$12,000 voucher?

[boedicca]

We do not and won't do that so your question is idiotic.

Thank you for providing yet more proof of that the progressive agenda is intellectually bankrupt.

What healthcare in this country is unlimited and free?

Government provided healthcare is unlimited unless you want to admit that it is rationed.

And for many of those who consume it, it is free.

 

[The Rabbi]

The voucher amount is roughly equivalent to what Medicare spends today. Most seniors buy medigap coverage already.
The myth is that we can continue funding Medicare at current levels. Even Obama's budget does not call for that. With his cuts there will be insufficient funds to cover all claims. What is his solution? Panels of experts to figure it all out. Doesn't that make you feel better?
The result of that of course is that we will get death panels and rationed care.

 

[boedicca]

At least with insurance companies, there are appeals processes.

Under ObamaCare, there won't be any as it will be impossible to find somebody who can make a decision independently other than Sebelius, Berwick and a handful of overseers who will be protected from The Public by an army of bureaucrats.

 

[chikenwing]

$12,000 VOUCHER?

GOP has a lot of explaining to do on how a private healthcare provider can insure a senior for a $12,000 voucher and provide affordable and efficient healthcare. And how seniors can afford it. For instance, a senior who gets $1,000 a month in Social Security and cannot pay premiums, co-pays and deductions for medical service. If a senior make a trip to ER for a fall it can cost $10,000, Rehab stay, $25,000 after a costly hospital and hip surgery. Plus a walker and other medical supplies. Seniors have healthcare problem that younger people do not have. A senior getting $1,000 in Social Security qualify for Medicaid assistance that pay Medicare premiums, co-pays, deduction, a power chair, hip replacements, MIRs, Rehab straw with physical therapy, home health nurse, etc. In other words low income senior do not pay anything for medical care except for co-pay for prescriptions. Medicaid pays the 20% that Medicare do not pay. Seniors make lots of trips to ER.

Private Healthcare Providers cannot afford to insure senior for a $12,000 voucher without going bankrupt or charging senior high co-pays and deduction, etc. And most senior will not be able to afford private healthcare insurance.

Voucher program for seniors is a joke that private healthcare cannot afford and seniors cannot afford either.

What is the advantage of being able to choose which private healthcare provider you want? Is one be able to provide more benefits than the other? Will one cost more depending on the benefits it provide? What do a senior get for $12,000? Will all the vouchers be for $12,000?

I would like to here the GOP explain how the voucher will work beside being able to choose the plan they want. That is all I have heard so far and I cannot see the advantage is doing that. There are two kind of seniors. Low income and higher income depending on their Social Security. Will a voucher cover long term healthcare in a rest home, etc?

Who's paying your bill now?

 

[NYcarbineer]

Thank you for providing yet more proof of that the progressive agenda is intellectually bankrupt.

What healthcare in this country is unlimited and free?

Government provided healthcare is unlimited unless you want to admit that it is rationed.

And for many of those who consume it, it is free.

What healthcare in this country is unlimited and free?

Specifically. Name the programs, and show how each of them is unlimited and free.

 

[NYcarbineer]

Thank you for providing yet more proof of that the progressive agenda is intellectually bankrupt.

What healthcare in this country is unlimited and free?

No kidding! If there is such a plan, who needs healthcare insurance from the private sector? Count me in!!!

boedicca has some mental problems.

 

[NYcarbineer]

Giving you a voucher to buy private health insurance is forcing you, under threat of financial penalty,

to buy a service/product from a private company.

Isn't that what the Right pretty much unanimously claimed was the unconstitutional part of so-called Obamacare?

I've yet to see anyone on the Right make an attempt to dispute this.

Fascinating.

 

[chikenwing]

We need to simply nationalize senior care and make it similar to veteran's healthcare.

mmmmmmmmmmmm thought veterans care was terrible. How would it be better than what we have now,how would we fund it?

A few details,beside a simplistic blast.

