Townhall.com, Where Your Opinion Counts
Talk Radio:   Bill Bennett   Mike Gallagher   Dennis Prager   Michael Medved   Hugh Hewitt   
BREAKING NEWS  LeftArrow - Townhall.com : Conservative, Political, Republican   RightArrow - Townhall.com : Conservative, Political, Republican  
Columns, funnies & more in your inbox!
  • Check the boxes and send us your email address to receveive your free newsletter
  • Your daily must-read of conservative columns, cartoons and news. Coulter, Sowell, Krauthammer and more.
  • Townhall.com’s weekly inside scoop on what’s happening behind the scenes in the world of politics. When news breaks, we report.
  • Signup to receive the latest daily Townhall cartoons
Monday, July 23, 2007
Star Parker :: Townhall.com Columnist
No to Medicaid for the middle class
by Star Parker
Vote on It:
Average Vote:
[+] Text [-]
 
Poll
Will the Dems' health care Christmas Present to America be an improvement or detriment to our health care system?


The Senate Finance Committee has approved a major expansion of SCHIP, the State Children's Health Insurance Program. President Bush had proposed expanding its $25 billion budget by $5 billion. But the committee has approved the Democrats' initiative to expand this government program far more aggressively.

Under the proposal, 50 percent more children will be covered by SCHIP through an increase in funding of $35 billion. The cost will be financed by a tax hike on cigarettes of 61 cents per pack.

More health-care coverage for children. More taxes on tobacco. Sounds like a winner, right?

Not at all. Responsible senators should vote against this major step toward further socialization of American health care. And if Congress does pass this, the president should veto it.

The reason for the launch of the SCHIP program in 1997 was affordability of health care. The point was to finance health care for children in families that earn too much to qualify for Medicaid.

Now, according to The Wall Street Journal, almost half of our nation's children have government-paid health care either through Medicaid or SCHIP.

This new proposed expansion would entrench government health care more deeply into the nation's middle class.

Whereas SCHIP coverage has commonly covered families earning up to 200 percent above the poverty line, the new proposal lifts this ceiling to 300 percent. According to the Congressional Budget Office, up to 75 percent of families in this income range already have private coverage.

Because the program is administered at the state level, coverage guidelines vary and in some cases have even included adults.

Meanwhile, as we extend last-resort government medical coverage for the poor into the middle class, increasing numbers of physicians are refusing to participate in Medicaid because of inadequate compensation.

But let's get back to the core issue: runaway health-care costs and accessibility of coverage.

Why, in a country of abundance such as ours, where practically everything just gets cheaper and more accessible, does health care stand out in just getting more expensive?

Or to put it another way: Name any product or service that is delivered in a competitive free market that has not gotten cheaper over time.

This should provide a hint to the problem in health care. Despite what our Democratic Party leadership would have us believe, the increasing costs and inaccessibility of health care is the result of excessive government interference in this market as opposed to not enough.

You'd think that our representatives in Washington would want to fix these distortions so that health care could be delivered more freely and hence more cheaply, imaginatively and abundantly.

But this doesn't sit well with the political-power-loving class in Washington. It would rather do what the Senate Finance Committee has just done: Ignore the real problems and then expand government even more to try and cover those who fall through the cracks.

As a result, we get Medicaid for middle-class America and children getting health care from different suppliers than their parents. Brilliant!

Bush offered a creative proposal in his State of the Union address this year that would start addressing the problem at its root. It puts a $15,000 ceiling on the deductibility of employer health coverage, and offers a $15,000 tax deduction to every American family to purchase health care. This would change current economics that favor plans delivered through employers rather than purchased individually.

Yet, Rep. Pete Stark, D-Calif., who chairs the health subcommittee of the House Ways and Means Committee, declared the president's proposal dead on arrival and said no hearings would be held.

The proposal alone might not deliver gold-plated plans to working-class Americans. But it certainly would increase the accessibility of basic coverage.

Leveling the tax field is just a start.

We need to allow a national market in health-care delivery to emerge to replace the crazy quilt of separate state-regulated fiefdoms, and to fix our tort-law system that requires young medical-school graduates to spend tens of thousands of dollars on malpractice insurance in order to start practicing their profession.

Health care follows the same laws of supply and demand as every other good or service.

It's not an accident why, as Regina Herzlinger of the Harvard Business School explained recently in a Wall Street Journal column, we don't see innovation and entrepreneurship in the delivery of health care like we see in every other marketplace. As she explains, the health-care marketplace is too controlled and constrained by government regulations.

