Pre-existing conditions coverage

[Andylusion]

Graduate Medical Education - Health Affairs

The Department of Health and Human Services (HHS), through the Centers for Medicare and Medicaid Services, is the single largest funder of graduate medical education (GME). This is the training that medical school graduates receive as residents in more than 1,000 of the nation's hospitals, known as "teaching" hospitals. These trainees are a key part of the labor supply at these hospitals.

In my home town where I grew up, the city counsel decided to increase taxes on business. Over the course of 10 years or so, businesses slowly moved out of the town, until entire malls formerly filled with business, were nearly deserted.

The idiots at city hall decided to promote business, by offering a coupon system, that specifically worked at local businesses. So someone could get the coupon for $10, and only redeem it at a local business. The program worked, but quickly racked up some large costs, which the city then increased business taxes to pay for.

This caused even more business to leave the area, and soon the coupons were nearly useless as there was so few businesses to redeem them at.

Finally, some city counsel politician grew a brain, and decided.... how about we just cancel the coupon program, and simply reduce taxes, so that business can succeed?

Crazy idea. They did it. And today both of the malls that I went to as a kid, that had been nearly abandoned by the time I was in high school, are both filled with stores, and with customers today.

Our government has implemented policies and regulations that have drastically driven up the cost of getting a medical degree. Additionally, they have also driven up the cost of running a practice, and created a Medicare and Medicaid system that under pays.

And here you are, promoting the government tossing a tiny bone, in the form of a grant to help train new doctors.

Here's a thought..... instead of regulating and taxing the hell out of the industry, and giving out a 'coupon' to train new doctors..... how about you just make being a doctor more profitable, and getting a medical degree less difficult?

Crazy idea huh?

 

[Bfgrn]

There isn't anything that the government does where they just "pay the bills". There are always all kinds of strings attached.

Check out medicare. They don't even pay enough to incent doctors to take on new patients. Now, that's health care for you.

I am 78 years old and my primary coverage is Medicare, with a supplement to cover the co-pay. I have never had a medical provider turn down providing services to me. If there are medical providers who won't accept Medicare, shame on them.

Of course our medical providers in my area aren't so greedy as those in some other areas.

It's pretty easy to just claim that others are greedy. That's fine.... but not true.

Have you ever worked in a doctors office? Have you ever seen the cost of running a general practice? Likely not.

I don't know what you did for a living, but if the cost of doing your job continued to climb, until you were not making the living you got the job to get, would you keep doing it?

Chances are you would not. Is that because you are greedy? Likely not.

If you got a 4-year degree in accounting, to earn a $60,000 income, and 10 years later you were earning $30,000, would you continue to work there?

No you would not.

Here's the bottom line. Medicare, and Medicaid, both do not pay out enough money to cover the cost of treatment. The payouts are low.

Doctors don't work for a middle income wage. Nor should they.

Remember Obama going to the Mayo Clinic? One of the leading clinics in the whole country? Remember that? Remember how he said Mayo was a model of health care?

Mayo Clinic Makes Medicare, Medicaid Cuts | Heartlander Magazine

The controversy over below-market government reimbursement rates has led the famed Mayo Clinic to close off access for many Medicare and Medicaid patients.

According to Mayo, Medicare was reimbursing doctors at the Mayo Clinic in Arizona for only about 50 percent of the cost of the primary care treatment they were providing, leading Mayo to make the decision to opt out of Medicare.

The Mayo Clinic that Obama praised, canceled Medicare and Medicaid.

Why? Because Medicare and Medicaid was only paying out 50% of the costs in treatment they were providing. So no more Medicare and Medicaid.

If you want the best health care in the US today, at the Mayo Clinic, Medicare and Medicaid patients need not apply. Show up with cash, or private insurance. No Medicare and Medicaid.

Now if you want to say they are greedy for not losing money, fine.... but if *YOU* were the one not getting paid, you wouldn't do it either. Welcome to reality.

Where do you come up with this 50% shit?

How Insurance Treats Your Physician

Reimbursement is how your physician gets paid by insurance. Some is paid by the patient, but most is paid by private insurance or programs like Medicare. But there is alot that we as patients don't know about the system of paying physicians and other practitioners or facilities.

Although Medicare was never meant to be used as a guide for private health insurance physician payment schedules, insurance companies and health plans have based their rates of payment on Medicare. No matter how much we pay for private insurance, their payment to physicians is either slightly above Medicare rates (for better insurance companies) or BELOW Medicare rates. It is not uncommon for some insurance companies to pay 10-20% LESS than Medicare.

 

[natstew]

C and P from the other thread:

Is the "feel-good" part the fact that we aren't required to explain to them, when very ill, that actual Capitalism would drop them like a hot rock if it were allowed to and tell them never to return? That once sick, if unregulated, no insurance company would ever cover them again and no employer would hire them given the chance? Yeah, that would make you feel-good I bet.

There you go, dodging the question again, classical Liberal response.

 

[jillian]

C and P from the other thread:

Is the "feel-good" part the fact that we aren't required to explain to them, when very ill, that actual Capitalism would drop them like a hot rock if it were allowed to and tell them never to return? That once sick, if unregulated, no insurance company would ever cover them again and no employer would hire them given the chance? Yeah, that would make you feel-good I bet.

There you go, dodging the question again, classical Liberal response.

perhaps you just don't understand his point

wait... not perhaps....

 

[Bfgrn]

Graduate Medical Education - Health Affairs

The Department of Health and Human Services (HHS), through the Centers for Medicare and Medicaid Services, is the single largest funder of graduate medical education (GME). This is the training that medical school graduates receive as residents in more than 1,000 of the nation's hospitals, known as "teaching" hospitals. These trainees are a key part of the labor supply at these hospitals.