 

[Greenbeard]

But if I had a voucher for 1000 a month for health care? I'm golden, and I'm 40. Just because it doesn't work for the 2% of the population that are medical train wrecks doesn't mean it won't work outstandingly well for the other 98%

That's great. Except the $8,000 voucher is being offered as a substitute for Medicare, which serves the elderly (and some disabled folks). Which happens to be a demographic in which high health costs are concentrated:

Older People Are Much More Likely To Be Among the Top-spending Percentiles

The elderly (age 65 and over) made up around 13 percent of the U.S. population in 2002, but they consumed 36 percent of total U.S. personal health care expenses. The average health care expense in 2002 was $11,089 per year for elderly people but only $3,352 per year for working-age people (ages 19-64).5 Similar differences among age groups are reflected in the data on the top 5 percent of health care spenders. People 65-79 (9 percent of the total population) represented 29 percent of the top 5 percent of spenders. Similarly, people 80 years and older (about 3 percent of the population) accounted for 14 percent of the top 5 percent of spenders (Chart 2, 40 KB).2 However, within age groups, spending is less concentrated among those age 65 and over than for the under-65 population. The top 5 percent of elderly spenders accounted for 34 percent of all expenses by the elderly in 2002, while the top 5 percent of non-elderly spenders accounted for 49 percent of expenses by the non-elderly.4

A principal reason why health care spending is spread out more evenly among the elderly is that a much higher proportion of the elderly than the non-elderly have expensive chronic conditions.

All of the proposals so far boils down to 2 main concepts: the gov't, in the form of the IPAB, will set HC prices to reign in costs, or the free market does through insurance companies. There really isn't a 3rd option out there as far as I know.

Yes, there is a third option and it's the one that's (tentatively, to be sure) being pursued: increasing value in the health system. That is, focusing on quality (and here we want to specifically hone in on health outcomes) achieved per dollar spent. That's not to say it's entirely orthogonal to what you're talking about but it is very different philosophically and, in certain applications, practically.

 

[The Rabbi]

Yes, there is a third option and it's the one that's (tentatively, to be sure) being pursued: increasing value in the health system. That is, focusing on quality (and here we want to specifically hone in on health outcomes) achieved per dollar spent. That's not to say it's entirely orthogonal to what you're talking about but it is very different philosophically and, in certain applications, practically.

In other words you want a system that cannot be quantified, its costs cannot be estimated, and its results unknowable.
Sounds like a winner.
When do you finish freshman year again?

 

[Greenbeard]

In other words you want a system that cannot be quantified, its costs cannot be estimated, and its results unknowable.

Apart from total national expenditures data, you're describing the system we have now. I'm advocating explicitly for a significantly more quantifiable system. That's one of the centerpieces of what I'm talking about.

 

[Brutus]

Thank you for providing yet more proof of that the progressive agenda is intellectually bankrupt.

The liberal will lack the IQ to understand capitalism so can't understand the beauty of the Ryan plan. The $12,000 voucher represents the same amount the Obama plan would spend per person that year.

The difference in the Ryan plan, from the Obama plan, is that seniors would get to shop for the best plan for them. Thus there would competition among providers to offer lower prices and better services. Capitialism requires competition and thusly produces higher and higher standards of living. The liberal socialist Obama plan has no mechanism to lower prices and improve our standard of living which would soon reach soviet standards if BO had his way.

Imagine someone who jogs for fun and someone who races in life and death "competition"? Who would be a faster runner? Now you understand competion and how it makes us better. Its hard for a liberal to grasp but please try your hardest. Thanks

 

[The Rabbi]

In other words you want a system that cannot be quantified, its costs cannot be estimated, and its results unknowable.

Apart from total national expenditures data, you're describing the system we have now. I'm advocating explicitly for a significantly more quantifiable system. That's one of the centerpieces of what I'm talking about.

NO, the system we have now has definite fixed costs (very fixed) with very quanitifiable results.
G-d only knows what you're talking about.

 

[Greenbeard]

The difference in the Ryan plan, from the Obama plan, is that seniors would get to shop for the best plan for them. Thus there would competition among providers to offer lower prices and better services. Capitialism requires competition and thusly produces higher and higher standards of living. The liberal socialist Obama plan has no mechanism to lower prices and improve our standard of living which would soon reach soviet standards if BO had his way.

Elsewhere:

For me, it is that it assumes free market solutions won't work without being able to explain why. My own view is that they lack the IQ to do so.