Americans should refuse to tolerate this latest move by our political class to address failure with more of the same. We need freer markets in health care, not more government.

Share:
Vote on It:
Average Vote:
 
About The Author
Star Parker is the founder and president of CURE, the Coalition for Urban Renewal & Education, a 501c3 think tank which explores and promotes market based public policy to fight poverty, as well as author of White Ghetto: How Middle Class America Reflects Inner City Decay.
 
TOWNHALL DAILY: Sign up today and receive Townhall.com daily lineup delivered each morning to your inbox.
Consider this analogy ..
Here is an interesting analogy that someone used to describe the harmful effects of such 'feel-good' policies - note, this isn't original, I read it in a published essay!

Imagine a law, that allows everyone with last names beginning A-D to send their restaurant bills to Uncle Sam.

If your name is Donald Duck, life is great! You eat all you want, at the best restaurants. Caviar, pate foie gras and filet mignon - no worries, just send the bill to Uncle Sam!

If you are a restaurant owner, great! Keep raising prices, inventing new exotic dishes - life is good, because you have a guaranteed demand, and a good, creditworthy customer.

Prices go up - but, why should you care, if your name is Donald Duck, or if you own a restaurant?

The increased prices impact those with last names beginning E-Z.
---------------end of excerpt-----------------
To read the article, click on: http://voice.townhall.com/g/c2d3bd2d-d898-496f-8300-7587a7210bb4

Why Healthcare Costs Are Rising
The reason that healthcare costs are rising is that people are living now with conditions that, in the past, used to be fatal in a very short amount of time. Think: Christopher Reeve after he was thrown from the horse; or cancer survivors Tony Snow and Elizabeth Edwards. It is costing millions of dollars to do so. Newt Gingrich often says that 10% of Americans consume 90% of health care resources. These Americans who are consuming the bulk of the health care resources are the chronically ill.
Star Parker mis-diagnoses the problem when she blames "third party payers" for the runup in costs. The run-up in costs is caused primarily by the success of the medical profession in prolonging life (and, thereby, postponing death) for the chronically ill. I'm pro-life, and on reflection, I'm willing to pay the costs to keep the chronically ill alive. (Besides, at any time, any one of us could join their ranks, even me, even you.)

jesus c.
Why don't you pick up the book "Common Sense Economics" by the authors James Gwartney, Richard L. Strope, and Dwight R. Lee. Educate yourself on economics!

jesus c.
The reason people with socialized medicine don't demand HMOs and insurance is that they are, in fact, part of the problem. What folks in Canada do is come to the U.S. If socialized medicine is so great, why did Castro have to bring in foriegn doctors for himself?

The answer to the health care problem is to get rid of insurance as we know it today, eliminate medicare and medicaid (gradually so we don't leave those that have been made dependent on it hanging) and replace all of those failures with with self-managed Health Savings Accounts. Participants have a very high deductible (usually $5,000 to $7500 per annum) with full coverage over that amount. Money can be put into a savings account tax-free for this purpose (usually a small monthly contribution to this account is part of the monthly premium) Money not spent is kept by the insured. History teaches that folks are much more careful with their own money than with someone else's.

When considering the high cost of medical care today, one must consider that our health care dollars, in addition to the doctors, nurses and other medical professionals, are supporting the insurance industry and their high salaries, bureaucratic redundancy, beautiful buildings and high profit margins. That is the real bugaboo. When one adds to that the over-bearing government regulations (HIPPAA compliance is extremely costly) and fear of malpractice suits (more insurance dollars not to mention the lawyers' full-employment guarantee) the actual hands-on health care providers don't get even half of our health care dollars. We don't need a fix. We need total dismantling and rebuilding on a free-market foundation.

one more thing
Sicko is, like every other Moore film, a very thing veneer of facts propped up by an substrate of lies resting on a foundation of false premises.

Jesus C
Reading the book that I have suggested would give you some knowledge on economics and how feel markets work. If you allow the market to work in the field of health care the cost would come down.

Open your eyes
"I never get an answer when I ask- If socialized medicine is so bad how come people who live in countries where they have it don't demand a 'free' market with HMO's and insurance companies??????"

Well, gee, maybe the reason is that the HMO system as it has arisen in this country is a direct result of the same governmental intervention that is the chief cause of the problem both there AND here. Maybe the problem is that insurance was never designed to handle the day to day medical iossues of people and the poor was better cared for BEFORE the implementation of Medicare.