In my home town where I grew up, the city counsel decided to increase taxes on business. Over the course of 10 years or so, businesses slowly moved out of the town, until entire malls formerly filled with business, were nearly deserted.

The idiots at city hall decided to promote business, by offering a coupon system, that specifically worked at local businesses. So someone could get the coupon for $10, and only redeem it at a local business. The program worked, but quickly racked up some large costs, which the city then increased business taxes to pay for.

This caused even more business to leave the area, and soon the coupons were nearly useless as there was so few businesses to redeem them at.

Finally, some city counsel politician grew a brain, and decided.... how about we just cancel the coupon program, and simply reduce taxes, so that business can succeed?

Crazy idea. They did it. And today both of the malls that I went to as a kid, that had been nearly abandoned by the time I was in high school, are both filled with stores, and with customers today.

Our government has implemented policies and regulations that have drastically driven up the cost of getting a medical degree. Additionally, they have also driven up the cost of running a practice, and created a Medicare and Medicaid system that under pays.

And here you are, promoting the government tossing a tiny bone, in the form of a grant to help train new doctors.

Here's a thought..... instead of regulating and taxing the hell out of the industry, and giving out a 'coupon' to train new doctors..... how about you just make being a doctor more profitable, and getting a medical degree less difficult?

Crazy idea huh?

Your little story is totally non sequitur. Apples and hand grenades.

Crazy?

Let's start destroying the fairy tales created in your simple mind of good guys (private sector) and bad guys (government).

What do you know about the American Medical Association/Specialty Society Relative Value Scale Update Committee, or RUC and how DOCTORS decide Medicare reimbursement?

AND...


How Much do Hospitals Cost Shift? A Review of the Evidence

Abstract:
Context: Hospital cost shifting - that private payers are charged more in response to shortfalls in public payments - has long played a role in debate over health care policy.

Findings: Analyses and commentary based on descriptive, industry-wide hospital payment-to-cost margins by payer provides a false impression that cost shifting is a large and pervasive phenomenon. More careful theoretical and empirical examinations suggest that cost shifting can and has occurred, but usually at a relatively low rate. Margin changes are also strongly influenced by the evolution of hospital and health plan market structures and changes in underlying costs.

AND...

Insurance Companies Settle Lawsuits on Physician Reimbursement

Insurance companies have consistently underpaid physicians over the last decade. After trying to find cooperative ways to resolve the problem, a class-action lawsuits on behalf of physicians has begun to produce some results, but much more is needed. While it is unfortunate that physicians had to resort to lawsuits to be treated fairly, we hope these outcomes will motivate other health plans to be more ethical and fair in their relationships with physicians and patients.

AND...

Bitter Pill: Why Medical Bills Are Killing Us

Steven Brill’s 24,000-word magnum opus in Time on health care billing practices in the United States is remarkably easy to summarize: American health care costs a lot because the prices Americans pay for health care services are very high. And hospitals charge those high prices for the same reason any other business would—because they can.

It’s easy to see why a health care provider is almost uniquely well-positioned to bilk you. If you don’t get treatment, you or someone you love might die. It’s a high-pressure emotional situation that makes it extremely difficult to bargain, comparison shop, or just decide to cut back. Most of us, fortunately, get to outsource most of that bargaining to our insurance companies. Cold-blooded executives, not stressed-out patients, cut the deals that determine how much actually gets paid. This means that the real price of health care services is driven largely by the purchasing clout of the buyer. An uninsured individual gets totally screwed. A big insurance company can drive a harder bargain and get a better deal. But as Brill shows, the best deal of all goes to the biggest insurer around: the federal government, whose Medicare program for senior citizens is such a large purchaser that it and it alone can drive a truly hard bargain and squeeze provider profit margins to the bone.

The policy upshot of this seems clear enough. Rather than cutting Medicare as is currently all the rage in deficit-hawk circles, we ought to be expanding it and enlarging the cheapest and most cost-effective part of the American health care system.

But of course only left-wing crazies think that, so though Brill concedes that this is precisely the reason that more-statist foreign health care systems have much lower costs than ours, he rejects the idea out of hand.

But Brill’s reason for rejecting the idea is interesting. He doesn’t care a fig for the hospitals, which are the villains of his story. Rather he rejects Medicare expansion because if Medicare expanded, “no doctor could hope for anything approaching the income he or she deserves (and that will make future doctors want to practice) if 100% of their patients yielded anything close to the low rates Medicare pays.” It’s true that many American doctors do believe that they would be crushed if they were paid only Medicare rates. They insist they’re hard-pressed as it is, barely getting by, and practically treat these Medicare cases as acts of charity. There’s no way they could swallow those reimbursement rates without the whole system collapsing.

But that’s not remotely true. The last time the OECD looked at this (PDF), they found that, adjusted for local purchasing power, America has the highest-paid general practitioners in the world. And our specialists make more than specialists in every other country except the Netherlands. What’s even more striking, as the Washington Post’s Sarah Kliff observed last week, these highly paid doctors don’t buy us more doctors’ visits. Canada has about 25 percent more doctors’ consultations per capita than we do, and the average rich country has 50 percent more. This doctor compensation gap is hardly the only issue in overpriced American health care—overpriced medical equipment, pharmaceuticals, prescription drugs, and administrative overhead are all problems—but it’s a huge deal.

Doctors aren’t as politically attractive a target as insurance companies, hospital administrators, or big pharma, but there’s no rational basis for leaving their interests unscathed when tackling unduly expensive medicine.