As was already pointed out to you, an exchange is a market--indeed, the concept is the very same as the one that anchored Paul Ryan's health reform bill and it's the concept behind ruby red Utah's ongoing reorganization of its small group market.

an insurance exchange is not a free capitalist market because it is mandated and managed by the government! Is that really over your head?

Hmm.

 

[Greenbeard]

NO, the system we have now has definite fixed costs (very fixed) with very quanitifiable results.

Why do you think people throw around mortality rates when trying to characterize health systems? Because good outcomes measures are hard to come by. Real quality measurement (i.e. quantifying results) still has a long, long way to go. What's popular now for gauging quality? HEDIS measures, which are almost uniformly process measures--indeed, they're generally obtained from claims data, they don't even delve into actual clinical data.

The transition to electronic health records is starting to move the needle on that a bit but valid, reliable outcomes measures that draw from clinical data are still in the future. So what are some basic things we need to get toward the health system I'm describing (and you're imagining we already have)?

• Valid metrics. There's a lot of movement in this area right now (see what organizations like NCQA and NQF have in the works, and agencies like AHRQ) but we've got a long way to go.
• Public reporting requirements (or at least inducements) on valid metrics. We've got some of that now and more coming down the pike via ACA but, as noted, that's mostly on process measures. Not a bad place to start but not the Holy Grail of quality measurement. So this one's still developing.
• Capacity for reliable, valuable quality reporting. This is part of the promise of electronic health records.
• Data on comparative effectiveness. We don't just need to know and track how we're doing on quality, it would be helpful to have a better idea of what works and when. Broad-based research is being funded in this area now and other advancements (like EHRs--see my thread a ways down about point-of-care clinical studies) also stand to help out on this front.

All of that's about better identifying value; once we get better at spotting it, we'll get better at paying for it (and not paying for its absence).

All of this, all of it, is about being able to quantify the important aspects of our system and in so doing align payment with health outcomes--in other words, ultimately become able to price health as an output good. Crazy thought that someday health might be the widget we're buying from our health care system. But it's going to take data and knowledge, and you're absolutely right that this is all about being able to quantify things.

That's one of the key concepts behind the focus on value. Welcome to the club.

 

[The Rabbi]

So an unreliable, untested theoretical system is your answer? And you accuse Ryan of dismantlng Medicare???

 

[Greenbeard]

So an unreliable, untested theoretical system is your answer?

No.

 

[NYcarbineer]

Thank you for providing yet more proof of that the progressive agenda is intellectually bankrupt.

The liberal will lack the IQ to understand capitalism so can't understand the beauty of the Ryan plan. The $12,000 voucher represents the same amount the Obama plan would spend per person that year.

The difference in the Ryan plan, from the Obama plan, is that seniors would get to shop for the best plan for them. Thus there would competition among providers to offer lower prices and better services. Capitialism requires competition and thusly produces higher and higher standards of living. The liberal socialist Obama plan has no mechanism to lower prices and improve our standard of living which would soon reach soviet standards if BO had his way.

Imagine someone who jogs for fun and someone who races in life and death "competition"? Who would be a faster runner? Now you understand competion and how it makes us better. Its hard for a liberal to grasp but please try your hardest. Thanks

Our healthcare is the most expensive in the industrialized world and also the most capitalistic.

So you're full of shit.

 

[NYcarbineer]

You really want your grandmother, or someday your mother, or someday YOU, in your 70's and beyond if you make it that far,

fighting day by day with some for-profit insurance company over what they'll pay or won't pay, fighting with a business whose business plan is to collect the most amount of premium possible and pay out the least amount possible?

For what purpose? For what good? How will your life be better? How will your senior years be better? How will the country be better?

 

[KissMy]

Medicare was created because nobody wants to insure 70-90 year olds

What makes Ryan think that private insurers would jump at the chance to insure a 75 year old man with diabetes and a heart condition?

How much care will a 75 year old man with diabetes and a heart condition get under the Original Obamacare Plan? It was going to be a whole lot less than what a current 75 year old man with those conditions is getting now. The Original Obamacare Plan showed a steep decline in care after age 51.