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Friday, March 30, 2007
Ed Feulner :: Townhall.com Columnist
It's time for a dose of reality in federal health-care spending
by Ed Feulner
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"If something's free, I'll take two," a mentor of mine once said. His point was that people don't value things they don't pay for, especially things the government "gives" them.

And it's not only individuals who harbor this attitude. State governments do, too.

Take Medicaid. Many states find themselves dragged down by the program's costs because they irresponsibly promised gold-plated benefits to as many people as possible, knowing that Washington would pick up part of the bill.

That's caused major problems. Consider upstate New York, where county governments have been forced to raise taxes and cut important services. Chautauqua County, for example, fired sheriff's deputies, and Chemung County closed libraries to pay for Medicaid benefits.

This dreary history may soon repeat itself through another federal health venture, the State Children's Health Insurance Programs.

In 1997, Washington agreed to spend $40 billion over 10 years to help states provide health-care coverage to low-income, uninsured children. However, to keep SCHIP from becoming a boondoggle like Medicaid, it was set up as a block-grant program. States would receive a fixed amount each year, rather than an open-ended promise to spend "whatever it takes."

The program seemed to work well enough in its early years. However, that was only because some states didn't spend all the money they'd been allotted, and that money was made available to fund programs in states that went over budget. In 2001, for example, more than $2 billion was reallocated from low-spending states to higher-spending ones.

But states see no reason they ought to leave federal funding on the table, so they found ways to spend it. By last year, only $173 million was left over for redistribution. That's partially because many states started making it easier to qualify for SCHIP. The program was intended to help only low-income cdren, those whose family income is less than double the federal poverty line. That's about $40,000 for a family of four.

Seven states, however, provide benefits to families earning much more. Four of them (Maryland, Massachusetts, Missouri and New Jersey) extend SCHIP coverage to three times the poverty level ($60,000 for a family of four). If these expansions continue, we could soon be at the point where a family is simultaneously eligible for SCHIP and yet subject to the Alternative Minimum Tax. That would be ironic because the AMT was created to make sure the wealthy paid their "fair share" of income taxes.

Meanwhile five states (Illinois, Minnesota, New Jersey, Rhode Island and Wisconsin) cover parents and even childless adults. This gets expensive -- and quickly. In fact, the federal General Accountability Office says, in the 14 states that went over budget in 2005, more than half of the SCHIP recipients were adults. This in a program aimed at helping "the children."

Not surprisingly, Washington has been bailing out states that spend too much. Congress spent $283 million to paper over last year's "shortfall," and will almost certainly have to spend more this year. The House already voted to add $750 million in "emergency" SCHIP funds and the Senate will more than likely follow suit.

This needs to change. It's time to bring SCHIP back into line and keep it from turning into another entitlement funded on taxpayers' backs.

Congress created the program to help poor children, not to give states another excuse to shower "free" benefits on middle-class families. By bailing out those states that spend too much, Washington simply encourages more extravagant behavior.

States are aware how much they'll get in SCHIP funding each year, and they should plan to spend only that much or less. If they want to expand their programs and end up going over budget, they should be prepared to pick up the bill, not pass it on to the rest of us.

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About The Author
Dr. Edwin Feulner is president of The Heritage Foundation, a Townhall.com Gold Partner, and co-author of Getting America Right: The True Conservative Values Our Nation Needs Today .
 
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Oh, he11, let's cut to the chase
There's no Constitutional authorization for expenditures for healthcare or insurance.

There's no guarantee in the Constitution or the Bill of Rights to good health.

Of the alleged "47 million uninsured" we're constantly yammered at about, how many are illegal aliens, and how many are people who could buy health insurance at their own expense but SIMPLY ELECT NOT TO DO SO?

I work my butt off to take care of my family and myself. I have absolutely no obligation or responsibility whatsoever to do so for anybody else. If you Lefty/libs feel so goddammed sorry for uninsured people that you feel they need to be taken care of, do it with your own money before even LOOKING at mine.

How's that for clarity?


BrianR
I think that when we cut to the chase, we find
that you are a very cranky person who doesn't have the slightest feeling of community. Maybe
if you went to bed on time, you would lighten up.

I am curious about just how much you work your
butt off when it appears that you spend most of
your time writing cranky posts on Town Hall.

So let's assume that you do put in your 8 hours
a day at work. How much time do you spend with
your kids? Or the little woman? There is more
than one way to provide for your family. Money
isn't the only thing that matters in this life.



BTW, Vidouche
or whatever the he11 you're name is.

Out here on the Left Coast, it's three hours earlier than the time printed on the screen.