Or maybe (and this is the most obvious), as a liberal, you simply haven't been paying attention. People are doing EXACTLY THAT when they come to this country by the hundreds of thousands to get care becasue theu can't afford to wait in their home countries. A man in Canada SUED to have access to fee-for-service care and more than half of Canadians (say polls) wish to have access to fee-for-service care.

The same blindness that makes one fail to see the demand for fee-for-service care is the same one that overlooks socialized medicines (lethal) failings.

jesus c(not your real name)
It's real simple. The dopes in those countries think their health care is "free", not realizing that all citizens pay for it. If you've ever had a real job working for a boss, you've noticed a large disparity on your pay stub between gross and net pay- that's the money that's being confiscated from you to pay for everybody elses health ins. But, hey anything that's free, including health care is worth every penny you pay for it.

Health Care Savings Accounts
Health Care Savings Accounts solve a problem that doesn't exist. The problem is not that people are consuming health care that they don't need because other people are paying for it. The problem is that, 90% of healthcare dollars are spent by the 10% of American citizens who are chronically ill (with cancer, or diabetes, or Parkinson's disease, etc., etc.). For the chronically ill, whatever the deductible of a health care plan is, they will meet it. Whatever the maximum out-of-pocket cost for a healthcare plan is, they will meet it. And, they will meet their deductibles using goods and services that the non-chronically-ill people do not use.
Health Care Savings Accounts will not reduce the amount of money spent on health care by the chronically ill, and since that's where the majority of health care money is spent, it won't do anything to solve the problem.

wrong
jesus c. - free markets work every time. Greed may be bad but enlightened self-interest and a profit motive are what has made our economy the best and strongest in the world. When we try to control that through government regulation the problems begin.

Georgia Gal - I have to disagree. Health Savings Accounts will drastically reduce the amount spent by the chronically ill in that they will no longer be supporting multiple layers of non-value adding bureaucracies. Additionally, insurance companies eliminate innovation in health care by being overly regulatory in what they pay for and what they don't. All of that compliance adds another layer of cost with not only no benefit but in many cases, great harm. YOU are correct that many people will never meet their deductible while some will meet it every year. In my experience, the total cost of the deductible plus the actual premium is less than the premium alone for what is considered maintsream health insurance. Thus, the cost to chronically ill is no greater than it would normally be. The benefit to the public is that those who do not use their full deductible get to keep the money (creating individual wealth instead of sending that money into the insurance industry) and mdical costs will decrease when de facto deregulation occurs by removing the onerous restrictions of the insurance industry.

THIS POLL
...among many others:

http://www.pollara.ca/Library/News/Dec_05_98.html

This one came out right after a man had to sue in order to be able to pay for NEEDED hip surgery.

The only "crap" involved here is that stuck within the cranial confines who are so wedded to liberalism that they can't be bothered to do a little research.

Hay-seus c(lueless)
"How come we don't have pay for service police and firemen? Give up, go home."

Actually, the police function is part of the inevitable responsibility of the state and, in fact, firemen came into being as a function of the private sector and in many, many cases remain a privert function.

"Did blue cross/ blue shield cover the sick that the real jesus cured?"

Of course, people DIED about three decades sooner...

Experiential Ratings
Mr. Right: Will the health insurance companies, under HSA's, still be able to use experiential ratings when setting premium costs to purchasers? A lady at church has a daughter recently diagnosed with juvenile diabetes. She worked for a small business. The health insurance company raised their rates to an amount greater than her gross income to purchase health insurance for her and her daughter. Yikes! Eventually, the lady from church came up with a solution wherein she quit her job in order to take a lower-paying job that qualified her to buy into the SCHIPS program that Star Parker hates so much, as that was the only way she could find to cover her daughter's health care costs.
Under HSA's, will the insurance company still be able to use "experiential ratings" to charge enormous premiums to the chronically ill, thus effectively keeping the chronically ill off their plans? If experiential ratings are outlawed, so that everyone who buys an HSA will pay the same rate regardless of their diabetes or cancer status, then maybe it might work. However, on CSPAN, insurance companies make impassioned arguements as to why they need to use experiential ratings in issuing their plans. I'd say HSA's if and only if the premium is identical for all purchasers, the same premium for the currently well as for the cancer patients.


Ms.Parker
The Senate has adopted a base assumption.That assumption is that the Medical Protocol will change from treatment to prevention.This change will be the nature of Health-Care in America for the foreseeable future.When we stabilize Health,we will inevitably stabilize cost.The Senate is taking a step in the right direction,even though it is not the "BEST" step.But it far surpasses any proposals made by others.If I explained how Economics should be allowed to control the question of Health- Care,you would not be able to understand it.WHY?Because most Americans are using old theories of Economics to address advancing conditions.If America is to move forward,it will take "NEW IDEAS"!! WE will save $78 billion in the next two years,with the adoption of prevention as a PROTOCOL.

