Massachusetts Experiment Gone Awry?

[deception]

http://www.nytimes.com/2009/07/15/us/15insure.html?hpw

The new state budget in Massachusetts eliminates health care coverage for some 30,000 legal immigrants to help close a growing deficit, reversing progress toward universal coverage just as Congress looks to the state as a model for overhauling the nation’s health care system. The affected immigrants, permanent residents who have had green cards for less than five years, are now covered under Commonwealth Care, a subsidized insurance program for low-income residents that is central to the groundbreaking health care law enacted here in 2006.

Gov. Deval Patrick has proposed restoring $70 million to the program, which would partly restore the immigrants’ coverage. But legislative leaders have balked, saying vital programs for other groups would have to be cut as a result. The cut, which would affect only nondisabled adults from 18 to 65 years old, would take effect in August unless the legislature approves Mr. Patrick’s proposal.

Because of its three-year-old law, Massachusetts has the country’s lowest percentage of uninsured residents: 2.6 percent, compared with a national average of 15 percent. The law requires that almost every resident have insurance, and to meet that goal, the state subsidizes coverage for those earning up to three times the federal poverty level, or $66,150 for a family of four.

But the recession has made an already difficult experiment far more challenging. Enrollment in Commonwealth Care has risen sharply in recent months, to 181,000, as more people have lost jobs. That increase, combined with plummeting state revenues, made it impossible to maintain last year’s level of service, said Cyndi Roy, a spokeswoman for the state’s Executive Office for Administration and Finance.

In addition to dropping the immigrant insurance program, Commonwealth Care will save an estimated $63 million by no longer automatically enrolling low-income residents who fail to enroll themselves.

Lindsey M. Tucker, health reform policy manager at Health Care for All, an advocacy group in Boston, said that restoring $70 million to the program might provide some preventive and emergency care.

“It’s in no way the best solution,” she said, “but it looks like we are going to need a compromise given the difficult climate.”

 

[Colonel Ronan]

I bet they are terrible drivers.

 

[Denny Crane]

Mass. has the highest GDP per capita and they can't afford to insure everyone.

Or they're banking on Obama and congress paying for everyone and bailing them out.

The 2.6% is suspect, BTW. They have a similar system in Hawaii and it's quite common that people work less than the required hours to qualify (like 29 instead of 30) or are paid under the table with no withholding.

 

[deception]

Mass. has the highest GDP per capita and they can't afford to insure everyone.

Or they're banking on Obama and congress paying for everyone and bailing them out.

The 2.6% is suspect, BTW. They have a similar system in Hawaii and it's quite common that people work less than the required hours to qualify (like 29 instead of 30) or are paid under the table with no withholding.

first, universal health care is a moral question. all other industrialized nations have it and americans dont. moreover, the number of insured is rising precipitously. second, fiscally your system is fucking retarded. u guys spend more proportionally of your gdp on your current health care system than many countries who already enjoy a robust universal program.

 

[Denny Crane]

first, universal health care is a moral question. all other industrialized nations have it and americans dont. moreover, the number of insured is rising precipitously. second, fiscally your system is fucking retarded. u guys spend more proportionally of your gdp on your current health care system than many countries who already enjoy a robust universal program.

It's not moral to take a person's (doctor, nurse) labor for a price under what the market dictates. I'd call that a form of slavery.

It's not something that FDR got done, nor Truman, nor LBJ (Great Society), nor Carter (Dem president, Dem congress), nor Clinton (ditto for two years).

Our GDP is 1/3 of the entire world, so we can afford to spend more on things, much the way a guy making $1M/year can afford $20K/month mortgage payments with plenty left over.

It's not surprising that we're spending more on health care costs as the years go on, since a very large chunk of our population is over 60 (baby boomers).

 

[CelticKing]

I bet they are terrible drivers.

All US drivers are terrible, just look at the exams and drivers test they have to pass and compare them to Europe. lmao


But yeah the experiment is a disaster, another stupid idea produced by the Mass. liberals. Sucks that I live here amongst so many liberals is all I can say. lol

 

[Denny Crane]

http://www.dailymail.co.uk/health/a...atment-Delay-mean-lifetime-agony-victims.html

A 9-month wait for arthritis treatment: Delay can mean a lifetime of agony for victims

Thousands of rheumatoid arthritis sufferers face a lifetime of agony because they are not being treated quickly enough, a report says.

Guidelines state that patients should receive treatment within three months of the first symptoms appearing.
But the average wait is nine months - and GPs are not trained well enough to know what help to offer.

There is no cure, but experts say that if arthritis is diagnosed in the first three months, drugs can be given which limit its progression. This means the disease will not be as painful as it would have been if the condition was diagnosed later.

The study by the National Audit Office found that patients do not know enough about the condition, and therefore delay going to see their GP.

Between half and three-quarters of people with symptoms wait more than three months before seeking medical help, and about a fifth delay for a year or more.

GPs lack the specialist knowledge required to diagnose the condition quickly, and on average it takes four visits before a patient is referred to a specialist for diagnosis and treatment, the report adds.

Its author, Chris Groom, said: 'This is a nasty disease, a progressive auto-immune disease, which attacks otherwise healthy joints. Early symptoms are joint pain and stiffness and it leads to inflammation and loss of strength.

'It also affects other parts of the body, such as the heart and lungs, and is also associated with increased risk of cardiovascular disease.'

The report found that the average length of time from the onset of symptoms to treatment has not improved in the past five years. Mr Groom said that services needed to be better coordinated and designed around people's needs, including helping them remain in work.

