No Rationing, Say Experts, But Public Doesn't Hear

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  1

  rick10605

  08/26/09 | Report as spam

  RE: No Rationing, Say Experts, But Public Doesn't Hear

  H.R. 3200, section 122, page 29, lines 4-16. The elephant in the room.

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  2

  verycold

  08/26/09 | Report as spam

  RE: No Rationing, Say Experts, But Public Doesn't Hear

  Medicare payments to doctors and hospitals will be cut. Obama already said that much. So then what happens is fewer take medicare payments because they financially cannot afford to do so. So then you pile on more people to join the insured with already not enough medical staff, coupled with fewer willing to accept medicare patients, and you have long lines and lots of waiting and eventually a form of rationing which we already see.
  
  The elephant in the room is the immigration problem the US refuses to fix. It should have been addressed first, but of course that makes too much sense for Washington. Both parties refuse to understand that allowing illegals to use the health care system as a compassionate country allows the tire to keep leaking. You can keep putting air in the tire, but it will continue to leak unless the hole is plugged.
  
  Part D many want to get rid of because they say it was never funded. Obama wants to get rid of the Advantage plan because it is hemorrhaging. Most still on FFS but most also buying supplemental to pay for what Medicare doesn't pay for. So if he do as democrats want and put everybody on a medicare type system, we will then be faced with much lesser care options as seen when FFS is chosen. People would not purposely choose to pay more for supplemental if the FFS choice was sufficient.
  
  

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  3

  colonie

  08/26/09 | Report as spam

  RE: No Rationing, Say Experts, But Public Doesn't Hear

  If Rick10605 wants to cut-and-paste blatantly false scare tactics
  from the web, allow me to cut-and-paste the truth:
  
  Section 122 outlines broad categories of benefits that must be
  included in an essential benefits package. It prohibits cost-sharing
  (deductibles and co-payments) for preventive care and limits
  annual out-of-pocket spending to $5,000 for an individual and
  $10,000 for a family, indexed for inflation. It says nothing about
  rationing or limiting treatment.

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  4

  Chitownmba

  08/26/09 | Report as spam

  RE: No Rationing, Say Experts, But Public Doesn't Hear

  if you think there will be no rationing under the government's new
  plan I don't think you are considering the laws of basic supply and
  demand

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  5

  Chitownmba

  08/26/09 | Report as spam

  RE: No Rationing, Say Experts, But Public Doesn't Hear

  The reality that there will be rationing is a logical outcome to
  anyone interested in actually thinking about the issue. If you
  drop the price of something, demand increases. If you give it for
  free, demand increases a lot. Add that reality to the fact that
  the government wants to add 45 million more to the system (the
  uninsured) and you have a dramatic increase in healthcare
  demand.
  
  That doesn't necessarily mean supply shortages (meaning
  rationing) but.... To control costs they gov't is going to control
  prices. Just as they do in Medicare and Medicaid. That means
  they are going to price fix below the current market prices.
  
  Unfortunately just as dropping price increases demand it also
  decreases supply. so... under the government's plan demand will
  increase dramatically and supply will decrease. And since by
  definition the government will be pricing below the equilibrium
  point between supply and demand, demand will always exceed
  supply in their system and thus rationing must occur.
  
  We see empirical data in countries that have followed a similar
  path. In the UK and in Canada, both with single-payer/socialized
  medicine, you see significant rationing in the form of long lines
  and long wait times for treatment. Canadians come to the
  United States for treatment of a time. Interestingly in Canada
  there is one medical community where there are no waiting lines.
  In fact you can immediately be seen for a CAT scan or an MRI.
  Unfortunately you have to be a dog or cat to have this
  opportunity. Where human medical services are socialized in
  Canada, veterinary services are privatized.

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  6

  verycold

  08/26/09 | Report as spam

  RE: No Rationing, Say Experts, But Public Doesn't Hear

  I think the scariest, albeit humorous, t.v. segment was the one in a rural town in Canada that actually has a box full of names that comes out when the local government clerk gets the call that one of those names can be added to the list to see a doctor. Holy cow. I mean I live rural and there is NO box being kept on a shelf in a closet behind the desk of the local clerk. Equally the UK and also Canada may have a single pay system, but those that can afford it also buy supplemental insurance to cover what the single pay will not cover.