I hope that helps assuage your concerns about my sleeping habits.

viruddh
I work 12 hours a day 7 days a week to provide for my family. This is for the present and future. Money isn't everything, but it sure helps.
It really doesn't make me feel any better to know that I am also working these hours to support a bunch of lazy people that won't get off their butts and do what I am doing.
I don't mind helping those that can't help themselves, but the majority of those that use Gov programs just WON'T help themselves. They won't lower themselves to work for what they want. But then why should they when they can just have the gov take my sacrifice.
I have a strong sense of community, but always disagree with the phrase "you need to give back to the community". What has the community given me that I need to return? All of the services that the community offers are already paid for from my taxes. Friendship and helping others is given from my heart, not because I owe it, but because I want to give.
America is the land of opportunity. Legal immigrants that arrive on our shores generally make it because they don't have a sense of entitlement. They come to our nation to stand on their own and make a good life for themselves.
On the other hand people born and raised here have the misguided notion that they are owed something just for breathing.
Lets just get our government back to it Constitutional limits and let people swim or sink on their own merits. Stay out of my wallet, I sacrifice too much to support those who don't deserve my life's blood, let alone my pity.

health care
There is this idea that the US does not have universal health care, but it is untrue. The US has some of the most expensive and wasteful healthcare in the world. If someone cannot pay for a doctors visit, they need only go to an ER and they cannot be refused service. Unfortunately, even though the caring physicians will not be payed they can be sued. The physicians are assuming risk WITHOUT PAY. How many airline pilots would take the risk of flying without getting paid? The healthcare system and the legal system needs sever overhaul.

Along the same line, people are spending obscene amounts of money for end of life care that is futile.

BrianR
"we find that you are a very cranky person who doesn't have the slightest feeling of community. Maybe if you went to bed on time, you would lighten up."

The above paragraph comes from my previous post.
It is worth repeating.

Good heavens, just exactly what has the world
done to you to make you so angry and unpleasant.

Virrudh happens to be the name of the movie I
was watching when I signed on. As for my
syntax, it is quite Midwestern and 4th to 6th
generation American. But thanks for asking.

I live in NY
Ed, I hear what your saying but I live in NY and I can tell you we don't need the sheriffs. They are just another group that stands at the hog trough like the state workers and all the other Unions that have been robbing NY blind for years.

Prior to our recent elections our scumbag politicians gave state workers a BILLION dollar "raise" and those same scumbags were re-elected.
I'm sure your getting the picture. NY Biggest problem is UNIONS so I don't feel sorry for them.

Rep. and Dems alike are using tax dollars to "buy votes" THAT is what we need to stop. Lets total up all the $ being used to BUY VOTES and I'll bet everything I own it's much higher than the other things. You can include Medicaid and Welfare in those figures because here, thats another "tool" our scumbag politicians use. I am sure it is the same in other states.

There are many forms of Welfare going on but the ones that eat most of our tax dollars are hardly mentioned.

State, County and City employee Unions.
Politicians "retirement" package
Health Care Unions
Teachers Unions (they are the worst)
The GREAT medical benefits ALL of the above have!
Political Pork

I do agree we have way to many "free" handouts
but politicians keep funding them because it's "VOTES" they care about, NOTHING ELSE.


Just goes to show.....
Touchy feely is good, saying it like it is....bad. Hmmm, anyone familiar with the charity begins at home statement? How about we stop sending our billions of dollars to countries who will take our money but not our advice on let's say the AIDS epidemic. Or stop sending those billions to the countries whose governments squander it while their people continue to live in floating huts. Everyone has gone mad feeling sorry about everyone. I, too live in NY and it absolutely unnerves me that politicians want to spend my hard earned/easily lost tax payer's money on a hiring hall for illegal immigrants, or that if you are a pregnant illegal, you automatically qualify for medicaid. People need to stop pretending as if handouts have ever been successful at doing anything but keeping those people at a grossly unmotivated, uninspired level. We need to stop pretending that political correctness makes anything "correct" or right. Has anything really changed? Or are we just making a mockery of people. Do blacks feel any more respected because they should be called african americans? Has anything changed for them since they became this new type of "person." Have the african american males stopped to say "hey wait a minute....we aren't black anymore...we're african americans now, we can stop with the inner city shootings of one another, and become the upstanding family man, the liberals have destined me to become." I don't think so. Nor have the illegal immigrants become any less illegal simply by calling them migrant workers. As far as I am concerned BrianR, keep on saying what's on your mind. That is the real problem!!! We are so afraid to say something at the risk of offending someone else. Well, I say suck it up Virrudh! We have the right to free speech, not the right to NOT be offended. As for the health care mess.....stop paying for illegals (who are out-reproducing whites) to keep reproducing. Or better yet, if you want to continue to treat them like they are legal, collect the taxes from them, fine them for driving without insurance and out of state license plates, ask them to pay for their healthcare the same way our employers ask us to do.

six-point healthcare solution
Herein Six Modest Suggestions:

1. (a) supply side: abolish the AMA cartel and allow the supply of new doctors to rise to the level of demand
(b) enable relatively unregulated "minute clinics" in places like Target and Walmart, for medical care providers who can provide "pareto optimal" generic care (they provide those 20% of the services that 80% of the people need)

2. demand side: return to "they who receive the medical service pay for the medical service"

3. cost and performance measurement: develop on-line database of actual costs paid for services rendered, by doctor, by service. Leave healthy room for qualitative descriptors such as extenuating circumstances and results of the procedure. Create blogging capability

4. medical insurance: deregulate and allow nationwide shopping

5. Care for the truly indigent: set up crisis care clinics, called something like "hospitals for the truly poor" and staffed primarily by first year residents. Every dr is encouraged to spend 40 hours a year as her/his continuing education in pro bono work at those facilities (tax credit for full value of in-kind service provided and credit toward continuing education requirement.)

