BF2S Forums Your Life, Your Choices

DBBrinson1 wrote:

So how well to you think a socialized health plan would help/harm nurses?

Who knows? it would probably would not make any difference to front line health care providers. The people who will be screwed by a national healthcare system are people that work in billing, insurance and other administrative functions. Its these positions where most of the cost savings and effiencies will be found. I'm not sure what the ratio is of frontline workers to adminstrative staff, I do know its over a 1:1 ratio. I thought I heard it was somewhere around 1:20+ when you include insurance companies and doctor and hospital staff. That's a lot of people for a patient to be paying and I would be frustrated if I were a patient and had to wander the halls saying "here nursey, nursey, nursey" when I needed assistance and no one is to be found because the money I was paying was going to the salaries of people whose only job it is is to collect money from me and not to the people who are there to look after me.

That said, if cost saving were realized and some of the money put back into the system, then patient care should improve.

Diesel_dyk wrote:

DBBrinson1 wrote:

So how well to you think a socialized health plan would help/harm nurses?

Who knows? it would probably would not make any difference to front line health care providers. The people who will be screwed by a national healthcare system are people that work in billing, insurance and other administrative functions. Its these positions where most of the cost savings and effiencies will be found. I'm not sure what the ratio is of frontline workers to adminstrative staff, I do know its over a 1:1 ratio. I thought I heard it was somewhere around 1:20+ when you include insurance companies and doctor and hospital staff. That's a lot of people for a patient to be paying and I would be frustrated if I were a patient and had to wander the halls saying "here nursey, nursey, nursey" when I needed assistance and no one is to be found because the money I was paying was going to the salaries of people whose only job it is is to collect money from me and not to the people who are there to look after me.

That said, if cost saving were realized and some of the money put back into the system, then patient care should improve.

Did you know that the insurance lobbies were hand in hand with the D's in writing our kennobamedibebacle.  You really think that would happen under either of the proposed plans?

Last edited by DBBrinson1 (2009-08-27 18:04:13)

FEOS wrote:

If you argue that, there are local oligopolies all over the country. If you bring the scope down narrowly enough, you can argue that there are only one or two companies that provide any service. That is simply a non-sensical argument.

In my opinion, it's far more nonsensical to have to drive to another state to get affordable healthcare because of local oligopolies.  This happens quite a lot.

FEOS wrote:

It would if pharmaceuticals produced by other companies weren't available. But they are. So it's not.

First of all, that completely ignores the fact that patents for new drugs in America extend much longer than in most other countries, so getting a generic for many medications isn't an option until several years down the road.

Second, even in the generics market, there aren't that many choices per drug, and because our government does not negotiate with companies over pricing, we pay a lot more for most medications.  This goes far beyond oligopolies, but they don't help either.

Third, as again the Canada situation shows, whenever an undercutter gets involved, the FDA often gets in the way.  This is one case where you and I might agree that we should have less governmental barriers in buying drugs from other countries.

FEOS wrote:

I'm gonna go ahead and say "no". I'm not going to provide scans of my son's EOBs simply to prove a point.

I didn't specifically ask for that, but ok then.  Your argument here still lacks evidence.

FEOS wrote:

Extend Medicare/Medicaid to the people who actually want but are unable to obtain private insurance (a number much smaller than the 47 million thrown around by Obama and others). The cost of providing Medicare coverage to those individuals is significantly lower than the reforms proposed by Obama, aimed at the entire population while being sold as a plan to cover those who currently are uninsured. If the plan focused solely on those who are truly uninsured (a number much, much smaller than the 47 million that's bandied about), the overall cost and the per-year cost to the taxpayer are much, much smaller.

Believe it or not, I could support that.  The question is whether or not the GOP would.

FEOS wrote:

Tort reform. Insurance portability reform. National standards for insurance eligibility (part of portability reform, tbh).

As examples.

I agree with those as well, but I don't believe they alone will be enough.  The Medicare/Medicaid extension idea has promise though.