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  7

  fergomez

  08/26/09 | Report as spam

  RE: No Rationing, Say Experts, But Public Doesn't Hear

  Colonie only reads but doesn't get it. There will not be enough money to cover everybody, including the illegals, in an expanded medicare program because that's what it will be. Visit any public hospital in any major city on Friday and Saturday nights and multiply that times 10, 20, 50 times and that's what we'll get with a government run healthcare program. We won't even look like any European country or Canada, we'll just be, not look like, the richest banana republic in the world with a tiny elite (exempt, of course, of everything they legislate for us to comply with) controlling our lives. All of those waiting for the government to provide for them, be it housing, education, food, transportation, clothing and all the goodies they can get through corruption (where there is rationing, there is corruption, you can bet on it), will feel at home. In fact, many of them are at home already. We already have corrupt people at many levels in government living off the current system but it is nothing to compare with what may coming ( I pray it never happens) our way if we allow the new elite to gain power. The corruption will be in all levels of society, not just the government elitists which will be promoting and condoning it to remain in power. I seen the future and it scares the hell out me. Where? Just look at our nearest neighbor, Cuba. Also check what's happening in Venezuela where some one using the democratic process (we know this will never happen here in the USA, right? well, think again) turned himself into an autocrat and stays in power through corruption. Buying everybody including the so called opposition to remain in control. Look at Ecuador, Nicaragua, Bolivia, etc. People who flee these regimes come to the United States of America looking for a place to start anew. The saddest part is that there is no other place to flee to if we become a banana republic. There is no other USA..... think about that!

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  slccom

  08/26/09 | Report as spam

  RE: No Rationing, Say Experts, But Public Doesn't Hear

  Did you miss the part where there will be a czar in charge of determining what is considered cost-effective, reporting only to the President? If a treatment costs $X and give Y months or years of "good" life (as determined by the temporarily able-bodied czar), then it will be approved. If it costs more, or gives less "good life," it will not be approved. There is NO APPEAL PROCESS for this.
  
  People with severe disabilities are afraid, very afraid. And any one of you could join that group in a split second.

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  mvmorello

  08/26/09 | Report as spam

  RE: No Rationing, Say Experts, But Public Doesn't Hear

  Great discussion, thanks for the info.

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  10

  dkberry

  09/17/09 | Report as spam

  RE: No Rationing, Say Experts, But Public Doesn't Hear

  verycold has it exactly right.
  
  DEM politicians and their stooges in academia can't figure it out themselves because neither of them have ever run anything. That's why their pledge that "you will not lose your plan or your doctor" is so meaningless coming from them.
  
  Sure... legislators are too smart to directly snip health care benefits for seniors... that would be the ultimate 'third-rail' suicide. So, they simply let CMS reduce reimbursements through its flawed FFS system which results in providers either dropping Medicare patients, not taking on new patients, or going out of business. Not sure why DEMS don't understand a 2-step process like this. Probably too complicated for them.
  
  Nearly 25% of Medicare beneficiaries have Medicare Advantage plans. Administration and its expert sidekicks would cut MA plans even though they enjoy over 90% satisfaction from subscribers ... avoid the need to pay for supplemental coverage ... and don't have a Part D donut hole. They beef that MA plans cost 13% more than traditional FFS ... which compares APPLES to grapes given how inferior traditional FFS is in comparision to MA.
  
  Smarter thing for government to do would be to get out of the FFS business and put 100% of Medicare beneficiaries in MA plans for about $60bil premium.
  
  

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  verycold

  09/18/09 | Report as spam

  RE: No Rationing, Say Experts, But Public Doesn't Hear

  Just heard yesterday that one insurance company will be offering more than 20 insurance plans to the public. The idea is that often times people are paying for an insurance policy that includes things that person will never use. The elderly will probably not need coverage for pregnancy, LOL. Equally a very young, healthy person could take the risk with a high deductible and perhaps just a catastrophic plan paying for just routine visits to the doctor for checkups and minor incidents.
  
  I think in the past several weeks we have all learned a lot more about the health care debate. A recent poll shows the majority of doctors not supporting the recent reform bills and in fact 40 percent suggesting they will leave the field and either retire early or find another occupation. This would cripple the health care system in that we already have a shortage of personnel.
  
  What bothers me is this stat. The top 5 percent of those with insurance spend approx 18,500 yearly on medical care. The top 5 percent that are NOT insured spend 6,600. Now you can argue the guy that is not insured only goes if necessary. Maybe...or perhaps when a person has to pay for services themselves they are prudent with their money. It was said yesterday that 1.6 million Americans go overseas to get medical care now because of the cost. Heart surgery cost only 7,000 in India at a private hospital that has the same certification as does the best hospitals here in the US. So somehow private hospitals in other countries know how to run a tight ship and many Americans are flocking to these dozen or so private hospitals. So it would be like having a Mayo clinic in other regions of the world. Sort of like the brand name Hilton.

