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URL: http://www.middletownusa.com/forum/forum_posts.asp?TID=1703 Printed Date: Dec 22 2024 at 10:41pm
Topic: Here lies the Problem with ObamaCarePosted By: Pacman
Subject: Here lies the Problem with ObamaCare
Date Posted: Aug 07 2009 at 12:32pm
Sorry Kathleen but it is the details that scares the HELL out of everyone.
Lifting A Burden Of Worry
By Kathleen Sebelius Tuesday, August 4, 2009
As the political debate about how to pay for and pass health reform grows louder and more contentious, we shouldn't lose sight of the reason we're even having this conversation: We have a huge, once-in-a-lifetime opportunity to improve the lives of all Americans, insured and uninsured alike.
Health insurance is fundamentally about peace of mind. If you have good insurance, you don't have to worry about an accident or sudden illness. You know that whatever happens, you and your family will be taken care of.
We can't eliminate all disease. But through health reform, we can give every American access to quality, affordable health insurance so that if they do get sick, they have the best chance possible of getting better without bankrupting their families.
The current health-care system gives insurance companies all the power. They get to pick and choose who gets a policy. They can deny coverage because of a preexisting condition. They can offer coverage only at exorbitant rates -- or offer coverage so thin that it's no coverage at all. Americans are left to worry about whether they'll get laid off and lose their insurance or wake up from surgery with a $10,000 bill because they didn't read the fine print on their policy.
By giving Americans choices, health reform will switch the roles. Americans will get peace of mind and insurance companies will start getting nervous. They will know that if they don't deliver a great value, their customers will flee. So they will start offering better coverage.
Reform will close the gaps in our current system. When my two sons graduated from college, I had mixed feelings. I was incredibly proud of their accomplishments, but I dreaded the fact that they would lose their health insurance when they left school. The peace of mind that comes with health reform means college graduations can go back to being the celebrations they are supposed to be.
Consider the entrepreneur sitting at her desk, dreaming about her idea for a new business. Right now, many entrepreneurs are paralyzed by our fractured health insurance system. They know that if they leave their job, they might not be able to get insurance for their families. So they, and their innovations, stay put. Health reform means unleashing America's entrepreneurs to chase their big ideas.
Without reform, we will miss out on these benefits. And our health-care system will still be a fiscal time bomb. Recent http://www.whitehouse.gov/assets/documents/CEA_Health_Care_Report.pdf - estimates indicate that by 2040, health-care costs will eat up 34 percent of our gross domestic product. By comparison, the entire federal budget today is just 20 percent of our GDP. By acting now, we have the chance to slow health-care costs in a way that doesn't slash benefits or reduce care. Instead, we can make investments in prevention, wellness and health information technology that will allow the health-care system to deliver incredible results at prices we can all afford. Imagine a system in which your doctor spends as much time trying to keep you healthy as treating you when you're sick, in which you and your doctor have all the information you need to choose the treatments that work best for you, in which you never have to fill out the same paperwork twice. Health reform is the first step in that direction.
President Obama and I are working closely with Democrats and Republicans in the House and Senate and health-care experts to make sure we get the details of health reform right. But we can't let the details distract us from the huge benefits that reform will bring. The urgency behind reform has nothing to do with the schedule of Congress and everything to do with the needs of the American people.
Nor should we let ourselves be distracted by attacks that try to use the complexity of health reform to freeze Americans in inaction. We've learned over the past 20 years that "socialized medicine" and "government-run health care" are code words for "don't change anything." With some insurers raising premiums by more than 25 percent and 14,000 people losing their health insurance every day, Americans want to hear something more from their leaders than "wait and see" and "more of the same." People have enough to worry about these days. Americans deserve the peace of mind that only health-care reform can provide.
The writer is secretary of health and human services.
Replies: Posted By: Pacman
Date Posted: Aug 10 2009 at 2:27pm
DEADLY DOCTORS
O ADVISERS WANT TO RATION CARE
By BETSY MCCAUGHEY
Last updated: 1:13 am July 24, 2009 Posted: 1:03 am July 24, 2009
THE health bills coming out of Congress would put the de cisions about your care in the hands of presidential appointees. They'd decide what plans cover, how much leeway your doctor will have and what seniors get under Medicare.
Yet at least two of President Obama's top health advisers should never be trusted with that power.
Start with Dr. Ezekiel Emanuel, the brother of White House Chief of Staff Rahm Emanuel. He has already been appointed to two key positions: health-policy adviser at the Office of Management and Budget and a member of Federal Council on Comparative Effectiveness Research.
Emanuel bluntly admits that the cuts will not be pain-free. "Vague promises of savings from cutting waste, enhancing prevention and wellness, installing electronic medical records and improving quality are merely 'lipstick' cost control, more for show and public relations than for true change," he wrote last year (Health Affairs Feb. 27, 2008).
Savings, he writes, will require changing how doctors think about their patients: Doctors take the Hippocratic Oath too seriously, "as an imperative to do everything for the patient regardless of the cost or effects on others" (Journal of the American Medical Association, June 18, 2008).
Yes, that's what patients want their doctors to do. But Emanuel wants doctors to look beyond the needs of their patients and consider social justice, such as whether the money could be better spent on somebody else.
Many doctors are horrified by this notion; they'll tell you that a doctor's job is to achieve social justice one patient at a time.
Emanuel, however, believes that "communitarianism" should guide decisions on who gets care. He says medical care should be reserved for the non-disabled, not given to those "who are irreversibly prevented from being or becoming participating citizens . . . An obvious example is not guaranteeing health services to patients with dementia" (Hastings Center Report, Nov.-Dec. '96).
Translation: Don't give much care to a grandmother with Parkinson's or a child with cerebral palsy.
He explicitly defends discrimination against older patients: "Unlike allocation by sex or race, allocation by age is not invidious discrimination; every person lives through different life stages rather than being a single age. Even if 25-year-olds receive priority over 65-year-olds, everyone who is 65 years now was previously 25 years" (Lancet, Jan. 31).
The bills being rushed through Congress will be paid for largely by a $500 billion-plus cut in Medicare over 10 years. Knowing how unpopular the cuts will be, the president's budget director, Peter Orszag, urged Congress this week to delegate its own authority over Medicare to a new, presidentially-appointed bureaucracy that wouldn't be accountable to the public.
Since Medicare was founded in 1965, seniors' lives have been transformed by new medical treatments such as angioplasty, bypass surgery and hip and knee replacements. These innovations allow the elderly to lead active lives. But Emanuel criticizes Americans for being too "enamored with technology" and is determined to reduce access to it.
Dr. David Blumenthal, another key Obama adviser, agrees. He recommends slowing medical innovation to control health spending.
Blumenthal has long advocated government health-spending controls, though he concedes they're "associated with longer waits" and "reduced availability of new and expensive treatments and devices" (New England Journal of Medicine, March 8, 2001). But he calls it "debatable" whether the timely care Americans get is worth the cost. (Ask a cancer patient, and you'll get a different answer. Delay lowers your chances of survival.)
Obama appointed Blumenthal as national coordinator of health-information technology, a job that involves making sure doctors obey electronically deivered guidelines about what care the government deems appropriate and cost effective.
In the April 9 New England Journal of Medicine, Blumenthal predicted that many doctors would resist "embedded clinical decision support" -- a euphemism for computers telling doctors what to do.
Americans need to know what the president's health advisers have in mind for them. Emanuel sees even basic amenities as luxuries and says Americans expect too much: "Hospital rooms in the United States offer more privacy . . . physicians' offices are typically more conveniently located and have parking nearby and more attractive waiting rooms" (JAMA, June 18, 2008).
No one has leveled with the public about these dangerous views. Nor have most people heard about the arm-twisting, Chicago-style tactics being used to force support. In a Nov. 16, 2008, Health Care Watch column, Emanuel explained how business should be done: "Every favor to a constituency should be linked to support for the health-care reform agenda. If the automakers want a bailout, then they and their suppliers have to agree to support and lobby for the administration's health-reform effort."
Do we want a "reform" that empowers people like this to decide for us?
Posted By: Hermes
Date Posted: Aug 10 2009 at 3:56pm
I've always had a sneaky feeling that someday we would get to the point of "euthanizing" senior citizens. I think I seen a movie 30 years ago about it. Soylent Green,I believe.
------------- No more democrats no more republicans,vote Constitution Party !!
Posted By: 2000+
Date Posted: Aug 10 2009 at 4:58pm
Pacman, I've spent far to much time wondering who you are based upon you posts. I would guess your a conservative Republican, about 50-60, live on the East-end, thought Ronald Regan was a God, Supported Bush in the Iraq two trillion dollar war, have some kind of literary background due to the quality / content of you writings and most of the time I find it hard to disagree with you. Close? Well maybe not most of the time.
Posted By: 2000+
Date Posted: Aug 10 2009 at 5:29pm
Pacman, Who is this Betsy McCaughey & in what publication did this opinion appear?
Posted By: Pacman
Date Posted: Aug 10 2009 at 5:32pm
Posted By: Pacman
Date Posted: Aug 10 2009 at 5:40pm
Watch this video and you will know why people are so upset. Listen to the Congressman's answer about this mans son having Cerebral Palsy and treatment for him under Obamacare. It is scary to say the least.
Posted By: Pacman
Date Posted: Aug 10 2009 at 5:49pm
2000+ Conservative Republican yes. Think Regan is a God no, Support Bush in Iraq Yes, 50-60 yes, live on the East End Yes, don't hold that against me though, Literary Background No. It's OK to disagree. I have no hidden agenda other than to see Middletown improve.
Posted By: 2000+
Date Posted: Aug 10 2009 at 11:12pm
Pac, Fox news watcher, yes. Saw the both the video of the town hall meeting and his soooo saaad- face interview by Fox . You've got to be kidding. My favorite quote of this guy "If I was be disruptive the police woul have arrested me. Can you imagine being shouted down in our council chambers by some individual who created such havoc that you were unable to even reply to any questions from other citizens!!!! If it didn't have to do with your particular left/right politics, I would expect your or anyones reactions to be. Baliff, please remove this disruptive person from the courtroom! And please don't call his behavior "democracy at it's best"
Posted By: Pacman
Date Posted: Aug 11 2009 at 7:31am
2000+ no fear of getting any answer in Middletown Council Meetings as they don't answer questions period as they are not set up for that. You miss the point, the point is this man's son has CP and the best the Congressman can do is say they will have an amendment to deal with the son's disease. Personally I think they would be better off asking tough questions in a civil manner and getting it on tape.
But when you talk about cutting $500 Billion from Medicare, to fund care for others including illegal immigrants emotions are going to run high and I don't blame them.
And spare me the outrage over the outburst at these meetings, liberals have been doing this for years, and all of a sudden the Conservatives take a page from the Liberal playbook and we have outrage from the liberals yeah right.
Posted By: Pacman
Date Posted: Aug 11 2009 at 5:41pm
You have advanced kidney cancer. It will kill you, probably in the next year or two. A drug called Sutent slows the spread of the cancer and may give you an extra six months, but at a cost of $54,000. Is a few more months worth that much?
If you can afford it, you probably would pay that much, or more, to live longer, even if your quality of life wasn’t going to be good. But suppose it’s not you with the cancer but a stranger covered by your health-insurance fund. If the insurer provides this man — and everyone else like him — with Sutent, your premiums will increase. Do you still think the drug is a good value? Suppose the treatment cost a million dollars. Would it be worth it then? Ten million? Is there any limit to how much you would want your insurer to pay for a drug that adds six months to someone’s life? If there is any point at which you say, “No, an extra six months isn’t worth that much,” then you think that health care should be rationed.
