Obama Offers More Health-Care Savings Through Limits on Payments

Would someone explain to me; why the public, one payer, universal health care option proposal cannot be combined with medicare/medicaid? Everyone is contributing to medicare now, what is the difficulty with creating one large, universal, one payer coverage for all citizens? And, if we limited the allowable profit percentage in health care companies, the greed factor should be removed.

The citizens of the country need to take back government but unfortunately it's not looking good. As easy as it is to become involved online and through programs such as Organize For America, people are apathetic that anything is actually going to get accomplished.

I wonder if anybody has considerd filing a class action law suit similar to that filed against the tobacco industry. If our system of healthcare is killing us why don't we take it out of the hides of the insurance companies, doctors and hospitals. They have know for years that this has been happening. I don't see any disconnect between tobacco and healthcare malfeasance.

The citizenry of the country really needs to march on their local courthouses and show from a grassroots level that change will occur or people will be replaced.

I don't know why the president even invites health care executives, insurance companies and the AMA to talk. Any input they have is selve serving and NOT in the best interests of citizens(patients).

Has anybody taken a look at the actual cost of existing implementations of technology? If so, they would probably find that the cost is triple what it should be due to the arrogance of the health care providers and senior management.

Five years from now we will be reading stories about botched technology that will make the failed IRS computer upgrade seem like chump change.

You heard it here first.

linda_521...you just used too much common sense in your post for those idiots on the hill to understand! Besides, if you look at one of the lead stories on the WaPo website, you will see that almost every one of the Senators that is going to be involved in this health care debate have millions of THEIR money at stake, something as simple as what you described will NEVER happen....it's too easy.

So Obama wants the poor and elderly to suffer? I thought we elected him to be a champion at for the poor, and I guess we hoped for some sort of compassion for the elderly. What happens if hospitals serving the poor are closed and a universal health insurance bill doesn't go through? Were we duped?

Obama is zeroing in on how to finance healthcare: Ration treatment to the elderly who have paid into it and keep them paying into it while reducing services to them. How Nazi of him!

He's in a big hurry to shove this fraud down our throats. WHY? Who's behind him?

Notice that every program he pushes is a CRISIS? Govern by emergency and the people won't notice what they're doing because they can't keep up!

Watch out for their AMNESTY for ILLEGALS, too! The more there are, the more demand for these "do gooder" programs and the fewer to pay for them. No new taxes for 95% of the people? B.S.! Not enough rich people to pay them and far fewer too when Pelosi gets her "Redistribute the wealth programs going. What wealth? Simple - If you got it, we want it!

The common word that keeps creaping out on all these programs is -- CONTROL!!

WAKE UP AMERICA! What's you're seeing is our first dictator!

There was a poster on another WAPO website who claimed to be 70 and was willing to forego cancer treatment so that someone younger could receive care. This was such an obvious plant. Under socialized healthcare, all the elderly will be given is the power of prayer.

Cut payments for the elderly and the poor but no mention of that new Dumbocrat voting block- illegal aliens. That's the real problem. Illegals have been storming our health care system for hangnails and the sniffles for years and we are paying for it. Are those of you believing the bull about this government run health care fraud stupid, blind or simply happy to get what you think is another freebie? I don't get it at all. The government destroys everything it touches and you want them making your health care choices. INSANE!!

If you cut back too much on the potential profit or income benefits in the health care industry, you remove the incentive for investing time and money in the research and education that are essential to quality and skill. Thus, we'll have fewer and fewer resources for more people.

We've all heard the horror stories of public health care decisions being prioritized along social lines. This measure, if passed, will allow us to get accustomed to prioritizing who gets to be first in line.

I don't see much difference between people not getting health care because they're not insured and people not getting health care because they are insured, but they're the wrong age or income level to matter.

Why doesn't the government focus on some sort of reforms that make it easier for businesses and individuals to provide insurance? For example, I could walk out into the street, invite the first stranger I meet to live with me and call him or her my life partner and throw that person on to my employer provided health insurance coverage for a relatively affordable increase in my share. But I'm not allowed to extend my plan to cover family members who don't fit into very narrow parameters - such as an aging parent or an under-employed adult child?

I think that insurance companies should have to consider changing their guidelines to address the non-traditional family structures that are becoming ever more commonplace.

Doth thou who provideth the sick with comfort regulate thine selves ? Yea, for those that had haveth richness in thy Street Wall learned a bitter end. Do not increase the tariff on ones with infirmity having much age. For thou burdens are too many now how shall you carry them ?

To linda_521. That makes perfect sense to me. I wonder why I didn't think of that. Yes, the system is already in place. They should hire you as a consultant. NOT! You have too much common sense for the government. Your thinking is too clear. The government only wants educated fools that over-complicate matters.

I am fascinated by the logic involved in this process of "saving." We will pay for the insuring of the uninsured by eliminating the payments to hospitals for treating the uninsured. Sounds a bit circular, don't you think? Actually, by not paying the hospital there is supposed to be enough money to cover paying the insurance companies, who will in turn pay the hospitals, after taking administrative costs and profits from the payments. So the amount of money now going to hospitals completely for medical care rendered will be diluted through a third party and that party's sticky fingers. Are we getting less medical care in the process? Is that where the savings really accrues?