6. Torts: (a) patients sign highly enforceable indemnity agreements that have varying levels of dr indemnification based on each dr's own assessment of her/his risks. Some drs might have "simple negligence" standards, others "gross negligence" standards (e.g. of the latter, the dr is indemnified and held harmless against all actions except those that result from gross negligence.)
(b) medical malpractice insurance: deregulate and cap punitive damages to 2X actual damages

Happy medical care hunting,
Tim Cranston

BrianR
On the money my man!

virrudh
Or what ever your funky do name is. If you are indeed working 12 hours a day, seven days a week, you have made some serious bad decisions in your life. That does not give you the right to pick the pockets of others who made the right decisions. You have a right only to what you can pay for. Period!

BrianR
There's no Constitutional authorization for expenditures for healthcare or insurance.

There's no guarantee in the Constitution or the Bill of Rights to good health.

AMEN!!!!

The only problem here is that when you use the word "Constitution" some folks curl up their upper lips and their eyes glaze over like they never heard the word before. If the pols would try reading the document before they vote we'd have a whole lot less problems in this country.

Tim
Some decent ideas. Number 4 is the best though.

If gov't would simply stop supporting the failed employer insurance system and allow the consumer to rejoin this market both quality and costs would improve.

What business does an employer have in a person's medical care in the first place?

If libertarian/free market ideals were introduced into this problem, private groups could take care of #4.

However, because most Americans now buy the idea that the gov't should "do something" about their personal problem... I don't think we're likely to see movement in the right direction.

Dan847
Typically when I enter a post on Town Hall I
address the columnist because I am not interested
in starting a conversation with anyone who is
going to tell me something I have heard over and
over and over already. In fact, most of the
time I write directly to the columnist through an
e-mail.

There are exceptions however and this morning was
one of those. I opened up this site and right
there front and center was Mr. Merry Sunshine
better known as BrianR going through his ritual
bellyache about the government and how he doesn't
owe anything to anyone. (Thank heavens he
readily admits he is not a Christian).

It was no surprise that I have received other
comments from my simple response to BrianR. He
tells me he works his butt off. I asked, when.
Now you tell me that you "work 12 hours a day 7 days a week to provide for family. This is for the present and future." A very impressive
statement. I have never met anyone who worked those hours every week except for a very few who were avoiding going home. To a man/woman they
are now divorced. In my youth I knew of many
farmers who worked those hours and more but only
in the summer and never on Sunday.

Perhaps it was a bit of an overstatement like
this other one: "the majority of those that use Gov programs just WON'T help themselves. They won't lower themselves to work for what they want. But then why should they when they can just have the gov take my sacrifice."

Ironically I just spent my morning at a community
funded day care center to complain about how my
tax dollars are spent. I bellowed: why don't
these women go out and get a job and pay for their own day care. Response: All of them are
working. The minimum wage does not begin to cover even the barest of essentials for living,
even in the least expensive state in the Union
much less this one.

2nd bellow: So why don't they get a 2nd job.
Response: Because they are mothers and want and
need to spend some time with their kids.

What could I say. I unloaded the books I had
bought for the day care center and read a couple
of stories to the very eager audience. I tried
to exclude those whose parents were probably illegal aliens, but the people at the center
wouldn't let me. A few of the kids gave me a hug
when I left I walked out the door with a song
in my heart and a smile on my face.

I think that you and I have very different opinions of what "community" is. It think yours
is more in tune with those who go ballistic when
you say the phrase "it takes a village" assuming
that it means you turn over your responsibilities
to someone else. It doesn't mean that at all,
but as I am not interested in conversation here, I won't bother to explain it. I think you either
get it or you don't.

Lolo
"virrudh
Or what ever your funky do name is. If you are indeed working 12 hours a day, seven days a week, you have made some serious bad decisions in your life."

Sorry, you got the wrong person. It was Dan874
who made that statement to me. And I agree -
it does appear that he has made some serious bad
decisions in his life, except I would have used
the more proper "seriously bad."

As for me, I don't work at all. I sit around
the house 24/7 reading romance novels, watching
television ads, and complaining about people who
complain about the government. I find it very
satisfying.

"funky do"! What kind of term is that? How
old are you? 14?

Golfnut
Whats the 'Constitution'? My experience: I am not a democrat, liberal or whatever but I seem to have a lot of friends that are. I am here to say they are the most easy going, out going and fun people but also the laziest people I know. They tend to stay in college for years and years and never finish their social work programs all the while getting school loans, working the barest minimum mecessary to pay for rent and food and never trying to get ahead, etc. This is just my own personal observation, though when I see it so much, I can't help but think the truth is being converged on.

Everyone but BrianR & Tim hacks me off!
Duh-Duh! spouts off about community: Duh-Duh!, do you mean community(free will to contribute), or communism(coerced contribution)? Do you comprehend the difference between the two? I think not!
I know socially, many Doctors, and they are no longer getting filthy rich, whih was the case 20 years ago. They graduate from school with huge college loans, which require years to pay back, and then have to cope with the current environment. Let me give you an idea of this environment. To treat someone that actually has insurance, they have to tiptoe around the patient, doing every conceivable test relating to the patients condition, lest the patient thinks they were shortchanged, and therefore hires a shyster to try and milk millions of dollars from the doctors insurance. Then the Doctor submits a bill, no matter which amount they submit, the profiteer insurance company immediately insists they will only pay 60% of the bill. Doctor is in a bind, right. So what does he do? He inflates all billing to match what the insurance companies will deduct so that he gets the fair amount.
To wit: Health insurance profiteer companies should be forced to become non-profit, that is the only way to cut healthcare costs.

