LOL! My Republican alternative would be to take on a system very much like the Canadian system. Despite the handful of horror stories that US politicians like to trot out, I know way too many happy Canadians, and transplanted Americans living in Canada, first hand. That includes fighting cancer, having babies, setting broken bones, you name it. Those I know who've endured both systems say Canada's is working better.
I think the rush is really out of politcal practicality and does have a lot to do with "do something while we have this unusual majority in both chambers". The more time spent on crafting and passing a bill the more time the extremely powerful vested interests arrayed against significant health care reform have to defeat it. I think this really has to be a "strike while the iron is hot" deal.
Refman, try to get the figures national health care if done properly will save money. In addition don't you think that there are things that could switch the money from to pay for it. The Bush tax cut, which you and I don't make enough to have beneiftted much from, would have done so. Besides don't you have any compassion (I want to avoid loaded concepts like Christian charity) toward the uninsured.
I agree in theory - I would really like to see some experimenting done as happened during the 1990's with welfare and individual states trying their own thing. However, I'm not sure how well that transfers to health-care. I think there are two issues here as far as the speed goes: 1. There is the unusual majority opportunity aspect. However, I'm not sure it's necessarily the wrong way to go from that aspect. After 2010, the 2012 campaign starts up, and chances for reform pretty much die during 2011/2012. The Dems had one chance in 1994 - they screwed it up and waited 15 years for another. If they believe it's a vital thing, then taking the chance on getting nothing could be the worst option. For example, if we had addressed the problem in 1994 even with a less-than-ideal solution, would we be better off than today, given how much health care costs have spiraled? 2. On the flipside, I'm not sure this is really being rushed. It feels like it, but consider that Dems and liberal thinktanks have been discussing these ideas for 15 years now. The reality with Congress is that they are going to do the vast majority of their work at the end of the process, and even within the Congressional aspect of it, the vast majority of the work will get done in the final weeks/days of the process. So we could spend 5 years doing more research, but whenever Congress gets around to it, it will still feel rushed - that's just the nature of how everything Congress does looks from the outside.
I forgot to mention this part - I think the new tax is dead-on-arrival. The strategy they seem to be using to get around all of the ways opposition can kill a bill is to pass something - basically, anything semi-functional - in each chamber. Then fix it up in the Senate-House conference and get it right there, and then leave everyone with an up-or-down vote with no amendments and no filibusters and hope the Dems can cobble enough people together to vote for the final product. The high-end tax just helped get some people on board, but it will be gone in the end.
According to the CBO, the proposed health care bills are not controlling healthcare costs. http://finance.yahoo.com/news/CBO-H...WsA?x=0&sec=topStories&pos=main&asset=&ccode= The health reform bills released so far would increase government spending on health care without sufficiently reining in health care costs. And at least initially they aren't likely to significantly lower premiums for the majority of Americans with employer-sponsored health insurance. That's the sobering takeaway from testimony Thursday by Congressional Budget Office Director Douglas Elmendorf. Elmendorf's preliminary conclusions were based on a bill jointly released by three committees in the House this week and another bill passed by the Senate health committee on Wednesday. "The creation of a new subsidy for health insurance ... would by itself raise federal spending on health care. ... [T]o offset that there have to be substantial reductions (on the tax or spending sides of the ledger]," Elmendorf told the Senate Budget Committee. "The changes we've looked at so far don't represent the fundamental change on the order of magnitude that would be necessary." CBO analyzes the costs of legislation. Congress is not obligated to follow their lead on estimates, but the agency can play a key role in shaping bills. Both the House bill and the Senate health committtee bill would use federal money to subsidize financially strapped Americans