By definition, payments to hospitals for treating the uninsured will no longer exist, therefore no one who is uninsured will receive any form of reimbursed treatment, leading one to believe that no one will receive treatment who is uninsured. Therefore, everyone will be required (forced) to have insurance. Those that attempt to fly under the radar by not requesting medical care will be exposed the moment they seek medical care. At that point they will have to procure insurance, but it will not really be insurance (against future risk) but a fee for services at the point of delivery. Why won't everyone wait until such time as they need it?

Perhaps there will be a penalty for delaying the purchase, similar to that of Medicare's Prescription Drug Program, which means at the time of "sickness" and the seeking of medical care, the uninsured person will not only be charged a premium for the service rendered, but a penalty on top of that for failure to comply in a timely fashion. If these people are truly uninsured because they are poor, how do they fund all this "unexpected" expense? Or are they just shuffled out the door until the necessary financial arrangements are made? Remember, no one who is uninsured, including those who cannot afford insurance, can receive treatment, since reimbursement for that treatment is no longer allowed. Presumably that also includes the ability of hospitals to shift the cost to other patients or deduct the expense from their taxes or cover it from "charitable" contributions.

All of this government intervention to avoid a system having government intervention is a fascinating labyrinth of intuitively misleading rejoinders more likely to generate heat than light.

Wow $600 billion dollars in cuts to Medicare over the next 10 years without any increases in premiums (it says premiums will actually decrease) and with better quality care for seniors!!!

George Bush must have been a real idiot to miss this $60 billion a year waste fraud and abuse in the Medicare program.

I guess it just shows how stupid the Republicans really are :-)

When it comes to health care, I believe that less is more.

Unfortunately, the American way says that 'there must be something that can be done'. That results in treatment for conditions that, if untreated, will get better in a week and if treated (expensively) get better in seven days.

I grew up in England under what is demonized by the right as 'socialized medicine'. When I came here in 1968, it was really quite frightening to discover that the more that my doctor did to me, the more he/she would get paid. Sometimes, I just want to be told either that it will get better in time or that there is really no useful treatment and that I will just have to get used to the condition.

And forget about customer directed medical care. I have a degree in agricultural science - so I know about bodies - and, as a result of a major automobile wreck (not my fault), all too much experience with doctors and hospitals. Even so, I still consider myself woefully incompetent to evaluate a treatment plan. My first reaction, therefore, is 'NO' but I think I am unusual in this approach.

Whether we can change customer attitudes sufficiently to reduce the current gross rate of over-consumption of medical services (I won't call it medical care) is doubful, but we must try.

Let's address the Rat in the woodpile. I am 72, on medicare and private suppliment insurance. I am diabetic which allows me to receive one pair of shoes a year which medicare pays 80% You may have seen the shoes in drug stores. They are made in china, cost over $200.00 and are equal to Walmarts quality. People on medicare can get a Post-a-Vac pump at very inflated price to medicare. Hoveraround and Scooter store, youve heard of them, overpriced and paid by our medicare. Greed-Corruption-lets go after the real rats in the woodpiles as a start. A Dr. I know had to pay with a Rolex watch to be an included provider on a medicare health plan. Pres.Obama and friends must set their sights lower,the slimmy greedy rats in the woodpile.

Just like all the other for-profit business', hospitals, drug makers and the rest of the health CARE industry has been totally deregulated and that is the reason for the runaway health care costs and nothing else.

The tremendous burden placed on the system by twenty million illegal aliens has overtaxed the system to the limit and more importantly has deprived our own citizens of needed treatment.

now we have a bunch of dictators in Washington that will ration our availability to health care, especially for the poor and elderly so they can turn over their Hilary care inspired health care system to the insurance giants and wall street investors.

Universal Health care will only mean they can collect their health care profits directly from the government coffers instead of you and I

Corporate Welfare must continue, whether it is a the expense of your health or not!!! Washington lobbyist rule, so live with it.......

Massachusetts requires everyone to have health insurance and subsidizes insurance for those who can't afford it. Yet the number of visits to hospital emergency rooms for non-emergency care hasn't been reduced.

Whether or not it works at least something is being done. I would not act on presumption, waiting instead for bonafide results. For instance the slashing of subsidies to hospitals that provide care for the uninsured. Wait until the hospital report shows that they have actually reduced. A good idea may be hampered by improper timing.

I have no doubt he will do this, particularly cut benefits to the elderly. He is going to heat up the war for benefits between the old and the young. His votes are from younger people so that is who he is going to serve.

But answer me this, he is going to get rid of ciggarettes, tell you what you can eat per the food police, so you are going to have people live longer and longer, but cut off benefits.

What a great country we live in

Maybe I am mistaken but didn't Mass. use the dispropotionate care (charity care) payments to hospitals to pay for the subsidies in it's new exchange????

What happens to the Mass. miracle if these payments disappear?

Influential senators working to overhaul the nation's health care system have investments and family ties with some of the biggest names in the industry.

The wife of Sen. Chris Dodd, the lawmaker in charge of writing the Senate's bill, sits on the boards of four health care companies. Members of both parties have industry connections, including Democrats Jay Rockefeller and Tom Harkin, in addition to Dodd, and Republicans Tom Coburn, Judd Gregg, John Kyl and Orrin Hatch.

Jackie Clegg Dodd, wife of the Connecticut Democrat, is on the boards of Javelin Pharmaceuticals Inc., Cardiome Pharma Corp., Brookdale Senior Living and Pear Tree Pharmaceuticals.