In the current U.S. debate over http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/health_insurance_and_managed_care/health_care_reform/index.html?inline=nyt-classifier - health care reform , “rationing” has become a dirty word. Meeting last month with five governors, http://topics.nytimes.com/top/reference/timestopics/people/o/barack_obama/index.html?inline=nyt-per - President Obama urged them to avoid using the term, apparently for fear of evoking the hostile response that sank the Clintons’ attempt to achieve reform. In a Wall Street Journal op-ed published at the end of last year with the headline “Obama Will Ration Your Health Care,” Sally Pipes, C.E.O. of the conservative Pacific Research Institute, described how in Britain the national health service does not pay for drugs that are regarded as not offering good value for money, and added, “Americans will not put up with such limits, nor will our elected representatives.” And the Democratic chair of the Senate Finance Committee, Senator http://topics.nytimes.com/top/reference/timestopics/people/b/max_baucus/index.html?inline=nyt-per - Max Baucus , told CNSNews in April, “There is no rationing of health care at all” in the proposed reform.
Remember the joke about the man who asks a woman if she would have sex with him for a million dollars? She reflects for a few moments and then answers that she would. “So,” he says, “would you have sex with me for $50?” Indignantly, she exclaims, “What kind of a woman do you think I am?” He replies: “We’ve already established that. Now we’re just haggling about the price.” The man’s response implies that if a woman will sell herself at any price, she is a prostitute. The way we regard rationing in health care seems to rest on a similar assumption, that it’s immoral to apply monetary considerations to saving lives — but is that stance tenable?
Health care is a scarce resource, and all scarce resources are rationed in one way or another. In the United States, most health care is privately financed, and so most rationing is by price: you get what you, or your employer, can afford to insure you for. But our current system of employer-financed health insurance exists only because the federal government encouraged it by making the premiums tax deductible. That is, in effect, a more than $200 billion government subsidy for health care. In the public sector, primarily http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/medicare/index.html?inline=nyt-classifier - Medicare , http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/medicaid/index.html?inline=nyt-classifier - Medicaid and hospital emergency rooms, health care is rationed by long waits, high patient copayment requirements, low payments to doctors that discourage some from serving public patients and limits on payments to hospitals.
The case for explicit health care rationing in the United States starts with the difficulty of thinking of any other way in which we can continue to provide adequate health care to people on Medicaid and Medicare, let alone extend coverage to those who do not now have it. Health-insurance premiums have more than doubled in a decade, rising four times faster than wages. In May, Medicare’s trustees warned that the program’s biggest fund is heading for insolvency in just eight years. Health care now absorbs about one dollar in every six the nation spends, a figure that far exceeds the share spent by any other nation. According to the http://topics.nytimes.com/top/reference/timestopics/organizations/c/congressional_budget_office/index.html?inline=nyt-org - Congressional Budget Office , it is on track to double by 2035.
President Obama has said plainly that America’s health care system is broken. It is, he has said, by far the most significant driver of America’s long-term debt and deficits. It is hard to see how the nation as a whole can remain competitive if in 26 years we are spending nearly a third of what we earn on health care, while other industrialized nations are spending far less but achieving health outcomes as good as, or better than, ours.
Rationing health care means getting value for the billions we are spending by setting limits on which treatments should be paid for from the public purse. If we ration we won’t be writing blank checks to pharmaceutical companies for their patented drugs, nor paying for whatever procedures doctors choose to recommend. When public funds subsidize health care or provide it directly, it is crazy not to try to get value for money. The debate over health care reform in the United States should start from the premise that some form of health care rationing is both inescapable and desirable. Then we can ask, What is the best way to do it?
Last year Britain’s National Institute for Health and Clinical Excellence gave a preliminary recommendation that the National Health Service should not offer Sutent for advanced kidney cancer. The institute, generally known as NICE, is a government-financed but independently run organization set up to provide national guidance on promoting good health and treating illness. The decision on Sutent did not, at first glance, appear difficult. NICE had set a general limit of £30,000, or about $49,000, on the cost of extending life for a year. Sutent, when used for advanced kidney cancer, cost more than that, and research suggested it offered only about six months extra life. But the British media leapt on the theme of penny-pinching bureaucrats sentencing sick people to death. The issue was then picked up by the U.S. news media and by those lobbying against health care reform in the United States. An article in The New York Times last December featured Bruce Hardy, a kidney-cancer patient whose wife, Joy, said, “It’s hard to know that there is something out there that could help but they’re saying you can’t have it because of cost.” Then she asked the classic question: “What price is life?”
Last November, Bloomberg News focused on Jack Rosser, who was 57 at the time and whose doctor had told him that with Sutent he might live long enough to see his 1-year-old daughter, Emma, enter primary school. Rosser’s wife, Jenny, is quoted as saying: “It’s immoral. They are sentencing him to die.” In the conservative monthly The American Spectator, David Catron, a health care consultant, describes Rosser as “one of NICE’s many victims” and writes that NICE “regularly hands down death sentences to gravely ill patients.” Linking the British system with Democratic proposals for reforming health care in the United States, Catron asked whether we really deserve a health care system in which “soulless bureaucrats arbitrarily put a dollar value on our lives.” (In March, NICE issued a final ruling on Sutent. Because of how few patients need the drug and because of special end-of-life considerations, it recommended that the drug be provided by the National Health Service to patients with advanced kidney cancer.)
There’s no doubt that it’s tough — politically, emotionally and ethically — to make a decision that means that someone will die sooner than they would have if the decision had gone the other way. But if the stories of Bruce Hardy and Jack Rosser lead us to think badly of the British system of rationing health care, we should remind ourselves that the U.S. system also results in people going without life-saving treatment — it just does so less visibly. Pharmaceutical manufacturers often charge much more for drugs in the United States than they charge for the same drugs in Britain, where they know that a higher price would put the drug outside the cost-effectiveness limits set by NICE. American patients, even if they are covered by Medicare or Medicaid, often cannot afford the copayments for drugs. That’s rationing too, by ability to pay.
Dr. Art Kellermann, associate dean for public policy at Emory School of Medicine in Atlanta, recently wrote of a woman who came into his emergency room in critical condition because a blood vessel had burst in her brain. She was uninsured and had chosen to buy food for her children instead of spending money on her blood-pressure medicine. In the emergency room, she received excellent high-tech medical care, but by the time she got there, it was too late to save her.
A New York Times report on the high costs of some drugs illustrates the problem. Chuck Stauffer, an Oregon farmer, found that his prescription-drug insurance left him to pay $5,500 for his first 42 days of Temodar, a drug used to treat brain tumors, and $1,700 a month after that. For Medicare patients drug costs can be even higher, because Medicare can require a copayment of 25 percent of the cost of the drug. For Gleevec, a drug that is effective against some forms of leukemia and some gastrointestinal tumors, that one-quarter of the cost can run to $40,000 a year.
In Britain, everyone has health insurance. In the U.S., some 45 million do not, and nor are they entitled to any health care at all, unless they can get themselves to an emergency room. Hospitals are prohibited from turning away anyone who will be endangered by being refused treatment. But even in emergency rooms, people without health insurance may receive less health care than those with insurance. Joseph Doyle, a professor of economics at the Sloan School of Management at http://topics.nytimes.com/top/reference/timestopics/organizations/m/massachusetts_institute_of_technology/index.html?inline=nyt-org - M.I.T. , studied the records of people in Wisconsin who were injured in severe automobile accidents and had no choice but to go to the hospital. He estimated that those who had no health insurance received 20 percent less care and had a death rate 37 percent higher than those with health insurance. This difference held up even when those without health insurance were compared with those without http://topics.nytimes.com/your-money/insurance/auto-insurance/index.html?inline=nyt-classifier - automobile insurance , and with those on Medicaid — groups with whom they share some characteristics that might affect treatment. The lack of insurance seems to be what caused the greater number of deaths.
When the media feature someone like Bruce Hardy or Jack Rosser, we readily relate to individuals who are harmed by a government agency’s decision to limit the cost of health care. But we tend not to hear about — and thus don’t identify with — the particular individuals who die in emergency rooms because they have no health insurance. This “identifiable victim” effect, well documented by psychologists, creates a dangerous bias in our thinking. Doyle’s figures suggest that if those Wisconsin accident victims without health insurance had received equivalent care to those with it, the additional health care would have cost about $220,000 for each life saved. Those who died were on average around 30 years old and could have been expected to live for at least another 40 years; this means that had they survived their accidents, the cost per extra year of life would have been no more than $5,500 — a small fraction of the $49,000 that NICE recommends the British National Health Service should be ready to pay to give a patient an extra year of life. If the U.S. system spent less on expensive treatments for those who, with or without the drugs, have at most a few months to live, it would be better able to save the lives of more people who, if they get the treatment they need, might live for several decades.
Estimates of the number of U.S. deaths caused annually by the absence of universal health insurance go as high as 20,000. One study concluded that in the age group 55 to 64 alone, more than 13,000 extra deaths a year may be attributed to the lack of insurance coverage. But the estimates vary because Americans without health insurance are more likely, for example, to smoke than Americans with health insurance, and sorting out the role that the lack of insurance plays is difficult. Richard Kronick, a professor at the School of Medicine at the http://topics.nytimes.com/topics/reference/timestopics/organizations/u/university_of_california/index.html?inline=nyt-org - University of California, San Diego , cautiously concludes from his own study that there is little evidence to suggest that extending health insurance to all Americans would have a large effect on the number of deaths in the United States. That doesn’t mean that it wouldn’t; we simply don’t know if it would.
In any case, it isn’t only uninsured Americans who can’t afford treatment. President Obama has spoken about his mother, who died from ovarian cancer in 1995. The president said that in the last weeks of her life, his mother “was spending too much time worrying about whether her health insurance would cover her bills” — an experience, the president went on to say, that his mother shared with millions of other Americans. It is also an experience more common in the United States than in other developed countries. A recent Commonwealth Fund study led by Cathy Schoen and Robin Osborn surveyed adults with chronic illness in Australia, Canada, France, Germany, the Netherlands, New Zealand, the United Kingdom and the United States. Far more Americans reported forgoing health care because of cost. More than half (54 percent) reported not filling a prescription, not visiting a doctor when sick or not getting recommended care. In comparison, in the United Kingdom the figure was 13 percent, and in the Netherlands, only 7 percent. Even among Americans with insurance, 43 percent reported that cost was a problem that had limited the treatment they received. According to a 2007 study led by David Himmelstein, more than 60 percent of all bankruptcies are related to illness, with many of these specifically caused by medical bills, even among those who have health insurance. In Canada the incidence of bankruptcy related to illness is much lower.
When a Washington Post journalist asked Daniel Zemel, a Washington rabbi, what he thought about federal agencies putting a dollar value on human life, the rabbi cited a Jewish teaching explaining that if you put one human life on one side of a scale, and you put the rest of the world on the other side, the scale is balanced equally. Perhaps that is how those who resist health care rationing think. But we already put a dollar value on human life. If the Department of Transportation, for example, followed rabbinical teachings it would exhaust its entire budget on road safety. Fortunately the department sets a limit on how much it is willing to pay to save one human life. In 2008 that limit was $5.8 million. Other government agencies do the same. Last year the http://topics.nytimes.com/top/reference/timestopics/organizations/c/consumer_product_safety_commission/index.html?inline=nyt-org - Consumer Product Safety Commission considered a proposal to make mattresses less likely to catch fire. Information from the industry suggested that the new standard would cost $343 million to implement, but the Consumer Product Safety Commission calculated that it would save 270 lives a year — and since it valued a human life at around $5 million, that made the new standard a good value. If we are going to have consumer-safety regulation at all, we need some idea of how much safety is worth buying. Like health care bureaucrats, consumer-safety bureaucrats sometimes decide that saving a human life is not worth the expense. Twenty years ago, the http://topics.nytimes.com/top/reference/timestopics/organizations/n/national_research_council/index.html?inline=nyt-org - National Research Council , an arm of the http://topics.nytimes.com/top/reference/timestopics/organizations/n/national_academy_of_sciences/index.html?inline=nyt-org - National Academy of Sciences , examined a proposal for installing seat belts in all school buses. It estimated that doing so would save, on average, one life per year, at a cost of $40 million. After that, support for the proposal faded away. So why is it that those who accept that we put a price on life when it comes to consumer safety refuse to accept it when it comes to health care?