If doctors earned less money, fewer people would want to be doctors. We could offset some of that impact by helping doctors out with medical malpractice reform and more government funding for medical school tuition. But a shortage of people wanting to enter the medical pipeline is the last thing we should be worrying about. As it stands, medical school is getting harder to get into (continuing a longtime trend) even as it gets harder for medical school graduates to find residency slots. What’s more, in the 18 states where lesser-paid nurse practitioners are allowed to do primary care without a doctor’s supervision, their treatment is just as good in terms of health outcomes and better in terms of patient satisfaction. Any shortage of primary caregivers, in other words, is about bad rules limiting the number of people who can practice, not a lack of monetary incentives. We need more residencies and more scope for nurses to work unsupervised, not higher-paid doctors.

When it comes to the federal budget, Medicare is a problem. An uncapped commitment to finance the health care needs of elderly Americans is a big challenge for an aging country. But when it comes to the question of health care costs overall, Medicare is the solution. Its vast bargaining clout lets it get much better prices than any private insurer, and we should be relying on it more to pay our bills, not less.

 

[The Rabbi]

That nonsense has been debunked over and over. One writer published an article in a Heritage publication and suddenly "conservatives" or "The GOP" invented the mandate.
Obama ran on the mandate in 08 and Hillary opposed it. Or vice versa, I can't remember. But not one GOP congressman voted for Obamacare or the mandate. How could it be their proposal and not one single person voted for it?

And here's the article debunking it. For the 10th time.
Don't Blame Heritage for ObamaCare Mandate | The Foundry: Conservative Policy News from The Heritage Foundation

Honesty has never been a conservative tenet.

Stuart Butler is LYING to you...

How the Heritage Foundation, a Conservative Think Tank, Promoted the Individual Mandate - Forbes

Avik Roy, Forbes Staff

Stuart Butler’s lecture describes what the Heritage’s mandate would look like:

"We would include a mandate in our proposal–not a mandate on employers, but a mandate on heads of households–to obtain at least a basic package of health insurance for themselves and their families. That would have to include, by federal law, a catastrophic provision in the form of a stop loss for a family’s total health outlays. It would have to include all members of the family, and it might also include certain very specific services, such as preventive care, well baby visits, and other items."

Taranto points out that the Heritage mandate was less onerous than the Obamacare one, as it focused on coverage for catastrophic illness, rather than the comprehensive health plans that Obamacare requires. “On the other hand, Butler’s vague language—‘it might also include certain very specific services…and other items’—would seem to leave the door wide open for limitless expansion,” he writes. “Whatever the particular differences, the Heritage mandate was indistinguishable in principle from the ObamaCare one. In both cases, the federal government would force individuals to purchase a product from a private company—something that Congress has never done before.”

So is Stuart Butler reliable when he advocates for a mandate and unreliable when he points out what he actually meant? Or vice versa?
As mentioned, I've never known the Democrats to take their marching orders from Heritage. Is this something new we can look forward to?

 

[Bfgrn]

That nonsense has been debunked over and over. One writer published an article in a Heritage publication and suddenly "conservatives" or "The GOP" invented the mandate.
Obama ran on the mandate in 08 and Hillary opposed it. Or vice versa, I can't remember. But not one GOP congressman voted for Obamacare or the mandate. How could it be their proposal and not one single person voted for it?

And here's the article debunking it. For the 10th time.
Don't Blame Heritage for ObamaCare Mandate | The Foundry: Conservative Policy News from The Heritage Foundation

Honesty has never been a conservative tenet.

Stuart Butler is LYING to you...

How the Heritage Foundation, a Conservative Think Tank, Promoted the Individual Mandate - Forbes

Avik Roy, Forbes Staff

Stuart Butler’s lecture describes what the Heritage’s mandate would look like:

"We would include a mandate in our proposal–not a mandate on employers, but a mandate on heads of households–to obtain at least a basic package of health insurance for themselves and their families. That would have to include, by federal law, a catastrophic provision in the form of a stop loss for a family’s total health outlays. It would have to include all members of the family, and it might also include certain very specific services, such as preventive care, well baby visits, and other items."

Taranto points out that the Heritage mandate was less onerous than the Obamacare one, as it focused on coverage for catastrophic illness, rather than the comprehensive health plans that Obamacare requires. “On the other hand, Butler’s vague language—‘it might also include certain very specific services…and other items’—would seem to leave the door wide open for limitless expansion,” he writes. “Whatever the particular differences, the Heritage mandate was indistinguishable in principle from the ObamaCare one. In both cases, the federal government would force individuals to purchase a product from a private company—something that Congress has never done before.”

So is Stuart Butler reliable when he advocates for a mandate and unreliable when he points out what he actually meant? Or vice versa?
As mentioned, I've never known the Democrats to take their marching orders from Heritage. Is this something new we can look forward to?

We've been over this before...maybe you just keep 'forgetting'...

When obstructionism prevents reforms and legislation that were part of your own Republican agenda, it becomes a form of domestic terrorism IMO.

Republicans were well aware that health care reform was paramount to repairing our economy and protecting the financial security of American families. McCain, and Republicans ALSO ran on promising health care reforms.

But Republicans made a conscious and collective decision to block and undermine any reform. Because it would be seen as a success for our President.

David Frum, the Republican and former economic speechwriter for George W. Bush was fired by the American Enterprise Institute for writing this op-ed, a right wing think tank whose 'scholars' ironically were ordered not to speak to the media on the subject of health care reform, because they agreed with too much of what Obama was trying to do.

Waterloo
by David Frum

At the beginning of this process we made a strategic decision: unlike, say, Democrats in 2001 when President Bush proposed his first tax cut, we would make no deal with the administration. No negotiations, no compromise, nothing. We were going for all the marbles. This would be Obama’s Waterloo – just as healthcare was Clinton’s in 1994.