Mrs. Dodd last year was one of the most highly compensated non-employee members of Javelin earning $32,000 in fees and $109,587 in stock options.

Mrs. Dodd earned $79,063 from Cardiome and Brookdale Senior Living gave her $122,231 in stock awards. She holds $15,000 in stock in Pear Tree, a development-stage pharmaceutical company.

And that is not all, there is more:

Rockefeller, D-W.Va., reported $15,001 to $50,000 in capital gains for his wife from the sale of a stake in Athenahealth Inc., a business services company that helps medical providers with billing and clinical operations.

Gregg, R-N.H., disclosed $250,001 to $500,000 in drug maker Bristol-Myers Squibb Co. stock and $1,000 to $15,000 each in stock in pharmaceutical companies Merck & Co. and Pfizer, the Johnson & Johnson health care products company and Agilent Technologies, which is involved in the biomedical industry.

Kyl, R-Ariz., the Senate minority whip, reported $15,001 to $50,000 in stock in Amgen Inc., which develops medical therapeutics. Kyl's retirement account held stakes in several health care businesses, including the Wyeth, Bristol-Myers Squibb, GlaxoSmithKline, Pfizer and AstraZeneca pharmaceutical companies; medical provider Tenet Healthcare Corp.; CVS Caremark prescription and health services company; Genentech, a biotherapeutics manufacturer; and insurer MetLife Inc.

Harkin, D-Iowa, and his wife, Ruth Raduenz, own shares of drug makers Amgen and Genentech, Inc., each stake valued at $1,001 to $15,000; Their largest health care holding, Johnson & Johnson, was valued at $50,001 to $100,000.

Hatch, R-Utah, a member of the Finance and Health committees, reported owning between $1,001 and $15,000 worth of stock in drug maker Pfizer Inc.

I can't help but feel that there is a least **some** self interest and conflict of interest in such close association between lawmakers and healtcare entities.

http://news.yahoo.com/s/ap/20090612/ap_on_go_co/us_senate_disclosures

Are we to trust government to make decisions about something as fundamental or our health? Will care be denied for any variety of reasons?

I don't know about you, but I don't trust any of them to look out for my best interests while they seem to be aligning themselves for a BIG payday, most likely at OUR expence.

Let's see, wage (Wall ST/auto execs) and price (health care) controls. Oh yeah, that was Nixon.

To Linda 521 - Here is the deal, Medicare is fee for service, meaning every procedure, doctor visit, everything is billed. Everyone else, you included, I'm sure, is either PPO or HMO. The difference is that the doctor gets paid, to simplify, by managing a patient pool and outcomes, more or less (it could be done better in most cases, Kaiser being one of the best at this).

Now, is you put everyone back on Medicare type fee for service, costs would just explode. We need to do the opposite, move Medicare and Medicaid to managed outcomes where doctors are hospitals are paid for success, not for each individual service which gives them the incentive to provide more and more expensive, and not always effective, services!

How is this going to be paid for? Where is the money going to come from? Enough of this voodoo economics of act now and figure it out later - d@mn officials in DC need to learn speak and have a solid plan, not just speak and dip into my pocket.

If I ran my finances like DC does I would be arrested.

free health care just encourages hypochondriac behavior. any free government benefit should include drug testing before disbursement.

"enough to cover the full cost of sweeping health reform, a top adviser said"
I wonder who he was?? Sanitary engineer in charge of removing recyclable hydrocarbons in circular storage centers found near every desk in every office?
Since the government has almost never been able to cut cost significantly without hurting services ,let's cut waste first and spend the savings after they are produced.

dollyq -- I am the 70 year-old-poster on the other WaPo comment board who stated I was considering the possibility of forgoing surgery for thyroid cancer so that a younger person could have needed medical treatment. I meant every word I said sincerely -- that was not a "plant." This is the second time you, or someone else, has called me a liar, and I don't appreciate it.

Perhaps you are too young to remember when citizens of this great country thought of someone other than themselves. Oh yes, that was before the Boomers hit with their "me" generation stuff.

Fortunately, my family taught to me think of the needs of other members of society and to act accordingly. It is a shame that that spirit of thoughtfulness and concern for all members of society is becoming lost.

Doesn't anyone else see anything wrong with the Democratic Party's positions? Let women kill their unborn children if it's too inconvenient to raise them, tax to death those that make it past abortion limits, and if that doesn't kill them, cap their old-age medical payments so they have to choose between dying of hunger or their degenerative condition.

Very compassionate, Mr President...

Marmac5 - your surgery isn't like a loaf of bread, where if you go hungry, someone else can eat. If you don't accept the care you need, you will just get sicker and no one will benefit from it. And even if your logic would bear fruit, who would want to be the recipient of your genorosity knowing how very much it cost you?

Please take the best possible care of yourself. I'm sure there are people who love you and who want you to stay with them for as long as possible. The more years you live, the more good you'll be able to do.

Medicare rolls are currently 43 million. The fund is supported by a payroll tax of 2.9% on 110 million working Americans, and roughly $230/quarter deducted from the social security checks of those 65 and older.
(Medicaid is a supplemental program and excluded from my comments).

Medicare covers hospitalization and nursing home care (90 days with copay, and 100% when family personal funds are exhausted). Although the program is efficient, the funds are insufficient to sustain the current level of services beyond 2017. An increase in the Medicare tax from 2.9% to 4.0% would provide long term viability (at least 50 more years) into the program.

