Repeal health law? Poll shows many think it should do more

[Dr.House]

The democratics should definitely run on "We need to add more to the healthcare bill."....

 

[snjmom]

Health costs are actually responsive to the market. Look at the costs for every elective surgery like Lasiks or breast implants and you'll see the cost has gone down over the years. Why? Because people ahve to pay for that themselves. So they shop. And providers have to make it affordable for the same reason.

The reason elective surgery can compete on a price basis is that it is elective. How much shopping are you going to do when you have a heart-attack or suddenly begin bleeding from your eyes or a tree branch pierces your thigh while you are sitting on a park bench having lunch?

Price is not a rational mechanism for distributing health care. We need to rein in costs, which are going to effect profits, hence fought against tooth and nail. Evidence based standards of practice with profit incentives based on the wellness of a patient instead of how many procedures and machines you use have to be implemented in order to get any real reform.

 

[The Rabbi]

Health costs are actually responsive to the market. Look at the costs for every elective surgery like Lasiks or breast implants and you'll see the cost has gone down over the years. Why? Because people ahve to pay for that themselves. So they shop. And providers have to make it affordable for the same reason.

The reason elective surgery can compete on a price basis is that it is elective. How much shopping are you going to do when you have a heart-attack or suddenly begin bleeding from your eyes or a tree branch pierces your thigh while you are sitting on a park bench having lunch?

Price is not a rational mechanism for distributing health care. We need to rein in costs, which are going to effect profits, hence fought against tooth and nail. Evidence based standards of practice with profit incentives based on the wellness of a patient instead of how many procedures and machines you use have to be implemented in order to get any real reform.

Unfortunately for your argument, most health care expenses do not come from emergency situations. Most doctor visits are in fact for minor things, or nothing at all.
And those things that become emergencies can be incentivized so they aren't. Make people more responsible financially and they will take steps to eliminate risk factors like obesity and smoking.

 

[Greenbeard]

Most health care spending in the U.S. isn't for minor things, it's for the treatment of chronic conditions afflicting a relatively small (but growing) slice of the population.

However, actual spending is distributed unevenly across individuals, different segments of the population, specific diseases, and payers. For example, analysis of health care spending shows that:

• Five percent of the population accounts for almost half (49 percent) of total health care expenses.
• The 15 most expensive health conditions account for 44 percent of total health care expenses.
• Patients with multiple chronic conditions cost up to seven times as much as patients with only one chronic condition.

[...]

Half of the population spends little or nothing on health care, while 5 percent of the population spends almost half of the total amount.2 In 2002, the 5 percent of the U.S. community (civilian noninstitutionalized) population that spent the most on health care accounted for 49 percent of overall U.S. health care spending (Chart 1, 40 KB). Among this group, annual medical expenses (exclusive of health insurance premiums) equaled or exceeded $11,487 per person.

In contrast, the 50 percent of the population with the lowest expenses accounted for only 3 percent of overall U.S. medical spending, with annual medical spending below $664 per person. Thus, those in the top 5 percent spent, on average, more than 17 times as much per person as those in the bottom 50 percent of spenders.2

That same population also often faces high out-of-pocket spending (e.g. almost one in five were spending more than 20% of their income on care out-of-pocket), so it's not the case that simply making their deductibles higher would magically make their chronic conditions disappear.

The reality is that most people spend virtually nothing on care--and I don't just mean individually, I mean cumulatively. The spending on the bottom half is adding up to 3 percent of spending.

To those who say Medicare is bankrupting us, the reason should be obvious: a disproportionate share of the elderly population belongs to that disproportionately expensive share of health spenders.

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.

Some, unsurprisingly, get the causality completely backwards and believe insuring that population (through Medicare) is expensive because the government is doing it. No, the government is doing it because that population is expensive (and thus the private sector has no incentive to do it). What's your solution? Cut care to the elderly? Stop treating chronic conditions?

There is unnecessary care out there, lots of it. But unless your solution is to throw the baby out with the bathwater and just cut care indiscriminately for anyone receiving it, the answer is a strategic approach: realigning incentives to reduce the imperative for more volume, coordinating care (particularly for those with chronic conditions), and a more data-driven, science-based approach to medicine in general.

And, yes, that involves lots more comparative effectiveness research (compiled and readily available through the Patient-Centered Outcomes Research Institute) so we stop paying for useless procedures.

During the past decade, the New England Journal of Medicine twice published studies showing that in comparisons arthroscopic surgery and nothing were equally effective treatments for knee pain, the Milwaukee Journal Sentinel reports. "One of the paradoxes of modern medicine is a procedure can gain wide acceptance without good evidence of its effectiveness -- yet once widely adopted, numerous studies must be done to persuade doctors that the procedure doesn't work." That's a problem when it comes to efforts to use science to combat the steep growth of health costs. "The hope is that comparative-effectiveness research can reduce spending on treatments that are ineffective or no more effective than less expensive alternatives, and, in some cases, may actually be harmful." But, only if the research finds acceptance.

 

[The Rabbi]

Thanks for this support to my position.
Yes, a lot of spending is on chronic conditions. Those conditions are frequently linked to life style issues like obesity and smoking. Make disincentives to do those things, like higher premiums, and they will tend to go away.
Glad we agree here.