Of course, it’s one thing to accept that there’s a limit to how much we should spend to save a human life, and another to set that limit. The dollar value that bureaucrats place on a generic human life is intended to reflect social values, as revealed in our behavior. It is the answer to the question “How much are you willing to pay to save your life?” — except that, of course, if you asked that question of people who were facing death, they would be prepared to pay almost anything to save their lives. So instead, economists note how much people are prepared to pay to reduce the risk that they will die. How much will people pay for air bags in a car, for instance? Once you know how much they will pay for a specified reduction in risk, you multiply the amount that people are willing to pay by how much the risk has been reduced, and then you know, or so the theory goes, what value people place on their lives. Suppose that there is a 1 in 100,000 chance that an air bag in my car will save my life, and that I would pay $50 — but no more than that — for an air bag. Then it looks as if I value my life at $50 x 100,000, or $5 million.
The theory sounds good, but in practice it has problems. We are not good at taking account of differences between very small risks, so if we are asked how much we would pay to reduce a risk of dying from 1 in 1,000,000 to 1 in 10,000,000, we may give the same answer as we would if asked how much we would pay to reduce the risk from 1 in 500,000 to 1 in 10,000,000. Hence multiplying what we would pay to reduce the risk of death by the reduction in risk lends an apparent mathematical precision to the outcome of the calculation — the supposed value of a human life — that our intuitive responses to the questions cannot support. Nevertheless this approach to setting a value on a human life is at least closer to what we really believe — and to what we should believe — than dramatic pronouncements about the infinite value of every human life, or the suggestion that we cannot distinguish between the value of a single human life and the value of a million human lives, or even of the rest of the world. Though such feel-good claims may have some symbolic value in particular circumstances, to take them seriously and apply them — for instance, by leaving it to chance whether we save one life or a billion — would be deeply unethical.
Governments implicitly place a dollar value on a human life when they decide how much is to be spent on health care programs and how much on other public goods that are not directed toward saving lives. The task of health care bureaucrats is then to get the best value for the resources they have been allocated. It is the familiar comparative exercise of getting the most bang for your buck. Sometimes that can be relatively easy to decide. If two drugs offer the same benefits and have similar risks of side effects, but one is much more expensive than the other, only the cheaper one should be provided by the public health care program. That the benefits and the risks of side effects are similar is a scientific matter for experts to decide after calling for submissions and examining them. That is the bread-and-butter work of units like NICE. But the benefits may vary in ways that defy straightforward comparison. We need a common unit for measuring the goods achieved by health care. Since we are talking about comparing different goods, the choice of unit is not merely a scientific or economic question but an ethical one.
As a first take, we might say that the good achieved by health care is the number of lives saved. But that is too crude. The death of a teenager is a greater tragedy than the death of an 85-year-old, and this should be reflected in our priorities. We can accommodate that difference by calculating the number of life-years saved, rather than simply the number of lives saved. If a teenager can be expected to live another 70 years, saving her life counts as a gain of 70 life-years, whereas if a person of 85 can be expected to live another 5 years, then saving the 85-year-old will count as a gain of only 5 life-years. That suggests that saving one teenager is equivalent to saving 14 85-year-olds. These are, of course, generic teenagers and generic 85-year-olds. It’s easy to say, “What if the teenager is a violent criminal and the 85-year-old is still working productively?” But just as emergency rooms should leave criminal justice to the courts and treat assailants and victims alike, so decisions about the allocation of health care resources should be kept separate from judgments about the moral character or social value of individuals.
Health care does more than save lives: it also reduces pain and suffering. How can we compare saving a person’s life with, say, making it possible for someone who was confined to bed to return to an active life? We can elicit people’s values on that too. One common method is to describe medical conditions to people — let’s say being a quadriplegic — and tell them that they can choose between 10 years in that condition or some smaller number of years without it. If most would prefer, say, 10 years as a quadriplegic to 4 years of nondisabled life, but would choose 6 years of nondisabled life over 10 with quadriplegia, but have difficulty deciding between 5 years of nondisabled life or 10 years with quadriplegia, then they are, in effect, assessing life with quadriplegia as half as good as nondisabled life. (These are hypothetical figures, chosen to keep the math simple, and not based on any actual surveys.) If that judgment represents a rough average across the population, we might conclude that restoring to nondisabled life two people who would otherwise be quadriplegics is equivalent in value to saving the life of one person, provided the life expectancies of all involved are similar.
This is the basis of the quality-adjusted life-year, or QALY, a unit designed to enable us to compare the benefits achieved by different forms of health care. The QALY has been used by economists working in health care for more than 30 years to compare the cost-effectiveness of a wide variety of medical procedures and, in some countries, as part of the process of deciding which medical treatments will be paid for with public money. If a reformed U.S. health care system explicitly accepted rationing, as I have argued it should, QALYs could play a similar role in the U.S.
Some will object that this discriminates against people with disabilities. If we return to the hypothetical assumption that a year with quadriplegia is valued at only half as much as a year without it, then a treatment that extends the lives of people without disabilities will be seen as providing twice the value of one that extends, for a similar period, the lives of quadriplegics. That clashes with the idea that all human lives are of equal value. The problem, however, does not lie with the concept of the quality-adjusted life-year, but with the judgment that, if faced with 10 years as a quadriplegic, one would prefer a shorter lifespan without a disability. Disability advocates might argue that such judgments, made by people without disabilities, merely reflect the ignorance and prejudice of people without disabilities when they think about people with disabilities. We should, they will very reasonably say, ask quadriplegics themselves to evaluate life with quadriplegia. If we do that, and we find that quadriplegics would not give up even one year of life as a quadriplegic in order to have their disability cured, then the QALY method does not justify giving preference to procedures that extend the lives of people without disabilities over procedures that extend the lives of people with disabilities.
This method of preserving our belief that everyone has an equal right to life is, however, a double-edged sword. If life with quadriplegia is as good as life without it, there is no health benefit to be gained by curing it. That implication, no doubt, would have been vigorously rejected by someone like http://topics.nytimes.com/top/reference/timestopics/people/r/christopher_reeve/index.html?inline=nyt-per - Christopher Reeve , who, after being paralyzed in an accident, campaigned for more research into ways of overcoming spinal-cord injuries. Disability advocates, it seems, are forced to choose between insisting that extending their lives is just as important as extending the lives of people without disabilities, and seeking public support for research into a cure for their condition.
The QALY tells us to do what brings about the greatest health benefit, irrespective of where that benefit falls. Usually, for a given quantity of resources, we will do more good if we help those who are worst off, because they have the greatest unmet needs. But occasionally some conditions will be both very severe and very expensive to treat. A QALY approach may then lead us to give priority to helping others who are not so badly off and whose conditions are less expensive to treat. I don’t find it unfair to give the same weight to the interests of those who are well off as we give to those who are much worse off, but if there is a social consensus that we should give priority to those who are worse off, we can modify the QALY approach so that it gives greater weight to benefits that accrue to those who are, on the QALY scale, worse off than others.
The QALY approach does not even try to measure the benefits that health care brings in addition to the improvement in health itself. Emotionally, we feel that the fact that Jack Rosser is the father of a young child makes a difference to the importance of extending his life, but his parental status is irrelevant to a QALY assessment of the health care gains that Sutent would bring him. Whether decisions about allocating health care resources should take such personal circumstances into account isn’t easy to decide. Not to do so makes the standard inflexible, but taking personal factors into account increases the scope for subjective — and prejudiced — judgments.
The QALY is not a perfect measure of the good obtained by health care, but its defenders can support it in the same way that http://topics.nytimes.com/top/reference/timestopics/people/c/winston_leonard_spencer_churchill/index.html?inline=nyt-per - Winston Churchill defended democracy as a form of government: it is the worst method of allocating health care, except for all the others. If it isn’t possible to provide everyone with all beneficial treatments, what better way do we have of deciding what treatments people should get than by comparing the QALYs gained with the expense of the treatments?
Will Americans allow their government, either directly or through an independent agency like NICE, to decide which treatments are sufficiently cost-effective to be provided at public expense and which are not? They might, under two conditions: first, that the option of private health insurance remains available, and second, that they are able to see, in their own pocket, the full cost of not rationing health care.
Rationing public health care limits free choice if private health insurance is prohibited. But many countries combine free national health insurance with optional private insurance. Australia, where I’ve spent most of my life and raised a family, is one. The U.S. could do something similar. This would mean extending Medicare to the entire population, irrespective of age, but without Medicare’s current policy that allows doctors wide latitude in prescribing treatments for eligible patients. Instead, Medicare for All, as we might call it, should refuse to pay where the cost per QALY is extremely high. (On the other hand, Medicare for All would not require more than a token copayment for drugs that are cost-effective.) The extension of Medicare could be financed by a small income-tax levy, for those who pay income tax — in Australia the levy is 1.5 percent of taxable income. (There’s an extra 1 percent surcharge for those with high incomes and no private insurance. Those who earn too little to pay income tax would be carried at no cost to themselves.) Those who want to be sure of receiving every treatment that their own privately chosen physicians recommend, regardless of cost, would be free to opt out of Medicare for All as long as they can demonstrate that they have sufficient private health insurance to avoid becoming a burden on the community if they fall ill. Alternatively, they might remain in Medicare for All but take out supplementary insurance for health care that Medicare for All does not cover. Every American will have a right to a good standard of health care, but no one will have a right to unrationed health care. Those who opt for unrationed health care will know exactly how much it costs them.
One final comment. It is common for opponents of health care rationing to point to Canada and Britain as examples of where we might end up if we get “socialized medicine.” On a blog on Fox News earlier this year, the conservative writer John Lott wrote, “Americans should ask Canadians and Brits — people who have long suffered from rationing — how happy they are with central government decisions on eliminating ‘unnecessary’ health care.” There is no particular reason that the United States should copy the British or Canadian forms of universal coverage, rather than one of the different arrangements that have developed in other industrialized nations, some of which may be better. But as it happens, last year the Gallup organization did ask Canadians and Brits, and people in many different countries, if they have confidence in “health care or medical systems” in their country. In Canada, 73 percent answered this question affirmatively. Coincidentally, an identical percentage of Britons gave the same answer. In the United States, despite spending much more, per person, on health care, the figure was only 56 percent.
Peter Singer is professor of bioethics at Princeton University. He is also laureate professor at the University of Melbourne, in Australia. His most recent book is “The Life You Can Save: Acting Now to End World Poverty.”
This article has been revised to reflect the following correction:
Correction: July 19, 2009 An article in The Times Magazine this weekend about the argument for rationing health care in the United States misstates the number of years it would take under the current system for the country to spend nearly a third of what it earns on health care. It is 26 years from now, or 2035, not 15 years.
Posted By: Leo Gorcey
Date Posted: Aug 11 2009 at 6:31pm
Pacman -
If only the masses of the electorate will speak out in opposition to NATIONALIZED HEALTH CARE. Canada, the United Kingdom, Germany, etc., can keep this aspect of SOCIALISM. In the U.S.A. we believe in States Rights and the power of the people! Centralized government in Washington, D.C. is not what we need!
Posted By: Merrell Wood
Date Posted: Aug 11 2009 at 7:44pm
Good God Pac,
Where do you get this stuff and do you really expect me to read it all?
This is the biggest post I've ever seen on this blog.
Give me a few days and I'll get back to you
Posted By: Pacman
Date Posted: Aug 11 2009 at 9:19pm
It is called a Newspaper Merrell, specifically the NY Times. Here let me give you an easier one. By the way Peter Singer the author of the above article is an Obama Consultant on heath care, truly scary.
Posted By: Pacman
Date Posted: Aug 13 2009 at 7:08pm
The Truth:
AMA responds to Obama’s amputation remarks
We agree with President Obama on the importance of prevention. However, a recent example used to illustrate his important point was misleading. Surgeons are not paid $30,000 to $50,000 to amputate a diabetic’s foot. Medicare pays a surgeon, on average, from $541.72 to $708.71 for one of two procedures involving a foot amputation.