The nursing home expense of the program is enormous, and it is well known that most medical expenses are incurred within the last 3 years of life, on average. Expansion of the Medicare program to all Americans would be significantly less expensive than the current program, but just as efficient. About 2 1/2% of Medicare expenses goes to administrative overhead (compared to 18-22% with private plans.)

For Medicare to expand into a national health insurance program for anyone, the Medicare payroll tax would need to increase into the range of 10 to 14%. This would include the 4% tax required for solvency in the current program, and 6-10% for each of the 110 million workers (and families) who would enter the program. Seniors would still need to pay the quarterly fee from social security.

At a 14% tax rate (the highest that I could foresee), an individual would need to make $72,000/year to buy private insurance equivalent to what Medicare currently covers. The median wage/salary is about $45,000/year, meaning most workers (about 80%) would be receiving a subsidy from the 20% of workers who make more than $72,000 per year.

However, the actual usage of health care services would be statistically the same across all income levels, slightly higher for lower income due to lifestyle choices, but not significant.

A majority of workers would receive coverage for themselves and their families superior to what they have now. 45 million have no health insurance, 55 million have plans ranging from gold plated to terrible (all of which are run less efficiently than Medicare.)

The issue of cost control is paramount, along with prevention measures. I also think that some type of penalty on individuals who abuse their lifestyle with alcohol, drugs, morbid obesity could also be worked into the program.

In the end, if people are treated fairly in society, they respond with fairness. This is the model of Australia, Canada, Germany, England, Japan, France and every other country I have worked in that uses a national single payer health insurance program. The US should get on board.

Time to write my congressman.

What else to expect from a guy who didn't go to his mom's funeral.

In every state, including Obama's home state of Illinois, Medicaid is a mess, and this pathetic excuse for a President thinks he will solve the problem by stealing a massive percentage of federal funds from the elderly?

Not one responsible health care professional in America, including doctors, nurses, and hospital administrators, supports the "single-payer" approach promoted by a pack of corrupt politicians.

In one fell swoop, Obama wrecked the struggling Detroit auto industry. Now he wants to destroy the best health care system in the world.

I am loathe to believe any of these phony numbers pulled out of a hat which state that if we change the system we will save X amount of dollars. It is nothing but pure conjecture and totally unreliable and based on the desire to do something you want to do and deal with the real consequences later when your phony hype turns out to be indeed phony. I also can't stand the fact that on such an important issue as this they are starting now and want everything finalized by a certain date with a Congressional summer recess thrown in. Is this going to be another get it done fast no matter what so long as it is passed his first year? Will it also turn out to be a bill where no one gets to read it before it is passed since Democrats have already inserted in previous legislation its easy passage with a simple majority in the Senate? I seriously am beginning to wonder whether the speed of this is nothing more than a desire to do anything no matter how it turns out before taxpayers catch on that like the TARP and auto bailouts, spending money he doesn't have and has to borrow seems to mean nothing to this administration. I really don't think that anyone can honestly believe that Obama's proposed savings to pay for this whole thing and make it revenue neutral is believable.

Yes by all means reduce paying for health care so you can keep funding war and destruction, and funneling billions to rich bankers.

President Obama, how exactly is this "change" ??

Brilliant.

WE DID NOT VOTE FOR THIS.

TIME FOR A C-H-A-N-G-E

WHY doesn't Obama just start a NATIONAL EUTHANASIA program, instead of skipping around the class thing and making our most vulnerable citizens pay for everything. Does he think there are not enough poor people in this country suffering?? Slashing programs that have already been reduced in EVERY state????
I guess it is more of the Bush doctrine of PULLING ONESELF UP BY ONES BOOTSTRAPS....I guess after 8 years, we really KNOW what t hat means. Let's just let those poor people die in our streets, because THAT is what already is happening, and is the little nasty SECRET of the United States now.......We'll get a few of those poor people to fight our wars also.

I fear for the future, I see massive taxes, uncontrolled special interest, and out right stupidity on this issue. We as a nation have seen many ideas go by the wayside, always too many hurdles to overcome, ( special intrests, lobbying). In the new era, like the old one, the goverment will wreck havoc on the american taxpayer, and we will be closer to solving the future as we were 25 years ago. In truth goverment health care, health care by degree, will realy make us all sick indeed!

Excerpt from todays article

"Cost estimates for extending health insurance to all Americans exceed $1 trillion over the next decade. Obama's budget proposal set aside $635 billion for health care reform. Today's address adds $313 billion more to the pot, offering what White House budget director Peter Orszag called an "unprecedented" effort to "put down in such clarity how reform will be financed."
-------------------------------------------
Where is the cost savings in this paragraph. It adds trillions to deficit[estimates are always off by 10 times to make it ridiculous).

What are these writers talking about?

As a 72 year old on Medicare, I very seldom see a physician. Had a scare with really high blood pressure and ended up in the ER - then had to see a GP who then sent me to a cardiologist. Got conflicting info from 3 different people at that office and said "no thanks" to them. NO to a chemical stress test, NO to the blood tests, NO to other stuff (had to say stuff since no profanity is allowed on this website).

Am on ONE medication, and pay $10. for a 3 month supply. BUT since I did not sign up for a Medicare D plan - way too costly - I now have to pay another $3.60 per month to my Medicare plan. So I am paying almost double monthly because I pay for my own prescription!