so they can buy health insurance. They would also create a national insurance exchange from which eligible Americans could choose among insurance plans. And they would establish a public health plan to compete with private insurers on the exchange. Elmendorf did not offer any assessment of a bill in the works at the Senate Finance Committee, which has yet to release draft legislation. Health policy analysts support two ways to "bend the curve" on health care costs above others, Elmendorf said. Change how employer-paid premiums for workers are treated -- currently they're tax-free to the worker. Change how Medicare pays providers to reward cost efficiency and quality of outcome rather than the a la carte approach of fees for service. The prospect of taxing a portion of employer-provided health benefits has become a political lightening rod on Capitol Hill as many lawmakers and unions expressed staunch opposition, and President Obama did not offer his outright support. Consequently, while taxing a portion of health benefits was a leading "pay-for" idea -- at least in the Senate Finance Committee -- the political pushback has muted its prospects for being a serious contender at this writing. Instead, the tricommittee House bill proposes to pay for half the cost of reform by taxing the richest households -- imposing a surtax as high as 5.4% for income over $1 million, and imposing lower rates on households making at least $350,000. Asked if cost containment becomes more difficult by relying primarily on Medicare cost savings without taxing employer-provided health benefits, Elmendorf said, "Tying one of the two hands behind one's back makes the job that much harder." The long-term concern The CBO has said numerous times and in numerous ways that the federal budget is on an unsustainable course. The economic crisis has made the debt situation more urgent, but it is not the primary cause. "Over the next 50 years, with rising health care costs, the retirement of the baby boom generation, and the permanent extension of the 2001 and 2003 tax cuts, federal debt will climb to more than 400% of the gross domestic product," Senate Budget Committee Chairman Kent Conrad, D-N.D., noted during Thursday's hearing. But there will be risk to the economy within the next 10 years. The country's debt is on track to exceed 60% of GDP next year and will top 80% by 2019. And that assumes interest rates stay low. Should buyers of U.S. debt grow concerned, however, that the country is not addressing its debt situation adequately they will start demanding higher rates, which would make the country's debt situation even worse. That's why fiscal policy experts have been calling on lawmakers to rein in health care costs, find ways to boost tax revenue and cut spending as soon as the economy is in recovery. Premiums unlikely to go down soon When asked whether the health bills released so far would help reduce premiums for Americans with health insurance, Elmendorf said the people most likely to see a decrease in what they pay are those who currently buy policies on their own because their employer doesn't provide a policy. That group could see their costs go down for three reasons: the creation of an insurance exchange; the additional competition from a public plan option in the exchange; and guarantees that insurers could not refuse coverage to anyone with a pre-existing condition, Elmendorf noted. But for the vast majority of Americans -- those who get their insurance through their employers -- the cost-reducing potential of the exchange and public plan, at least initially, would have "fairly small effects relative to the level and trajectory that health care premiums are taking," he said. "We don't think those workers will see noticeable changes in their premiums." That's in part because the two bills as they're written currently would limit eligibility for who may use the exchange. Should specialists, nurse practitioners and physician assistants be encouraged to fill in the gap left by shortage of primary care doctors? We want to hear about your experiences. E-mail your story to realstories@cnnmoney.com.com and you could be part of an upcoming article. For the CNNMoney.com Comment Policy, click here.
This would be a real problem. Regardless of what the final solution is, if it doesn't control costs, it's doomed to failure. The primary focus should be on controlling costs rather than covering everyone. You can't do the latter without the former for any length of time.
Yes, but how do control cost? You have to take away from the docotors, drug companies, hospitals and insurance companies, no one is willing to do that on a level that really matters.
