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Posted

Given the exchanges are relatively new, and many not set up, and some red states playing hardball, then isn't it a bit early to judge the sucess of a programme? Based on evidence from places like Australia, which have incentives to get people to also take out private health insurance, people don't generally think about it until tax time when they become aware of the tax penalties for not having private health insurance and then take it out.

So it is a bit rich running around after the first week and saying 'see, it isn't working'.

Having said that, the only way to get people to take out the right level of health care is to make it universal, automatic and based on need, not on what you've paid. You can never predict what level of medical care you need, and if left to a private market, like the US still is, people still will refuse to insure, or under insure. The exchanges will bring health care to many via the tax sting if they don't, but not to all unfortunately.

In other words, it's ill-conceived, poorly implemented, and doomed to fail. But that doesn't stop it from costing federal and state governments $trillions.

And we're supposed to like it?

No, it is a half way house to a proper system of universal health care.

It is a bit disingenuous of you to criticise the this interim given your side of politics has gotten apoplectic at Obamacare, let alone a proper single payer government funded system.

Or are you advocating for a UK, EU, Australian type system? Cause the one which Obamacare is replacing sucks.

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Posted

@midas, let's speak again after tax time. I know American exceptionalism means you blokes are loath to admit other places in the world can do things differently and better, but it happens you know? wink.png

As for MaxYakov. Of course this doctor is going to say that. Health systems which are a little more universal in nature mean that he'll only be able to buy two BMW's annually instead of his usual three. Listening to the most self interested parties in debates such as this does no one any good. The doctors union, otherwise known as the AMA, are ultimately there to represent their members, not patients, though they will still present their self interested arguments under the auspices of patient care.

As for being slaves? Ask the citizens of every other democratic OECD country (yes their are others who do democracy too) whether having access to medical care makes you feel like a slave, and they'll laugh in your face. Not having to worry about your health care is the ultimate freedom.

On American Exceptionalism: Maybe you should do a little research on a term before using it: http://en.wikipedia.org/wiki/American_exceptionalism

Not to worry, Obama (or his speech-writers) is ignorant of the term and its history also - by his very use of it in his speeches.

On Dr. Carson: Do I detect a bit of wealth-envy? Have you visited his garage or had access to this tax returns? Considering his career, do you begrudge him his wealth? I'd say he said what he said because he's a political conservative.

On the American Medical Association (AMA): So that's your opinion of the AMA - to ultimately represent their members and not the patients? So you think his speech was a violation of the AMA's mission statement?:

The AMA's stated mission is to promote the art and science of medicine for the betterment of the public health, to advance the interests of physicians and their patients, to promote public health, to lobby for legislation favorable to physicians and patients, and to raise money for medical education

http://en.wikipedia.org/wiki/American_Medical_Association

On the USA: That would be a constitutional republic of fifty states, last I looked. A least one other on this thread has difficulty remembering the "constitutional" part. You might want to read about it here:

http://en.wikipedia.org/wiki/Federal_government_of_the_United_States

On "Not having to worry about your health care is the ultimate freedom": Would you be willing to live under a totalitarian government as long as it provided you with worry-free health care?

What makes you think that having universal health care means you have a totalitarian government? Plenty of mature democracies can walk and chew gum on this matter...

As for criticising the good doctor? A good truism of politics: the ones squealing loudest often have most to lose.

As for the AMA? A grouping of profession who look out of the interests of its members? A union in my book. If it walks like a duck, and talks like a duck.... You've just never thought about it through the prism I've presented it in, hence the disbelief.

Posted

Given the exchanges are relatively new, and many not set up, and some red states playing hardball, then isn't it a bit early to judge the sucess of a programme? Based on evidence from places like Australia, which have incentives to get people to also take out private health insurance, people don't generally think about it until tax time when they become aware of the tax penalties for not having private health insurance and then take it out.

So it is a bit rich running around after the first week and saying 'see, it isn't working'.

Having said that, the only way to get people to take out the right level of health care is to make it universal, automatic and based on need, not on what you've paid. You can never predict what level of medical care you need, and if left to a private market, like the US still is, people still will refuse to insure, or under insure. The exchanges will bring health care to many via the tax sting if they don't, but not to all unfortunately.

In other words, it's ill-conceived, poorly implemented, and doomed to fail. But that doesn't stop it from costing federal and state governments $trillions.

And we're supposed to like it?

No, it is a half way house to a proper system of universal health care.

It is a bit disingenuous of you to criticise the this interim given your side of politics has gotten apoplectic at Obamacare, let alone a proper single payer government funded system.

Or are you advocating for a UK, EU, Australian type system? Cause the one which Obamacare is replacing sucks.