More jesus c. drivel
"...every American for the price of the 'war on drugs'"

...and put more people in the ground...

...even if there were any actual basis for that statement.

The cost of liberal programs is ALWAYS lowballed either initially or (as other countries do) by hiding relevant costs in the bureaucracy. Welfare has cost more than $7 TRILLION and has INCREASED poverty.

It's no accident that we have the highest quality ACTUAL CARE anywhere in the world while 170 Ontarians are sentenced to death every year for dealys receiving heart surgery alone (on a per capita basis that equates to about 4,000 people here) and that's just for a single procedure in a single Cnadian province.

you have to be a woman
Jesus C. You have to be a woman

Georgia Gal
What HSAs will do is drive down the cost through competition. Whenever insurance companies pay, cost is irrelevant to the end-user. If all diabetes patients paid for their own supplies for the first $5,000 they would shop for a better deal and competition would be introduced. There is absolutely no competition presently as prices are determined by the insurance companies. Medical supply companies and drug companies know this. So for an item that costs them $10 to produce, they state their price as $100, knowing the insurance company will only pay them $60. With all the hassle and red tape in following ridiculous FDA rules and regulations the company blows another $30 and they are left with a with a gross margin of $20 on direct costs of $40. SGA will take another $10 to $15 and the drug company is left with a modest net margin.

In the meantime, the insurance company collects $150 in premiums so that they can pay the drug company $60 and spend another $50 on their overhead costs, another $20 on their SGA and they have their profit to pay to shareholders and you have consumers spending $150 for $10 worth of drugs.

One of the beauties of an HSA system is that patients can negotiate their care with their physician because they are paying for the first $5000 or so. I have had an HSA for several years now. When I needed an outpatient surgical procedure, the surgeon was not listed as part of my plan but that was not a concern, I used him anyway. I told him I would be paying cash and asked for a discount. I reminded him that none of the insurance people working in his office would need to bother with this - just send me a bill and I'll pay it. I would take care of sending a copy of the bill to my insurance company to be applied against my deductible. I got a substantial discount and he offered to switch the procedure to another hospital than the one we had originally planned on using because they would also offer a cash discount as would the anesthesiologist. I saved a bundle and didn't even need to call Geico!!!

Changing the parameters under which health care is paid for will change all of the current assumptions. Prices would become elastic instead of static. As for the lady in your church, with no standard insurance and an HSA system, she may be amazed at the amount of help that would be available through charitable organizations and the church itself if she were to find herself in a real bind. I know that we didn't have the technology that we have today but the whole world existed for centuries with no insurance industry whatsoever.

Why health care costs increase...
They increase for two reasons: 1) The costs of inputs increase. Insurance, doctors' salaries, and other associated costs often climb annually, and if health care providers are to make a profit, they have to increase the prices charged. Second, the inelasticity of demand...if you need emergency surgery, you are not going to shop around for the best rates, you're going to find out who can do it right away. Further, even if prices are cheaper for health care in California, I'm not going to fly from Illinois to take advantage of them. Thus, there is no "national" health care market in a de facto sense, because no one is going to travel thousands of miles to receive care.

But blaming particular groups for health care costs when they all contribute their share to it and pull down its profits is asinine. Why are American doctors among the most highly compensated in the world? Why are our malpractice suits higher? why can we not have more effective policing and honest disclosure of doctors' mistakes? One study here in Illinois suggested that 5% of doctors were responsible for 30% of the malpractice suits. They are the ones who drive up costs for the other 95%.

It's sad to think that like everything else, health care has become politicized - left wing moonbats blame high-priced doctors, right wingnuts blame high-priced lawyers.

Jesus C.
The reason why I think your a woman is your using emotions and not the BRAIN that you maker has giving you. Now buy the book that I suggested and increase the size of that lump (which is three feet above your a double ss) with some knowledge.

jesus c
Now that is overstatement if I ever heard it. The exaggerated dialgue over the war, over global warming etc is making it impossible to talk to one another.