Then when I paid 3 months in advance I got a phone call from them saying I could only pay one month at a time. I questioned this, asked to see this rule in writing and was told a supervisor would call me. Guess what? NO call!!!!!

We have to question, read, study for our own health care. After working in the medical profession for years in nursing, I know that some tests are not really needed and referrals to specialists are sometimes not needed, either. They all want a piece of the pie.

Drugs for the VA are cheaper because the drug companies must bid for the business. Why not the same with Medicare? To me, Medicare D is a gift to the drug companies at our expense.

We need a better constitutional procedure to remove a sitting President. If Obama tries to let the old people die, I for one would try to lobby that we send him back to Chicago.

Now the wealthy might think their Beamers are more important than granddaddy's quintuple bypass surgery.

Eat the rich.

For whatever reason, it would appear that Obama is showing his hand as far as his health care plan is concerned. It appears that a core element is rationing by cost--for example; reimburse physicians less, thus fewer private physicians can afford to remain in practice, thus MORE patients will have LESS access to care. In the meantime those "of means" (read wealthy, former gov't officials, members of congress, etc.) will always have their own personal care guaranteed while the rest of us will go on the waiting list. This list will definitely involve specialized studies now done at a hospital which will also be cost constrained from hiring more staff or buying better equipment. This is just ONE example of the flaw in his plan, and for him to show it before it's initiated just might force more careful consideration rather than rushing it through "before the summer is over"! Need I remind readers of the situation in Quebec, Canada which has NO med-evac helicopters for the entire Province (due to gov't budgeting reasons alone) and which possibly had some influence in the tragic death of Liam Neeson's daughter!

How could hospitals POSSIBLY reduce costs any further? Aren't they already strapped to the bone?

I guess those community outreach organizers are essential to hospital operations.

We NOW have a CLASS WAR to add to the lists of WARS OF THE OBAMA ADMINISTRATION. Anybody that thinks Obama is in touch with the poor people that are right NOW suffering in this country, might as well have fallen off a turnip truck. Obama is a total BETRAYAL to the people that put him in office . His office of the presidency is about the $$$$$ that put him there and ALL the normal special interests, lobbyists, etc ,etc ad nauseum. TOTAL BETRAYAL, particularily for disenfranchised people that voted for him because of the color of his skin. This is NOT about RACE, it is about CLASS. Take away MORE from our most vulnerable.....GIVE to the RICH (banks, etc) and take away from the POOR. Now, isn't THAT EXACTLY what this president has done!

Well, linda_521, It's like this, the insurance industry, medical industry and corporate America don't want logical, efficient, effective, reasonable cost solutions.

Just exactly where is all the money going that has bankrupted so many Americans?

Why doesn't anyone ask that question.
We all know who it's going to, the medical-industrial complex.

My barber told me that he didn't blame his doctor or hospital for his 21,000.00, 2 day hospital fiasco. Thus verifying just how easily Americans are duped by their gods the AMA.

I was just billed 5500.00 for a cat scan that took all of 20 minutes. The machine was so used that the paint was wearing off of it in places. So you know it's been heavily used for years. Let's see, that's 3 scans an hour, 24 scans in a working day, billable total - 132,000.00 a day. That's one million dollars in 7.5 days.

Come on now, truth be told, it's the medical community that has found a deep pool of financial suckers.

I work, as an analyst, researching cost management for Medicare and Medicaid. One thing I have learned is that costs run double due to flat fraud and abuse. A feeding frenzy by, in the main, pharacetical companies and durable medical equipment (wheelchairs, scooters, and other mobility aides, oxygen equipment) providers, accounted for 19 billion dollars in overcharges for one small state just last year. So, a cost saving of $313 is actually modest.

Obama's health plan:

Keeping big rich insurance companies healthy.

Screwing over the old and/or sick.

So,the more I see of this empty suit joke
of a Community Organizer in Chief Fake Messiah Barack Hussein Obama and His Idiotic Health Care Plan,that all leads me
to conclude,Comrade Dictator Wannabe Obama
should more correctly call his plam,"The
Obama Final Solution For The Elderly,The
Poor and Chronic Long Ill People!"

Since clearly Der Leader Obama wants to
exterminate or eliminate all of them,just
like Adolf Hilter in WW2 Nazi Germany!

It's time for our gutless yellow coward own
US Congress to Impeach and Remove Little
Adolf Hitler Wannabe Barack Obama from office or face the entire Congress becoming
unemployed on election day. Let's Make
Comrade Leader Barack Hussein Obama a One
Term President and Out! And please vote
every damn do nothing incompetent gutless
wonder Democrat and Republican out as well.
Time To Take Back America for Americans!

Healthcare Reform -

The insurance industry has geared up to influence health care reform. They will bombard Congress with political contributions and lobbyists. The media will enjoy a huge increase in ad revenues.

I would like to suggest another approach.

What if President Obama by Executive Order made Medicare payment schedules user friendly public information. HCFA can publish CPT schedules in a format that patients and doctors can readily understand and utilize. The President can ask medical providers to agree to accept Medicare pricing for the service provided, if the patient will pay the doctor directly at time of service with a medical credit card issued by either hospitals, banks or insurance carriers. One advantage is that all medical bills (hospitals, doctors, drugs and medical equipment) would be tracked on one database. Most importantly, doctors would no longer have the enormous back office costs of filing a claims form with various insurance companies on different forms and waiting months to get paid. Their financial savings would be enormous. Patients would soon be able to decide if 1st dollar insurance policies are really cost effective. They may well switch to high deductible catastrophic policies, which is really what insurance is supposed to protect against. Patients with verifiable low incomes can have the government pay their credit card bills on a sliding scale based on their income. This could eliminate Medicaid. The implications of this simple change are enormous and it can be done with little cost to government.

