.m.
gmorton,
I thought of a better analogy: It’s like the difference between free gas and free auto repair.
If you give people free gasoline, they’ll find ever-more creative ways to use it, from taking the scenic way home from work, to more weekend trips to the coast, to bigger, heavier cars. The demand will always increase.
But free car care (not dent removal and paint jobs and such — that’s plastic surgery) has a certain demand limit, providing you have enough mechanics to get past the self-exacerbating curve (the people who have to wait for a month to get that noise under the hood checked may need an overhaul by the time the mechanic gets to them, whereas they might have only needed a new fan belt if the problem had been caught in time). Preventive auto maintenance is always the best, and cheapest, kind.
But if you don’t have enough mechanics to meet the demand, much of the work will necessarily be triage — deciding which cars have to be serviced right away and which are too far gone. Preventive maintenance will almost always be secondary. You might never catch up, and you could wind up like Canada’s health care system.
gmorton on July 19 at 10:28 a.m.
56traveler wrote,
“But people will always want free ice cream or gasoline, as much as they can get, and the demand will only increase with population growth.”
Oh, no. You can only eat (and will only want) so much ice cream, and you only have so much time to drive.
When I said demand approaches infinity, that was hyperbole. There is always some natural (and finite) limit, called the “absolute demand,” i.e., the quantity which would be consumed if supply were unlimited and free.
“If Canada were to increase its GDP percentage by 50 percent, or nearly double its per-person spending, to match America’s, I’m sure the supply would be much closer to the demand.”
Well, since spending $6700 in the US still falls far short of meeting absolute demand, it’s hard to see why it would meet it in Canada. And costs would continue to increase exponentially, as they do in the US, because there are are no cost-benefit tests applied and no competition.