GeorgiaGal and Mr. Right
I agree with some of what each of you says, and disagree with other portions of your posts. One of the primary drivers of health care costs is, of course, involvement of corporate insurers and commercial health plans. UnitedHealth, Aetna, Humana and others are not in the equation to be altruistic. There is a huge amount of money to be gained in corporate insurance, and even more from working on the administrative services only side for self-insured companies. In every state, the insurance lobby is as big and aggressive as anything we can imagine. Keep in mind, insurance is a business and, for the most part, consumers are not the customers or clients -- employers who offer benefits packages are. Employers decide what benefits to provide and they also pass on premium increases in the forms of higher premium contribution as an employee and by negotiating higher copayment levels with insurers.

Georgia Girl, you are not wholly correct when you cite the famous 10% of the population is causing 90% of the cost problem (which is an industry stat and not really from Newt) and then cite the chronically ill, and especially when you discuss prolonging life for the chronically ill. There are four main disease states -- diabetes, asthemas, COPD and congestive heart failure -- that have been identified as very costly chronic conditions. But -- these diseases are also somewhat manageable and treatable. The appropriate medical management of these diseases -- medications, proper diet and exercise, regular check-ups and lab testing -- reduce costs. What causes costs to skyrocket are, for example, diabetics who don't follow the doctor's diet recommendations, don't exercise, don't test regularly, and THEN end up being ambulanced to the emergency room and admitted to the hospital. ER resources and inpatient admissions cost infinitely more than meds, routine testing and regular office visits. It doesn't sound like much, but consider a $15,000 or $20,000 hospital admission times, maybe, 10,000 or 15,000 diabetics who will cause those admissions. And suddenly it's millions.

Mr. Right, I believe you are absolutely right about HSAs, and especially about the ability of every patient to negotiate cost with health care providers. Providers easily send out bills for three, four and five times the cost that they have agreed to with their insurance company contracts. A person who doesn't have group insurance, or like you wants to use an out-of-network provider, can and should be prepared to ask how much a procedure costs in advance, request a discount, if possible ask what the provider's insurance contracts would pay for the procedure and, absolutely, get that cost down to a reasonable amount -- sometimes 25 or 30% of the cost that would be "billed." Way too often, consumers won't even discuss costs with a physician. They act like it's not part of the equation.

Costs will be controlled and possibly reduced when everyone, with or without insurance, questions the cost and shops for cost as well as quality. I believe health care is a market in which there is enormous room for variability, and some savvy and entrepreneurial providers could really clean up in terms of profit, still deliver quality care and still help consumers keep it somewhat affordable. But it absolutely requires a free market.

Sorry for the length. Had a lot to say.

jesus c
how does your above comment deal with health care and the market place? Now you bring the emotion "fear" into the picture along with Bush and Bin Laden. You still need a crash course on economics. Did they teach economics in the school you went to?

No to Medicaid for the middle class
Our federal debt is $9 TRILLION DOLLARS! China owns $400 billion dollars of our debt and still has $1 trillion dollars, cash, in the bank. Does anyone see anything disturbing about this?

For years, politicians from the Democrat, Republican, and Independent parties have for a long, long time placed us in such a spot when they buy votes. Yes, they reach out to selected groups of citizens and promise them goodies. It is hard-working farmers, seniors, etc. It is illegal aliens or whatever. Notice the Emergency Spending Bill they just porked up in the House and Senate? It has the largest tax increase in it in history, all for the average taxpayer.

USA TODAY, Dennis Cauchon reported in May 2006, what federal, state and local governments owe in unpaid debt, at least $57.8 trillion —$510,677 per household — for Medicare, Social Security, civil servant health care and other obligations. Medicare's financial situation already is deteriorating. The government's audited financial statement, released Friday, reported that Medicare's unfunded liability raised $2.4 trillion in 2006 to $32.3 trillion.

How many of our financial experts in office right now are warning us about a financial collapse of our government?

David Walker Comptroller General says, “The most powerful words in the Constitution need to come alive. Those are the first three words,’ We the people.” Walker tours the nation giving his “Fiscal Wake-Up Tour,” telling American’s who will listen just how far in debt we are. Nobody seems to listen, especially in Washington and statehouses across the 50-states.

Federal Reserve Chairman Ben Bernanke warned Congress January 18, 2007 that the economy could be gravely hurt if Social Security and Medicare aren’t revamped and urged lawmakers to tackle the nation’s thorny fiscal issues sooner rather than later. “If early and meaningful action is not taken, the U.S. economy could be seriously weakened,” Bernanke said in testimony to the Senate Budget Committee.

It marked the Fed chief’s most forceful warning to date on the potential problems facing the United States with the looming retirement of 78 million baby boomers, the oldest of whom will start retiring January 1, 2008. “In the end, the fundamental decision that Congress, the administration and the American people must confront is how large a share of the nation’s economic resources to devote to federal government programs, including transfer programs such as Social Security, Medicare, and Medicaid,” he said.