Medicare pays doctors far less than insurance companies pay and far far below what an individual without insurance is billed. Doctors today, when they see a patient, do not even know when or how much they will be paid. All they know is that they have been forced to combine into group practices because of the enormous financial cost of filing claims and fighting with insurance companies over billings and procedure approvals.

This is such a simple solution. Doctors know their patients, put them back in charge of their patient’s well being.

Posted by: nlynnc | June 13, 2009 7:41 AM

The profits are the reason the providers and insurance companies are in business; healthcare has been a business. To be a provider in healthcare, deliver competent and compassionate care, that provider insures less profit because they spend more time with the patient. Medicare already limits profits to providers through DRG and other "reforms" in all areas. Medicare provides 50% of the income for all providers, except the physicians who do not participate in Medicare,including hospitals, skilled nursing facilities, home health agencies,durable medical equipment companies, and many outpatient offices. Since its inception, some providers have committed fraud and continue to do so. Others, bend the rules, commit actual fraud but are too numerous to find. It has been a big cash cow to all providers in Medicare. The industry is essentially self policing. Bluntly reducing profits to a set number will be passed on to employees and patients so the actual profit is maintained. Doing more with less does not always work. It becomes exponential assembly line medicine, with top administrators, physicians, making the same or more while employees make the same or less. Those with power and higher income will maintain it and those without it will be further subjugated by it.

Healthcare is a business; the big corporations that deliver services and equipment, maximize profits with their economic and political clout. The small businesses compete with less resources. Managed care and preferred provider organizations limit their groups, limit the choice of provider. They determine fee schedules- who gets paid what.

For profit companies and entities make a profit- financially reward shareholders and executives, not for profit entities do actually make a "profit" but dole it out as bonuses, or obtain real estate to make it look like they did not make one, or if they get caught, get a slap on the hand as punishment.

The healthcare industry does not function as a free market industry and holds patients pretty much hostage with a monopoly in many regions. Whether it would continue to exist as an industry or as an entitlement depends on how it is structured and if providers and patients play on a level playing field. If profit was relegated to a component of the industry versus the top priority of it, it would be possible to make everyone happy.

Good grief doesn't anyone get it? Can anyone read?? We are already paying tax dollars to hospitals etc. to get them to treat the uninsured. Then the hospital BILLS the uninsured patient anyway after treatment

What he is proposing would simply take the money that we are already giving hospitals and reallocate it to the patients themselves. The hospitals will no longer be able to double dip on payment from the govt and then bill the patient too,

If everyone has insurance we dont need to pay the hospitals and pharmacy companies to provide care for the uninsured.

The govt will pay(with our tax dollars) ONLY when care is given. Yes this will save a ton of money, it will cut the hospitals profits is all. That is fine with me!

Let's see, if we cut the programs for the poor and the elderly, that's a start. Next we cut the programs for the blacks and latinos, then for anyone who's sick. As long as they all pay for their health insurance, actually treating them is just an unnecessary expense.

There. That'll make the system profitable.

Our healthcare system has issues today, but what is being proposed is going to take the % GDP spent today on healthcare and INCREASE it, just take a look at Canada! It will also create a class system of healthcare delivery, those who get the "governement plan" and those who can afford private plans. Also, things like the "electronic medical record" that is touted to save billions will take years to create standards and implement and will cost us all billions to deploy. Just one example of the outright misleading claims of our governement to push "governement" healthcare on all americans.
Lastly, has anyone stopped to calculate the impact to our economy of the jobs that are going to be lost as we destroy pharm, device companies in the process of "getting them to pay their fair share" of all this?? Oh I forgot, we'll have plenty of those $8 per "shovel ready jobs" for those folks!

I just lover Jerzy's conservative double speak. Ignore the thousands of physicians and nurses in organizations like PNHP and the CA nurses Assoc. Ignore the many polls that show the garduating classes of many med schools prefer single payer by huge majorities. These people are not "reasonable."

Here are the facts which the Post will not cover:

Myth - “It will be very expensive to get good health to everyone.”

Fact - Actually there’s a way we can have better universal health care at no more than we are now paying (see 5. below). Here are the facts (cf. http://www.pnhp.org):

1. We waste $100 - $200 Billion a year on the high overhead of insurance companies.
2. We waste 200 - $400 Billion a year on doctors filling out forms for insurance companies.
3. I don’t know the compliance cost of patients fighting with insurance companies, but it must also be in the 100’s of Billions.
4. We pay the highest drug cost in the world to drug companies that spend twice as much on profit and three times as much on “marketing” as they spend on research. This is about another $100 Billion each year.
5. Because of the above, we could give Super Medicare (few limitations, no co-pays, no deductibles and complete drug, dental & mental coverage) to everyone at no more cost per person than we are now paying.

Other countries with single payer systems get better health care as measured by all the basic public health statistics and they do it at less than half the cost per person. If we build on our rotten system, we will get a health care system with rotten foundations.