I will never advocate for "a UK, EU etc. type system." It puts the people in slavery and it isn't working out so well. In fact it's going broke. On top of that, the poor suckers who bought into it pay such high taxes that I can't believe how much things cost there. The taxes are "hidden" in the price of consumer goods and other taxes. It's also effectively rationed. Anyone who denies the problems today, and the upcoming problems with NHS is kidding himself.

Now, we had a link on this very thread that showed that 85% of all Americans are covered by health insurance. The drive to put through Obamacare does not cover that other 15% unless they pay for it. Right now senior citizens have Medicare and poor people have Medicaid. Most companies provide insurance for employees and the self employed have access to buy it.

Taxes are super low in the US as are consumer prices.

Obamacare is NOT a step in the right direction. It is a step backwards which will cost all 50 states and the federal government $trillions in administration and implementation.

I don't think you know what Obamacare is. I also don't think you know how much "other countries" citizens" pay for their "free" health care in hidden costs.

I don't think you know much at all, frankly.

Obamacare is a federal mandate that those who are uninsured buy their own insurance or pay a fine, period. You act like you think this is government provided health care. Obviously you don't mind your government ordering you around, but I do mind it.

  • Like 2
Posted

@midas, let's speak again after tax time. I know American exceptionalism means you blokes are loath to admit other places in the world can do things differently and better, but it happens you know? wink.png

As for MaxYakov. Of course this doctor is going to say that. Health systems which are a little more universal in nature mean that he'll only be able to buy two BMW's annually instead of his usual three. Listening to the most self interested parties in debates such as this does no one any good. The doctors union, otherwise known as the AMA, are ultimately there to represent their members, not patients, though they will still present their self interested arguments under the auspices of patient care.

As for being slaves? Ask the citizens of every other democratic OECD country (yes their are others who do democracy too) whether having access to medical care makes you feel like a slave, and they'll laugh in your face. Not having to worry about your health care is the ultimate freedom.

On American Exceptionalism: Maybe you should do a little research on a term before using it: http://en.wikipedia.org/wiki/American_exceptionalism

Not to worry, Obama (or his speech-writers) is ignorant of the term and its history also - by his very use of it in his speeches.

On Dr. Carson: Do I detect a bit of wealth-envy? Have you visited his garage or had access to this tax returns? Considering his career, do you begrudge him his wealth? I'd say he said what he said because he's a political conservative.

On the American Medical Association (AMA): So that's your opinion of the AMA - to ultimately represent their members and not the patients? So you think his speech was a violation of the AMA's mission statement?:

The AMA's stated mission is to promote the art and science of medicine for the betterment of the public health, to advance the interests of physicians and their patients, to promote public health, to lobby for legislation favorable to physicians and patients, and to raise money for medical education

http://en.wikipedia.org/wiki/American_Medical_Association

On the USA: That would be a constitutional republic of fifty states, last I looked. A least one other on this thread has difficulty remembering the "constitutional" part. You might want to read about it here:

http://en.wikipedia.org/wiki/Federal_government_of_the_United_States

On "Not having to worry about your health care is the ultimate freedom": Would you be willing to live under a totalitarian government as long as it provided you with worry-free health care?

" On "Not having to worry about your health care is the ultimate freedom": Would you be willing to live under a totalitarian government as long as it provided you with worry-free health care? "

Yes indeed...........I don't know how much of this is fact or fiction but it certainly thought-provoking, isn't it?ohmy.png

http://www.naturalnews.com/042427_Obamacare_private_details_Trojan_Horse.html##ixzz2hKfrEbN7

Posted

Sorry Scott please allow me to add.

Whilst the GDP numbers are clear, lest we forget a large proportion of the cost is for medicine with high cost patent medicines, when you factor those numbers out and replace them with generics the cost drops significantly.

Sorry back on topic.

Edit: messed up quotes

Posted

The AMA's stated mission is to promote the art and science of medicine for the betterment of the public health, to advance the interests of physicians and their patients, to promote public health, to lobby for legislation favorable to physicians and patients, and to raise money for medical education

http://en.wikipedia.org/wiki/American_Medical_Association

You should read your links a bit better there Max.

The AMA opposed Medicare.

Milton Friedman, one of the founders of the Chicago school of economics called the AMA a 'guild', ie a professional union.

The opposed more doctors being trained, because, who wants more competition to force down wages???

Posted

In other words, it's ill-conceived, poorly implemented, and doomed to fail. But that doesn't stop it from costing federal and state governments $trillions.

And we're supposed to like it?

No, it is a half way house to a proper system of universal health care.