Three-quarters of sufferers are of working age when diagnosed, meaning delays cost the economy almost £2billion a year - about £560million a year in NHS healthcare costs and £1.8billion in sick leave and work-related disability.

'Once people fall out of the job market with this disease, it is very hard to get back in', Mr Groom said.
The report also found that 50 per cent more people have rheumatoid arthritis than was previously thought.

Mr Groom added: 'We estimate that 580,000 adults in England have the condition, which is higher than existing estimates of 400,000 for the UK, and that there are 26,000 new cases each year in England, compared to estimates of 12,000 for the UK.'

Neil Betteridge, chief executive of the charity Arthritis Care, said: 'The report echoes what people with rheumatoid arthritis have been telling Arthritis Care for years.

'Early diagnosis and referral for suitable treatment is crucial as it can stop this debilitating condition in its tracks.

'We applaud the audit's recommendations that the Department of Health and Primary Care Trusts replace their often scattergun delivery with joined-up services.'

Tory MP Edward Leigh, chairman of the Commons public accounts committee, said the NHS needed to improve support services for people with arthritis.

Health minister Ann Keen said: 'We welcome this report and will consider it carefully before responding.'

 

[deception]

It's not moral to take a person's (doctor, nurse) labor for a price under what the market dictates. I'd call that a form of slavery.

It's not something that FDR got done, nor Truman, nor LBJ (Great Society), nor Carter (Dem president, Dem congress), nor Clinton (ditto for two years).

Our GDP is 1/3 of the entire world, so we can afford to spend more on things, much the way a guy making $1M/year can afford $20K/month mortgage payments with plenty left over.

It's not surprising that we're spending more on health care costs as the years go on, since a very large chunk of our population is over 60 (baby boomers).

these above comments are preposterous. america does produce a greater gdp than any other nation, although, that reinforces my own argument for fiscal mismanagement of the system. essentially what your saying is that we not only spend a large proportion of our gdp on health care, we also spend more gross dollars than anyone else- providing a system that leaves the majority of americans either uninsured or at the mercy of a private plan. and europe and the rest of the world both are experiencing aging populations so the baby boom phenomena isnt isolated to america. besides, u guys have universal healthcare for veterans as well as seniors, and they arent complaining.

the slavery and doctor salaries argument makes no sense because fundamentally doctors get paid handsomely and slaves dont get paid at all. as for the failures of previous governments- it underscores the pliability of government to the whims of the insurance lobby. hopefully, this time its different for the sake of americans. as for the article u posted about waiting lists- im fairly confident the 46 million insured would prefer to be on a waiting list than not receive any treatment at all. moreover, under a public system there are tradeoff's between "essential" care which cant wait and non-essential which can.

 

[Denny Crane]

Every part of what I wrote is correct.

There's no argument for fiscal management of the system. I'd add that people without insurance still get services. I went without insurance for years. I got flu shots for $15 at the drug store during flu season. When I got sick, I paid $65 at a walk-in clinic to see a doctor, the $50 for a prescription and maybe $200 for blood/urine test. They actually cut me a 60% discount because I was paying cash. If I got into a car accident or something, I wouldn't have been turned away at the ER.

We WANT to spend more gross dollars than anyone else on our health care. For everyone but black folks, the numbers show our system is vastly superior to anyone else's. That'd be life expectancy, live births, you name it. We might be better off addressing why black folks don't live as long (the stats are skewed by violent deaths, but the live births stats are disturbing).

Veterans' care is horrible except in a few hospitals. Even some of those that were top VA hospitals are now dives (Walter Reed is getting there).

Wage Slavery is a form of slavery, no matter how you slice it.

There's no waiting lists here that I know of, except where not enough organ donations create a shortage and those have to be rationed somehow under any system.

 

[deception]

Every part of what I wrote is correct.

There's no argument for fiscal management of the system. I'd add that people without insurance still get services. I went without insurance for years. I got flu shots for $15 at the drug store during flu season. When I got sick, I paid $65 at a walk-in clinic to see a doctor, the $50 for a prescription and maybe $200 for blood/urine test. They actually cut me a 60% discount because I was paying cash. If I got into a car accident or something, I wouldn't have been turned away at the ER.

We WANT to spend more gross dollars than anyone else on our health care. For everyone but black folks, the numbers show our system is vastly superior to anyone else's. That'd be life expectancy, live births, you name it. We might be better off addressing why black folks don't live as long (the stats are skewed by violent deaths, but the live births stats are disturbing).

Veterans' care is horrible except in a few hospitals. Even some of those that were top VA hospitals are now dives (Walter Reed is getting there).

Wage Slavery is a form of slavery, no matter how you slice it.

There's no waiting lists here that I know of, except where not enough organ donations create a shortage and those have to be rationed somehow under any system.

your paying user fees for services that u would othersie enjoy free in rest of the industrialized world. plus, the user fees u cited are affordable but how would u be as amendable to user fees for long term care like cancer? probably not, in fact, u would probably file for personal bankruptcy as insurmountable health care bills are the leading cause of personal bankruptcy in america.

are u an accountant denny crane? cause excluding african americans seems like some crafty accountanting practices. u guys are ranked a laughable 37th: http://www.photius.com/rankings/healthranks.html - just ahead of slovenia and cuba. if blacks skew the stats- then couldnt european countries argue that their numbers are skewed by an influx of guest workers?

look at the core im a capitalist but when it comes to education and health care im a socialist. and the world agrees with me and thats why we produce healthier and brighter people in aggregate terms.