Being a CPA and having worked in the health care field for 25 years, I feel compelled to point out that most of these posters have zero idea what they are talking about. Catchy phrases like "socialized medicine" and "rationing" are meant to create knee-jerk reactions rather than rational thought. While many complain about "costs" they argue simply over who "pays". I find it amusing to observe the contortions people will put themselves through to avoid the obvious, and retain the status quo, as if that works for you.

We currently have a non-system (a system is defined as a group of independent but interrelated elements comprising a unified whole); our patchwork of unrelated elements is disjointed and separate. The physician is the entry point into "the system", rather than, say, a triage nurse who could actually take the time to listen to you and refer you to the apropriate resources, be that a specialist, a community outreach program, a support group, etc. The physician is probably the worst entry point we could devise; the most expensive, has the least time, and who doesn't know or care about other community resources. They do, however, have an entire billing department, each with their own.

If you were king (or queen) of the USA, and you could eliminate the need to charge individual patients for health care services, determined to be appropriate for your subjects in the kingdom by nurses, physicians and the patient, how would you design the system to work? Then, how could you devise a mechanism to pay everyone involved what they were worth in this process? Is an insurance company required? Would insurance administrators, operating under secrecy, going to make better decisions than governmental administrators operating in the open according to "best practices"?

Obama says that, politically, we cannot "start from scratch" because their are too many entrenched and well-funded special interests, and he may well be right. But if the status quo is unsustainable, which I believe it is, then how to we start this 1,000 mile journey?

The best way to persuade a skeptical public that health care needs reform is to have all emergency rooms refuse treatment for the poor and uninsured. The result will be misery, suffering, and an outcry which will lead politicians finally to take action.

What Obama is proposing is just another word for the rationing of health care.If you are to sick to treat[read to expensive] you be left with no care.If Congress goes along with this socialistic plan to weed out the sick and disabled they will lost their jobs in the next election.

"President Obama proposed today to rein in spending on federal health programs for the elderly and the poor...."
_______

"President Obama announced today that the United States will provide $73 million in aid to Zimbabwe...."
________

Obama to Elderly: Drop Dead

I am a Canadian. Every province in Canada devotes 45% of it's budget to health care. Each province also receives more millions from the Fed. govt. for health care. Obama can spin it all he wants but universal healath care is paid for with TAXES. Check with the Europeans - TAXES,TAXES.

What's missing from Obama's proposal is any sort of cap on malpractice awards. Doctors will always practice defensive medicine in the wake of huge awards... I'm not sure how well thought through this is. Obama needs to stand up to the trial lawyers the same we he wants to stand up to big pharma and the hospitals.

Obama'a the black Bernie Madoff. He's a great talker but it will become increasingly obvious even to the Obama cult over the next four years that he's running a public Ponzi scheme. Imagine Obama thinking he's qualified to run our auto industry, our financial system, our health care system and the world climate all at the same time and be effective in foreign policy. He is a slick used car salesman that many believe is God but even he will not be able to talk the American people he suckered into voting for him into his schemes. I do agree that health care for the poor in America should be drastically cut back. It is largely for people who have nothing else to do but sit in a doctor's office with their children that we pay for them to have out of wedlock. Here are some predictions that are not difficult to make. In four years we will not have taken one step toward energy independence that matters, the deficit will be the largest by every measure in the history of our country, our health care system will still be expensive and inefficient, our foreign policy will not be any better and may be worse than it was under Bush, Wall Street will still be corrupt and an arm of the federal government, contributing billions to both Democrats and Republicans, and our economy will be a disaster. Obama is a one term president so the cult should enjoy their worship while it lasts. So far though it is costing every man, woman and child over half a million dollars in debt to go down Obama's primrose path. He truly is the black Bernie Madoff.

Let's look at who's doing the complaining about healthcare-

1. Illegal immigrants
2. Students who just graduated and found out they actually have to pay for their own health-care.
3. People too lazy to move or re-invent themselves.

I work for a living and pay premiums for healthcare. I have a great policy and it works for me and my family. People who work and have employer subsidized health-care are too busy working to complain or protest.

I don't want Obama care, i don't want my benefits taxed, I don't want a national sales tax scheme that would kill any chance of recovery.

Would someone show this impetulant and belligerent little boy, along with Orzag and Axelrod the door, on Election Day in 2012?

If Obama, et al want to reduce health care costs, start with a law prohibiting campaign contributions from the health care industry to President and members of Congress. Continue with limiting the number of health industry lobbyists whose salary we all end up paying for. Finish by keeping candidate Obama true to his promise to not tax working people's health insurance premiums (for those who switched their votes from McCain to Obama for that very issue, well, they have been defrauded.) Invite to the table those who have studied this issue for decades, but whose only deficiency is to claim that health care should not be a for-profit business and that access to affordable health care is a right not a privilege. Finally, have the media be useful for once and truly explain health care systems from other industrialized countries, which, except for the UK, is totally private (total access to any doctors/clinics/hospitals--no in and outside networks here--with one ATM-like card, the only part being 'socialized' is the administration of it all--just like Medicare, Medicaid, the Military, etc., etc. America has the resources, the technology and the incentive to transform its health care system (yes, we can!)by being bold, radical, progressive--if only it had the will!

Many doctors have chosen to opt out of Medicare. that means that they will no longer take Medicare patients because the medicare payments DON'T COVER THEIR COSTS!