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  dbuxs

  09/24/09 | Report as spam

  RE: No Rationing, Say Experts, But Public Doesn't Hear

  I read a lot a ignorant rants about "socialized" medicine here.
  I am a US citizen who has actually lived for extended periods of time in Europe (don't close you eyes yet) and Canada and, like anyone else I have been sick in this places along with people I know. So, let me start:
  US citizens should wake up from the idea that they have the best Healthcare in the world. That simply is not true. We have excellent healthcare but what good is it, really, when fewer and fewer people and businesses can afford it? Also know that he truth of the matter is that the US ranks# 50 in life expectancy behind - (keep your eyes open, you ideologues) all the major European countries, Canada and others that have some form of... socialized medicine. The source? The CIA itself. (https://www.cia.gov/library/publications/the-world-factbook/rankorder/2102rank.html)
  In essence our HC system actually is terrible considering it's also the most expensive in the world (as % of GDP).
  So you still believe that the US is the best system? Do you still believe blindly in privatization of HC as a matter of course? Then I hope you or your family will never have to go uninsured and that life and finances will ALWAYS be good to you.
  
  Now, to be honest, I'm not sure such a model would be the best for the US (given size, population and culture) but leaving things as they are is just simply not sustainable.
  And please, stop telling moronic fearful tales about long lines and rationing and death panels as an automatic result of "socialized medicine".
  
  

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  verycold

  09/25/09 | Report as spam

  RE: No Rationing, Say Experts, But Public Doesn't Hear

  dubxs, you really don't get to tell others how they should feel. In case you haven't noticed we still live in a free society that allows everybody to come to their own conclusion. People that immigrated to this country did so because they didn't like their own natural country. So there is an independent streak that is pervasive throughout the US and you only diminish your position when you ask everybody to shut up and call them names. I know that is what liberals are best at, but all it does is further divide the country.
  
  Any sort of ranking system needs to be transparent how those numbers were obtained. After all, models are only as good as the human input.
  
  Because our income comes from a UK company, I too am aware of the health care system in the UK. I won't take the low road like you did, but suffice to say that all employees would certainly not have a lot of good things to say for obvious reasons to most people. It would be like those in the FFS program of medicare that get the basics - somewhat.
  
  I too have been sick and so has my family with very serious ailments. I have lived all over the US as well and yes the health care varies depending on region. I have had no insurance, HMO, PPOs, self insured, and all in all I would rate the care a 9 since I am sure there was something that could have been improved. Yup, and if you knew me nothing pleases me and so from my personal extensive experience our health care is excellent in this country for most people.
  
  I totally agree that health care coverage cost way too much. I think there are far too few family doctors. That is because they get over worked and paid considerably less than the specialists. We need to change that. We need to encourage many more to join the medical world which at this point is not looking encouraging. Part of the problem is that class size for each graduating class is small with long waiting lists. It is like that all over the US. Thus it is ignorant of the US government to want to extend coverage to all for all purposes when health care personnel is presently seeing shortages. To do so, is not attacking one of the core problems.
  
  If Medicare and Medicaid was a streamline program with the ability to strike hard at any corruption, you would see citizens much less opposed to any mandated government health care system because they would have confidence. Unfortunately those depending on those programs know better. They might not want it taken away, but they know the severe limitations and now they know those programs lose about 70 billion a year due to corruption. The government does not have the anti-corruption personnel employed to cut out the corruption like the private sector does. The reason being is that they have no incentive to do so thus far because profit is not their motive although it sure should be. The government never thinks about reining in costs and please don't think they will going forward unless we replace all the nitwits in Washington. If the president is telling the truth that there is billions of waste in the system and thus that savings can pay for his system, then clean it up first and show the American public that in fact government does know how to fight corruption and does know how to be efficient. Would you invest in a company that had zero history of cost efficiency, innovative ideas, and wasn't even willing to give you a business plan???????????????

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  14

  dbuxs

  09/25/09 | Report as spam

  RE: No Rationing, Say Experts, But Public Doesn't Hear

  Verycold, thank you for your response. I my last paragraph I say that I am not sure a Euopean-style HC system would be appropriate in the US. Prior to that I was reacting to the incredibly misleading campaign of the "all private" ideologues that uses soviet style imagery to describe any form of social medicine.
  That said, I would agree with you that the US government does not hold any impressive record for leniency and efficiency but at the end of the day it's about people's health, the country's health, so while efficiency is nice, it's no longer essential here (unlike for other industries). We also need to realize the actual (not projected if... _actual_, as in _it_has_happened_) failure of the all-private, all market-driven system and its corruption (medicare/aid are corrupt too but you know as well as I do that they are not any more so that the private, colluded monopolies).
  So, I'm NOT saying "let Washington rule and all our problems will go away" but I think that there needs to be serious government- (or State) driven regulations and reforms that will work for the vast majority of US citizens not just for the privileged few and the bunkered industry.
  Essentially it comes down to recapturing the true essence of capitalism: diversity and competition. It cannot work if we rely on monopolies, collusion and overpowering lobbies. We need to go back to the basic tenets of capitalism if we want its ideals to be sustained.