It is a bit disingenuous of you to criticise the this interim given your side of politics has gotten apoplectic at Obamacare, let alone a proper single payer government funded system.

Or are you advocating for a UK, EU, Australian type system? Cause the one which Obamacare is replacing sucks.

I will never advocate for "a UK, EU etc. type system." It puts the people in slavery and it isn't working out so well. In fact it's going broke. On top of that, the poor suckers who bought into it pay such high taxes that I can't believe how much things cost there. The taxes are "hidden" in the price of consumer goods and other taxes. It's also effectively rationed. Anyone who denies the problems today, and the upcoming problems with NHS is kidding himself.

Now, we had a link on this very thread that showed that 85% of all Americans are covered by health insurance. The drive to put through Obamacare does not cover that other 15% unless they pay for it. Right now senior citizens have Medicare and poor people have Medicaid. Most companies provide insurance for employees and the self employed have access to buy it.

Taxes are super low in the US as are consumer prices.

Obamacare is NOT a step in the right direction. It is a step backwards which will cost all 50 states and the federal government $trillions in administration and implementation.

I don't think you know what Obamacare is. I also don't think you know how much "other countries" citizens" pay for their "free" health care in hidden costs.

I don't think you know much at all, frankly.

Obamacare is a federal mandate that those who are uninsured buy their own insurance or pay a fine, period. You act like you think this is government provided health care. Obviously you don't mind your government ordering you around, but I do mind it.

Yep, whatever.

I've lived in the UK, paid taxes there and been treated by the NHS.

I've lived and worked in Australia. Am an Australian citizen and just returned from a three year stint there partly due to looking after a close family member who was cared for there, including two bone marrow transplants which in the US would have cost half a million a pop. World class care, and didn't cost our family a cent. Oh yeah, we just had an election last month, where we voted in a conservative government, and we have those federally every three years, every four years at a state level. None of us are under a government yoke. We get more opportunities to kick out our leaders than you do.

And we pay a heck of a lot less for our health care as a % of our GDP than you do, so yes, I do know how much health care costs. It costs a lot less than yours.

I know it isn't one of your conspiracy theory websites, but for many of us, the world bank is pretty authoritative.

http://data.worldbank.org/indicator/SH.XPD.TOTL.ZS

We could agree on one thing. Health care costs in the US are much too expensive. However, Obamacare missed a big opportunity to do something about that. Off the top of my head I could name ten things I'd like to see happen to lower the costs and it should be done.

It's one of my biggest complaints about Obamacare. It forces the uninsured to buy insurance to pay for this expensive health care without addressing costs.

If the government, instead of forcing Obamacare on people, had first gone to work to reduce costs, it would have done the country a lot more good. But in a nutshell, the reason that health care costs are so expensive is that so many special interests have lobbied for their piece of the pie, and the costs are largely controlled by the lawyers and the lobbyists.

Obamacare has done nothing to improve health care for Americans. It has taken the existing expensive system and crammed it down the throats of everyone, forcing people to buy insurance to pay for it or pay a fine.

I can't see how anyone likes it. Once it's had a year, and people see what it really is, I think it will become VERY unpopular. For the time being, some people mistakenly think it is a "step in the right direction" when if fact it is a big step backwards, assuring that the broken system gets more entrenched.

It's a loser, which maintains the high costs and forces that on everyone, much to the delight of those who profit from it.

  • Like 1
Posted

The AMA's stated mission is to promote the art and science of medicine for the betterment of the public health, to advance the interests of physicians and their patients, to promote public health, to lobby for legislation favorable to physicians and patients, and to raise money for medical education

http://en.wikipedia.org/wiki/American_Medical_Association

You should read your links a bit better there Max.

The AMA opposed Medicare.

Milton Friedman, one of the founders of the Chicago school of economics called the AMA a 'guild', ie a professional union.

The opposed more doctors being trained, because, who wants more competition to force down wages???

I was interested only in their mission statement. Of course, what they say their mission is and what their agenda actually is could differ - you should be able to vouch for that, yes? I don't care if they opposed Medicare - that's not the subject of this thread (neither is the AMA, for that matter). Since around only 25% of doctors are members AND it cannot be confirmed that Dr. Carson is a member, I fail to see how it bears substantially on the subject of Dr Carson or his speech.

Can you provide a source for your latest assertion?

Posted

The American Medical Association (AMA) is one of the biggest culprits in high medical costs in the US. But they got a pass in Obamacare. They have had the power to limit the number of new doctors and the number of new medical schools in the US, creating something far less than a free market and very high pay for doctors.

Obamacare gave them a pass, and forced everyone to buy insurance to pay their exorbitant fees. They are, after all, big lobbyists and campaign contributors.