Healthcare for everyone...what a nice dream.. and only a dream. As long as business and government turns a blind eye to massive illegal immigration, primarily from South America, we could never hope to pay for it. If you think otherwise, drop the glue bag and quit huffing! In a closed system if might possibly work, but not in this one! If you are conflicted about this, let me give a a scenario. City X says "we are going to give all 5,000 homeless people in the city a free apartment, with free food, to be paid for by the gainfully employed people of this city". Works fine for a few weeks, until word gets out to the bums in other cities about the program. Suddenly, you have the bums racing to the city via bus, horse, covered wagon, van, you name it. Now you suddenly have 20,000 homeless persons in your city, to be housed and paid for again by gainfully employed citizens of the city. Eventually, you end up with more bums than gainfully employed citizens, citizens by the way, most of whom have fled the city to avoid being taxed to pay for the bums.... Now do you get it, Communist!
Longest post I have ever done, but some Commies just don't get it!

viruddh
Sorry to disappoint. I am retired military. I am currently a contractor in the middle east. I am making enough now to walk away 100% debt free and able to send my daughters to a decent collage. My family understands why I am here. We are willing to sacrifice a little time together now so that my kids can have a better life than me and my wife. this is a short term job. And I still don't appreciate my money being taken and given to others.
The decisions I've made in my life have made me a successful and responsible adult. My only debt is a mortgage, and that will be gone in a few short months. My kids will have good educations. All without government handouts.
This is the way it should be. I stand on my own two feet without government aid because I have a strong work ethic and great love for my family. I set the example for my children, that if you work for something you will have it.
Now I applaud you for reading at a community center. I have done the same at my daughters school when they were younger. But I did find it much more satisfying to teach them to read on their own.
I volunteer at my church. We work in the local area helping the elderly improve their homes. I have delivered fire wood to the poor.
When I get home, I will continue to help in the community. Not because I owe anything, but because it is the right thing to do.
Which is the greater good, to give, or to give back?


DAN874
MMM. INTERESTING POST. Actually, you sound like
a great candidate for becoming a Democrat. There
was a serious attitude thing in your first post
that was extremely off-putting.

My own road to Democrat-hood happened over a
relatively short period of time and had a whole
lot, at first, to do with the women's movement.
I'm not here to give my life history, but what
I will say is that except for a couple of big,
big bumps in the road I have had a very nice life. I grew up in a farming community. It was
certainly not a hard-scrabble town but no one was
rich. I was one of the few in my class to go
to college and even then I had to wait awhile
because my parents would not pay for college for a girl.

I married a great guy and he happened to provide
a very nice life for me both emotionally and
financially. On the financial end, I had
very little to do with it. I just lucked out.
Except for five years I have always had a job but it was more of an amusement, and when I tired of it I went on to something
else. None of the jobs were ever more than part time after the kids came. I suppose the fact that my financial stability was handed to me has
played a part in my attitude towards others. I
cannot say that I deserve the life I have any
more than anyone else, and especially not more
than someone who has had to scrape all of their
lives to put food on the table. They deserve
what I have, but it just doesn't work that way
in this world.

Of course, there are some worthless bums out there but there were a lot of worthless bums at Enron too. And contrary to popular conception, there are very few healthy males who are living off govt handouts - at least officially. More likely they are living off their mothers or girlfriends or selling drugs on the street corner.

I am no pollyanna. I am furious that we have a
nation of unwed mothers and fathers who
disappear from the scene. I am furious when kids
do not graduate from high school. I am sick to
death of attitude.

But there are two things that I am sure about and
one is that it is my expectation (and requirement
as a Christian) to help whomever I can in whatever way that I can. And that I want a
government and a citizenry who wishes to protect and help the poor first and then the strong.

My own personal opinion is that I need more
protection from the strong and greedy and power
hungry than I do from those who live on welfare.
The former can do a whole lot more damage because
they have the power and money and connections and a sense of entitlement that declares to them that they can play by a different set of rules.

To Tim
There are a few problems with the solutions you suggest.

1) The AMA does not regulate the number of new doctors allowed in the medical profession (this is a popular myth among online right-wing posters).

2) Requiring doctors to provide 40 hours a year of pro bono service would not allow for continuity of care---with such a revolving door staff, it's unlikely that a patient would ever see the same doctor twice.

3) What do you mean by "unregulated" clinics? Without state regulation, anybody can say he is a doctor and do anything he wants to a patient, using any equipment and giving any treatment or medication. Anything at all. Is that a standard of medical practice you would recommend?