FEOS wrote:

Turquoise wrote:

FEOS wrote:

If you argue that, there are local oligopolies all over the country. If you bring the scope down narrowly enough, you can argue that there are only one or two companies that provide any service. That is simply a non-sensical argument.

In my opinion, it's far more nonsensical to have to drive to another state to get affordable healthcare because of local oligopolies.  This happens quite a lot.

Define "local". That might be an issue in border regions between states, but I haven't seen it anywhere I have lived, either personally or reported.

I know for a fact that there is quite an oligopoly in my city of Greensboro.  We have the third most expensive cardiology market in the U.S.

I can also tell you that we definitely do not have the third highest wages.

Generally speaking, when I say local, I mean it on a metropolitan area level, because that's the most relevant market size to individuals.  It doesn't matter how competitive the nation might be as a whole -- what matters is how competitive the local market is, unless you can afford to go cross country to get care.

FEOS wrote:

Turquoise wrote:

FEOS wrote:

It would if pharmaceuticals produced by other companies weren't available. But they are. So it's not.

First of all, that completely ignores the fact that patents for new drugs in America extend much longer than in most other countries, so getting a generic for many medications isn't an option until several years down the road.

That's true. But it doesn't ignore that fact. The fact that patents last such a long time doesn't obviate the fact that other countries' pharmaceutical companies can sell their goods here...which does obviate the small number of large pharmaceutical companies here.

Turquoise wrote:

Second, even in the generics market, there aren't that many choices per drug, and because our government does not negotiate with companies over pricing, we pay a lot more for most medications.  This goes far beyond oligopolies, but they don't help either.

Actually, our government--and private insurers--do exactly that. It's when you aren't covered by government-provided or private insurance that you pay market price. Except for some of those evil companies like Wal-Mart that have negotiated costs themselves with companies, providing many generics at low prices even without insurance.

When government only negotiates for the benefit of the few under its plans, that doesn't have the same benefits for the population as a whole like a socialized system would.

Second, while it is true that Walmart does its own negotiating, you're still going to pay more for drugs at Walmart than you would with a socialized system.

FEOS wrote:

Turquoise wrote:

Third, as again the Canada situation shows, whenever an undercutter gets involved, the FDA often gets in the way.  This is one case where you and I might agree that we should have less governmental barriers in buying drugs from other countries.

I think that so long as the regulatory agencies of the countries involved pass muster, there shouldn't be any limits on where we can purchase our prescription drugs. Mexico clearly is not one of those situations, where Canada is.

I would agree, but unfortunately, that's not how our market is currently designed.

FEOS wrote:

Turquoise wrote:

FEOS wrote:

I'm gonna go ahead and say "no". I'm not going to provide scans of my son's EOBs simply to prove a point.

I didn't specifically ask for that, but ok then.  Your argument here still lacks evidence.

That is my evidence. Reading EOBs. Seeing what gets paid versus what gets charged. Seeing why certain things don't get paid. The only way to source my first-hand experience is to scan and post my son's EOBs and explain them. I'm simply not going to do that.

You can either think I'm making shit up to make a point or you can believe me. I really don't care either way. However, I would think that my posting history should remove any thoughts you may have of me making shit up to make a point.

I'm not saying you're making shit up.  I'm saying that the private sector does a whole lot of denial of service on its own.  "Pre-existing conditions" are mostly a bullshit way of insurance companies saving profits over helping people.  Less of that sort of thing happens in systems like those of France.

Also, in places like France, they are more clear beforehand what you can get covered and what you can't.  This is why people have both public and private insurance there.  They have the private coverage specifically for what the public coverage doesn't offer.

In America, knowing what gets covered is much less clear unless you happen to be lucky enough to have an employer plan that is good.  I'm one of the few lucky people where my plan actually is pretty clear and good.

FEOS wrote:

Turquoise wrote:

FEOS wrote:

Extend Medicare/Medicaid to the people who actually want but are unable to obtain private insurance (a number much smaller than the 47 million thrown around by Obama and others). The cost of providing Medicare coverage to those individuals is significantly lower than the reforms proposed by Obama, aimed at the entire population while being sold as a plan to cover those who currently are uninsured. If the plan focused solely on those who are truly uninsured (a number much, much smaller than the 47 million that's bandied about), the overall cost and the per-year cost to the taxpayer are much, much smaller.