"...But that’s not how it has worked in medicine since 1910 when the Flexner report, commissioned by the AMA, declared that a surplus of substandard medical schools in the country were producing a surplus of substandard doctors. The AMA convinced lawmakers to shut down “deficient” medical schools, drastically paring back the supply of doctors almost 30% over 30 years. No new medical schools have been allowed to open since the 1980s.

Still, the AMA along with other industry organizations until recently had issued dire warnings of an impending physician “glut” (whatever that means beyond depressing member wages), even convincing Congress to limit the number of residencies it funds to about 100,000 a year. This imposes a de facto cap on new doctors every year given that without completing their residencies from accredited medical schools, physicians cannot obtain a license to legally practice medicine in the U.S. Even foreign doctors with years of experience in their home countries have to redo their residencies–along with taking a slew of exams–before they are allowed to practice here...."

Forbes

Posted

A record 70 percent of Americans disapprove of the way Republicans in Congress are handling their jobs, according to the new NBC News/Wall Street Journal poll, but outside Washington, Republican governors are faring much better.

http://nbcpolitics.nbcnews.com/_news/2013/10/12/20923992-gop-governors-separate-themselves-from-an-unpopular-party?lite

Full poll results here:

http://msnbcmedia.msn.com/i/MSNBC/Sections/A_Politics/_Today_Stories_Teases/Oct_poll.pdf

Posted

Jeez, more education by Google and political spin.

GPs make surprisingly little money. I have several friend and client GPs that either stopped taking any insurance (illness) patients or see them 2 days a week. They have turned to anti aging, IV and alternative therapies so they can make more than $30 or so for a visit.

Plastic surgeons do well because elective is outside insurance coverage. ER docs make squat for the amount of education. Thoracic surgeons make less than some of my young associates. The orthopods and neurosurgeons can do okay, but 2 level spinal fusions pay only about $1,200 to $1,500 for 3 hour surgery that is very invasive, delicate and requires much skill.

Lets just say most medical devise and drug reps I know make more than the doctors so this should tell you were a big problem is. To say docs are running up charges and burdening the system reflects educated by Google and political rhetoric that is just as ignorant or simply dishonest.

  • Like 1
Posted

I am slightly suspicious of doctors who are clients of an attorney.....just saying.

Health care lawyer also does compliance, regulatory, stark, QA, review contracts, draft and review lease agreements with medical device companies and etc. for docs that have never been sued for malpractice. I also know many good radiologists and anesthesiologists that are top of their field, but get dragged into litigation yearly. Then I have seen some orthos I would not let put a cast on me, much less operate on me.

The issue was compensation or amount billed insurance companies for service. That does not change if they are top in field or a hack that gets sued often.

Posted

Thanks, F430murci, I suspected that, but I just couldn't resist having a little poke! My apologies.

Posted

Below is an excerpt from a CNN article I just read concerning the Tea Party and Obamacare.

[(CNN) -- If we allow this awful measure to stand, predicted the conservative spokesman, "behind it will come other federal programs that will invade every area of freedom as we have known it in this country until one day...we will wake to find that we have socialism [and] we are going to spend our sunset years telling our children and our children's children what it once was like in America when men were free."

This could be a tea party representative warning about the perils of Obamacare and willing to keep the government closed until it is delayed or repealed. But it was Ronald Reagan speaking back in 1961. And the program he viewed as the driving wedge of socialism was Medicare.]

http://edition.cnn.com/2013/10/12/opinion/kazin-tea-party/index.html?hpt=hp_t5

So whether it's medicare, social security, civil rights...whatever, conservative Republicans never seem to change their tune.

  • Like 1
Posted
We could agree on one thing. Health care costs in the US are much too expensive. However, Obamacare missed a big opportunity to do something about that. Off the top of my head I could name ten things I'd like to see happen to lower the costs and it should be done.

It's one of my biggest complaints about Obamacare. It forces the uninsured to buy insurance to pay for this expensive health care without addressing costs.

If the government, instead of forcing Obamacare on people, had first gone to work to reduce costs, it would have done the country a lot more good. But in a nutshell, the reason that health care costs are so expensive is that so many special interests have lobbied for their piece of the pie, and the costs are largely controlled by the lawyers and the lobbyists.

Obamacare has done nothing to improve health care for Americans. It has taken the existing expensive system and crammed it down the throats of everyone, forcing people to buy insurance to pay for it or pay a fine.

I can't see how anyone likes it. Once it's had a year, and people see what it really is, I think it will become VERY unpopular. For the time being, some people mistakenly think it is a "step in the right direction" when if fact it is a big step backwards, assuring that the broken system gets more entrenched.