4) Providing medical care on a basis of "fee for service" is not realistic. Have you seen a hospital bill lately? $20K for a two-day stay is not unusual, nor is $300K for a longer stay involving major surgery and/or intensive care. Few Americans could pay these bills out-of-pocket, especially when stays are sequential or when a family encounters multiple medical costs. Suppose you have a year when your wife gives birth to a premature baby that requires two months of neonatal care, then you have an automobile accident in which your pelvis is crushed, then your father's stroke occasions brain surgery, intensive care, repeated hospitalizations, rehabilitation, and home care---the total cost of $500K wipes him out, so you have to help. What are your options? (Remember: you are now living in that ideal world of fee-for-service.)

5) Re malpractice, suppose your surgeon operates while drunk and accidentally removes your healthy kidney, leaving your diseased one behind: please let us all know what you think that's worth.

6) Re your proposed list of comparative costs: great idea. I once went to a doctor who was a staunch free-market capitalist Republican---he had even run for Congress and had photographs of Ronald Reagan in his office. He did a procedure on me for which he charged $600 and the hospital where he did it charged another $2400 (he was a big shot at that hospital). Subsequently I changed my care to a university medical center where all the doctors work on straight salary (something like a nationalized health program only smaller) and when I had the identical procedure, done by a full professor, the TOTAL charge was $125. So much for capitalism in medicine. So I really like your suggestion.

In the days before Social Security and Medicare it was not unusual for an adult to postpone marriage for decades because he had to support his parents or "pay for Mama's operation", and older parents typically moved in with your children. I am curious to know how many age 65+ posters have opted to refuse Medicare while paying their bills out of pocket, and how many younger posters have taken their parents to live with them so that Social Security can be refused as a matter of principle. Judging from the unbelievable greed I see displayed on townhall, I would guess the answer to be: none.

To Lolo
A basic rule of public policy is that society will not support a law that runs counter to the values of that society. For example, our society would not support a law limiting families to one child, or a law requiring euthanasia for all cancer patients. You suggest that people should receive only the medical care they can pay for out-of-pocket. Think that through. Imagine accident victims forced to live out their lives with broken bones---in chronic pain and perhaps deformed, they would probably be unable to work. Imagine stroke victims sustaining major paralysis because their family could not pay for surgery to stop the bleeding in the brain. Imagine the parents of a child with leukemia being told "just take her home and plan the funeral". You are suggesting that the United States return to the eighteenth century or be like a Third-World country. Would society accept that? Would you?

And before you accuse me of being a liberal bleeding-heart, let me remind you that good medical treatment often returns patients to the work force where they can earn MONEY.

sjt18's question about employers
"What business does an employer have in a person's medical care in the first place?"

Health insurance is a pre-tax benefit that replaced pensions as a pre-tax benefit.

I believe it was ERISA, the Employee Retirement Income Security Act of 1974, that imposed a uniformity requirement on pensions, increasing the expense to employers while reducing the effectiveness of using pension plans as a way to attract and hold desirable employees.

Health insurance was a consolation prize.

Unintended consequences.

More unintended consequences
"If something's free, I'll take two."

My favorite theory of why health care costs have skyrocketed (besides runaway torts and the cost of bringing new drugs to market):

Because so few people pay for their health care or pay directly for their healthcare insurance, there is little reason to conserve, to research more economical (but just as effective) alternatives. That, and fear of being sued, leads physicians to over-prescribe drugs and tests, jacking the costs once again.

Universal health insurance will accomplish two things: At first, it will encourage more waste. Second, more waste will necessitate an involuntary diminishment of services.

It's a pity more hasn't been done to promote HEALTH SAVINGS ACCOUNTS.

Significant participation in health savings accounts would accomplish reducing the cost of insurance, encourage people to question procedures and medicines before the fact and voluntarily refuse the least effective ones, reduce the wasteful burden on health care providers, and help slow the growth of the cost of health care as a percentage of GDP.

Free Market Healthcare
Let doctors, hospitals, and the various providers of healthcare advertise their prices and compete. Most doctors, nurses, and various technologists are not far removed from car mechanics and such like. Some are excellent, some mediocre, and a few extremely lacking in skills regardless of the schools they may have attended or from which they graduated.

BUYER BEWARE!!!

It is not unusual to hear people speak of their unhappiness with their doctor/s and/or other providers. My often whispered response is "FIRE THEM" and hire a new "paid servant" to take care of your various needs. Seek and ye shall find.

Keep in mind, most doctors and many nurses practice medicine as a religion, of which, they are the High Priests. Information they hold is priveledged. You, poor patient, haven't the ability to fully understand or appreciate the importance or broader scope and ramifications, albeit, the complexities and nuances, of all this information. Only those of higher intelligence, MDs, RNs, and such, could possibly really understand it all. You, just need to trust us. Don't worry about the bill. We'll negotiate terms later.

Healthcare is an industry. Don't begrudge it. But, as with any business, they are in business to earn money.

Trust "us" to tell you the truth! We hold your life in our hands. You are precious. And, of course, so is your insurance policy and whatever other assets you may have, precious also.

As with a used car salesman, "BUYER BEWARE"!

As with other purchases of goods and services one generally knows what he is going to receive and for what price. These things are typically negotiated days weeks and months in advance.

True, if one is in a situation of an eminent threat to life or limb, one must seek immediate medical attention. But, one should be able to "shop" for providers that will render the usual needed healthcare based on quality, quantity, and price. Hopefully, when a customer finds a reasonable practioner matching his needs, he will soon learn where he will need to go in the event of a real emergency.