So to solve the problem the Government proposes to cut payments more. How stupid is that?

Health care is a huge cash cow. Everybody needs to see a doctor from time to time. So, health care has been monetized. The trouble is, the big players have gotten greedy. Employers and their direct reports are paying more for less. The government programs are very popular and are routinely mined for ill-gotten gains. The same wheelchair was sold over 1,000 times at full cost to the government. No patient benefited. A felon went freely about his business. Exactly why do you have to have an employer in order to get the benefit of health insurance? Either that or have no record of anything more serious than a hangnail and the common cold.

There is always enough money to pay off campaign contributors and there is always enough money to murder bushels of brown people in other countries. But there is never enough money in this country to take care of our own citizens, other than to lock them up in corporate-owned prisons of course.

When are you idiots going to realize that there is no republican or democratic parties, but there is one corporate party with two marketing arms? There will never be meaningful change within this rigged game.

If a business controls the product selection in a market segment then there is no real alternative and the business wins regardless of the product selected. It's true with dishwasher detergent, shampoo, and political parties.

Sheep get sheared.

I am a Canadian. Every province in Canada devotes 45% of it's budget to health care. Each province also receives more millions from the Fed. govt. for health care. Obama can spin it all he wants but universal healath care is paid for with TAXES. Check with the Europeans - TAXES,TAXES.
Posted by: brely | June 13, 2009 11:13 AM
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That's better than PREMIUMS, COPAYS, AND BANKRUPTCY.

Obama doesn't have cost savings, all this is phoney. I worked five years in hospitals in financial area. I know nonsense when I see it.

Since that time I have worked in the medical area in research and can tell where saving exist. People in politics keep doing the same things again and again, Obama is no exception. Brown years ago in California used to do the same thing when it came to hospitals. You can not keep trying cut hospital revenue as you simply put them in bankruptcy.

This is not General Motors where cars are simply from another country (China) instead manufactured here. Than again patients could be outsourced to another country for there healthcare. Labor costs are 70% and ours are not cheap. Could ship patients to mexico if we setup hospitals there or bring cheap labor here. But the politics would be impossible. Still it does show that skilled american labor is expensive. It does show that reform from people in politics is nonsense in healthcare because it is local. Worse is the ER where people wait for hours and if they get tired they go home to die.

For michael4 - Canada spends less than half per person of what we spend on health care and they get better bottom line results than the US. Look it up.

For crodgers23 -
1. The total of all malpractice insurance premiums amounts to 0.56% of health care costs.

2. The CBO has examined the idea of defensive medicine. They found no difference in practice between state with limits on tort settlements and those with no limits. Defensive medicine is a myth.

Obama is assuming there is no more cost-shifting because everyone will have "coverage", therefore costs will be lower as a result.

One solution to all this statist nonsense is to borrow a page from Ayn Rand's novel, Atlas Shrugged: Doctors, hospitals, pharmacies, drug companies, and medical equipment manufacturers should threaten to GO ON STRIKE and refuse to participate in Medicare anymore on a date certain (July 4th, Independence Day, would be symbolic but probably too soon).

The Atlases of Medicine would return when Obama and company stop marching us down the road to socialized health care, which is unconstitutional, immoral, economically catastrophic, and--given the availability of free-market proposals--quite unnecessary.

This would certainly mobilize the Greatest Generation to speak up and protect their piece of the collectivist pie. This group is after all a very, very active voting block.

Fight fire with fire. After all is said and done: Who is John Galt?

Government controlled health care will not improve competition among health insurance companies. In fact, it will do the opposite. Who would want to continue to pay for their own private health insurance plan when they are already being forced to pay for Obamas plan? Soon enough we will find that private companies won't be able to compete with the governments plan. People who were once happy with their private insurer will have to switch to the government's socialized medicine because they are forced to pay for it whether they use it or not. Socialism has failed in every country that has tried it. Now is not the time to introduce socialism to America.

As an Orthopedic surgeon I can only say that unless something is done about tort reform nothing will stop me ordering tests as a precaution to being involved in a malpractice case .Cost is the last thing on my mind .Also we read that the American people do not want 'choice of physician ' taken away from them .Does anybody realize that the only people who can choose their doctor without any strings attached are Medicare recipients .I say bring on a single payer and get rid of the corrupt insurance companies

Linda_521,

Single-payer won't pass because a lot of folks who use various private insurers right now will not risk loosing them for a funding and services model that has mixed results elsewhere, aka Canada. (I think getting any model to work well is about accountability and good legislation - which I don't trust our Congress to pull-off)

Having said that, we MUST fix the rising costs of the current system. The Congressional Budget Office (and every other projection from Cato to Brookings) shows that Healthcare will bankrupt the country in 25-40 years.
http://www.cbo.gov/publications/collections/health.cfm

The problem also compounds the longer we put it off for the "perfect" solution. Support one now that will get votes to pass!

What is the basis for the following statement: "His 10-year budget would shrink the $1.3 trillion annual deficit left by the Bush administration before allowing it to widen again in its final years, even before taking new spending on health care into account." The following website shows the final Bush deficit being closer to $410 billion: http://blog.heritage.org/2009/03/24/bush-deficit-vs-obama-deficit-in-pictures/
It seems to me that such egregious discrepancies are a result of some considerable deficit shifting on the part of someone.

I have not seen any evidence that the final Bush deficit was $1.3 Trillion. Please document this assertion. Thanks.