 

[Denny Crane]

your paying user fees for services that u would othersie enjoy free in rest of the industrialized world. plus, the user fees u cited are affordable but how would u be as amendable to user fees for long term care like cancer? probably not, in fact, u would probably file for personal bankruptcy as insurmountable health care bills are the leading cause of personal bankruptcy in america.

are u an accountant denny crane? cause excluding african americans seems like some crafty accountanting practices. u guys are ranked a laughable 37th: http://www.photius.com/rankings/healthranks.html - just ahead of slovenia and cuba. if blacks skew the stats- then couldnt european countries argue that their numbers are skewed by an influx of guest workers?

look at the core im a capitalist but when it comes to education and health care im a socialist. and the world agrees with me and thats why we produce healthier and brighter people in aggregate terms.

Free? No such thing as a free lunch. Instead of paying $15 once a year and another $200-$400 once in a while, I'd be paying several times that amount PER MONTH.

http://books.nap.edu/openbook.php?record_id=12534&page=10
TABLE 1 Life Expectancy at Birth by Race and Sex for Selected Years
2005
75.2 male, all races
80.4 female, all races
75.7 male, white
80.8 female, white
69.5 male, black
76.5 female, black
SOURCE: Adapted from NCHS, 2007.

Look at your own WWW site, we rank #24, but our white people rank #1:
http://www.photius.com/rankings/healthy_life_table2.html

(total, male, female)
[SIZE=+1]1 Japan 74.5 71.9 77.2[/SIZE][SIZE=+1]
24 United States 70.0 67.5 72.6


[/SIZE]And:

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5401a1.htm

In the 2000 census, 36.4 million persons, approximately 12.9% of the U.S. population, identified themselves as Black or African American; 35.4 million of these persons identified themselves as non-Hispanic (1). For many health conditions, non-Hispanic blacks bear a disproportionate burden of disease, injury, death, and disability. Although the top three causes and seven of the 10 leading causes of death are the same for non-Hispanic blacks and non-Hispanic whites (the largest racial/ethnic population in the United States), the risk factors and incidence, morbidity, and mortality rates for these diseases and injuries often are greater among blacks than whites. In addition, three of the 10 leading causes of death for non-Hispanic blacks are not among the leading causes of death for non-Hispanic whites: homicide (sixth), human immunodeficiency virus (HIV) disease (seventh), and septicemia (ninth) (Table). This week's MMWR is the third in a series* focusing on racial/ethnic health disparities. Eliminating these disparities will require culturally appropriate public health initiatives, community support, and equitable access to quality health care.

 

[deception]

dude the richest country in the world is 24th in life expectancy and u think thats a redeeming stat about your system. and u cant segregate your numbers by race because ppl measure these indicators in aggregate terms, irrespective of race. and i would venture to say that blacks are disproportionately poor so your system punishes the poor- again, that reverts to the moral deficiency of your system. besides, your current system is fiscally irresponsible as demonstrated by your ridiculous expenditure that leaves so many unaccounted for.

and nothing is free but a subsidized system is a lot cheaper than a private one. and i thought u were pro business- those rising insurance premiums unfairly burden american business. imagine the jobs and the higher wages americans would enjoy if american firms didnt have to pay insurance premiums for their employees?

 

[Denny Crane]

dude the richest country in the world is 24th in life expectancy and u think thats a redeeming stat about your system. and u cant segregate your numbers by race because ppl measure these indicators in aggregate terms, irrespective of race. and i would venture to say that blacks are disproportionately poor so your system punishes the poor- again, that reverts to the moral deficiency of your system. besides, your current system is fiscally irresponsible as demonstrated by your ridiculous expenditure that leaves so many unaccounted for.

and nothing is free but a subsidized system is a lot cheaper than a private one. and i thought u were pro business- those rising insurance premiums unfairly burden american business. imagine the jobs and the higher wages americans would enjoy if american firms didnt have to pay insurance premiums for their employees?

Look at your own data. In countries that supposedly have the best health care, the % of GDP spent has gone up every year. Nobody's holding down costs.

http://www.photius.com/rankings/total_health_expenditure_as_pecent_of_gdp_2000_to_2005.html

A Kia is cheaper than a cadillac, you do get what you pay for.

If you care to look at real data, the picture isn't as bleak as some people make it out to be. The #1 reason black males here live an average of 8 years less than white males is death by MURDER/VIOLENCE at a young age. That's a social problem, not one that universal health care is going to solve. The data actually looks good for black males once they reach a certain age (like 30 or 40) - they live to about the same as white males.

The infant mortality rates are ridiculously bad for black people. My assessment is not a health care problem as much as we're throwing young black men in jail at far too high a rate, or they're victims of violence at a young age. It's a lot easier on a woman if she's got some extra support from the father, rather than having to work throughout the pregnancy to pay the bills.

Your assertion that black people are poor and the system hurts the poor doesn't wash. You might realize that if 100% of black people are poor and 15% of white people are poor, there's an equal number of each race. Yet 75% or more of black people are not at all poor, and those poor white folks aren't hurting the numbers for white males/females I already posted.

 

[deception]

Look at your own data. In countries that supposedly have the best health care, the % of GDP spent has gone up every year. Nobody's holding down costs.

http://www.photius.com/rankings/total_health_expenditure_as_pecent_of_gdp_2000_to_2005.html

A Kia is cheaper than a cadillac, you do get what you pay for.

If you care to look at real data, the picture isn't as bleak as some people make it out to be. The #1 reason black males here live an average of 8 years less than white males is death by MURDER/VIOLENCE at a young age. That's a social problem, not one that universal health care is going to solve. The data actually looks good for black males once they reach a certain age (like 30 or 40) - they live to about the same as white males.