This time, when we went for all the marbles, we ended with none.

Could a deal have been reached? Who knows? But we do know that the gap between this plan and traditional Republican ideas is not very big. The Obama plan has a broad family resemblance to Mitt Romney’s Massachusetts plan. It builds on ideas developed at the Heritage Foundation in the early 1990s that formed the basis for Republican counter-proposals to Clintoncare in 1993-1994.

-------------------------------------------------------------------------------------------------
The final irony:
The health care bill Obama and Democrats passed was not the reform liberals and progressives sought. It was and IS a carbon copy of the Republican bills proposed by Senator John Chafee, (R-R.I) and Senate Minority Leader Bob Dole in the early 1990's. Including the conservative idea...the individual mandate.

-------------------------------------------------------------------------------------------------

David Frum and the Closing of the Conservative Mind

Posted by Bruce Bartlett

As some readers of this blog may know, I was fired by a right wing think tank called the National Center for Policy Analysis in 2005 for writing a book critical of George W. Bush's policies, especially his support for Medicare Part D. In the years since, I have lost a great many friends and been shunned by conservative society in Washington, DC.

Now the same thing has happened to David Frum, who has been fired by the American Enterprise Institute. I don't know all the details, but I presume that his Waterloo post on Sunday condemning Republicans for failing to work with Democrats on healthcare reform was the final straw.

Since, he is no longer affiliated with AEI, I feel free to say publicly something he told me in private a few months ago. He asked if I had noticed any comments by AEI "scholars" on the subject of health care reform. I said no and he said that was because they had been ordered not to speak to the media because they agreed with too much of what Obama was trying to do.

 

[RKMBrown]

C and P from the other thread:

Is the "feel-good" part the fact that we aren't required to explain to them, when very ill, that actual Capitalism would drop them like a hot rock if it were allowed to and tell them never to return? That once sick, if unregulated, no insurance company would ever cover them again and no employer would hire them given the chance? Yeah, that would make you feel-good I bet.

If that were true, since everyone's been sick at least once. There would be no one left to insure.

But since that's to practical to consider you wouldn't want to even consider that huh? Nah just FORCE everyone to bend to your will, right?

 

[paperview]

Honesty has never been a conservative tenet.

Stuart Butler is LYING to you...

How the Heritage Foundation, a Conservative Think Tank, Promoted the Individual Mandate - Forbes

Avik Roy, Forbes Staff

Stuart Butler’s lecture describes what the Heritage’s mandate would look like:

"We would include a mandate in our proposal–not a mandate on employers, but a mandate on heads of households–to obtain at least a basic package of health insurance for themselves and their families. That would have to include, by federal law, a catastrophic provision in the form of a stop loss for a family’s total health outlays. It would have to include all members of the family, and it might also include certain very specific services, such as preventive care, well baby visits, and other items."

Taranto points out that the Heritage mandate was less onerous than the Obamacare one, as it focused on coverage for catastrophic illness, rather than the comprehensive health plans that Obamacare requires. “On the other hand, Butler’s vague language—‘it might also include certain very specific services…and other items’—would seem to leave the door wide open for limitless expansion,” he writes. “Whatever the particular differences, the Heritage mandate was indistinguishable in principle from the ObamaCare one. In both cases, the federal government would force individuals to purchase a product from a private company—something that Congress has never done before.”

So is Stuart Butler reliable when he advocates for a mandate and unreliable when he points out what he actually meant? Or vice versa?
As mentioned, I've never known the Democrats to take their marching orders from Heritage. Is this something new we can look forward to?

We've been over this before...maybe you just keep 'forgetting'...

When obstructionism prevents reforms and legislation that were part of your own Republican agenda, it becomes a form of domestic terrorism IMO.

Republicans were well aware that health care reform was paramount to repairing our economy and protecting the financial security of American families. McCain, and Republicans ALSO ran on promising health care reforms.

But Republicans made a conscious and collective decision to block and undermine any reform. Because it would be seen as a success for our President.

David Frum, the Republican and former economic speechwriter for George W. Bush was fired by the American Enterprise Institute for writing this op-ed, a right wing think tank whose 'scholars' ironically were ordered not to speak to the media on the subject of health care reform, because they agreed with too much of what Obama was trying to do.

Waterloo
by David Frum

At the beginning of this process we made a strategic decision: unlike, say, Democrats in 2001 when President Bush proposed his first tax cut, we would make no deal with the administration. No negotiations, no compromise, nothing. We were going for all the marbles. This would be Obama’s Waterloo – just as healthcare was Clinton’s in 1994.

This time, when we went for all the marbles, we ended with none.

Could a deal have been reached? Who knows? But we do know that the gap between this plan and traditional Republican ideas is not very big. The Obama plan has a broad family resemblance to Mitt Romney’s Massachusetts plan. It builds on ideas developed at the Heritage Foundation in the early 1990s that formed the basis for Republican counter-proposals to Clintoncare in 1993-1994.

-------------------------------------------------------------------------------------------------
The final irony:
The health care bill Obama and Democrats passed was not the reform liberals and progressives sought. It was and IS a carbon copy of the Republican bills proposed by Senator John Chafee, (R-R.I) and Senate Minority Leader Bob Dole in the early 1990's. Including the conservative idea...the individual mandate.

-------------------------------------------------------------------------------------------------

David Frum and the Closing of the Conservative Mind

Posted by Bruce Bartlett

As some readers of this blog may know, I was fired by a right wing think tank called the National Center for Policy Analysis in 2005 for writing a book critical of George W. Bush's policies, especially his support for Medicare Part D. In the years since, I have lost a great many friends and been shunned by conservative society in Washington, DC.