Let them all advertise their prices for services and products just as the various car mechanics do and consumers of healthcare services will see their costs go down.

You, the consumer must demand better. You, must demand laws repealed to allow the free market to work. You, the consumer and constituent, must defeat the AMA lobby and other such like who protect their sacred turf. The only only sacred turf should be the citizen and his property. But, that is a whole other discussion.

I did not mean to demean or otherwise impugn the good reputations of used car salesmen or car mechanics by juxtaposing them with the vultureous lowlife my posting is centered on.

GEM



Who Makes Medical Decisions?
I understand the anticipated negatives of having the government make our health decisions, but what we all (most of us anyway) live with now is having them made by Big Business aka insurance companies.

I really can't imagine anybody thinking that's an ideal situation. Every one of us has heard the horror stories of patients discharged from the hospital three days after spinal fusion surgery or on the same day as a mastectomy. I know a woman 83 years old who lives alone and has no family and little money to hire help but she was sent home one week after having a major stroke---trying to care for herself led to serious falls that left her with broken bones. In a hospital waiting room I chatted with the family of an older woman then undergoing an 8-hour liver surgery; the night before she had had to prepare by drinking one gallon of Go-Lightly laxative then had to make the 125 mile car trip to the hospital between 3 and 5 AM because insurance wouldn't pay for an overnight presurgical stay.

This is crazy. This is cruel. Patients used to be able to sleep in a hospital bed the night before surgery. They used to be able to recover in bed after major surgery or a stroke. Now they are told "Get off the operating table and go catch a cab". And it's insurance companies saying that. It's insurance companies mandating how long your doctor can spend with you, and they are also empowered to change your doctor's prescription to a totally other drug. They can also decide whether the treatment he wants you to have (chemotherapy, for instance) is OK.

We've all heard those horror stories. It's not realistic to say "Everyone should pay fee-for-service and out-of-pocket"---this is not viable when one or two major hospitalizations can consume a family's entire means, including their home. And it's not humane to say "Just don't have the treatment if you can't pay for it"---tell that to your grandmother next time she has a stroke or heart attack (what, no clot-busting drug, no surgery to relieve the blood clot on the stroked brain? What, no angioplasty to stop the heart attack? Not covered on your policy.).

"He who pays the piper calls the tune" is well and good, but in this case I want a medical doctor calling the tune. Given the choice, I would rather have decisions made by a doctor working for the government than a clerk working for the insurance company.

So, in the grip of all these problems, I am willing to give national health insurance a try although I have some doubts about it. I don't want Third-World medicine, but I also don't want a greedy profit-driven insurance company making my medical decisions for me so they can pay their CEO $100 million per year.

My Dear Miss Lilly
And what if that doctor paid for by the government decides that your life is, well, no longer contributing to the greater good of society and therefore society in particular and our government in general will be better served by your immediate demise so we may be in a better position to take care of those from whom we may reasonbly expect to recover and thereby continue contributing to the good of the nation?

Hmmm...

With government healthcare we may expect the government to democratically dictate, by way of our elected representatives, both when life may begin and end. That is to abort all undesirable fetuses, as prescribed by law of course, long before they come to term, and, to sever those non-productive adults from society with a "comprehensive" euthanasia program. All as determined for the better good of society and efficiency of government by our most enlightened and educated elected and appointed officials.

Why not government housing too! Let the government build and determine who lives where.

Why for that matter let the government choose children according to test scores and determine their lifelong carreers for them. Then they will not have to worry about they will do when they grow up.

The government could better determine what vocations need filling and in what areas of the country. There is no end to the things we may accomplish with central planning. If only we could get everyone to go along and conform.

If all of those who adore government healthcare would migrate to those countries where it already exists the debate would halt in twenty-four months or less.

GEM

It is all about the money
I am not sure where the original comment was made but healthy people are not profitable for health care providers. The drug companies has us on more, more expensive, prescriptions than ever. The emphasis is on treatment of profitable illness and not on making us healthier. Insurance is incredibly profitable for the insurer under current regulations designed to make the insurance business profitable. As risks rise, so do the premiums so the insurance industry, big pharma, big hospital corps and the government officials they choose to contribute too, want us all unhealthy and paying more and more for ourselves and everyone else who is unhealthy. Don't forget that paying for insurance is spending your money for the care or others if you do not get sick.

Health care is one area where I think it is a mistake to have it run by the free market. Health care is far to complicated for people to manage on their own and there is far too many charlatans. If, and it clearly wishful thinking, we had some leadership that actually cared about the people rather than the money from the corps, there are likely some innovative solutions to the problem. As long as the profits are so good the way things are, we have little hope for true beneficial reform in health care.