Posted By: Pacman
Date Posted: Aug 13 2009 at 7:13pm
Truth:
AMA Responds to Obama:
In the case of tonsillectomies, a patient is http://click.adbrite.com/mb/click.php?sid=1255326&banner_id=13040224&variation_id=1565633&uts=1250205265&cpc=302e3035&keyword_id=69711&inline=y&ab=168362101&sscup=09bdc57508d8f0bb2c6a1ad464ec509f&sscra=93f413483e472d3f4616879db6d189c5&ub=417312835&guid=66cdf187-25e4-498f-89ea-6ef779e26076&odc=vrx&rs=&r= - referred to a surgeon after medication therapy has proven to be ineffective. Actually, the medical profession itself recognized http://click.adbrite.com/mb/click.php?sid=1255326&banner_id=13040224&variation_id=1565633&uts=1250205290&cpc=302e30343535&keyword_id=178044&inline=y&ab=168362046&sscup=6754e7efd0fab0b40e229c52318842d4&sscra=93f413483e472d3f4616879db6d189c5&ub=417312835&guid=998bb205-2010-4af6-a5b0-5a7e62862e1e&odc=vrx&rs=&r= - questions about utilization and appropriateness of tonsillectomies and took action by http://click.adbrite.com/mb/click.php?sid=1255326&banner_id=13020640&variation_id=1556995&uts=1250205289&cpc=302e33343331&keyword_id=92802&inline=y&ab=168362064&sscup=0d89b776c723715ea7a901d7805abd68&sscra=93f413483e472d3f4616879db6d189c5&ub=417312835&guid=4214ed6c-8c89-4a2d-bdd1-bc4e144d3948&odc=vrx&rs=&r= - developing clinical guidelines, which has resulted in a sharp decline in the rate of tonsillectomies.
Posted By: Pacman
Date Posted: Aug 13 2009 at 9:17pm
http://www.huffingtonpost.com/2009/08/13/internal-memo-confirms-bi_n_258285.html - Internal Memo Confirms Big Giveaways In White House Deal With Big Pharma
First Posted: 08-13-09 11:10 AM | Updated: 08-13-09 05:49 PM
Read More: /tag/big-pharma - Big Pharma , /tag/health-action - Health Action , /tag/obama-big-pharma - Obama Big Pharma , /tag/obama-drug-companies - Obama Drug Companies , /tag/obama-drug-industry - Obama Drug Industry , /politics - Politics News
A memo obtained by the Huffington Post confirms that the White House and the pharmaceutical lobby secretly agreed to precisely the sort of wide-ranging deal that both parties have been denying over the past week.
The memo, which according to a knowledgeable health care lobbyist was prepared by a person directly involved in the negotiations, lists exactly what the White House gave up, and what it got in return.
It says the White House agreed to oppose any congressional efforts to use the government's leverage to bargain for lower drug prices or import drugs from Canada -- and also agreed not to pursue Medicare rebates or shift some drugs from Medicare Part B to Medicare Part D, which would cost Big Pharma billions in reduced reimbursements.
In exchange, the Pharmaceutical Researchers and Manufacturers Association (PhRMA) agreed to cut $80 billion in projected costs to taxpayers and senior citizens over ten years. Or, as the memo says: "Commitment of up to $80 billion, but not more than $80 billion."
Representatives from both the White House and PhRMA, shown the outline, adamantly denied that it reflected reality. PhRMA senior vice president Ken Johnson said that the outline "is simply not accurate." "This memo isn't accurate and does not reflect the agreement with the drug companies," said White House spokesman Reid Cherlin.
Stories in the http://www.latimes.com/features/health/la-na-healthcare-pharma4-2009aug04,0,3660985.story - Los Angeles Times and the http://www.nytimes.com/2009/08/06/health/policy/06insure.html - New York Times last week indicated that the administration was confirming that such a deal had been made.
Critics on Capitol Hill and online responded with outrage at the reports that Obama had gone behind their backs and sold the reform movement short. Furthermore, the deal seemed to be a betrayal of http://www.huffingtonpost.com/2009/08/09/flashback-obama-promises_n_254833.html - several promises made by then-Sen. Obama during the presidential campaign, among them that he would use the power of government to drive down the costs of drugs to Medicare and that negotiations would be conducted in the open.
And over the past several days, both the White House and PhRMA have offered a series of http://www.huffingtonpost.com/2009/08/07/white-house-confirms-deal_n_254408.html - sometimes conflicting http://www.huffingtonpost.com/2009/08/06/dem-senators-white-house_n_253502.html - accounts of what happened in an http://www.huffingtonpost.com/2009/08/10/white-house-insists-it-di_n_255682.html - attempt to walk back the story.
The White House meeting took place on July 7th, as http://online.wsj.com/article/SB124700977149808565.html - first reported that evening in the Wall Street Journal. Also on the same day, a health care lobbyist following the talks was provided the outline of the deal by a person inside the negotiations. That outline had been floating around K Street before being obtained by the Huffington Post. In order to learn more about its origin, HuffPost agreed not to reveal the name of the lobbyist who originally received it.
"That is the PhRMA deal," said the lobbyist of the outline. He then clarified, "It was the PhRMA deal."
The deal, as outlined in the memo:
Commitment of up to $80 billion, but not more than $80 billion.
1. Agree to increase of Medicaid rebate from 15.1 - 23.1% ($34 billion)
2. Agree to get FOBs done (but no agreement on details -- express disagreement on data exclusivity which both sides say does not affect the score of the legislation.) ($9 billion)
3. Sell drugs to patients in the donut hole at 50% discount ($25 billion) This totals $68 billion
4. Companies will be assessed a tax or fee that will score at $12 billion. There was no agreement as to how or on what this tax/fee will be based.
Total: $80 billion
In exchange for these items, the White House agreed to:
1. Oppose importation
2. Oppose rebates in Medicare Part D
3. Oppose repeal of non-interference
4. Oppose opening Medicare Part B
"Non-interference" is the industry term for the status quo, in which government-driven price negotiations are barred. In other words, the government is "interfering" in the market if it negotiates lower prices. The ban on negotiating was led through Congress in 2003 by then-Rep. Billy Tauzin (R-La.), who is now the head of PhRMA.
The rebates reference is to Medicare overpayments Big Pharma managed to wrangle from the Republican Congress that Democrats are trying to recoup. The House bill would require Big Pharma to return some of that money. The rebate proposal would save $63 billion over ten years, according to the Congressional Budget Office. The White House, given the chance, declined to tell the Wall Street Journal for a July 17th http://online.wsj.com/article/SB124779006528954995.html - article that it supported the effort to pursue the rebates.
The Medicare Part B item refers to "infusion drugs," which can be administered at home. If they fall under Part B, Big Pharma gets paid more than under Part D. The agreement would leave infusion drugs in Part B.
In the section on Big Pharma's concessions, "FOBs" refers to follow-on biological drugs. Democrats have pushed to make it easier to allow generic drug makers to produce cheaper versions of such drugs, an effort Big Pharma has resisted. The Senate health committee bill gives drug makers 12 years of market exclusivity, five more than the White House proposed.
PhRMA's Johnson cast doubts on the provenance of the outline. "The memo, as described, is simply not accurate," he said in a statement. "Anyone could have written it. Unless it comes from our board of directors, it's not worth the paper it's written on. Clearly, someone is trying to short circuit our efforts to try and make health care reform a reality this year. That's not going to happen. Too much is at stake for both patients and the U.S. economy. Our new ads supporting health care reform are starting this week, and we are redoubling our efforts to drive awareness of why this issue is so important to America's future."
Johnson added that "no outside lobbyists -- not a single one -- were ever involved in our discussions with the Senate Finance Committee or the White House so someone is blowing smoke."
But the lobbyist who was given the outline defended its authenticity. And although the White House now says that drug price negotiations and reimportation were not actually discussed in the talks with PhRMA, the lobbyist said: "Well, that's bull -- that's baloney. That was part of the deal, for them not to push that."
The new uncertainty surrounding the deal comes after House Speaker Nancy Pelosi (D-Calif.) has repeatedly said that her chamber is not bound by any agreement it is not a party to. On July 8th, the day after the Journal reported some elements of the deal, Energy and Commerce Committee Chairman Henry Waxman (D-Calif.) said in a public speech that his committee would not be tied down by the agreement.
Before recess, he followed through. His committee passed a bill that allowed for re-importation and drug-price negotiations.
In the Senate, Democrats Sherrod Brown (Ohio) and Byron Dorgan (N.D.) pressed White House officials at a closed-door meeting last week, asking whether the White House had tied the Senate's hands.
The health care lobbyist said that what deal still exists is uncertain, as a result of House pressure. "Now the White House is backing away from it, as you know, because of pressure from the House, because the House was not a party to the deal," he said. "The Speaker put enormous pressure on the White House, [saying], 'We weren't a party to it and we reserve the right to do whatever we want.' And which they did in the House Energy and Commerce Committee bill, which led the White House to say, 'Well, maybe it's not cast in concrete.'"
Obama is walking a tightrope here. He wants to keep PhRMA from opposing the bill, and benefits by having its support, which now includes a http://www.nytimes.com/2009/08/09/health/policy/09lobby.html - $150 million advertising campaign . That's a fortune in politics -- more than Republican presidential candidate John McCain spent on advertising during his entire campaign -- but it's loose change in the pharmaceutical business.
Opponents of the deal with PhRMA hope that Obama is playing a multilayered game, making a deal in order to keep the drug makers in his camp for now, but planning to double-cross them in the end if he needs to in order to pass his signature initiative.
Big Pharma, however, is still comfortable. "As far as the pharmaceutical industry, PhRMA and its member companies, yes, they say a deal is a deal. We'll see what happens," said the health care lobbyist.
Posted By: wasteful
Date Posted: Aug 20 2009 at 9:19pm
Copyright 2009 Dow Jones & Company, Inc. All Rights Reserved
Posted By: Pacman
Date Posted: Aug 24 2009 at 9:17pm
Posted By: John Beagle
Date Posted: Aug 24 2009 at 10:09pm
According to the popular conception, Eskimos must work so hard to survive that they simply cannot manage to support adults who are no longer contributing to the well-being of the group.
Thus, when old-age strikes, rather than waiting around as they dwindle toward death, eating food their companions fight to catch and clothing their companions struggle to construct, the elderly Eskimos are taken to sea, and set adrift on a floating iceberg.
Alone on their iceberg, the elderly must inevitably freeze or starve to death, facing their end, uncomfortable, and horrifyingly alone.
This is essentially socialized health care.
------------- http://www.johnbeagle.com/" rel="nofollow - John Beagle
Middletown USA
News of, for and by the people of Middletown, Ohio.
Posted By: wasteful
Date Posted: Aug 27 2009 at 11:17am
Posted By: Pacman
Date Posted: Aug 28 2009 at 6:42am
ABC, NBC Won't Air Ad Critical of Obama's Health Care Plan
The refusal by ABC and NBC to run a national ad critical of President Obama's health care reform plan is raising questions from the group behind the spot -- particularly in light of ABC's health care special aired in prime time last June hosted at the White House
By Joshua Rhett Miller
FOXNews.com
Thursday, August 27, 2009
The refusal by ABC and NBC to run a national ad critical of President Obama's health care reform plan is raising questions from the group behind the spot -- particularly in light of ABC's health care special aired in prime time last June and hosted at the White House.
The 33-second http://www.youtube.com/watch?v=TEHl_RhpMh8 - ad by the League of American Voters, which features a neurosurgeon who warns that a government-run health care system will lead to the rationing of procedures and medicine, began airing two weeks ago on local affiliates of ABC, NBC, FOX and CBS. On a national level, however, ABC and NBC have refused to run the spot in its present form.
"It's a powerful ad," said Bob Adams, executive director of the http://leagueofamericanvoters.com/index.html - League of American Voters , a national nonprofit group with 15,000 members who advocate individual liberty and government accountability. "It tells the truth and it really highlights one of the biggest vulnerabilities and problems with this proposed legislation, which is it rations health care and disproportionately will decimate the quality of health care for seniors."