Now the same thing has happened to David Frum, who has been fired by the American Enterprise Institute. I don't know all the details, but I presume that his Waterloo post on Sunday condemning Republicans for failing to work with Democrats on healthcare reform was the final straw.

Since, he is no longer affiliated with AEI, I feel free to say publicly something he told me in private a few months ago. He asked if I had noticed any comments by AEI "scholars" on the subject of health care reform. I said no and he said that was because they had been ordered not to speak to the media because they agreed with too much of what Obama was trying to do.

^ A post so nice, it should be seen twice. ^

 

[The Rabbi]

So is Stuart Butler reliable when he advocates for a mandate and unreliable when he points out what he actually meant? Or vice versa?
As mentioned, I've never known the Democrats to take their marching orders from Heritage. Is this something new we can look forward to?

We've been over this before...maybe you just keep 'forgetting'...

When obstructionism prevents reforms and legislation that were part of your own Republican agenda, it becomes a form of domestic terrorism IMO.

Republicans were well aware that health care reform was paramount to repairing our economy and protecting the financial security of American families. McCain, and Republicans ALSO ran on promising health care reforms.

But Republicans made a conscious and collective decision to block and undermine any reform. Because it would be seen as a success for our President.

David Frum, the Republican and former economic speechwriter for George W. Bush was fired by the American Enterprise Institute for writing this op-ed, a right wing think tank whose 'scholars' ironically were ordered not to speak to the media on the subject of health care reform, because they agreed with too much of what Obama was trying to do.

Waterloo
by David Frum

At the beginning of this process we made a strategic decision: unlike, say, Democrats in 2001 when President Bush proposed his first tax cut, we would make no deal with the administration. No negotiations, no compromise, nothing. We were going for all the marbles. This would be Obama’s Waterloo – just as healthcare was Clinton’s in 1994.

This time, when we went for all the marbles, we ended with none.

Could a deal have been reached? Who knows? But we do know that the gap between this plan and traditional Republican ideas is not very big. The Obama plan has a broad family resemblance to Mitt Romney’s Massachusetts plan. It builds on ideas developed at the Heritage Foundation in the early 1990s that formed the basis for Republican counter-proposals to Clintoncare in 1993-1994.

-------------------------------------------------------------------------------------------------
The final irony:
The health care bill Obama and Democrats passed was not the reform liberals and progressives sought. It was and IS a carbon copy of the Republican bills proposed by Senator John Chafee, (R-R.I) and Senate Minority Leader Bob Dole in the early 1990's. Including the conservative idea...the individual mandate.

-------------------------------------------------------------------------------------------------

David Frum and the Closing of the Conservative Mind

Posted by Bruce Bartlett

As some readers of this blog may know, I was fired by a right wing think tank called the National Center for Policy Analysis in 2005 for writing a book critical of George W. Bush's policies, especially his support for Medicare Part D. In the years since, I have lost a great many friends and been shunned by conservative society in Washington, DC.

Now the same thing has happened to David Frum, who has been fired by the American Enterprise Institute. I don't know all the details, but I presume that his Waterloo post on Sunday condemning Republicans for failing to work with Democrats on healthcare reform was the final straw.

Since, he is no longer affiliated with AEI, I feel free to say publicly something he told me in private a few months ago. He asked if I had noticed any comments by AEI "scholars" on the subject of health care reform. I said no and he said that was because they had been ordered not to speak to the media because they agreed with too much of what Obama was trying to do.

^ A post so nice, it should be seen twice. ^

^A comment so dumb you must suck your thumb.

 

[The Rabbi]

Honesty has never been a conservative tenet.

Stuart Butler is LYING to you...

How the Heritage Foundation, a Conservative Think Tank, Promoted the Individual Mandate - Forbes

Avik Roy, Forbes Staff

Stuart Butler’s lecture describes what the Heritage’s mandate would look like:

"We would include a mandate in our proposal–not a mandate on employers, but a mandate on heads of households–to obtain at least a basic package of health insurance for themselves and their families. That would have to include, by federal law, a catastrophic provision in the form of a stop loss for a family’s total health outlays. It would have to include all members of the family, and it might also include certain very specific services, such as preventive care, well baby visits, and other items."

Taranto points out that the Heritage mandate was less onerous than the Obamacare one, as it focused on coverage for catastrophic illness, rather than the comprehensive health plans that Obamacare requires. “On the other hand, Butler’s vague language—‘it might also include certain very specific services…and other items’—would seem to leave the door wide open for limitless expansion,” he writes. “Whatever the particular differences, the Heritage mandate was indistinguishable in principle from the ObamaCare one. In both cases, the federal government would force individuals to purchase a product from a private company—something that Congress has never done before.”

So is Stuart Butler reliable when he advocates for a mandate and unreliable when he points out what he actually meant? Or vice versa?
As mentioned, I've never known the Democrats to take their marching orders from Heritage. Is this something new we can look forward to?

We've been over this before...maybe you just keep 'forgetting'...

When obstructionism prevents reforms and legislation that were part of your own Republican agenda, it becomes a form of domestic terrorism IMO.

Republicans were well aware that health care reform was paramount to repairing our economy and protecting the financial security of American families. McCain, and Republicans ALSO ran on promising health care reforms.

But Republicans made a conscious and collective decision to block and undermine any reform. Because it would be seen as a success for our President.

David Frum, the Republican and former economic speechwriter for George W. Bush was fired by the American Enterprise Institute for writing this op-ed, a right wing think tank whose 'scholars' ironically were ordered not to speak to the media on the subject of health care reform, because they agreed with too much of what Obama was trying to do.