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  15

  dkberry

  10/08/09 | Report as spam

  RE: No Rationing, Say Experts, But Public Doesn't Hear

  Mr. dbuxs... Please provide facts to back up your assertions. Only DEMS and the uninformed talk in generalities.
  
  1. A government single payer system is equally flawed as one where the government pays itself to operate the system as in the UK.
  
  Fact: Medicare, Tricare, and Medicaid programs run by CMS and the states reimburse providers between 80-53% of what providers bill them. There is no negotiation in this rate setting. The government simply states what it will pay regardless of what that impact is on the providers.
  
  Fact: Low Medicare reimbursement rates along with the high cost of medical school loans that future physicians must pay back is the cause of the estimated 30% US deficit in primary care health service capacity.
  
  Fact: When there is insufficient health care capacity due to physicians leaving the market or a practice having to make staffing cuts to allied health care providers... the result is fewer clinic appointments available. That means patients must wait longer to get an appointment... in some cases 2-3 weeks out forcing those who really don't have an urgent need to go to the local ER for very expensive routine primary care services. Giving out insurance coverage does not assure access... and with further cuts being made to providers what is going to result is longer waits for services. THAT IS RATIONING OF HEALTH CARE SERVICES... by the actions of taking $500bil over 10 years from providers by cutting Medicare rates.
  
  2. Fraud costs public and private health care programs an estimated $75-250billion annually according to the FBI. Health Affairs reports that in 2008 DHHS recovered (only) $14.4billion with $12.5bil returned to Medicare and $1.2bil returned to the Fed component of Medicaid.
  
  FACT: Government 'pay and chase' strategy is prime target by organized crime due to lack of internal control which has resulted in pop up fraudulent medical equipment providers, infusion clinics, and other Medicare providers such as one in Miami Dade County between January and June 2005 billing and collecting from Medicare $4.1mil in fraudulent claims. Despite recent efforts by DHHS government programs are the primary target of organized crime. A new government public plan would be an even more lucrative target due to the amount of new services being opened to a totally new beneficiary base.
  
  BOTTOM LINE: Health care suffers from too much government involvement which attracts fraud, waste, and abuse. Creating a monopolistic single payer system results from government programs underwritten by tax revenues compete with private sector payers and providers.
  
  ADMINISTRATION'S and DEMS health care reform is all about providing health care coverage subsidies to those who voted them into office... and paying for it (between $829bil and $1.2tril by taxing those who aren't their constituents and cutting Medicare reimbursments which cause providers to draw down capacity further affecting predominantly seniors who typically don't vote Democratic.

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  16

  verycold

  10/09/09 | Report as spam

  RE: No Rationing, Say Experts, But Public Doesn't Hear

  I have worked for both government and the private sector. People not having that same experience, can't imagine the difference. It was easy working for government because nobody worried about time being spent on any project since it isn't measured. I worked for a good size city for the city manager, budget director, personnel director, benefits, legal, city counsel, to name a few departments. I loved it because it was both political and civic. The interaction between city and citizen was fascinating and very revealing. Government puts most of their efforts into putting together a budget and then they pretty much sit back the rest of the year doling out the dough. My experience was it wasn't so much corrupt as it was slow, not very imaginative, and not particularly of a high standard of work or efficiency. At one time we had a high ranking official from the US military running the show that only lasted about 2 years and then called it quits. To put it bluntly, it was just too pathetic for him. It lacked discipline and the workers were not about to conform. After all, everybody go the same pay raise and so there was zero incentive to stand out. Government jobs are often jobs that nobody worries about on the job, and certainly not off the job. My experience doing the same sort of work in the private sector was quite different. We had deadlines, lots of early mornings, late nights, and a need to do work with a time frame because the clock was ticking.
  
  Those serving in Washington are often career government workers having never started a business themselves nor worked for private business. They are a victim of their own lack of resume. you only know what you know. You can read about things, talk to people, but to really know the score one must walk the walk.

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  17

  dkberry

  10/09/09 | Report as spam

  RE: No Rationing, Say Experts, But Public Doesn't Hear

  verycold... Having spent 30 years in the USAF I can truly relate in my dealings with local government and other departments outside DoD in DC.
  
  Government workers know what they know and there is little reason to know anything else. Work is about just maintaining their own safety net not about producing value for the citizens they are supposed to be serving. Little distinction between one office and another... its all mashed potatoes.
  
  All the 'ideas' come from academics who apply for grants to study, write, and propose things that they have never done either.
  
  So the government worker, the typical 10 term Congressman, and the academic is a triad of parties who have never done anything on their own and are really only interested in perpetuating their own processes, connections, and special interests... inside Fort Beltway.