It's a loser, which maintains the high costs and forces that on everyone, much to the delight of those who profit from it.

I'm sure you can probably name 10 things that can bring the costs down. Here's the 11th, and the most effective: Government procures the costs medicines on behalf of hospitals and pharmacists.

Economics 101. When you have a powerful/oligopoly seller you need a powerful buyer who can negotiate the lowest and most economically efficient price. Brings the cost of health care way down. No way an individual buyer can haggle with a powerful pharma company as well as a independent government agency on behalf of a couple of hundred million consumers.

Plently of countries do this. Don't believe the hype of rationing etc. Brits and Australians get access to the same medicines, for a much lower cost. Doctors still chose which medicines are prescribed. Patients still get a say in how they are treated. No big brother telling you that you can't have the best medicine even if it is warranted.

What you do next is up to you. Most countries then chose to subsidise the medicines, so that they are accessible. But, cause the government has cut a good deal in the first place, those subsidies are much lower than they otherwise could have been.

But I'l stop now. I'm guessing you had a heart attack reading this. I'm guessing the founding fathers didn't want people to have good access to health care, and we can't piss off a bunch of dead guys now can we?

  • Like 1
Posted

That's all we need.

Another government run bureaucracy to purchase medication instead of $600 hammers and $5,000 toilet seats.

  • Like 2
Posted

That's all we need.

Another government run bureaucracy to purchase medication instead of $600 hammers and $5,000 toilet seats.

Can't be prepared to think ourside the box now can we?

You are already paying twice what other comparable countries do. That is what the 'free' market gives you.

American exceptionalism at its best.

  • Like 2
Posted

Anybody who is interested in the cost should take a look at the cost of HIV medication in the US -- Much of which is paid for by the gov't and it's many programs to help with the AIDS situation. Then compare the costs to Thailand. Costs in Africa are even cheaper and it is the same medication.

  • Like 1
Posted

“A government bureau is the nearest thing to eternal life we’ll ever see on earth.”

Ronald Reagan

I'm not sure why you are quoting Regan like he is Plato. The man had a convienient contempt for things like, well facts.

The man who championed voodoo economics with quotes such as ""I am not worried about the deficit. It is big enough to take care of itself."

  • Like 1
Posted

This is pretty tough talk but, in my judgement, justifiable and justly deserving, at least in its sentiment.

Indeed, the reputable scientific polling data tell us the US body politic put the blame squarely on the Republican party for the shutdown and the tempest over the debt ceiling which threatens the full faith and credit of the United States and, does indeed, threaten the US dollar's status and the global currency to include its position as the world's reserve currency.

The Republicans in Washington and in the tea party don't care. They are in their own little - really small and localized - world, set apart from reality.

polusa-logo-360x86.jpg

China Calls For a ‘De-Americanised’ World Thanks to GOP Shutdown & Default Threat

This must be what conservatives mean by “USA! USA! USA!” Kill the exceptionalism, violate the Constitutional mandate to pay our debt, and turn America into an international joke, causing America to lose its world standing even when W isn’t in office.

This is WINNING, Tea Party style.

This country had better get a handle on these Republicans, or they are going to do what Al-Qaeda never managed to do to the US.

http://www.politicususa.com/2013/10/13/republican-shutdown-default-empowers-china-call-de-americanised-world.html

  • Like 1
Posted

I hope many of the Tea Party preppers and their supporters have all the cheap goods they need as they let the US default. I think they are wishing for the US to fail.

  • Like 1
Posted

I hope many of the Tea Party preppers and their supporters have all the cheap goods they need as they let the US default. I think they are wishing for the US to fail.

I'm sure they are all well prepared given the stocked bunkers they've all built in anticipation of the Ruskies/UN/New world order invasions. Given the others couldn't do it, they went for wrecking the place themselves.

I'm sure they'll feel nice and free and all libertised with a smoking ruins of an economy laying all around them.

  • Like 2
Posted

“A government bureau is the nearest thing to eternal life we’ll ever see on earth.”

Ronald Reagan

I'm not sure why you are quoting Regan like he is Plato. The man had a convienient contempt for things like, well facts.

The man who championed voodoo economics with quotes such as ""I am not worried about the deficit. It is big enough to take care of itself."

that seems to be the attitude of a lot of the republicans in congress now. the NBC/WSJ poll has made them look like fools and dangerous morons more than ever and yet still they persist with this insanity.

you've even got staunch conservatives like peter king saying "nobody has done more to strengthen bamacare than ted cruz". the GOP are eating themselves from the inside. long may that continue. just stop playing brinkmanship with people's lives and futures.

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