The infant mortality rates are ridiculously bad for black people. My assessment is not a health care problem as much as we're throwing young black men in jail at far too high a rate, or they're victims of violence at a young age. It's a lot easier on a woman if she's got some extra support from the father, rather than having to work throughout the pregnancy to pay the bills.

Your assertion that black people are poor and the system hurts the poor doesn't wash. You might realize that if 100% of black people are poor and 15% of white people are poor, there's an equal number of each race. Yet 75% or more of black people are not at all poor, and those poor white folks aren't hurting the numbers for white males/females I already posted.

rising cost is attributable to inflation, i dont see how thats germane to our discussion. moreover, those numbers u provided in the link reasserts my point that your system is grossly inefficient.

i dont know how exactly the WHO established their rankings but im confident its based on aggregate measures. so its a collection of a whole bunch of things like life expectancy, infant mortality, wait times, quality of care, etc. so your point about race skewing the results has negligible effects. plus, african americans are a minority group behind whites and latino; i highly doubt the 40 odd million african american would skew the results so much so that u would go from 37th to first.

i agree about the absurd incarceration mentality of americans. although, linking incarceration to poor health care indicators is a leap in my estimation.

going back to the economic side of the argument- the universal system is also a hedge against recessions. with companies in cutting cost mode these days- they are simply choosing to layoff workers, rather than pay the exorbitant premiums demanded by insurance companies.

 

[Denny Crane]

rising cost is attributable to inflation, i dont see how thats germane to our discussion. moreover, those numbers u provided in the link reasserts my point that your system is grossly inefficient.

i dont know how exactly the WHO established their rankings but im confident its based on aggregate measures. so its a collection of a whole bunch of things like life expectancy, infant mortality, wait times, quality of care, etc. so your point about race skewing the results has negligible effects. plus, african americans are a minority group behind whites and latino; i highly doubt the 40 odd million african american would skew the results so much so that u would go from 37th to first.

i agree about the absurd incarceration mentality of americans. although, linking incarceration to poor health care indicators is a leap in my estimation.

going back to the economic side of the argument- the universal system is also a hedge against recessions. with companies in cutting cost mode these days- they are simply choosing to layoff workers, rather than pay the exorbitant premiums demanded by insurance companies.

Look at the numbers in your first link. The difference between 1st and 37th is about one year of life expectancy. What's true for white people is true for black people who aren't killed in their youth a violent death.

How can the WHO data be accurate about health care quality if it includes people who die of a gunshot wound and never are treated by the system for it?

Use your own logic. If inflation is 1% and you spend $100 on something and I spend $1000 on it, your cost next year is $101 and mine is $1010. My costs went up 10x more than yours.

Kia. Cadillac.

And you are almost right about the last bit. If they are forced to pay health care premiums, they will pay workers under the table or reduce the # of hours people are allowed to work so they don't have to consider them full-time (skirt the law).

 

[deception]

Look at the numbers in your first link. The difference between 1st and 37th is about one year of life expectancy. What's true for white people is true for black people who aren't killed in their youth a violent death.

How can the WHO data be accurate about health care quality if it includes people who die of a gunshot wound and never are treated by the system for it?

Use your own logic. If inflation is 1% and you spend $100 on something and I spend $1000 on it, your cost next year is $101 and mine is $1010. My costs went up 10x more than yours.

Kia. Cadillac.

And you are almost right about the last bit. If they are forced to pay health care premiums, they will pay workers under the table or reduce the # of hours people are allowed to work so they don't have to consider them full-time (skirt the law).

your argument is laden with assumptions. u've totally hinged your entire argument on the perceived backwardness of african americans, its not only bigoted, its spurious. as an example- australia has an aboriginal population who routinely engage in revenge killings at an almost hunter gather rate and yet they manage to have a better system than u according to the WHO. the question is priorities- america has the best military in the world because your leaders want to impose themselves on others; conversely, your health care system is inept because your elected officials are on the payroll of insurance companies.

as for the inflation thing- i took a cursory glance at the numbers and it appears like the numbers are very similar in terms of rising cost. and in the kia- cadillac analogy- americans are kia and the rest of the industrialized world is cadillac according to the WHO.

 

[Denny Crane]

your argument is laden with assumptions. u've totally hinged your entire argument on the perceived backwardness of african americans, its not only bigoted, its spurious. as an example- australia has an aboriginal population who routinely engage in revenge killings at an almost hunter gather rate and yet they manage to have a better system than u according to the WHO. the question is priorities- america has the best military in the world because your leaders want to impose themselves on others; conversely, your health care system is inept because your elected officials are on the payroll of insurance companies.

as for the inflation thing- i took a cursory glance at the numbers and it appears like the numbers are very similar in terms of rising cost. and in the kia- cadillac analogy- americans are kia and the rest of the industrialized world is cadillac according to the WHO.

I'm not bigoted toward black people. Far from it. I pointed out factual and measurable data. I pointed out that our incarceration of young black men is inexcusable. I pointed out we have serious social issues. What else can I say?

Australian Aboriginal makes up .58% of Australia's population, and the median age there is like 35.

I don't think our priorities are messed up. We spend 4% or less of our GDP on our military and 4x that on health care. When you spend 4% of a really big number, you end up with a well equipped military. That's just how the numbers work when our GDP is 1/3 of the entire world.

25% of a $millionaire's income buys him a house with $250K/year mortgage payments. 25% of a $100,000 income buys a house with $25K/year mortgage payments. Or one can afford the cadillac, the other the kia.