Does anyone remember a government program that has been accurately estimated? I have not. Take for example the cost of the Iraq war. In the days before the war four years ago, the Pentagon estimated that it would cost about $50 billion. Lawrence Lindsey, a White House economic adviser, was a bit more realistic, predicting that the cost could go as high as $200 billion, but President Bush fired him in part for saying so. What has not been estimated in any of the official cost projections is the long-term needs of veterans returning from the Iraq and Afghanistan wars. Estimates I have seen places the cost over $2 Trillion dollars.

The National Health Care Anti-Fraud Association estimates that this fraud collectively costs Americans between $60 billion and $100 billion a year.

jesus c.
The victims of socialized medicine are changing it because they don't have the freedom. The perpetrators of it won't change it because they won't give up the power.

Now take your silly question on down the road. The adults would like to have a discussion.

Power and control
Countries with socialised "health care," are under the control of politicians who are even less responstive to the electorate than are ours, or under the control of totalitarian dictators such as Castro. It is greatly to the advantage of these sorts of misrulers to keep the population dependent upon "the government" to the greatest extent possible. (In the case of the dictators, the population depends on not incurring the ill-will of the govenment in order to continue to breathe.)
The supposedly wonderful Cuban health care system that Moore lies about is actually a three tier system, with the top tier, which is modern and good, rewerved for foreigners, referred to as "medical tourists. They get care that the Cuban citizen can only dream about.
Then there is the second tier, also modern and good, for the elite, Castro and his minions, the "nomenklatura" to use the Russian term for them. And then there is the third and largest tier, that which is available to Cuban citizens. If you go to a hospital you have to bring your own sheets, blankets, food, even light bulbs. Aspirin tablets are hard to find at that level.
And, as a final question, if socialised medicine is so wonderful, and if Cuban socialised medicine in particular is so superior to anything in this country, then why do people continue to escape, and note that word well, escape from Cuba. We have a problem of people sneaking into our country illegally, and Cuba the same laws about leaving the country as apply to leaving a prison. Anyone who has a mind to can emigrate from this country; but you have to escape from Cuba.

My guess is...
that people in countries with social medicine have been programmed to believe that thier health care is not something they are responsible for, being good little sheep the goverment with take care of this for them. Some people (the uninformed) in this country think that everything will be the same as it is now with social medicine, I have a a feeling it will be nothing like it is now. Take a look at public housing or anything else the goverment gets their hands in, it is a mess and always cost alot more than it should. The push for socialized health care is about power and control, pure and simple. I for one take responsililty for myself and my family and have no desire for the goverment to have control over something as important to me as my health care.

Canadians come to the US for health care
They can't change the system they live in because the voters don't have the kind of power American voters have (Canadian parliment is much more powerful than the voters compared to a stronger democratic bent in the US Constitution). So, instead of changing their system, they come across the border into the United States and pay for our health care. This has been noted by Alaskan physicians for 20 years and it is well known in other border states as well.

In recent years, my cousin the doctor has been telling me that rich European citizens also come to the United States for treatment rather than wait for years for needed procedures. He was an "exchange" doctor about a decade ago and he saw a lot of patients who were terminal while he was in France. Come to find out, their appointment with the specialist (him) had been made years before. R's co-physician (the guy he exchanged with) ended up staying in the US because he was so pleased to be seeing patients he could actually save instead of treat to prolong their life a few months.

Anyone who thinks that socialized medicine works has never known anyone who has lived under socialized medicine.

naive...
When did all of you swallow the lie that there is any form of free market in health care?...do you really think health insurance prices are aren't fixed?...why does the AMA disallow doctors to advertise their fees?...do you really think drug companies don't talk to each other about what they intend to charge for their pills?...and most importantly, do you seriously think all of these industries don't kick back dough to the various government entities (dem's and rep.'s) so no one will investigate them?

health care
My new book, EQUAL HEALTH CARE FOR ALL, and web site, http://www.equalhealthcareforall.com, offer a revolutionary overhaul for our entire health care system.
Doctor K.