Waterloo
by David Frum

At the beginning of this process we made a strategic decision: unlike, say, Democrats in 2001 when President Bush proposed his first tax cut, we would make no deal with the administration. No negotiations, no compromise, nothing. We were going for all the marbles. This would be Obama’s Waterloo – just as healthcare was Clinton’s in 1994.

This time, when we went for all the marbles, we ended with none.

Could a deal have been reached? Who knows? But we do know that the gap between this plan and traditional Republican ideas is not very big. The Obama plan has a broad family resemblance to Mitt Romney’s Massachusetts plan. It builds on ideas developed at the Heritage Foundation in the early 1990s that formed the basis for Republican counter-proposals to Clintoncare in 1993-1994.

-------------------------------------------------------------------------------------------------
The final irony:
The health care bill Obama and Democrats passed was not the reform liberals and progressives sought. It was and IS a carbon copy of the Republican bills proposed by Senator John Chafee, (R-R.I) and Senate Minority Leader Bob Dole in the early 1990's. Including the conservative idea...the individual mandate.

-------------------------------------------------------------------------------------------------

David Frum and the Closing of the Conservative Mind

Posted by Bruce Bartlett

As some readers of this blog may know, I was fired by a right wing think tank called the National Center for Policy Analysis in 2005 for writing a book critical of George W. Bush's policies, especially his support for Medicare Part D. In the years since, I have lost a great many friends and been shunned by conservative society in Washington, DC.

Now the same thing has happened to David Frum, who has been fired by the American Enterprise Institute. I don't know all the details, but I presume that his Waterloo post on Sunday condemning Republicans for failing to work with Democrats on healthcare reform was the final straw.

Since, he is no longer affiliated with AEI, I feel free to say publicly something he told me in private a few months ago. He asked if I had noticed any comments by AEI "scholars" on the subject of health care reform. I said no and he said that was because they had been ordered not to speak to the media because they agreed with too much of what Obama was trying to do.

You didnt answer the question.
Did Heritage write Obamacare? Did Heritage bribe senators to pass it? Did Heritage lie about keeping your doctor and health plan?
Looks like the answer is no to all of those. Democrats own this mess.

 

[dnsmith35]

The modern conservative is engaged in one of man's oldest exercises in moral philosophy; that is, the search for a superior moral justification for selfishness.
John Kenneth Galbraith

Were it not for the fact that Mr. Galbraith and his followers will exercise considerable power and influence there would be no purpose in discussing the ideas of this man. For as a thinker, Mr. Galbraith is not overly distinguished. His procedure is to combine an immense moral pretentiousness with a rather limited understanding of the teachings of the economists. And though he depicts himself as a daring innovator writing in defiance of an overwhelmingly hostile intellectual environment, his practical position is in essence no different from that of the typical leftist club-woman.

The thesis of 'The Affluent Society' is a variant of the Marxian dialectic. Our social morals, economic science and political institutions are, in Galbraith’s eyes, the products of an age of scarcity. George Reisman

 

[Andylusion]

I am 78 years old and my primary coverage is Medicare, with a supplement to cover the co-pay. I have never had a medical provider turn down providing services to me. If there are medical providers who won't accept Medicare, shame on them.

Of course our medical providers in my area aren't so greedy as those in some other areas.

It's pretty easy to just claim that others are greedy. That's fine.... but not true.

Have you ever worked in a doctors office? Have you ever seen the cost of running a general practice? Likely not.

I don't know what you did for a living, but if the cost of doing your job continued to climb, until you were not making the living you got the job to get, would you keep doing it?

Chances are you would not. Is that because you are greedy? Likely not.

If you got a 4-year degree in accounting, to earn a $60,000 income, and 10 years later you were earning $30,000, would you continue to work there?

No you would not.

Here's the bottom line. Medicare, and Medicaid, both do not pay out enough money to cover the cost of treatment. The payouts are low.

Doctors don't work for a middle income wage. Nor should they.

Remember Obama going to the Mayo Clinic? One of the leading clinics in the whole country? Remember that? Remember how he said Mayo was a model of health care?

Mayo Clinic Makes Medicare, Medicaid Cuts | Heartlander Magazine

The controversy over below-market government reimbursement rates has led the famed Mayo Clinic to close off access for many Medicare and Medicaid patients.

According to Mayo, Medicare was reimbursing doctors at the Mayo Clinic in Arizona for only about 50 percent of the cost of the primary care treatment they were providing, leading Mayo to make the decision to opt out of Medicare.

The Mayo Clinic that Obama praised, canceled Medicare and Medicaid.

Why? Because Medicare and Medicaid was only paying out 50% of the costs in treatment they were providing. So no more Medicare and Medicaid.

If you want the best health care in the US today, at the Mayo Clinic, Medicare and Medicaid patients need not apply. Show up with cash, or private insurance. No Medicare and Medicaid.

Now if you want to say they are greedy for not losing money, fine.... but if *YOU* were the one not getting paid, you wouldn't do it either. Welcome to reality.

Where do you come up with this 50% shit?

How Insurance Treats Your Physician

Reimbursement is how your physician gets paid by insurance. Some is paid by the patient, but most is paid by private insurance or programs like Medicare. But there is alot that we as patients don't know about the system of paying physicians and other practitioners or facilities.

Although Medicare was never meant to be used as a guide for private health insurance physician payment schedules, insurance companies and health plans have based their rates of payment on Medicare. No matter how much we pay for private insurance, their payment to physicians is either slightly above Medicare rates (for better insurance companies) or BELOW Medicare rates. It is not uncommon for some insurance companies to pay 10-20% LESS than Medicare.