 

[deception]

the daily show has a hilarious take on the health care debate tonight

 

[Denny Crane]

http://www.nytimes.com/2009/07/16/us/16hospital.html?_r=1

Massachusetts in Suit Over Cost of Universal Care

By ABBY GOODNOUGH

BOSTON — A hospital that serves thousands of indigent Massachusetts residents sued the state on Wednesday, charging that its costly universal health care law is forcing the hospital to cover too much of the expense of caring for the poor.

The hospital, Boston Medical Center, faces a $38 million deficit for the fiscal year ending in September, its first loss in five years. The suit says the hospital will lose more than $100 million next year because the state has lowered Medicaid reimbursement rates and stopped paying Boston Medical “reasonable costs” for treating other poor patients.

“We filed this suit more in sorrow than in anger,” said Elaine Ullian, the hospital’s chief executive. “We believe in health care reform to the bottom of our toes, but it was never, ever supposed to be financed on the backs of the poor, and that’s what has happened in Massachusetts.”

The central charge in the suit is that the state has siphoned money away from Boston Medical to help pay the considerable cost of insuring all but a small percentage of residents. Three years after the law’s passage, Massachusetts has the country’s lowest percentage of uninsured residents: 2.6 percent, compared with a national average of 15 percent.

Low-income residents, who have benefited most from expanded access to health care, receive state-subsidized insurance, one of the most expensive aspects of the state plan. But rapidly rising costs and the battered economy have caused more problems than the state and supporters of the 2006 law — including Boston Medical — anticipated.

According to the suit, Massachusetts is now reimbursing Boston Medical only 64 cents for every dollar it spends treating the poor. About 10 percent of the hospital’s patients are uninsured — down from about 20 percent before the law’s passage in 2006. But many more are on Medicaid or Commonwealth Care, the state-subsidized insurance program for low-income residents.

One of the state’s reimbursement rates to Boston Medical, dropped from $12, 476 in 2008 to $9,323 by 2009, the suit says.

Wendy E. Parmet, a professor at the Northeastern University School of Law, said the suit was “a step in a wider minuet” as state lawmakers, health care providers and other stakeholders try to figure out how to make the new law work in the long term.

“I think it’s going to be a very hard lawsuit for them to prevail on,” Professor Parmet said of the hospital. “I think they’re trying to bring another weapon into what is essentially, in many ways, a political and economic battle going on in the state about how to pay for health care, and making sure their voice gets heard.”

The suit comes as Congress looks to Massachusetts as a potential model for overhauling the nation’s health care system. Even before the suit, the state’s fiscal crisis had cast doubts on the law’s sustainability.

To help close a growing deficit, the Democratic-controlled Legislature eliminated coverage for some 30,000 legal immigrants in the new state budget. Gov. Deval Patrick, a Democrat, is seeking to restore about half of the $130 million cut, but lawmakers have expressed reluctance, saying that doing so would require cuts to other important programs.

State officials expressed surprise at the lawsuit, saying that Boston Medical received $1.5 billion in state funds in the past year and should not be seeking more in the midst of a fiscal crisis.

“At a time when everyone funded and served by state government is being asked to do more with less, B.M.C. has been treated no differently,” said Dr. JudyAnn Bigby, the state secretary of health and human services, in a prepared statement. “We are confident that the administration’s actions in this area comply with all applicable law and will be upheld.”

State officials have suggested that Boston Medical could reduce costs by operating more efficiently. The state has also pointed out that the hospital has reserves of about $190 million, but Tom Traylor, the hospital’s vice president of federal and state programs, said the reserves could only sustain the hospital for about a year.

“The magnitude of the loss here can’t be solved on the program-cutting or expense-cutting side,” Mr. Traylor said. Professor Parmet said the hospital’s dissatisfaction with the new law should be a warning to Congress that “insurance alone doesn’t solve the problems” of the health care system. In fact, she said, it might exacerbate the financial problems of safety-net hospitals in the short term.

Katie Zezima contributed reporting

 

[Denny Crane]

The sorry conclusion to this mess is going to be $.64 worth of care instead of $1. And instead of working their asses off for years to become doctors, some of our brightest and most able people will go work on Wall Street where they can get big paychecks off of government bailouts.

 

[deception]

The sorry conclusion to this mess is going to be $.64 worth of care instead of $1. And instead of working their asses off for years to become doctors, some of our brightest and most able people will go work on Wall Street where they can get big paychecks off of government bailouts.

dude your missing the point again. universal health care has worked all over the world as demonstrated by its cheaper and greater efficiency. if mass. fails, it doesnt necessarily mean the rest of the country would. as pointed out in the analysis of the situation- mass's central problem is the recession induced hit on the program. plus, these doctors associations (e..g ama) and insurance companies are obviously working to railroad the entire thing. here in canada, the same shit happened to tommy maddox ,the architect of universal health care in canada, but we moved beyond it.

as for the best and brightest going to wall street, they already do. however, beyond intelligence- doctors have a fiduciary responsibility to their clients (i.e. patients) that involves empathy as well as compassion. those traits arent rooted in levels in compensation, its rooted in service for mankind. in contrast, the wall street types cant even assume responsible stewardship over your mom's retirement plan.

 

[Denny Crane]

you're missing the point.

$.64 health care is Kia, $1.00 health care is Cadillac.

Something is going to suffer, as it is in Mass., as it does in Canada and everywhere else. Long lines, long waits, or VA quality (which is $2500/veteran) that is not as good as anywhere else in the states.