Health Ins.
I do not want universal health care, just ask any country that has it.
ONE - expense
TWO - long waits
My friend in Germany had to wait 8 months with a large ulcer in her leg. ridiculous

One of the things foisted on us that makes me furious is medicaid for illegal alien pregnant women, I know they need health care, BUT why isn't this ever considered in their AMNESTY that all in congress are trying to push on us?
I didn't get my babies for free, even when we didn't have insurance, I HAD TO PAY! At around $10,000.00/anchor baby, that is NOT cheap!
BUT even worse is Medicaid is denied to my Daughter 16 years with MS, and the complications are getting quite harsh for her. YES to illegal aliens, NO to legal citizens with problems.
THEN our wonderful congress decided last week to give the illegal children one year of medicaid FREE. Well excuse me, legal citizens have to pay.
And when I see them trotting down the street with 3, 2, 1, and one in the oven, I'm getting pissed.
AND I do help in the community, I even help an orphanage in Mexico.
BUT I would NEVER be a Democrat, they are NOTHING but enablers. The great society didn't do a damn thing, but enable women to pop out babies for others to pay for, while the fathers went on their merry way. This is not fair to others! NO ONE but the parents should be responsible for a baby.
I agree about helping with things IF the mother is trying her best to take care of her children, and to have them work 2 jobs is ridiculous! One job would be outside the home, Second job is taking care of her children and making sure they are doing the best they can.
BUT when they shell them out like my friend who works in the school system says they do, 4 kids ALL getting special needs, (because they can't do things like tie their shoes), all with different fathers, She's driving a lincoln, my friend drives a 10 year old car. So who's zoomin who here.
I believe in helping, I don't believe in shelling out $$ to people milking the system, because they can. Who's making them accountable for their lifestyle at others expense?

Why Not Liberty, O so modern1
Let those of us who want LIBERTY, be they providers or consumers of healthcare, choose whether or not to participate in the central government healthcare program. Do not ask those of us who choose liberty to pay into this program. Allow us to provide and consume for ourselves, according to our needs on our terms; not yours. We are not asking for anything from you. We do not want you asking anything of us.

Overall when the government gets involved, overtime, beneficial outcomes diminish. Public education from kindergarten to college is a bright and shinning pearl of an example of government failure for over a generation.

From the days of the Huntley/Brinkley Report to this very day there is the same old saw on how to fix the lack-luster government programs. An appeal is made for more money in general. More money needed for infrastructure. More money needed for buildings, equipment, transportaion, security, and so forth. More money needed for better salaries. More money needed to educate those from the bottom of the government program to the top and "further" "continuing" education, of course. And to get more money, TAXES must be RAISED.

But since those days of a generation ago the problems that existed then, loom as large as ever today. Why?

Because, as Ronald Reagan said, "Government is not the solution; government is the problem."

Equality may be OK with some but I want the liberty to rise above the man who chooses to live in a cardboard box on the river bank. The liberty to rise to higher rungs of the financial ladder than the man who chooses to smoke dope all day. And the liberty to choose not only who my healthcare providers are, but, when and where it will be provided on my terms. Not yours!

Some may be too ignorant or just too plain stupid to make their own decisions and take care of themselves.

But I, and many others, are too smart and well informed to allow those of an inferior mind and capability to ever choose for us.

Socialism is a slow death and communism is its more efficient grave digging cousin.

Government social programs are tyranny. The less government in our day to day lives the better.

If it doesn't prmote Liberty it is tyranny!


GEM





Universal Medical Care
Are not the politicians who are so gleefully pointing to Walter Reed Hospital as an example of the "corruption" of the Republican Party the same ones that are telling us we must have Universal Health Care?

Is not the widely reported mess at Walter Reed the inevitable result of government run health care?

Put the two together.

When all medicine is gov'ment run
How different will a trip to the doctor be than a trip to the DMV?

Waiting on hard, uncomfortable chairs under florescent lights, going into a grimy exam room and being tended by people who would rather be anywhere else, and not shy about letting you know it.

It will be better than nothing, but that's what will eventually happen to medicine if, like Canada, it is AGAINST THE LAW to offer alternatives to state run medical care.

There will be offshore floating hospitals for those who can afford it, like there are floating casinos, now. Venture capital opportunity?

Social Policy, Law, and Values
The first thing they taught me in a social policy course in graduate school was that society will not support a law counter to its values. For example, this society would not support a law requiring all cancer patients to be euthanized. By the same token, our society would scream if women in labor were turned away from a hospital---even if those women are illegal immigrants. Nor would our society accept a baby with 104* fever being turned away without treatment. And if that fever happens to be a symptom of a communicable disease, you can triple or quadruple that reaction by society.

So maybe we'd better come to terms with our being basically a decent bunch of people who don't want Third-World streets full of diseased, deformed, suffering, sick people. Let's start with that. These cries that illegal aliens should be refused treatment might make you feel like John Wayne, but they won't work. And I bet you don't really want to live in a world like that.

And to VIRRUDH, I agree with you: I am much more afraid of business than I am of immigrants or the homeless or the poor. Business just absolutely scares the hell out of me, for reasons you gave.

And to GARY, is that what worries you about nationalized health care? You think it means forced abortions and forced euthanasia? Check around. Has that happened in the Scandinavian countries or England or Canada? Forced abortion and euthanasia are not the law of the land: a national health service would have to follow the law!

As for long waits, last year I waited FOUR MONTHS for the next available appointment with a specialist, and I live in a major city and have optimum health care providers and marvelous insurance and can afford co-pays. Our system is not perfect.