To all
Good luck negotiating fees with your physician/surgeon. Let me know how it goes, really. I am one and will not do so. My fee is my fee. The insuance company gets a break because they send large numbers of patients my way that are very accepting of treatment mainly because they don't have to pay out of pocket. So, what are you, one individual, going to do for me to deserve a discount? Threaten to leave? Good luck finding any kind of specialist outside of major metropolitan areas. People wait for a neurologist for 4-6 months here in Central PA- gonna try to negotiate that office visit fee? Watch a neurologist become a proctologist before your eyes. HSAs are the way to go! I can lower my fees or just hold the line since I will be able to let 2-3 full-timers go if there is no insurance crap to deal with. Plus I will get paid more quickly. And, Scortched, buddy, you obviously do not own a business and have to purchase insurance for employees. It is a competitive business-Arby got it right-they market to the business owners, not the worker bees. This year, it went up so much that my employees got next to no raise. Georgia Gal- they are in it for the money, it is a business. Would you bet on a losing team after the game is already over and you knew the score? Why would an insurance company take on a bunch of seriously ill people that they KNOW will be a net loss for them. It is a gamble for both sides when you buy insurance and they at least have to see some chance at a profit or they won't issue a policy. Stop believing the insurance company propaganda- they are banks and do not give a rat's petoot about your or my health.

Mr Thomas
Sorry, sir, but noone has a RIGHT to health care any more than they have a right to foie gras or home heating oil. This is the exact emotion-driven "thinking" that has landed this country in big financial trouble. It's a damn shame that you think this way. So, even though the govt stepped in with the EMTALA laws (another law passed "for the kids") and require ERs to treat anyone with a life-threatening condition, you don't think that that is enough. The hospital should never send a bill if someone really needs it, right? Are you going to tell the nurses why they aren't being paid that week? How about the lowly lab tech who lives check to check? Or the guy that takes out the trash? How about the company that supplies the drugs for the surgery? Or the electric company? People like you never think about all the costs involved in running a high overhead business. All you see are the doctors' nice cars parked outside and "can't these rich hospital people give a little back?" Pardon me while I laugh.

True American
Jesus C. is a socialist. Funny how these people have socialist ideas and partake in CAPITALISM everyday of their lives. OH and by the way...Anthony Thomas.....YOU NEED A LESSON IN ECONOMICS!!!!!!!!!!!!

True American, the poster
"jesus c" would appear to have been flagged and banned. This is yet another immature TH troll who lurks in the shadows, waiting to post complete and utter senseless ramblings (similar to soothsayer.)

CVN65, great response to Anthony Thomas.
This person would appear to be suffering from
"entitlement syndrome" (you know, the people who say things like "you better give me my birthday off, dammit" or "if you don't give me at least 20 each sick and vacation days each year I am going to just quit!") Sound familiar? This syndrome does seem to affect great numbers of younger people, although I have no idea as to Mr. Thomas' actual age (his mental age is clearly revealed in his post.)

Also, CVN65 and others who posted about negotiating doctor fees...we have had an HSA for about 5 years and I have yet to find a provider willing to do this. Each one has insisted on having office personnel bill the insurance, even though we have to pay for the first $5000 each year. They tell me they cannot allow me to know of the contracted price, nor can they discount it the SAME day of service in order to take the cash and forget ever dealing (billing,etc.) with the insurance. We would much prefer to just pay cash (the contracted amount if provider in network) and not have anything to do with insurance unless we have gone over the deducible amount.

I did finally stop going through the HSA insurance for RX's. I just get all prescriptions filled with the discount club price and forget the insurance. That way I don't have to put up with "it has not been 30 days," "you can only get one month at a time on this," and "you need preauthorization before this can be filled" (aahh, so what if you need the medication right away?)baloney.

Just a note here, aren't
smokers finding their way around having to pay these per pack taxes? Like internet, going across state lines, black market, etc.? And are numbers of smokers decreasing? If so, wouldn't these two factors significantly compromise the money for this cash cow health fund that legislators are counting on being there?

Ms. Parker, another great article. I have heard back from my Democrat Senator about how this law is "for the children" bull which is typical of the argument Democrats resort to whenever they want to raise any taxes. Once cigarettes, etc. cannot be taxed any higher (I know that sounds like an oxymoron)Dems will go for the high carb and fast food items to tax.

True American, you may be able to
qualify for an HSA, but it will still take money to pay the premiums and get enough money in to cover your deductible. My husband's business has employees who earn about the same as you, but he still pays for health insurance for each employee. It is high deductible, but then the business helps an employee if they are hospitalized and have to pay the deductible first. And the employees still get yearly cost of living raises and bonuses. These employees know a good employer and are willing to stay employed at this business because they know this would be hard to find elsewhere.