 

[Denny Crane]

http://www.cqpolitics.com/wmspage.cfm?parm1=5&docID=news-000003168293

CBO Chief: Health Bills To Increase Federal Costs

By David Clarke and Edward Epstein, CQ Staff

The health care overhauls released to date would increase, not reduce, the burgeoning long-term health costs facing the government, Congressional Budget Office Director Douglas Elmendorf said Thursday.

That is not a message likely to sit well with congressional Democrats or the Obama administration, and House Speaker Nancy Pelosi , D-Calif., said Thursday she thinks lawmakers can find ways to wring more costs out of the health system as they continue work on their bills.

The chairman of the Senate Finance Committee, Democrat Max Baucus of Montana, who has not yet released a bill, said his panel is acutely aware of the long-term cost concern. “Clearly our committee will do what it can,” he said. “We are very seriously concerned about that issue. We very much want to come up with a bill that bends the cost curve.”

But Baucus suggested the White House is making the task difficult with opposition to one cost-cutting approach Elmendorf cited — limiting or even ending the tax exclusion for employer-provided health benefits.

The Democrats and President Obama have cited two goals in their overhaul proposals — expanding coverage to the estimated 47 million Americans who currently lack it and bringing down long-term costs because the growth in Medicare and Medicaid spending threatens to swamp the federal budget in coming years.

Under questioning from Chairman Kent Conrad , D-N.D., Elmendorf told the Senate Budget Committee that the congressional proposals released so far do not meet that second test.

“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 and, on the contrary, the legislation significantly expands the federal responsibility for health care costs,” he said.

Elmendorf was not addressing the narrow question of whether the Democrats’ legislation would be budget-neutral over 10 years. Congressional Democrats and the White House have promised to offset the cost of health care legislation over that period.

But budget analysts and some members fear the legislation will not slow the growth of health care spending enough to prevent it from overwhelming the federal budget after that 10-year window.

Earlier this week, House leaders introduced their overhaul plan, which is being considered by three committees this week.

Elmendorf said that CBO has not completed its evaluation of the House plan, but what it has seen so far does not represent “the sort of fundamental change, the order of magnitude necessary to offset the direct increase in federal health costs from the insurance coverage proposals.”

Senate Bills

The Senate Health, Education, Labor and Pensions Committee approved its draft bill Wednesday, and Christopher J. Dodd , D-Conn., the acting chairman of that panel, said his panel had reduced the initial price tag of its bill as estimated by the CBO. “I’m very confident we can meet the president’s goal of having a fully paid-for 10 year program on health care right around $1 trillion,” he said.

Senate Finance, not the HELP Committee, has jurisdiction over the tax code and Medicare — the areas Elmendorft targeted for savings.

Dodd complained that CBO refuses to assume that government savings will occur from an increased focus on wellness and preventive health care.

“The only thing CBO does is tell you how much taxpayer money has to be invested to achieve those results,” Dodd said.

“We believe we have crafted legislation that does bend that curve, bring health care costs down and make it affordable for all Americans,” he said. “I appreciate their work, but frankly we’re on the right track, we have a solid bill and one that’s affordable.”

The Senate Finance Committee has yet to release its overhaul proposal, and Elmendorf said he did not want to publicly discuss the conversations he has had with members of that committee, including Conrad.

When asked what could be done to help “bend the curve” of health care costs over time, Elmendorf pointed out that most health experts believe the tax exclusion for employer-provided health insurance is an area that could help reduce costs. Many experts say the exclusion encourages high health care spending since it shields workers from the cost of their coverage.

Baucus took aim at Obama on that point. “Basically, the president is not helping us. He does not want the exclusion” to be capped or eliminated, he said.

None of the congressional plans released so far address the tax exclusion, and it is not clear whether Finance will tackle the issue.

Many experts also have told CBO that altering the Medicare payment system so that it emphasizes cost effectiveness, rather than fees for services as the current system does, would also help, Elmendorf said.
“Delivery system reforms,” Baucus said, would be “a game changer in this bill.”

However, he told reporters two days ago that the payment reforms in his bill and in the House bill are more similar than they are different. And those would not significantly alter the current system.

Surtax vs. Cost Savings

Meanwhile, House Speaker Nancy Pelosi said Thursday that if more cost savings can be produced in the legislation now being assembled in the House, a proposed $544 billion tax surcharge on the wealthiest Americans could be scaled back.

As three House committees began marking up the health care overhaul bill (HR 3200), Pelosi told reporters that she thinks the legislation can eventually wring more costs from the health system.

“I believe all the costs of the health care reform bill can come out of squeezing costs out of the health care system,” she said.

But then she added that even if that were true, the revenue from the proposed surtax would be needed to help with startup costs associated with making changes to the health system and for reducing the big federal budget deficit.

“We have to have a revenue stream to pay for it,” she said of the bill. “If we don’t need it, we can use it to reduce the deficit,” Pelosi said.

Under questioning, she said that some of those high-income taxpayers who would face the proposed surcharge might get a break. “If we can get more savings, perhaps we can cut it at the high end,” Pelosi said.

Under the surtax plan spelled out by the Ways and Means Committee, the bottom two surtax rates would disappear if health care savings to the government exceed $175 billion by 2013. But those rates would double if the government fails to save at least $150 billion.

Pelosi said she wants to encourage House members to propose more structural changes that could wring costs out of the system. “More structural changes? Absolutely. They are already significant, “she said, referring to the proposed legislation unveiled Tuesday. “Can there be more? Absolutely,” she added.

Pelosi said she remains confident that the legislation can be changed enough to bring on board many of the Blue Dog Democrats who have threatened to walk away from a bill that they see as too expensive.