 

[Greenbeard]

Are you sidestepping the point that was explicitly noted in my post about the most expensive folks already experiencing a heavy burden from cost-sharing?

Out-of-pocket costs can impose a significant financial burden on individuals and families. These expenses include deductibles, copayments, and payments for services that are not covered by health insurance. Over half the people in the top 5 percent of all health care spenders had out-of-pocket expenses (not including out-of-pocket health insurance premiums) over 10 percent of family income. More specifically:

• Thirty-four percent had out-of-pocket medical expenses that exceeded 10 percent of family income.
• Eighteen percent had out-of-pocket expenses in excess of 20 percent of family income.

Apparently that disincentive didn't work.

 

[RDD_1210]

Thanks for this support to my position.
Yes, a lot of spending is on chronic conditions. Those conditions are frequently linked to life style issues like obesity and smoking. Make disincentives to do those things, like higher premiums, and they will tend to go away.
Glad we agree here.

LOL, just like my article supported your position???? LMAO!!

I'm still waiting for you to quote me the portion of the article that supported your claim.

Cue insults in 3,2,1.......

 

[RDD_1210]

Are you sidestepping the point that was explicitly noted in my post about the most expensive folks already experiencing a heavy burden from cost-sharing?

Out-of-pocket costs can impose a significant financial burden on individuals and families. These expenses include deductibles, copayments, and payments for services that are not covered by health insurance. Over half the people in the top 5 percent of all health care spenders had out-of-pocket expenses (not including out-of-pocket health insurance premiums) over 10 percent of family income. More specifically:

• Thirty-four percent had out-of-pocket medical expenses that exceeded 10 percent of family income.
• Eighteen percent had out-of-pocket expenses in excess of 20 percent of family income.

Apparently that disincentive didn't work.

He's been side stepping all thread. Even when he can't do basic math. Side stepping is what is best at. Save your breath with him.

 

[The Rabbi]

Are you sidestepping the point that was explicitly noted in my post about the most expensive folks already experiencing a heavy burden from cost-sharing?

Out-of-pocket costs can impose a significant financial burden on individuals and families. These expenses include deductibles, copayments, and payments for services that are not covered by health insurance. Over half the people in the top 5 percent of all health care spenders had out-of-pocket expenses (not including out-of-pocket health insurance premiums) over 10 percent of family income. More specifically:

• Thirty-four percent had out-of-pocket medical expenses that exceeded 10 percent of family income.
• Eighteen percent had out-of-pocket expenses in excess of 20 percent of family income.

Apparently that disincentive didn't work.

95% of the population accounts for over 50% of the spending. There is your incentive population right there.
Case closed.

 

[snjmom]

Rabbi, only a twat would fawn over ideology in the face of overwhelming evidence. What's that saying about having only a hammer makes everything look like nails?

Economic theory doesn't hold all the answers anymore than physics or biology do.

Try a TED Talk. The pay off of a population in good health with a decent education whatever their economic class gets passed over by the invisible hand. Don't treat that hand like a crutch. Take some responsibility for your contribution to civilization.

 

[Harry Dresden]

LOL, Charles_Main doesn't have insurance so I asked how he planned to pay in the situation I proposed......So your chiming in with your baseless comment about insurance picking up the rest was pointless and doesn't even make sense. Please try and keep up, you're not making yourself look good by commenting on things you don't understand.

FUCK YOU.....another dipshit who only thinks HE understands whats going on...do you and Dean take turns rubbing each others feet?......

And there it is......stay classy and uninformed.

of course YOUR the informed one around here right?......you sound like your boyfriend Dean.....one things for sure....your both assholes....

 

[RDD_1210]

FUCK YOU.....another dipshit who only thinks HE understands whats going on...do you and Dean take turns rubbing each others feet?......

And there it is......stay classy and uninformed.

of course YOUR the informed one around here right?......you sound like your boyfriend Dean.....one things for sure....your both assholes....

YOU'RE

And yes, on this topic at least, I am informed. What have you contributed thus far besides insults?

 

[Mr. Shaman]

Gee.....didn't Republicans say they WANTED people to have more-of-a-choice, regarding health-care??? ​

"Repealing President Barack Obama's health-care overhaul is a major goal of House Republicans' "Pledge to America," the agenda unveiled on Sept. 23. Total repeal is a long shot, even if the Republicans win control of the House in upcoming midterm elections. So Republicans are preparing a starve-the-beast approach—cutting off taxpayer funds that government agencies will need to issue new regulations and oversee expansion of insurance coverage.

GOP strategists are already plotting how they can defund health care, starting with sitting on the President's 2012 budget request, due in February. Aides to Representative Eric Cantor (R-Va.), the second-ranking House Republican, have carved out other ways they hope to choke off new health programs. Among the targets, they say, is funding for the health insurance exchanges that states are supposed to create so consumers can compare plans and buy coverage.

Also in their sights are the new agency meant to oversee research comparing the effectiveness of treatments and any funds Obama requests to hire federal workers to implement the law."

 

[Harry Dresden]

And there it is......stay classy and uninformed.

of course YOUR the informed one around here right?......you sound like your boyfriend Dean.....one things for sure....your both assholes....

YOU'RE

And yes, on this topic at least, I am informed. What have you contributed thus far besides insults?

your the one who threw the first shot Alf......