Adams said the advertisement is running on local network affiliates in states like Louisiana, Arkansas, Maine and Pennsylvania. But although CBS has approved the ad for national distribution and talks are ongoing with FOX, NBC has questioned some of the ad's facts while ABC has labeled it "partisan."
"The ABC Television Network has a long-standing policy that we do not sell time for advertising that presents a partisan position on a controversial public issue," spokeswoman Susan Sewell said in a written statement. "Just to be clear, this is a policy for the entire network, not just ABC News."
NBC, meanwhile, said it has not turned down the ad and will reconsider it with some revisions.
"We have not rejected the ad," spokeswoman Liz Fischer told FOXNews.com. "We have communicated with the media agency about some factual claims that require additional substantiation. As always, we are happy to reconsider the ad once these issues are addressed."
Adams objects to ABC's assertion that his group's position is partisan.
"It's a position that we would argue a vast majority of Americans stand behind," he said. "Obviously, it's a message that ABC and the Obama administration haven't received yet."
Dick Morris, a FOX News political analyst and the League of American Voters' chief strategist, conceptualized the advertisement and said its purpose was to "refocus" the debate on health care reform.
"I feel the whole debate on health care reform needed to be refocused on the issue of Medicare," he told FOXNews.com. "Most of the debate had been on issues of socialized medicine and cost. I felt that the impact of the legislation in cutting the Medicare program and enforcing rationing needed to be addressed."
Morris, a onetime advisor to former President Bill Clinton, said he was particularly troubled by ABC's decision not to air the spot.
"It's the ultimate act of chutzpah because ABC is the network that turned itself over completely to Obama for a daylong propaganda fest about health care reform," he said. "For them to be pious and say they will not accept advertising on health care shuts their viewers out from any possible understanding of both sides of this issue."
Posted By: Pacman
Date Posted: Sep 09 2009 at 10:44am
Obama and the Bureaucratization of Health Care
The president's proposals would give unelected officials life-and-death rationing powers.
Writing in the New York Times last month, President Barack Obama asked that Americans "talk with one another, and not over one another" as our health-care debate moves forward.
I couldn't agree more. Let's engage the other side's arguments, and let's allow Americans to decide for themselves whether the Democrats' health-care proposals should become governing law.
Some 45 years ago Ronald Reagan said that "no one in this country should be denied medical care because of a lack of funds." Each of us knows that we have an obligation to care for the old, the young and the sick. We stand strongest when we stand with the weakest among us.
We also know that our current health-care system too often burdens individuals and businesses—particularly small businesses—with crippling expenses. And we know that allowing government health-care spending to continue at current rates will only add to our ever-expanding deficit.
How can we ensure that those who need medical care receive it while also reducing health-care costs? The answers offered by Democrats in Washington all rest on one principle: that increased government involvement can solve the problem. I fundamentally disagree.
sense tells us that the government's attempts to solve large problems more often create new ones. Common sense also tells us that a top-down, one-size-fits-all plan will not improve the workings of a nationwide health-care system that accounts for one-sixth of our economy. And common sense tells us to be skeptical when President Obama promises that the Democrats' proposals "will provide more stability and security to every American."
With all due respect, Americans are used to this kind of sweeping promise from Washington. And we know from long experience that it's a promise Washington can't keep.
Let's talk about specifics. In his Times op-ed, the president argues that the Democrats' proposals "will finally bring skyrocketing health-care costs under control" by "cutting . . . waste and inefficiency in federal health programs like Medicare and Medicaid and in unwarranted subsidies to insurance companies . . . ."
First, ask yourself whether the government that brought us such "waste and inefficiency" and "unwarranted subsidies" in the first place can be believed when it says that this time it will get things right. The nonpartistan Congressional Budget Office (CBO) doesn't think so: Its director, Douglas Elmendorf, told the Senate Budget Committee in July that "in the legislation that has been reported we do not see the sort of fundamental changes that would be necessary to reduce the trajectory of federal health spending by a significant amount."
Now look at one way Mr. Obama wants to eliminate inefficiency and waste: He's asked Congress to create an Independent Medicare Advisory Council—an unelected, largely unaccountable group of experts charged with containing Medicare costs. In an interview with the New York Times in April, the president suggested that such a group, working outside of "normal political channels," should guide decisions regarding that "huge driver of cost . . . the chronically ill and those toward the end of their lives . . . ."
Given such statements, is it any wonder that many of the sick and elderly are concerned that the Democrats' proposals will ultimately lead to rationing of their health care by—dare I say it—death panels? Establishment voices dismissed that phrase, but it rang true for many Americans. Working through "normal political channels," they made themselves heard, and as a result Congress will likely reject a wrong-headed proposal to authorize end-of-life counseling in this cost-cutting context. But the fact remains that the Democrats' proposals would still empower unelected bureaucrats to make decisions affecting life or death health-care matters. Such government overreaching is what we've come to expect from this administration.
Speaking of government overreaching, how will the Democrats' proposals affect the deficit? The CBO estimates that the current House proposal not only won't reduce the deficit but will actually increase it by $239 billion over 10 years. Only in Washington could a plan that adds hundreds of billions to the deficit be hailed as a cost-cutting measure.
The economic effects won't be limited to abstract deficit numbers; they'll reach the wallets of everyday Americans. Should the Democrats' proposals expand health-care coverage while failing to curb health-care inflation rates, smaller paychecks will result. A new study for Watson Wyatt Worldwide by Steven Nyce and Syl Schieber concludes that if the government expands health-care coverage while health-care inflation continues to rise "the higher costs would drive disposable wages downward across most of the earnings spectrum, although the declines would be steepest for lower-earning workers." Lower wages are the last thing Americans need in these difficult economic times.
Finally, President Obama argues in his op-ed that Democrats' proposals "will provide every American with some basic consumer protections that will finally hold insurance companies accountable." Of course consumer protection sounds like a good idea. And it's true that insurance companies can be unaccountable and unresponsive institutions—much like the federal government. That similarity makes this shift in focus seem like nothing more than an attempt to deflect attention away from the details of the Democrats' proposals—proposals that will increase our deficit, decrease our paychecks, and increase the power of unaccountable government technocrats.
Instead of poll-driven "solutions," let's talk about real health-care reform: market-oriented, patient-centered, and result-driven. As the Cato Institute's Michael Cannon and others have argued, such policies include giving all individuals the same tax benefits received by those who get coverage through their employers; providing Medicare recipients with vouchers that allow them to purchase their own coverage; reforming tort laws to potentially save billions each year in wasteful spending; and changing costly state regulations to allow people to buy insurance across state lines. Rather than another top-down government plan, let's give Americans control over their own health care.
Democrats have never seriously considered such ideas, instead rushing through their own controversial proposals. After all, they don't need Republicans to sign on: Democrats control the House, the Senate and the presidency. But if passed, the Democrats' proposals will significantly alter a large sector of our economy. They will not improve our health care. They will not save us money. And, despite what the president says, they will not "provide more stability and security to every American."
We often hear such overblown promises from Washington. With first principles in mind and with the facts in hand, tell them that this time we're not buying it.
Posted By: Pacman
Date Posted: Sep 10 2009 at 8:34am
Read the Union Health-Care Label
Get ready for Detroit-style labor relations in our hospitals.
By /search/search_center.html?KEYWORDS=MARK+MIX&ARTICLESEARCHQUERY_PARSER=bylineAND - MARK MIX
Posted By: Pacman
Date Posted: Sep 10 2009 at 9:16am
Posted By: Pacman
Date Posted: Sep 10 2009 at 11:02am
Of course you are going to have a double digit jump when you poll more than twice as many Democrats as you do Republicans. Makes you just shake you head at Politics and the News.
September 10, 2009
http://politicalticker.blogs.cnn.com/2009/09/10/cnn-poll-double-digit-post-speech-jump-for-obama-plan/ - CNN Poll: Double-digit post-speech jump for Obama plan
Posted: September 10th, 2009 10:51 AM ET
WASHINGTON (CNN) — Two out of three Americans who watched President Barack Obama's health care reform speech Wednesday night favor his health care plans — a 14-point gain among speech-watchers, according to a CNN/Opinion Research Corporation national poll of people who tuned into Obama's address Wednesday night to a joint session of Congress.
Sixty-seven percent of people questioned in the survey say the support Obama's health care reform proposals that the president outlined in his address, with 29 percent opposed. Those figures are almost identical to a poll conducted immediately after Bill Clinton's health care speech before Congress in September, 1993.
The audience for the speech appears to be more Democratic than the U.S. population as a whole. Because of this, the results may favor Obama simply because more Democrats than Republicans tune into the speech. The poll surveyed the opinions of people who watched Wednesday night's speech, and does not reflect the views of all Americans.
(Full results after the jump)
About one in seven people who watched the speech changed their minds on Obama's health care plan. "Going into the speech, a bare majority of his audience — 53 percent — favored his proposals. Immediately after the speech, that figure rose to 67 percent," says CNN Polling Director Keating Holland. "But the real question is whether those conversions will last. Bill Clinton got similar numbers after his 1993 address to Congress, but five months later a majority of the country no longer supported his plan."
Fifty-six percent of people questioned say they had a very positive reaction to the speech, with 21 percent indicating they had a somewhat positive reaction and a equal amount suggesting they had a negative reaction. The 56 percent who said they had a very positive reaction is lower than the 68 percent of speech watchers who had a similar reaction to the president's first address to a joint session of Congress in February.
More than seven in ten say that Obama clearly stated his goals, with one in four saying he didn't express his goals clearly.
Three out of four say it's very or somewhat likely that the president will pass most of his proposals on health care reform through Congress, with one in four saying it's unlikely.
Seven in 10 say that Obama's policies will move the country in the right direction, up 10 points from before the speech.
The CNN/Opinion Research Corporation poll was conducted just before and just after the president's speech, with 427 adult Americans questioned by telephone. The survey's sampling error is plus or minus 5 percentage points.
The sample of speech-watchers in this poll was 45 percent Democratic and 18 percent Republican. Our best estimate of the number of Democrats in the voting age population as a whole indicates that the sample is about 8-10 points more Democratic than the population as a whole.
Posted By: 2000+
Date Posted: Sep 10 2009 at 9:47pm
Pacman, Any rationale will do. Why is it so necessary to challange almost every point made by the other side. Balance is found in both views. I thought this blog was about the expression of a variety of viewpoints that encouraged rational conversation, not manifesto's directed at those who somehow miss the point of the lession of the day.
I was looking at the membership list the other day, and I noticed the large number of folks who are members compared to the small number who actually join in the conversation. From what I could see there are about 15 to 20 regular's and the rest check in from time to time to make short comment. Sorry, but not enough objective opinions to make this blog relevant. It's been a hoot, but I can find the same partisan dialogue in the bar at Wildwood.
Posted By: Pacman
Date Posted: Sep 10 2009 at 10:06pm
2000+ these posts span over a months time. I am not, I repeat not a believer in the Obama policies and have no desire or intention of trying to justify something I do not believe in and think is bad for this country. Now Obama won the Presidency I would think that there are more than enough people who can defend what Obama is trying to do with Health Care, it won't be me.
Not my fault no one else posts in favor of Obamas Health care plan, including you, if you believe in it?
My best advice to you is head on over to Wildwood if that suits you and after awhile it will all blur together for you.
Posted By: wasteful
Date Posted: Sep 11 2009 at 8:10am
I look at what Pacman has done here as a Public Service Announce on the fallacies of the Obama Health Care Policy. I particularly like the Czars Gone Wild Heading which makes for interesting reading. It is like the Pacman Report of Middletown. Thank you Pac.
Posted By: wasteful
Date Posted: Sep 26 2009 at 7:51am
September 24, 2009 Categories: http://dyn.politico.com/livepulse/index.cfm/category/Senate%20 - Senate
Flout the mandate penalty? Face the IRS
Americans who fail to pay the penalty for not buying insurance would face legal action from the Internal Revenue Service, according to the Joint Committee on Taxation.