Energy and Commerce Committee Chairman Henry A. Waxman , D-Calif., plans to meet with Blue Dogs to see how their concerns can be addressed.

“What we’re saying is, let the process unfold in the public process,” Pelosi said. She said members are getting a chance to speak up in the committee markups, then in the Rules Committee and finally on the floor.
She said the bill will be on the House floor in the last week of July, which would fulfill her pledge to have the House vote on the bill before it leaves for its long August recess.

Alex Wayne, Jane Norman and John Reichard contributed to this story.

 

[deception]

you're missing the point.

$.64 health care is Kia, $1.00 health care is Cadillac.

Something is going to suffer, as it is in Mass., as it does in Canada and everywhere else. Long lines, long waits, or VA quality (which is $2500/veteran) that is not as good as anywhere else in the states.

no one else qualifies your analysis. ill just redirect u to the WHO's ranking who seem to think your much more kia than caddy.

 

[Denny Crane]

We already went through this. WHO is counting people who get shot to death as if it has some bearing on the quality of the care and providers. But they do rate our system #1 in responsiveness. Whatever that means to you.

If the 15+% of GDP on HC costs is bad for you, the Democrats are proposing to up that to 25+%.

And the non-partisan Congressional Budget Office has weighed in that all of the big social programs crowd out govt's ability to do all things basic and worthy of being a govt. exercise.

Adding a huge expense in a down economy when we're already going warp 9 to the sun in terms of spending our way into oblivion just isn't smart. Especially when the system is tops in the world and our quality of life is as good as can get, even for our "poor."

 

[deception]

We already went through this. WHO is counting people who get shot to death as if it has some bearing on the quality of the care and providers. But they do rate our system #1 in responsiveness. Whatever that means to you.

If the 15+% of GDP on HC costs is bad for you, the Democrats are proposing to up that to 25+%.

And the non-partisan Congressional Budget Office has weighed in that all of the big social programs crowd out govt's ability to do all things basic and worthy of being a govt. exercise.

Adding a huge expense in a down economy when we're already going warp 9 to the sun in terms of spending our way into oblivion just isn't smart. Especially when the system is tops in the world and our quality of life is as good as can get, even for our "poor."

every time i see your assumption laced arguments (i.e black ppl are skewing our numbers and white ppl are the healthiest ppl in the world)- i think of rudy gulani's infamous assertions on the campaign trail that he would have died of his cancer if he lived in canada.

a few points i want to reiterate here

1) accessibility- nearly 50 million are uninsured and millions of insured are deemed to have a "preexisting condition" when they want to undergo a life saving procedure

2) cost- the burdensome cost of a system that doesnt even account for most americans is probably cause to undertake a facelift

3) the heavy costs (exorbitant premiums) imposed on business and the depressing influence on wages for the insured

4) morally bankrupt- allowing ppl to go without is blasphemous for a "christian nation"

 

[Denny Crane]

every time i see your assumption laced arguments (i.e black ppl are skewing our numbers and white ppl are the healthiest ppl in the world)- i think of rudy gulani's infamous assertions on the campaign trail that he would have died of his cancer if he lived in canada.

I'm not saying it's black peoples' fault. It might help if the local Democrats didn't direct funds from their schools to other districts where their campaign donors live, district the black neighborhoods for toxic waste dumps, force segregation by building projects that turn into ghettos, regulate in ways that makes minority business formation difficult, institute welfare programs that don't allow people on those programs to build up any capital/savings or even save up to buy a car, etc.

a few points i want to reiterate here

1) accessibility- nearly 50 million are uninsured and millions of insured are deemed to have a "preexisting condition" when they want to undergo a life saving procedure

Doctors do a lot of pro bono work, and when they don't, they give people payment plans to pay their bills. People without insurance are not denied health care.

If portability is a problem, then they can outlaw insurance companies from refusing people for preexisting conditions. It'd save us $trillions.

2) cost- the burdensome cost of a system that doesnt even account for most americans is probably cause to undertake a facelift

I guess in Canada, "most" means something less than 1/6th.

3) the heavy costs (exorbitant premiums) imposed on business and the depressing influence on wages for the insured

Businesses in most places are not required to provide insurance. They do it as a benefit (there's other benefits, like retirement plans) for their workers. Mandating these heavy costs be imposed on business is going to reduce the number of jobs and make it difficult for small businesses to get started or succeed. Not a brilliant thing to do.

4) morally bankrupt- allowing ppl to go without is blasphemous for a "christian nation"

You're confusing going without insurance vs. going without health care.

Pro bono work done by doctors is a christian thing to do, I presume.

 

[deception]

I'm not saying it's black peoples' fault. It might help if the local Democrats didn't direct funds from their schools to other districts where their campaign donors live, district the black neighborhoods for toxic waste dumps, force segregation by building projects that turn into ghettos, regulate in ways that makes minority business formation difficult, institute welfare programs that don't allow people on those programs to build up any capital/savings or even save up to buy a car, etc.



Doctors do a lot of pro bono work, and when they don't, they give people payment plans to pay their bills. People without insurance are not denied health care.

If portability is a problem, then they can outlaw insurance companies from refusing people for preexisting conditions. It'd save us $trillions.



I guess in Canada, "most" means something less than 1/6th.



Businesses in most places are not required to provide insurance. They do it as a benefit (there's other benefits, like retirement plans) for their workers. Mandating these heavy costs be imposed on business is going to reduce the number of jobs and make it difficult for small businesses to get started or succeed. Not a brilliant thing to do.


You're confusing going without insurance vs. going without health care.