Believe it or not, I could support that.  The question is whether or not the GOP would.

They already have, believe it or not. The problem is that other options are not being considered.

Ok, give me a source for that then.  This is news to me.

FEOS wrote:

Turquoise wrote:

FEOS wrote:

Tort reform. Insurance portability reform. National standards for insurance eligibility (part of portability reform, tbh).

As examples.

I agree with those as well, but I don't believe they alone will be enough.  The Medicare/Medicaid extension idea has promise though.

Of course they may not be enough...but if we attempt reform without also reforming those leeching problems, it won't get any better.

Agreed.

FEOS wrote:

And guess what opens markets to more specialists?

Tort reform.

Do you know why the cardiology market is so expensive there? Could it be fewer cardiologists per capita? And why would that be?

The AMA has some pretty strict limits on medical education.  That's why.  We have fewer doctors of every kind per capita than in most European nations -- primarily because of the AMA's restrictions.

FEOS wrote:

Turquoise wrote:

When government only negotiates for the benefit of the few under its plans, that doesn't have the same benefits for the population as a whole like a socialized system would.

Second, while it is true that Walmart does its own negotiating, you're still going to pay more for drugs at Walmart than you would with a socialized system.

I pay less per prescription at Wal-Mart than I do under my current socialized plan.

Reality simply doesn't square with your opinion, Turq.

Reality is that you would pay even less in France or Canada than under any plan here.

FEOS wrote:

Or you have to be able to read. You know, the plan documentation when you sign up for it. It's pretty straightforward.

Not always.

FEOS wrote:

Turquoise wrote:

Ok, give me a source for that then.  This is news to me.

http://www.washingtonpost.com/wp-dyn/co … 02036.html

Romney enacted in Massachusetts:
http://www.cprights.org/plan.php?plan=10

Jindal's plan in LA:
http://www.cprights.org/plan.php?plan=11

http://www.cprights.org/plan.php?plan=23

Believe it or not, it's fairly difficult to find good sources for just about anything involving healthcare reform...it's simply too polarizing of an issue.

I did hear it on the radio the other day about Republicans pushing for other options (to include Medicare expansion) to be considered before scrapping the current system. Just can't find it anywhere...

First of all, the expansion of Medicare only applies to senior citizens -- not all poor people as you mentioned.

Second, while it is true that Romney and Jindal have done things on the state level, it's a bit difficult to get every state on the same page healthcare wise.  This is why I support the feds pushing through at least a minimal plan to get the ball rolling.

I would rather at least see a transitional plan in place to give every state some lead time to set up their own systems than have nothing at all on the fed level.

Turquoise wrote:

FEOS wrote:

And guess what opens markets to more specialists?

Tort reform.

Do you know why the cardiology market is so expensive there? Could it be fewer cardiologists per capita? And why would that be?

The AMA has some pretty strict limits on medical education.  That's why.  We have fewer doctors of every kind per capita than in most European nations -- primarily because of the AMA's restrictions.

And what does that have to do with a single-payer system? Or any other cost reform measures, for that matter?

Reform the AMA, not everything else.

Turquoise wrote:

FEOS wrote:

Turquoise wrote:

When government only negotiates for the benefit of the few under its plans, that doesn't have the same benefits for the population as a whole like a socialized system would.

Second, while it is true that Walmart does its own negotiating, you're still going to pay more for drugs at Walmart than you would with a socialized system.

I pay less per prescription at Wal-Mart than I do under my current socialized plan.

Reality simply doesn't square with your opinion, Turq.

Reality is that you would pay even less in France or Canada than under any plan here.

Reality is that with my private insurance, I pay pretty much nothing already.

Turquoise wrote:

FEOS wrote:

Or you have to be able to read. You know, the plan documentation when you sign up for it. It's pretty straightforward.

Not always.

Pretty much.

Granted, it's not like reading the Sunday Comics, but it is understandable.