The remarks Thursday from the committee's chief of staff, Thomas Barthold, seems to further weaken President Barack Obama's contention last week that the individual mandate penalty, which could go as high as $1,900, is not a tax increase.
Under questioning from Sen. John Ensign (R-Nev.), Barthold said the IRS would "take you to court and undertake normal collection proceedings."
Ensign pursued the line of questioning because he said a lot of Americans don't believe the Constitution allows the government to mandate the purchase of insurance.
"We could be subjecting those very people who conscientiously, because they believe in the U.S. Constitution, we could be subjecting them to fines or the interpretation of a judge, all the way up to imprisonment," Ensign said. "That seems to me to be a problem."
Ensign's argument , however, wasn't persuasive to the committee -- which rejected an amendment from Sen. Jim Bunning (R-Ky.) to eliminate the individual mandate.
Sen. Olympia Snowe (R-Maine) was the only Republican to vote with Democrats to preserve the mandate.
September 25, 2009 Categories: http://dyn.politico.com/livepulse/index.cfm/category/Senate%20 - Senate
Ensign receives handwritten confirmation
http://www.politico.com/static/PPM110_090925_document2.html - This doesn't happen often enough.
Sen. John Ensign (R-Nev.) received a handwritten note Thursday from Joint Committee on Taxation Chief of Staff Tom Barthold confirming the penalty for failing to pay the up to $1,900 fee for not buying health insurance.
Violators could be charged with a misdemeanor and could face up to a year in jail or a $25,000 penalty, Barthold wrote on JCT letterhead. He signed it "Sincerely, Thomas A. Barthold."
The note was a follow-up to Ensign's http://www.politico.com/livepulse/0909/Flout_the_mandate_penalty_Face_the_IRS.html?showall - questioning at the markup.
Posted By: Mike_Presta
Date Posted: Sep 26 2009 at 8:43am
Send me to jail for refusing to buy a government mandated health insurance policy???
Well, first, that's STUPID!!! Then they would not only have to pay for my health care, but also have to feed and cloth me.
Second, if they actually enforce this uniformly, they are going to need a lot more prisons.
Finally, they might be able to do get me to prison...right after the fight!!!
The way things seem to be going, I certainly hope that the military stands on the side of THE PEOPLE!!!
------------- “Mulligan said he ... doesn’t believe they necessarily make the return on investment necessary to keep funding them.” …The Middletown Journal, January 30, 2012
Posted By: lrisner
Date Posted: Sep 26 2009 at 11:15am
Knock off all the cut and paste, Pacman ! It is like a spoiled child who wants to dominate the Scene. Just think, if you are able, what the site would look like if some Obama fan were to match you c.p. for c.p. The site would then be useless for everyone else.
Good God, is it all about You?
Posted By: wasteful
Date Posted: Sep 26 2009 at 11:39am
Mommy Dearest, aka irisner, the name is Wasteful and if you don't want to read the truth then move along like a good little boy. I could careless if you want to create a heading and post about what you perceive as Obama's achievements, knock yourself out. You are like all bully's in this world can't stand it when someone doesn't bow down to your rants and demands.
Obama tends to do one thing well, he sticks to the top 5 or 6 crowd pleasing points in all of his speeches about ObamaCare, but in reality it is what is contained in the the rest of the 1000+ page bill that shpuld scare the crap out of everyone.
You know Irisner Obama shouldn't lie though. When he says to the public, "if you like the insurance you have now, you won't have to change." Tell that one to the 11,000,000 Seniors in Medicare Advantage, which Obama wants to do away with and force all of them into Medicare with no advantage.
Run along little boy you have shown your ignorance and how little you can contribute to this conversation for today.
Posted By: Hermes
Date Posted: Sep 26 2009 at 1:58pm
I'd like to see how the IRS or Washington itself will collect fine payments from the poor if they decide not to accept the 'mark of the beast". Does anyone actually believe that Obama or any politician cares whether you have insurance or not ?? If you do your more naive than you should be. This is not about your health plan. It's the same plan that was forced on us when they mandated automobile insurance. Nothing more. The insurance companies lobbied for this crap for years to make every citizen participate so they could make money. Pay into a plan that will not pay you is the name of the game. Deny those medical test,deny that surgery,deny,deny,deny. But the money keeps rolling in and never goes back out. This is Corporate America , not just America.
------------- No more democrats no more republicans,vote Constitution Party !!
Posted By: lrisner
Date Posted: Sep 26 2009 at 2:13pm
wasteful wrote:
Mommy Dearest, aka irisner, the name is Wasteful and if you don't want to read the truth then move along like a good little boy. I could careless if you want to create a heading and post about what you perceive as Obama's achievements, knock yourself out. You are like all bully's in this world can't stand it when someone doesn't bow down to your rants and demands.
Obama tends to do one thing well, he sticks to the top 5 or 6 crowd pleasing points in all of his speeches about ObamaCare, but in reality it is what is contained in the the rest of the 1000+ page bill that shpuld scare the crap out of everyone.
You know Irisner Obama shouldn't lie though. When he says to the public, "if you like the insurance you have now, you won't have to change." Tell that one to the 11,000,000 Seniors in Medicare Advantage, which Obama wants to do away with and force all of them into Medicare with no advantage.
Run along little boy you have shown your ignorance and how little you can contribute to this conversation for today.
As usual, people like yourself "Rant and Rave" about things you do not know anything about.
Find me one post where I have shown any support for Mr Obama. Can you? No, of course not. I am NOT an O'bama supporter!. My "ranting" is about stupidity and useless Cut and Paste and bad info. Any idiot under the Sun can search the internet and find an article for c&p supporting whatever their position is on something. I only ask that posters use their own minds to create their own posting material.
It is clear to me that there are many Forum posters thru out the Internet, you in particular are an example, who care nothing for facts or discussion and only want to "Rant and Rave"and pick at those that don't share you perverted views.
Can't contribute? Certainly not at your asinine level!
Posted By: rngrmed
Date Posted: Sep 26 2009 at 8:00pm
I think there are a lot of flaws with "ObamaCare", but if you think the AMA is innocent you are jumping on the wrong band wagon. And guess what, health insurance companies already decide what treatments you can and can not have. As a nurse that works in an ICU, I am tired of taking care of patients that refuse to take their medications or follow their treatment plans, become unresponsive and come in to the ER and ICU's for help. These patients routinely do not have insurance are crude and expect the staff to kiss their asses. And the hospital eats the cost. I think facilities/medical staff should be able to refuse these people medical treatment. Do I get to go in to a store, be an ass, take a bunch of items, not pay and continually go back?
I am not saying don't treat the young man with CP. But should we do open heart surgery on a patient with terminal cancer? I have seen it done. And the outcome was not good. And not just on one occassion either. This is a pretty regular occurence because the family wants it done.
As of right now for any of you people you with DNR orders. Did you know your family can override those once it has been determined you can not make decisions for yourself? I have seen that time after time.
I think the Government should step up and make some restrictions on who gets what.
This is not a easy fix and will not be fixed over night. There will be a lot of bad ideas tossed around.
But I am glad that Obama has the balls to step up and try to fix this problem. Instead of letting the problem go on.
Posted By: wasteful
Date Posted: Sep 26 2009 at 8:26pm
Irisner what an ass.
The above posts I C & P'ed came from Politico.com a very credible website and a website I doubt many people here including yourself read. It doesn't matter to me whether you like it or not. I also could careless if you like Obama's Health Care Plan or not. Whether you like my posts or not doesn't matter either.
People like you that can't stand not being in control and are insignificant.
Posted By: wasteful
Date Posted: Sep 26 2009 at 8:31pm
MgrMed sounds like to me you should be working in the UK National Health Service. Personally I don't think the Government should be playing God.
So you think when Obama basically dumps 40-50 million new insured patients into the health care system with no increase in Drs. or Hospitals, etc., you are going to have it any better. I think you better think it over again. You should probably retire now or find another line of work.
Posted By: rngrmed
Date Posted: Sep 26 2009 at 9:41pm
Then who gets to play God? Are you saying we should just let a patient lie there in bed, completely unresponsive, no cough reflex, no eye movement? What are role do you think we are playing when we do open heart surgery to save someone's life? When we use medicine to help a family conceive a child when previously they were physically unable to? Is that not a form of playing God?
Do I think things are going to get better because 40 or 50 million more people have Government sponsored insurance? NO! But do believe there should be some affordable option made to those 40-50 million people. Some sort of reasonable healthcare. Maybe some sort of piece together plan with benefits that they need and can afford.
This country already has how many people that qualify for Government assistance? How many senior citizens that receive medicare? Maybe we should take that away from them?
Maybe you don't have a problem bringing in some drug dealer to the ER that just swallowed a bunch of crack so he doesn't get arrested with it and spending hundred of thousands of dollars to save his life, but I do!
Do I have a problem paying for some innocent person that got shot in a drive by? NO! An 80-90 year old person that is otherwise healthy and needs open heart surgery? NO!
But the people that continually abuse the system? yes.
Should there be a mandated Government insurance plan? Not hardly.
I think people should be able to go to whichever insurance provider they want. But many insurance companies don't cover preventative medicine. What a waste. Remember the once of prevention is worth a pound of cure.
Hell, my wife and I pay almost $400/month for her, a 2 year old and I. And we work in healthcare. And there are things my insurance doesn't cover. I either have to carry what work offers or pay more with no added benefits because Insurance companies doesn't have to offer those options in the State of Ohio. Maybe there should be some sort of Federal guidelines as to what is offered or have people be able to pick and choose.
Posted By: wasteful
Date Posted: Sep 27 2009 at 9:09am
mgrmed I think you know very well what I am talking about when I say "The Government should not be playing God."
I am not talking about Fertility drugs or treatments to have children. I am talking about treatments which involve the denial of service to patients in dire need to sustain their lives, because people like you feel it is not financially worth performing the needed medical treatment on them. Like I said if you want to practice this type of medicine then move on over to the UK.
"How many senior citizens that receive Medicare? Maybe we should take that away from them?" You lost me on this one as to why you would even want to do or suggest this.
"An 80-90 year old person that is otherwise healthy and needs open heart surgery? NO!"
So by your thinking, a 60 yr old man with non-Hodgkin's lymphoma who has a heart attack should just be allowed to die, rather than have the surgery to repair his heart and possibly live another 5-10+ years with cancer.
Oh and what about people who suffer traumatic brain injuries do we just write them off also because they now cost us money and can no longer contribute to society in a fashion the government deems worthy and productive? Are we going to allow soldiers at war who suffer these injuries to just die and be done with them?
Then we have childhood diseases like diabetes mellitus do we let these children go 50-60+ years of living their lives doing what they have to, to live a good life and then when they begin to suffer the affects of Diabetes, heart failure, kidney disease, circulation problems, diabetic retinopathy, do we just write them off also? Do we just let children die when they are born with serious diseases because of the monetary costs to take care of them? Would you advocate allowing your 2 yr old daughter to die if she had been born with some horrible disease, I doubt it.
As far as drug dealers and swallowing crack, unfortunately you must treat these people even though many of us myself included don't think so.
You are not alone in your health care costs. My family also pays $400.00 per month for the 3 of us and we have choices that are limited by the employer also. Preventative care is not covered by our insurance either and we will end up paying $50-100.00 for flu shots this year, etc.
I agree that the insurance industry needs to be reformed, but decisions that concern my families heath care and what services they need are mine and my families to make. If you start denying services under your criteria you do nothing but give insurance companies another reason to deny services thus cutting costs and people will die who may not have to.
What Insurance Company's should be forced to do:
We need to have more choices by allowing insurance companies to sell across state lines.
there should be no pre-existing condition health clause in policies.
preventative care should be available.
there should be no limit on the dollar figure on each policy.
out of pocket expenses need to be reined in.
tort reform is needed for doctors and medical facilities.
you can't be dropped from a policy just because you become ill.
Posted By: Hermes
Date Posted: Sep 27 2009 at 10:02am
rngrmed - Who or what hospital you working for ? Your getting screwed on your insurance IF your working for a hospital.