I just posted the link. If you couldn't figure it out, that's what the link was there for.

The Mayo Clinic, the clinic that Obama said was a model for health care, said that Medicare was only paying out 50% of the cost of treatment.

The Mayo Clinic canceled Medicare and Medicaid because of this.

Nothing you say, contradicts that.

Now as far as private insurance companies paying less..... That's not what the hospitals are reporting.

I know of no example where hospitals have indicated that they do not lose money on Medicare and Medicaid. And the evidence is clear that the more they lose, the more is shifted to private insurance in higher costs.

 

[Andylusion]

What do you know about the American Medical Association/Specialty Society Relative Value Scale Update Committee, or RUC and how DOCTORS decide Medicare reimbursement?

I am aware of how this effective Union for health care practitioners has helped to increase cost. That is exactly the reason why we need to move back toward a free market system of competition. Unions when faced with competition, end up ruining themselves and going into irrelevance.

I assume you already know about how the AMA applied pressure on government to restrict medical schools, intentionally to inhibit new doctors in the field, thus increasing price?

How Much do Hospitals Cost Shift? A Review of the Evidence

Abstract:
Context: Hospital cost shifting - that private payers are charged more in response to shortfalls in public payments - has long played a role in debate over health care policy.

Findings: Analyses and commentary based on descriptive, industry-wide hospital payment-to-cost margins by payer provides a false impression that cost shifting is a large and pervasive phenomenon. More careful theoretical and empirical examinations suggest that cost shifting can and has occurred, but usually at a relatively low rate. Margin changes are also strongly influenced by the evolution of hospital and health plan market structures and changes in underlying costs.

Isn't it interesting how just changing the focus, seems to call into question the entire premise?

It "HAS OCCURRED".... PERIOD. IT *HAS* OCCURRED. PERIOD.

Your own link.... the very link you posted on this forum, make it absolutely, undeniably clear, that cost shifting HAS OCCURRED.... PERIOD.

The only question is to the degree. Which honestly, just look at evidence they used....

"More careful theoretical (?!?) and empirical examinations..."

Theoretical.... oh yes, and empirical!.... examinations.... Theory? Part of their 'evidence' that cost shifting is fairly um... you know minor and unimportant..... is based on 'theoretical'.... examinations. AND some empirical stuff too.

Now this is great, because I actually downloaded the whole report, and started reading..... then laughing.....

Do you have any idea where this graph that I posted several days ago, came from? It's from YOUR LINK. LOL

The graph clearly showing and proving that cost shifting HAS OCCURRED, came from the very report that you yourself, just posted a link too.

How poetic is that. The more arrogant people act on here, the faster they shove their own foot into their mouth.

So I kept reading.... and laugh again, when I got to page 15.

If this isn't hilarious, I don't know what is.

The claim "hospitals are out to maximize profits".... therefore prices are already as high as they can be. Thus, they can't possibly cost shift from under paying Medicare to Private payers, because their prices are already maxed out.

The only reason why anyone can't increase their prices, is because of competition. The less competition, and the more regulated the competition, the higher the prices can go, but it's still limited. Eventually people will go to a different hospital.

The theory that a hospital can't raise prices to cost shift, is based on that idea.

But there is a fundamental flaw this paper doesn't cover. That argument would be true..... if other hospitals didn't raise their prices.

But Medicare effects ALL hospitals. So ALL hospitals would raise their price together.

It's the same thing as the minimum wage. Yeah, if the minimum wage only effected McDonald's, they would not have been able to increase costs, because Burger King and Wendy's would have slaughtered them.

But since it effect all of them, prices have increased by 50% to 75% after the minimum wage went from $5.25 to $7.25.

Price Increases at Fast Food Restaurants from 2002 to 2013

This guy did a simple before and after comparison of Wendy's Burger King, McDonald's, Taco Bell, from 2002 to 2012.

Same thing with Hospitals. If you increase costs, through Medicare and Medicaid losses.... those losses are going to effect all hospitals, and thus the "theoretical evidence" that suggests they can't increase costs, is idiotic.

This report you linked to is a joke. All the rest of their arguments are the same. Lots of theory, let's of claims, zero empirical evidence. The graph, that clearly shows cost shift, *IS* the empirical evidence.

And BTW, I also had to laugh when they concluded that Medicare paying only 90% of the cost of treatment can't possibly be to blame for private care charged 25% over. Dur.... the people who wrote this report, not even look at their own published graph? Um.... Medicaid? Which pays even less than Medicare? Ya think that might make up a significant portion of that rest?

Of course I highly doubt you read any of this report you linked too. So typical.

 

[g5000]

This is one of the most popular provisions in an otherwise despised law, Obamacare. It polls consistently well. And it sounds good: Insirance companies cannot deny coverage for pre existing conditions. Right?
But why would they deny coverage to begin with?
When they are forced to issue policies to people with pre existing conditions, who pays for the higher risk the company incurs by insuring them?
I realize these are beyond Stage One questions so the leftists here wont have a clue what I mean. But maybe some of the more informed posters can chime in.

It is precisely because of the requirement to insure high risk customers that we have an individual mandate. The expense of the high risk customers is offset by forcing low risk customers into the pool.

You mean to say after all these years bloviating about ObamaCare you did not know this before now?

 

[Seawytch]

This is one of the most popular provisions in an otherwise despised law, Obamacare. It polls consistently well. And it sounds good: Insirance companies cannot deny coverage for pre existing conditions. Right?

But why would they deny coverage to begin with?

When they are forced to issue policies to people with pre existing conditions, who pays for the higher risk the company incurs by insuring them?