Turquoise wrote:

FEOS wrote:

Turquoise wrote:

Ok, give me a source for that then.  This is news to me.

http://www.washingtonpost.com/wp-dyn/co … 02036.html

Romney enacted in Massachusetts:
http://www.cprights.org/plan.php?plan=10

Jindal's plan in LA:
http://www.cprights.org/plan.php?plan=11

http://www.cprights.org/plan.php?plan=23

Believe it or not, it's fairly difficult to find good sources for just about anything involving healthcare reform...it's simply too polarizing of an issue.

I did hear it on the radio the other day about Republicans pushing for other options (to include Medicare expansion) to be considered before scrapping the current system. Just can't find it anywhere...

First of all, the expansion of Medicare only applies to senior citizens -- not all poor people as you mentioned.

See my last couple of sentences.

Turquoise wrote:

Second, while it is true that Romney and Jindal have done things on the state level, it's a bit difficult to get every state on the same page healthcare wise.  This is why I support the feds pushing through at least a minimal plan to get the ball rolling.

But it's not the Fed's job. It is not a task or power given to them in the Constitution, therefore it belongs to the States. The only play the Feds would have (which I fully support, btw) would be to leverage the Interstate Commerce language to ensure transportability/commonality between the States' plans.

Turquoise wrote:

I would rather at least see a transitional plan in place to give every state some lead time to set up their own systems than have nothing at all on the fed level.

See above.

Turquoise wrote:

FEOS wrote:

And what does that have to do with a single-payer system? Or any other cost reform measures, for that matter?

Reform the AMA, not everything else.

The AMA is a private organization.  The government would have a much harder time legally forcing the AMA to reform than it would instituting reforms with a medical infrastructure controlled or at least partially funded by the state.

That still doesn't change AMA's problems. Clearly they have some sort of power in this situation that would not be changed under a single-payer system. Their influence is extra-governmental.

Turquoise wrote:

FEOS wrote:

Reality is that with my private insurance, I pay pretty much nothing already.

In all seriousness, who is your provider?

Mine is the government. And it sucks.

My family's is changing due to changing contracts, but I believe it is HealthNet. Soon to be Aetna.

Turquoise wrote:

FEOS wrote:

But it's not the Fed's job. It is not a task or power given to them in the Constitution, therefore it belongs to the States. The only play the Feds would have (which I fully support, btw) would be to leverage the Interstate Commerce language to ensure transportability/commonality between the States' plans.

There are plenty of other things that the feds attend to that aren't mentioned in the Constitution.  And considering that times have changed quite a lot since those days, I'm not exactly one to strictly interpret the Constitution.  To me, that's an unrealistic way to shape policy.

When it comes to specified powers, there's only one way to interpret the Constitution.

Turquoise wrote:

FEOS wrote:

That still doesn't change AMA's problems. Clearly they have some sort of power in this situation that would not be changed under a single-payer system. Their influence is extra-governmental.

That's assuming we don't disband the AMA first.

That sounds awfully dictatorial and "non-Bill of Rights"-ish.

Turquoise wrote:

FEOS wrote:

Turquoise wrote:

That's assuming we don't disband the AMA first.

That sounds awfully dictatorial and "non-Bill of Rights"-ish.

True, but the Founders didn't properly account for the tyranny of corporations and corporate guilds.

That's a bit melodramatic, don't you think?

Turquoise wrote:

FEOS wrote:

Turquoise wrote:

True, but the Founders didn't properly account for the tyranny of corporations and corporate guilds.

That's a bit melodramatic, don't you think?

Not when it comes to the AMA.

But they do more good than bad. Unlike say...the UAW or the NEA.

I am going to start talking to a therapist online. Just looking for a service that will take my (good) insurance.

good for you macbeth. mean it sincerely.

it does sound like you have a recurring pattern on here of doing something 'bad' (which isn't even necessarily so bad), but then getting caught in a loop of self-recrimination and guilt. definitely an unhealthy habit of mind. i say that with no judgment or condescension: lord knows i've worked through a few damaging cycles of behaviour in my own adult life too.

hope it goes well.