Pro bono work done by doctors is a christian thing to do, I presume.

african americans most be the dumbest ppl in the world if all what u said was true because they overwhelming vote democrat. fyi- many repubicans didnt even have the decency to vote for the mlk holiday. and lest we forget that the civil rights legislation was passed by LBJ (a democrat) and that goes for almost anything meaningful to african americans.

1) if u got shot in america and u were uninsured, u would be admitted to the hospital and treated. if i were to juxtapose that same scenario to sri lanka (a war torn, third world nation bogged down by hyperinflation and every other economic shock) u would also be treated even if u didnt have penny to your name like in that american scenario. although, in america u would walk out indebted probably in the hundreds of thousands of dollars, while in sri lanka u would walk out in the same socio-economic position u came in. to reiterate- the greatest trigger of personal bankruptcy in america is exorbitant health care bills.

2) i should have used "many" but the nearly 50 million without coverage and the many who are deemed to have a preexisting condition when life saving surgery is required are the ones i was referring to.

3) if u were graduating from college with degree in actuarial science (its in demand profession) and u had a choice between a company that offered health care coverage and one which didnt, i would suspect u would choose the one that had. companies compete for talent and providing coverage as become a necessary cost. plus, i heard companies can now opt for the potentially cheaper govt option if passed so that again is a huge savings in these uncertain times.

4) i think your confusing going without coverage and just not being able to afford it or deemed not worthy by the insurance company. i highly doubt a single mother wouldnt purchase coverage if she could afford it. btw, should these good samaritan doctors = socialists be eradicated because they are undermining the integrity of your world renowned system? doctors need incentives to practice right? fyi- obama has changed his campaign position on forcing ppl to purchase the govt plan.

 

[Denny Crane]

african americans most be the dumbest ppl in the world if all what u said was true because they overwhelming vote democrat. fyi- many repubicans didnt even have the decency to vote for the mlk holiday. and lest we forget that the civil rights legislation was passed by LBJ (a democrat) and that goes for almost anything meaningful to african americans.

LOL, you need to study up on your history.

The Republican Party here was the one that freed the slaves and then occupied the south with military troops to enforce civil rights. The KKK was started by Democrats in the South and they lynched black people and murdered Republicans who were there to help the newly freed slaves get educated and so on. This was certainly true from the 1850s through 1960, when the major black civil rights leaders supported Nixon against JFK in the election. Certainly true in 1968, when racist George Wallace ran as a democrat and lost the primaries, then ran as an independent and won a whole lot of Democrats' states.

That civil rights legislation that LBJ got passed was done with votes from nearly every republican and fewer of the democrats (who controlled congress). Maybe you're too young to remember Eisenhouer mobilizing the national guard to push the governor of Arkansas (Clinton's home town) away from blocking the High School doors, so the first black students could enter. Or maybe you don't remember JFK and RFK sitting on their hands while the Freedom Riders got the shit kicked out of them for letting black folks sit in the front of their buses as they went from town to town in the South.

But whatever.

1) if u got shot in america and u were uninsured, u would be admitted to the hospital and treated. if i were to juxtapose that same scenario to sri lanka (a war torn, third world nation bogged down by hyperinflation and every other economic shock) u would also be treated even if u didnt have penny to your name like in that american scenario. although, in america u would walk out indebted probably in the hundreds of thousands of dollars, while in sri lanka u would walk out in the same socio-economic position u came in. to reiterate- the greatest trigger of personal bankruptcy in america is exorbitant health care bills.

You'd much more likely die in Sri Lanka. They've got KIA, we've got state of the art everything and the best trained doctors, nurses, and research people ANYWHERE. The ERs here do not turn people away, whether they can pay or not.

2) i should have used "many" but the nearly 50 million without coverage and the many who are deemed to have a preexisting condition when life saving surgery is required are the ones i was referring to.

Hell, you can't even get arthritis treatment for 9 months in Canada. You can here. The system is superior here to anywhere else.

3) if u were graduating from college with degree in actuarial science (its in demand profession) and u had a choice between a company that offered health care coverage and one which didnt, i would suspect u would choose the one that had. companies compete for talent and providing coverage as become a necessary cost. plus, i heard companies can now opt for the potentially cheaper govt option if passed so that again is a huge savings in these uncertain times.

Actuaries make so much that the cost of insurance is in the noise.

4) i think your confusing going without coverage and just not being able to afford it or deemed not worthy by the insurance company. i highly doubt a single mother wouldnt purchase coverage if she could afford it. btw, should these good samaritan doctors = socialists be eradicated because they are undermining the integrity of your world renowned system? doctors need incentives to practice right? fyi- obama has changed his campaign position on forcing ppl to purchase the govt plan.

My father was a doctor, my mother a nurse. Both retired. I grew up listening to them gripe about how long it took to get paid by the government (medicare, medicaid), and how they needed a large staff of people just to do all the paperwork. Maybe that's where some of the costs come from.

 

[deception]

http://www.independent.co.uk/news/w...-tactics-to-sell-healthcare-plan-1748285.html

Case study: Left to pick up $165,000 bill

Greg Douglas of Maine was out of luck when he flipped his pick-up truck and his flying tool box broke his collar bone and several ribs.

As he was rushed to hospital – where he would remain for nearly a month – he thought the insurance his wife had through her waitressing job would see them through. It didn't.It turned out that the restaurant group that employs his wife, Pam Douglas, had weeks before switched insurers and the new firm baulked at paying the costs of the hospital stay, leaving the family to pay $165,000. Neighbours did their best to help, raising $3,000. "The town put on this benefit," said Mrs Douglas. "Nobody had ever seen so many people. I cried the whole time." It has helped, but not much.