I have to agree with wasteful, not much of what your saying makes sense. My wife is a nurse and I personally know several doctors and nurses and none have taken the stance that you have. You sound scary my friend. If I might make a suggestion,get out of the healthcare field and find another career.
------------- No more democrats no more republicans,vote Constitution Party !!
Posted By: wasteful
Date Posted: Sep 28 2009 at 10:13pm
Liberals seek health-care access for illegals
/staff/stephen-dinan/ - Stephen Dinan
Fearful that they're losing ground on immigration and health care, a group of House Democrats is pushing back and arguing that any health care bill should extend to all legal immigrants and allow illegal immigrants some access.
The Democrats, trying to stiffen their party's spines on the contentious issue, say it's unfair to bar illegal immigrants from paying their own way in a government-sponsored exchange. Legal immigrants, they say, regardless of how long they've been in the United States, should be able to get government-subsidized health care if they meet the other eligibility requirements.
"Legal permanent residents should be able to purchase their plans, and they should also be eligible for subsidies if they need it. Undocumented, if they can afford it, should be able to buy their own private plans. It keeps them out of the emergency room," said Rep. Michael M. Honda, California Democrat and chairman of the Congressional Asian Pacific American Caucus.
Mr. Honda was joined by more than 20 of his colleagues in two letters laying out the demands.
Coverage for immigrants is one of the thorniest issues in the health care debate, and one many Democratic leaders would like to avoid. But immigrant rights groups and the Democrats who sent the letters say they have to take a stand now.
President Obama has said he does not want health care proposals to cover illegal immigrants. The bill drawn up by Sen. Max Baucus, Montana Democrat and chairman of the Senate Finance Committee, excludes illegal immigrants from his proposed health care exchange.
Mr. Honda and his allies, though, say illegal immigrants should be allowed to pay for insurance if they can afford it, even if it comes through a government-established exchange. As a generally young, healthy part of the population, illegal immigrants could help reduce overall costs for those who buy into health exchange plans, the lawmakers said.
The Democrats' letters, however, do not issue ultimatums or threaten to withhold support for the bills if their requests aren't met.
The National Council of La Raza launched its own "flood their voice mail" campaign last week to put pressure on Mr. Baucus to expand coverage in his proposal to include all legal immigrants and to drop verification language in the legislation that would prevent illegal immigrants from obtaining coverage.
Mr. Honda told The Washington Times that he's not pushing for illegal immigrants to gain access to taxpayer-subsidized benefits. "That's an argument that's been done already," he said.
Rep. Steve King, Iowa Republican, said proposals that include government coverage for illegal immigrants leave him incredulous.
"If anybody can, with a straight face, advocate that we should provide health insurance for people who broke into our country, broke our law and for the most part are criminals, I don't know where they ever would draw the line," he said.
Mr. King, who opposes Democrats' health care plans in general, said illegal immigrant access in legislation "would be a poison pill that would cause health care to go down" to defeat.
Twenty-nine Democrats signed on to the letter on legal immigrants, while 21 signed the letter on covering illegal immigrants. Although the leadership of the Congressional Black Caucus signed the legal-immigrant letter in their capacity as CBC officials, they signed the other letter as individual members of Congress.
Under the 1996 welfare law overhaul, Congress restricted most federal benefits to longtime holders of green cards - those who have been in the country at least five years.
But Democrats chipped away at that rule when they reauthorized the State Children's Health Insurance Program earlier this year and allowed states to cover all immigrant children and pregnant women, regardless of how long they've been in the country.
In their letter, the Democrats said health care costs are much lower for legal immigrants than for native citizens.
"Immigrants are part of our families, our communities, our economy, and contribute to the fabric of America," they wrote. "It is simply wrong that their taxes would pay for public health insurance programs to which they are not allowed access."
Posted By: Hermes
Date Posted: Sep 29 2009 at 12:58pm
Good post there wasteful.
But I wonder if there isn't a hidden agenda behind providing illegal immagrants with healthcare. If they are illegal and go for medical care wouldn't that reveal they are illegal and thus be deported or at least detained ??
------------- No more democrats no more republicans,vote Constitution Party !!
Posted By: wasteful
Date Posted: Sep 29 2009 at 1:35pm
Posted By: Hermes
Date Posted: Sep 29 2009 at 4:05pm
Thanks for posting that video wasteful first time I've seen that.
There is just something very fishey about this national healthcare plan. And I liked the way Congresswoman Jackson just danced her way through Gretas' question about being illegal and going to jail. Her answer didn't even relate to the question.
Someone should ask the millionaire congresswoman how many illegal immigrants work for her. I think it has more to do with the wealthy wanting cheap labor more than anything else. Nothing about it makes sense.
------------- No more democrats no more republicans,vote Constitution Party !!
Posted By: rngrmed
Date Posted: Sep 30 2009 at 1:00am
Yes I work in a hospital. I'm not sure how to respond to other statements. Maybe I miscommunicated my the point I was trying to make. But I do know many that agree with me as well. Physicians and nurses as well.
Posted By: Hermes
Date Posted: Sep 30 2009 at 8:44am
rngrmed wrote:
Yes I work in a hospital. I'm not sure how to respond to other statements. Maybe I miscommunicated my the point I was trying to make. But I do know many that agree with me as well. Physicians and nurses as well.
rngrmed - You have to kind of overlook me,I can be very abrasive and opinionated.
Everyone has a different outlook on whats happening to our healthcare system and the biggest problem with any of it is the friggin politicians. Obama had my support in the beginning of his term but with his plan for healthcare he is making me very afraid.
------------- No more democrats no more republicans,vote Constitution Party !!
Posted By: rngrmed
Date Posted: Sep 30 2009 at 12:26pm
Hermes--I don't agree with his plan either...I just think it takes a lot of balls to try to tackle such a huge problem and piss off both parties. To me it sounds like they are just throwing a plan together to make change. Good or bad. I think the current plan is bad.
You're also entitled to your opinion.
Posted By: Hermes
Date Posted: Sep 30 2009 at 1:19pm
rngrmed wrote:
Hermes--I don't agree with his plan either...I just think it takes a lot of balls to try to tackle such a huge problem and piss off both parties. To me it sounds like they are just throwing a plan together to make change. Good or bad. I think the current plan is bad.
You're also entitled to your opinion.
I can understand Washington reigning in healthcare cost (what it cost us out of pocket) putting some controls on it or something. I think everyone would agree that cost is a major issue. But what Obama and congress want to do doesn't make sense.
All I know is it is a very scarey time in America and things are only getting worse.
------------- No more democrats no more republicans,vote Constitution Party !!
Posted By: Pacman
Date Posted: Oct 01 2009 at 2:33am
Senators turn back ID requirement for immigrant healthcare
By Jeffrey Young - 09/30/09 01:03 PM ET
Senate Finance Committee Democrats rejected a proposed a requirement that immigrants prove their identity with photo identification when signing up for federal healthcare programs.
Finance Committee ranking member Chuck Grassley (R-Iowa) said that current law and the healthcare bill under consideration are too lax and leave the door open to illegal immigrants defrauding the government using false or stolen identities to obtain benefits.
Grassley's amendment was beaten back 10-13 on a party-line vote.
The bill, authored by committee Chairman Max Baucus (D-Mont.), would require applicants to verify their names, places of birth and Social Security numbers. In addition, legal immigrants would have to wait five years, as under current law, after obtaining citizenship or legal residency to access federal healthcare benefits such as Medicaid and the Children's Health Insurance Program or receive tax credits or purchase insurance through the exchange created by the legislation.
But the would not require them to show a photo ID, such as a drivers license. Without that requirement, the bill "remains dearly lacking when it comes to identification," Grassley said. "Frankly, I'm very perplexed as to why anyone would oppose this amendment," he said.
But Democratic Sen. Jeff Bingaman, who represents the border state of New Mexico, said that the type of fraud Grassley said he wants to prevent is highly uncommon. "The way I see the amendment, it's a solution without a problem," Bingaman said.
Posted By: VietVet
Date Posted: Oct 01 2009 at 7:14am
Immigrant usage of the healthcare system is a problem and ID's should be required. The Democratic Senator from New Mexico is wrong when he says "it's a solution without a problem". This is unbelievable coming from a Senator who is in a border state that is affected by this. We saw the effects in Tucson on their healthcare system. The waiting rooms in labs, doctor's offices, hospitals, and clinics were overburdened with them. I know New Mexico had the same problems. Why doesn't this see that?
Posted By: arwendt
Date Posted: Oct 01 2009 at 10:22am
------------- “Sell not virtue to purchase wealth, nor Liberty to purchase power.” Benjamin Franklin - More at my http://wordsoffreedom.wordpress.com/ - Words of Freedom website.
Posted By: Pacman
Date Posted: Oct 01 2009 at 10:37am
Hey Vet the next time I go to the emergency room at Atrium I think I will refuse to show my drivers license and see what they say.
Posted By: VietVet
Date Posted: Oct 01 2009 at 11:44am
Oh no you don't Pacman! This ID thing doesn't apply to people like you, mister! You toe the line and stand aside while we cater to the immigrant saturation in our healthcare programs. You're just an ordinary born and bred American citizen. Give us more attitude like that and we'll knuckle your head before you can count to four! Back off! Our focus now is to see that they are comfortable and content in knowing that they will be taken care of first. You, on the other hand, will wait for the leftover scraps and you will LIKE IT!
Posted By: Hermes
Date Posted: Oct 01 2009 at 11:45am
The scary part is if they go ahead and give the illegal immigrants health care with no restrictions wouldn't that cause a major migration of illegals coming here just for the medical benefits ?
With all the procedures in place in the U.S. for having to provide proof of citizenship and showing ID's then turn around and do what they (politicians) want to do concerning illegals is beyond ridiculous.
------------- No more democrats no more republicans,vote Constitution Party !!
Posted By: Hermes
Date Posted: Oct 01 2009 at 11:53am
Pacman wrote:
Hey Vet the next time I go to the emergency room at Atrium I think I will refuse to show my drivers license and see what they say.
Pac you do that and the very next thing you'll hear someone hollering is "TASER,TASER,TASER !!!"
Repeat this phrase 20 times each day : I am a good American,I will do what my leaders demand of me,I will not revolt,I will not refuse,I support all leaders regardless of party affiliation,my leaders are supreme,I am a good American.
------------- No more democrats no more republicans,vote Constitution Party !!
Posted By: wasteful
Date Posted: Oct 01 2009 at 12:30pm
The other day, I needed to go to the emergencyroom.
Not wanting to sit there for 4 hours, I put on my old Army fatigues and stuck a patch onto the front of my shirt that I had downloaded off the Internet.
When I went into the E.R., I noticed that 3/4 of the people got up and left. I guess they decided that they weren’t that sick after all. Cut at least 3 hours off my waiting time.
Here’s the patch. Feel free to use it the next time you’re in need of quicker emergency service.
It also works at the DMV and the laundromat.
Don’t try it at McDonald’s, the whole crew will exit and you’ll never get your order.
Posted By: Hermes
Date Posted: Oct 01 2009 at 12:50pm
Wasteful you've got me rolling in the floor with that one !!
------------- No more democrats no more republicans,vote Constitution Party !!
Posted By: VietVet
Date Posted: Oct 01 2009 at 1:09pm
EXCELLENT wasteful!!!
Posted By: Middletown News
Date Posted: Oct 12 2009 at 10:24am
Obamacare Invades Your Wallet
Source: The Heritage Foundation
Throughout his campaign, and even in to the first few months in office, President Barack Obama repeatedly promised the American people that his health care plan would reduce their health insurance premiums by $2,500 a year. It has been a while since President Obama made that promise, and any honest look at the health legislation being considered in Congress explains why.