Miss Lilly, Please...
Forced, or shall we say coerced, abortion is the policy in China. Germany once had policies, less than seventy-five years ago, that covered abortion and euthanasia. Both countries are regarded for their ancient and modern higher intellect. These policies do not commence over night. They are implemented progressively over time.

I am sorry about your long wait. I have "fired" doctors and other providers and even insurance companies for poor performance. I would suggest you do the same. I have never had to wait more than a couple of days for whatever diagnostic test I wanted or needed and including the diagnosis and treatment that followed.

As a consumer I demand the best and expect it for my money. Be it the grocery store, the auto mechanic, the electrician, or whatever proffessional services I may want or require.

If you expect the government to render a more "perfect" system that the one we now have, enjoy the dream.

The real problem is, you and yours, want me and mine, to pay for your healthcare and that of folks who do not take reasonable care of themselves to start with. I can take care of myself without any assistance from you and yours.

The study of socialist policy may be OK but I would recommend you study the Founders of the country and their Liberty minded influences more closely. Charity is a fine thing but the government has no business engaging in it.

Liberty! Indenpendance! Individualism! Sef-Reliance! These have made America great and will keep her that way.

GEM

Personal experiances
Anecdotes are sometimes helpful so here goes.

My last visit to the Dr. involved arriving on time, waiting in a bright unfriendly waiting room for an incompetent receptionist to find my chart, then was put in a glaringly lit room where I waited for an hour for the Dr. It was so hot in the room I could hardly stand it. My last visit to the DMV was comfortable and efficient. I was out in 10 minutes and my picture was not bad.

I am changing to personally funded health insurance from corporate funded insurance. I have not found comparable insurance for the same cost as the corporate policy under COBRA which runs over 800 a month for one person.

My elderly mother nearly died in an emergency room because the facility was full of gun shot victims, drug overdoses, non-english speaking patients and kids with the flu. She waited 7 hours in extreme pain and finally, because of my being a real pain in the rear, she got the care she needed. The surgeon said was maybe an hour away from dying. She has full, self paid insurance and could afford the care but could not get it because of the dregs of our society had clogged the facility.

Another mom story. I traveled with my parents to Norway and my mom fell and broke her arm. We went the hospital. The facility was nice and comfortably lit with a friendly receptionist who did not have to drag us through the financial responsibility portion of the admissions process. There were few people waiting, no gun shots or drug overdoses. It was interesting that everyone there spoke English, which was not the case in our local hospital. She was seen in about 10 minutes, treated and the only problem was they could not figure out a way to charge us for the services so they told us not to worry about it and to enjoy our trip.


O Mordern1
My hat is off to you!

The dregs of society do often interfere with the "paying" consumers receiving the propper attention. This happens in schools too.

I am glad to hear your trip to the DMV was a pleasent and efficient experience.

Likewise I am happy your mother received the courteous and proffessional attention she did while in Norway. Just curious, how much of a problem do the Norwegian people have with illegal immigration, or undocumented workers?

Curiosity makes me wonder. Have you considered moving to Norway. I hear it is beautiful there no matter the season.

It puzzles me though, how so many countries are said to be so far advanced beyond the United States but there aren't many of our citizens willing to emigrate from here to those countries. Yet, there are hundreds of thousands seeking to immigrate to the United States. Why? When there are so many other countries on the cutting edge of "national" healthcare, education, housing, welfare, and so on. Why do so many people want to come the United States? Why do so many people, who praise the social programs of other countries to no end, desire to stay in the United States? Why aren't more citizens, at least those who can afford the tickets to go, leaving the United States for their healthcare, housing, security, and so forth?

Simply put, the answer is, the United States provides the best overall deal around and the rest of the WORLD knows it very well!!!

GEM






Sick Insurance
Health insurance should be called sick insurance, because you use it when you are sick, not when you are healthy. Life insurance should be called death insurance, because it is used when you die, not when you have life. See how words are twisted to make things sound better? Real health insurance is eating well and exercising regularly. Get it?? Now politicians are calling it sick insurance "healthcare". I thought that was what you went to the doctor for. Another slick change in words. If you don't have "sick insurance" you must be be healthy. I dropped "sick insurance" 15 years ago when the cost got too high. At $300 per month for 15 years I have saved $54,000. I work out three times a week and watch what I eat. Since dropping insurance have seen a doctor maybe once or twice and paid for my medicine and visit. Saved a lot didn't I? Years ago we had no "sick insurance" and paid for our doctors visits and medicine. You bought a "major medical" policy, which was for hospital stays and major illnesses. Why do we not have that now??? Why does everyone want to have every little bill paid for by insurance, while the cost gets higher and higher. Wake up, folks. The original way worked better.

Was Once Not Possible
The tenth amendment, "The powers not delegated to the United States by the Constitution, nor prohibited by it to the states, are reserved to the states respectively, or to the people." originally would have stopped this kind of largess. It is largess, on the surface meant to help those in need, but underneath to ensure a block grant for a block of votes - it is about keeping power and using the general Treasury to buy it. I think that is what is meant in Article I, "...to pay the debts and provide for the common defense and general welfare of the United States"; not general welfare to provide just whatever to anyone in need, but not to corrupt the purpose of the Treasury. What happened to the courts when Congrefs started to overstep its authority? Oh, probably on the take like the States, respectively, or the people.
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