I realize these are beyond Stage One questions so the leftists here wont have a clue what I mean. But maybe some of the more informed posters can chime in.

It is precisely because of the requirement to insure high risk customers that we have an individual mandate. The expense of the high risk customers is offset by forcing low risk customers into the pool.



You mean to say after all these years bloviating about ObamaCare you did not know this before now?

Shit...forget the ACA...that's what insurance groups are for, period...B4 "Obamacare"

 

[dnsmith35]

It's pretty easy to just claim that others are greedy. That's fine.... but not true.

Have you ever worked in a doctors office? Have you ever seen the cost of running a general practice? Likely not.

I don't know what you did for a living, but if the cost of doing your job continued to climb, until you were not making the living you got the job to get, would you keep doing it?

Chances are you would not. Is that because you are greedy? Likely not.

If you got a 4-year degree in accounting, to earn a $60,000 income, and 10 years later you were earning $30,000, would you continue to work there?

No you would not.

Here's the bottom line. Medicare, and Medicaid, both do not pay out enough money to cover the cost of treatment. The payouts are low.

Doctors don't work for a middle income wage. Nor should they.

Remember Obama going to the Mayo Clinic? One of the leading clinics in the whole country? Remember that? Remember how he said Mayo was a model of health care?

Mayo Clinic Makes Medicare, Medicaid Cuts | Heartlander Magazine



The Mayo Clinic that Obama praised, canceled Medicare and Medicaid.

Why? Because Medicare and Medicaid was only paying out 50% of the costs in treatment they were providing. So no more Medicare and Medicaid.

If you want the best health care in the US today, at the Mayo Clinic, Medicare and Medicaid patients need not apply. Show up with cash, or private insurance. No Medicare and Medicaid.

Now if you want to say they are greedy for not losing money, fine.... but if *YOU* were the one not getting paid, you wouldn't do it either. Welcome to reality.

Where do you come up with this 50% shit?

How Insurance Treats Your Physician

Reimbursement is how your physician gets paid by insurance. Some is paid by the patient, but most is paid by private insurance or programs like Medicare. But there is alot that we as patients don't know about the system of paying physicians and other practitioners or facilities.

Although Medicare was never meant to be used as a guide for private health insurance physician payment schedules, insurance companies and health plans have based their rates of payment on Medicare. No matter how much we pay for private insurance, their payment to physicians is either slightly above Medicare rates (for better insurance companies) or BELOW Medicare rates. It is not uncommon for some insurance companies to pay 10-20% LESS than Medicare.

I just posted the link. If you couldn't figure it out, that's what the link was there for.

The Mayo Clinic, the clinic that Obama said was a model for health care, said that Medicare was only paying out 50% of the cost of treatment.

The Mayo Clinic canceled Medicare and Medicaid because of this.

Nothing you say, contradicts that.

Now as far as private insurance companies paying less..... That's not what the hospitals are reporting.

I know of no example where hospitals have indicated that they do not lose money on Medicare and Medicaid. And the evidence is clear that the more they lose, the more is shifted to private insurance in higher costs.

1. I did not accuse our doctors of being greedy.
2. But that said, I have never known a doctor not to make a very good living.
3. It was I who said, "doctors here accept medicare." Gladly!

 

[The Rabbi]

This is one of the most popular provisions in an otherwise despised law, Obamacare. It polls consistently well. And it sounds good: Insirance companies cannot deny coverage for pre existing conditions. Right?
But why would they deny coverage to begin with?
When they are forced to issue policies to people with pre existing conditions, who pays for the higher risk the company incurs by insuring them?
I realize these are beyond Stage One questions so the leftists here wont have a clue what I mean. But maybe some of the more informed posters can chime in.

It is precisely because of the requirement to insure high risk customers that we have an individual mandate. The expense of the high risk customers is offset by forcing low risk customers into the pool.

You mean to say after all these years bloviating about ObamaCare you did not know this before now?

Yes, we overcharge some people to subsidize other people. Never mind it is unjust, it plain won't work. Healthy people will pay the penalty and tell insurance companies to stuff it. That will leave a pool of older sicker people who will rack up claims, leaving the insurance companies to be bailed out by the taxpayer. Then you can complain about corporate welfare.

 

[The Rabbi]

This is one of the most popular provisions in an otherwise despised law, Obamacare. It polls consistently well. And it sounds good: Insirance companies cannot deny coverage for pre existing conditions. Right?

But why would they deny coverage to begin with?

When they are forced to issue policies to people with pre existing conditions, who pays for the higher risk the company incurs by insuring them?

I realize these are beyond Stage One questions so the leftists here wont have a clue what I mean. But maybe some of the more informed posters can chime in.

It is precisely because of the requirement to insure high risk customers that we have an individual mandate. The expense of the high risk customers is offset by forcing low risk customers into the pool.



You mean to say after all these years bloviating about ObamaCare you did not know this before now?

Shit...forget the ACA...that's what insurance groups are for, period...B4 "Obamacare"

^^Low information poster in action.

 

[M14 Shooter]

I am 78 years old and my primary coverage is Medicare, with a supplement to cover the co-pay. I have never had a medical provider turn down providing services to me. If there are medical providers who won't accept Medicare, shame on them.

Of course our medical providers in my area aren't so greedy as those in some other areas.

Ah... so you don't just want the federal government to force the young and healthy to subsidize the old and sick in general, you want them to be forced to subsidize YOU, personally.

The young don't have to subsidize me. I paid for my medicare over 45 years. You are doing the same.....unless you are a tax cheat.

Nothing here changes the fact that you suupport involuntary servitude.