I think these are really two completely separate issues. Health care costs are going up everywhere and every country will have to deal with that at some point, and the solution to that problem, although difficult, will be fairly straight forward, imo. The primary causes for the increasing cost of health care is linked to advances in technology, and a large secondary factor is the aging of our population. We are developing more sophisticated treatments and drugs all the time, but many of these are very expensive. At some point, then, we’re going to have to make some tough decisions about what should and should not be covered by basic health care insurance. In Alberta the AHCIP has recently delisted the limited chiropractic care that had previously been included, and sex change operations. http://www.calgaryherald.com/health/Delisting+Alberta+health+services+back+agenda/1498397/story.html These were not overly controversial decisions but in the next couple of decades I think tougher decisions will likely have to be made. Again, his is a question of redefining what constitutes basic care, however, and is separate from the issue of universal coverage. Basic universal health care is a basic right for all citizens in first world countries, but what basic means will be up for debate in coming years. For example, a lot of money is spent on end of life care that produces very little gain. Many thousands of dollars are often spent extending someone’s life a few months, and often their quality of life during that time is not very good, and I suspect that we’ll see some of those end of life procedures being delisted in the future. A person or their family will always have the options to pay for them themselves, of course, or to buy private insurance to cover such possibilities, but I suspect that we’ll come to the conclusion at some point in the future that the state should not be spending tens of thousands of dollars to extend the life of an 85 year old person for only a few months.
Biden says we need to spend more money, or else we will go bankrupt... http://www.cnsnews.com/public/content/article.aspx?RsrcID=51162 (CNSNews.com) – Vice President Joe Biden told people attending an AARP town hall meeting that unless the Democrat-supported health care plan becomes law the nation will go bankrupt and that the only way to avoid that fate is for the government to spend more money. “And folks look, AARP knows and the people with me here today know, the president knows, and I know, that the status quo is simply not acceptable,” Biden said at the event on Thursday in Alexandria, Va. “It’s totally unacceptable. And it’s completely unsustainable. Even if we wanted to keep it the way we have it now. It can’t do it financially.” “We’re going to go bankrupt as a nation,” Biden said. “Now, people when I say that look at me and say, ‘What are you talking about, Joe? You’re telling me we have to go spend money to keep from going bankrupt?’” Biden said. “The answer is yes, that's what I’m telling you.” (Listen to Audio) The event, sponsored by the AARP – which supports the Obama administration’s plan – was attended by mostly AARP members who were bussed in for the meeting. Biden took time from answering questions to chat with a member of the audience, who were mostly members of the AARP. Biden told the group that the Obama health plan will not eliminate people’s ability to choose their health care insurance and that people who cannot afford insurance will be covered by the plan. “They’ll be a deal in there so there’s competition, so what you’ll have in there is you’ll have the ability to go in there and say, ‘Now look, this is the policy I want. This is the one,” Biden said. “And those people who can’t afford to get in there, up to a certain income, we’re going to subsidize them, you get in there and we’ll help you pay for it,” Biden said. After opening remarks by Biden and AARP CEO A. Barry Rand, the audience asked questions, which were fielded by Biden, Health and Human Services Secretary Kathleen Sebelius and Nancy Ann DeParle, director of the White House Office of Health Reform.
I think Biden is saying that we have to spend a trillion or two more over ten years to fix the system. 2007 OECD findings on how much we spend on healthcare in comparison to the rest of the world.
I don't believe costs can be controlled. Technology is improving rapidly and it's expensive. Whether it's a free market system or a government run system, I think costs are going to continue to go up. I actually think talking about "controlling costs" could hurt passage of the bill. When you think of controlled costs in health care, you think of getting denied coverage, waiting lines, etc.
What you SHOULD be thinking of here is denying shareholder profits, exorbitant C-level salaries and bonuses, and all of the "overhead" that consumes 30% of the dollars that go to the insurance industry.
In that case, none of this matters. Health care costs are spiraling up at several times the rate of wages - which is completely unsustainable. If we pass gov't care, we'll go broke. If we don't, only the rich will have health care soon. In either case, the whole system will implode.
There was a time that we thought overhead and shareholder profits were bad, then we tried socialism. Is this stuff also bad in other markets or just medicine?
That endgame would potentially be a libertarian's wet dream. No gov. intervention in healthcare because the government can't afford to do so. Private industry would theoretically rise up and provide everyone with healthcare driven at fair market values...