The Senate Finance Committee bill written by Chairman Max Baucus (D-MT) (the Baucus bill) first drives up the cost of health insurance for all Americans and then forces everyone to buy it or face tax penalties or jail time. While the Baucus bill does cap out-of-pocket costs based on a person’s income, the effect on American families is still staggering. According to the Center for Data Analysis, the Baucus bill would:
For individuals making $34,140 (three times the Federal Poverty Level) the Baucus health care proposal could mandate up to $4,097 in annual premiums, a sum which could have been spent on over nine months of food, almost four months of housing or well over a year of utilities.
For a family of four making $69,480 (300% above poverty) the Baucus bill mandates annual health insurance premiums of $8,338, which would be worth the equivalent of over ten months of food, four months of housing or almost two years of utilities.
For individuals earning $45,520(400% above poverty) Baucus mandates $5,462 for health insurance, or over a year of food, four months of rent or a year and a half of utilities.
For families earning $92,640 (400% above poverty) Baucus mandates $11,117 in health premiums, the equivalent of over a year of food, five months of housing or two years of utilities.
And those numbers include the subsidies for health insurance in the Baucus bill. To pay for all this new health care spending, plus the massive expansion of Medicaid, the Congressional Budget Office estimates that the Baucus bill will collect $4 billion in fines from those who do not purchase insurance, $200 billion taxing health insurance companies with generous health plans, and $25 billion in taxes on employers. Not to mention the billions in cuts to Medicare payments to hospitals which will result in significant cost shifting to consumers.
PricewaterhouseCoopers has done a study on what all these new taxes and regulations will do to Americans health insurance premiums and the results are not pretty. Instead of reducing the average family’s health insurance premiums by $2,500 per year, as President Obama promised, the Baucus bill would actually raise them by $4,000 more than they would have been without reform.
The Baucus bill spends at least $1 trillion, fails to cover all Americans, taxes employers for creating jobs, and inflicts higher out-of-pocket health care costs on all Americans. We can do better.
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Posted By: Hermes
Date Posted: Oct 12 2009 at 1:46pm
As I've said before this healthcare plan is just like automobile insurance when it first began. The whole boondoggle is being orchestrated behind the scenes by the insurance industry. Theres not a politician in DC that cares whether you and I have healthcare or not. Why should they ? If DC really cared then we'd get the same benefits as them. No debate. But a mandated requirement to have healthcare is a money maker plain and simple for the industry. And it won't be free or cheap.
------------- No more democrats no more republicans,vote Constitution Party !!
Posted By: Pacman
Date Posted: Oct 16 2009 at 2:18pm
Overweight? Smoker? Health bills hit hard
Bills could put workers under pressure to lose weight, stop smoking
By David S. Hilzenrath
The Washington Post
updated 9:18 p.m. ET,Thurs., Oct . 15, 2009
Get in shape or pay a price.
That's a message more Americans could hear if the health care reform bills passed by the Senate Finance and Health committees become law.
By more than doubling the maximum rewards and penalties that companies can apply to employees who flunk medical evaluations, the bills could put workers under intense financial pressure to lose weight, stop smoking or even lower their cholesterol.
The initiative, largely eclipsed in the health care debate, builds on a trend that is already in play among some corporations and that more workers will see in the packages they bring home during this month's open enrollment. Some employers offer lower premiums to people who complete personal health assessments; others offer only limited benefit packages to smokers.
The current legislative effort takes the trend a step further. It is backed by major employer groups, including the U.S. Chamber of Commerce and the National Association of Manufacturers. It is opposed by labor unions and groups devoted to combating serious illnesses, such as the American Heart Association, the American Cancer Society, and the American Diabetes Association.
A colossal loophole? President Obama and members of Congress have declared that they are trying to create a system in which no one can be denied coverage or charged higher premiums based on their health status. The health insurance lobby has said it shares that goal. However, so-called wellness incentives could introduce a colossal loophole. In effect, they would permit insurers and employers to make coverage less affordable for people exhibiting risk factors for problems like diabetes, heart disease and stroke.
"Everybody said that we're going to be ending discrimination based on preexisting conditions. But this is in effect discrimination again based on preexisting conditions," said Ann Kempski of the Service Employees International Union.
The legislation would make exceptions for people who have medical reasons for not meeting targets.
Supporters say economic incentives can prompt workers to make healthier choices, thereby reducing medical expenses. The aim is to "focus on wellness and prevention rather than just disease and treatment," said Business Roundtable president John J. Castellani.
BeniComp Group, an Indiana company that manages incentives for employers, says on its Web site that the programs can save employers money in a variety of ways. Medical screenings will catch problems early. Employers will shift costs to others. Some employees will "choose other health care options."
Douglas J. Short, BeniComp's chief executive, said the incentives he uses focus on outcomes, not conditions.
"I can't give you an incentive based on being a diabetic or not being a diabetic, but whether you're managing your blood glucose level — I can give you an incentive based on that," Short said.
National epidemic of obesity The incentives could attack a national epidemic of obesity. They also cut to a philosophical core of the health care debate. Should health insurance be like auto insurance, in which good drivers earn discounts and reckless ones pay a price, thereby encouraging better habits? Or should it be a safety net in which the young and healthy support the old and sick with the understanding that youth and good health are transitory?
Under current regulation, incentives based on health factors can be no larger than 20 percent of the premium paid by employer and employee combined. The legislation passed by the Health and Finance committees would increase the limit to 30 percent, and it would give government officials the power to raise it to 50 percent.
A single employee whose annual premiums cost him and his employer the national average of $4,824 could have as much as $2,412 on the line. At least under the Health Committee bill, the stakes could be higher for people with family coverage. Families with premiums of $13,375 — the combined average for employer-sponsored coverage, according to a recent survey — could have $6,687.50 at risk.
An amendment passed unanimously by the Health Committee would allow insurers to use the same rewards and penalties in the market for individual insurance, though legislative language subsequently drafted by the committee's Democratic staff does not reflect that vote, Sen. Mike Enzi (Wyo.), for the committee's ranking Republican, has said. The bill drafted by the Senate Finance Committee would set up a trial program allowing insurers in 10 states to use wellness-based incentives for individuals.
America's Health Insurance Plans, an industry lobby, has argued that insurers should be allowed to consider participation in wellness programs when setting individual premiums.
Wellness incentives voluntary Employers and other advocates of expanded wellness incentives say taking steps to get healthier would be voluntary. Sen. John Ensign, a Nevada Republican and lead sponsor of the Finance Committee's wellness provision, said his proposal "would guarantee that the incentive is strong enough for Americans to want to participate."
Wellness incentives have been spreading rapidly in the corporate world. Unlike the legislative proposals, which address incentives based on results, the corporate programs typically compensate employees based on effort alone — for example, enrolling in smoking cessation programs even if they fail to kick the habit, or undergoing detailed medical assessments regardless of the findings. But there are exceptions: The Safeway supermarket company allows certain employees to reduce their premiums by meeting standards for body mass and other measures. Safeway chief executive Steve Burd has framed it as an issue of personal responsibility.
Valeo, a supplier of auto parts, four years ago raised the deductible on an employee health plan to $2,200 from $200 for individual coverage and to $4,400 from $400 for family coverage. Then it gave employees the opportunity to reduce the deductible to its starting point by being nonsmokers and meeting goals for blood pressure, cholesterol, and body mass index, said Robert Wade, Valeo's director of human resources for North America.
"If they don't comply they end up being penalized, if you will, but we refer to it as a Healthy Rewards program," Wade said.
Workers who choose not to submit to yearly medical assessments have been offered a different health plan that carries higher premiums, Wade said.
Results are mixed for some programs The results are mixed. The number of employees meeting some targets in the Healthy Rewards program has risen while the number meeting others has fallen, Wade said. On average, employees have succeeded in bringing their deductibles down to about $600 in the case of individual coverage. Meanwhile, Valeo has managed to keep annual increases in health care costs per employee down to about 1 percent, he said, which is far below average.
Higher deductibles alone could explain some of the savings. They can make people more cost-conscious when deciding whether to go to the doctor or obtain other medical services.
Paychex, a payroll management company, offers incentives for participation in wellness programs but refrains from pegging them to biometric targets.
"Employees could be doing everything right and still not achieve the desired outcome. And so then you're holding them accountable for something that may not be achievable," said Jake Flaitz, the company's director of benefits.
Workers at a company called Bemis, which makes packaging, went on strike this year partly because the firm was insisting that they and their spouses submit to health risk assessments to remain eligible for their health insurance, the Workers United union said in an August news release. The union called the assessments "invasive."
North Carolina has angered some state employees by introducing a wellness program that would limit the most generous benefits package to those who meet body mass targets and don't smoke. The state would allow employees to satisfy the requirement by enrolling in weight management or smoking cessation programs.
When fully implemented, the program is projected to reduce the state health plan's medical expenses by 1.2 percent, spokeswoman Linda McCrudden said by e-mail.
The top executive at the health plan, Jack W. Walker, predicted that over the long run the federal government will pay for North Carolina's success. State workers who live longer will spend more time collecting benefits from Medicare, the federal insurance program for older Americans, he said.
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Posted By: wasteful
Date Posted: Dec 12 2009 at 3:16pm
Health care loophole would allow coverage limits
By RICARDO ALONSO-ZALDIVAR, Associated Press Writer Ricardo Alonso-zaldivar, Associated Press Writer Fri Dec 11, 10:12 am ET
WASHINGTON – A loophole in the Senate health care bill would let insurers place annual dollar limits on medical care for people struggling with costly illnesses such as cancer, prompting a rebuke from patient advocates.
The legislation that originally passed the Senate health committee last summer would have banned such limits, but a tweak to that provision weakened it in the bill now moving toward a Senate vote.
As currently written, the Senate Democratic health care bill would permit insurance companies to place annual limits on the dollar value of medical care, as long as those limits are not "unreasonable." The bill does not define what level of limits would be allowable, delegating that task to administration officials.
Adding to the puzzle, the new language was quietly tucked away in a clause in the bill still captioned "No lifetime or annual limits."
The 2,074-page bill would carry out President Barack Obama's plan to revamp the health care system, expanding coverage to millions now uninsured and trying to slow budget-busting cost increases. A tentative deal among Senate Democrats to back away from creating a new government program to compete with private insurers appears to have overcome a major obstacle to the bill's passage.
Officials of the American Cancer Society Cancer Action Network said they were taken by surprise when the earlier ban on annual coverage limits was undercut, adding that they have not been able to get a satisfactory explanation.
"We don't know who put it in, or why it was put in," said Stephen Finan, a policy expert with the cancer society's advocacy affiliate.
Democratic officials of the Senate Health, Education, Labor and Pensions Committee would not comment publicly but said the bill contains numerous provisions that will benefit patients with cancer and other life-threatening illnesses, not to mention improvements in preventive care.
Advocates for patients say they're concerned the language will stay in the bill all the way to Obama's desk.
"The primary purpose of insurance is to protect people against catastrophic loss," Finan said. "If you put a limit on benefits, by definition it's going to affect people who are dealing with catastrophic loss." The cost of cancer treatment can exceed $100,000 a year.
Under the health care bills in Congress, the major expansion of health insurance coverage won't take place until three to four years after enactment. Democrats have touted a series of consumer protections as immediate benefits Americans will secure through the legislation. Both the Senate and House bills, for example, ban lifetime limits on the dollar value of coverage.
But Finan said the change in the Senate bill essentially invalidates the legislation's ban on lifetime limits.
"If you can have annual limits, saying there's no lifetime limits becomes meaningless," he said. A patient battling aggressive disease in its later stages could conceivably exhaust insurance benefits in the course of a year.
It's unclear how widespread such coverage limits are in the current insurance marketplace. Large employers have moved away from coverage limits, but insurers have wide discretion in designing plans for small businesses and individual customers.
In the House bill, neither annual nor lifetime limits would be allowable under an essential benefits package intended to provide comprehensive coverage.
Posted By: Hermes
Date Posted: Dec 12 2009 at 5:26pm
In reference to the above post,I hope no one really thinks this "health care" over haul will do the people any real good. It's being crafted by the same idiots who vote themselves their own pay raises and then raise our taxes. All are a bunch of idiots.
------------- No more democrats no more republicans,vote Constitution Party !!