"Free" Healthcare?
I spent quite a bit of time this weekend reading about the "health care crisis" in the USA and various proposals to fix it. Unfortunately, most of them are simply variations on the same theme: socialize it. Take from the rich, give to the poor. There is no free lunch here, folks. One fellow went so far as to propose what he seemed to think was a brilliant, out-of-the-box concept. Apparently he was too provincial in his thinking to understand the concept of "been there, done that." What he proposed was essentially the Canadian system. How do I know? Because I lived under the CDN healthcare system between 1988 and 1994, so I have experienced it first-hand.

Fact: Doctors in Canada make approximately 50% of their American counterparts.

Fact: Doctors in the U.K. make only 25% of their American counterparts.

I am not a physician and do not work in or sell to the healthcare industry - so I have no vested interest in the matter other than my own health.

You have to ask yourself why anyone would enter this field if they have to invest 12+ years of their life in post-secondary education, rack up $200,000 in educational expenses, expose themselves significantly to the likelihood of being sued for malpractice at some point during their career, long hours, high stress -- and at the end of the day, make the same money they would make in professions that require only a fraction of the schooling, risk, and investment. Heck, just skip school altogether, don a hardhat, and get a union construction job. Same pay, less stress, less risk, and the hours are a whole lot better.

This is one of the reasons that Canadian physicians are bailing and coming to the USA. It is also why the Brits are having a very difficult time convincing their indigenous population to pursue careers in medicine. The Brits are having to import their doctors and future doctors from the third world because they can't attract anyone else. It is also why getting medical treatment in Britain is increasingly equated with an assembly-line - and third-world medicine.

You get what you pay for.

When we don't let the free market decide worth, we end up with "government doctors" and it isn't pretty. We also end up with rationing whereby necessary surgeries result in waiting lines that are months or years long. And emergency room waits that are interminable (Vancouver B.C. recently boasted that the wait was "only" 16 hours).

I am under no illusion that we will remain status quo for much longer. Barring dramatic intervention, we will probably have a universal health care system in the USA by the end of this decade.

But I hope people truly realize what they are signing up for here. It will be immensely expensive. Estimates range between $70B and $100B per year with benefits or tax credits equal to $7000 per person each year. This money has to come from somewhere.

Honestly, the next time I hear somebody utter the words "free" and "healthcare" in the same sentence, they need to be censured for having an IQ too low to allow them to post on this website.

Universal? Perhaps. Free? Absolutely not.

Anthony Thomas
"The HMOs are horrible!"

Sir, just what do you think "Universal Health Care" will be? It will be ONE HMO (the federal government). Hate your HMO? Too bad. Guess what? Now there is NO COMPETITION to force your HMO to get their act together. Want to opt out and pay your own way as a form of protest? No can do.

I lived under Universal Health Care in Canada for 7 years. It is a system that runs semi-functional for a few decades, and then starts to tank - badly. It is all the things you hate about your HMO, only magnified about 10X.

Suggestion: if you want to know what this feels like, move to Britain and get really, really sick. Like maybe blow your knee out and wait 15 months for orthopedic surgery - the same surgery that could be obtained in weeks in the USA. Or better yet, have a heart attack or find yourself in need of an organ transplant. You may well die waiting in line due to government rationing and their chronic inability to match supply to demand. That's what 40+ years of socialized medicine will get you. Long lines. Substandard care. Crumbling buildings. Apathy. And inferior doctors.

I know folks like you will never be convinced. You haven't lived under these socialized systems, and even if you did, it wouldn't matter because "somebody else is paying."

Yes, there are problems with healthcare affordability in this country. One of the biggest problems is that "managed care" is largely outside the hands of the actual consumer and put in the hands of employers instead. No surprise that their priorities don't always line up with their employee's priorities. One of the first changes I'd like to see is insurers giving individuals access to the same plans as "big business" and "big business" giving their employees money to "buy their own" healthcare. This would start driving things in the right direction by putting the HMOs in closer connection to the people that are actually the consumers of their services. They would also have to compete more aggressively for individuals rather than "big accounts". Sort of like your cell phone company.

When's the last time an HMO called you at dinnertime, desparate to give you a better deal? Exactly my point. Very little competition. Complacency. Poor service. "Don't like our service? Dial 1-800-POUND-SAND."

Contrast this with the cost and quality of telecommunications now that we privatized it and took away AT&T's monopoly.

That's the way the free market works. It makes things better. The more you socialize (and employer-sponsored healthcare is a form of socialization) the worse things typically get.

Healthcare affordibility
nevadamistermom: The primary problem with your solution is that the people with pre-existing medical conditions would not be able to purchase health insurance from the private sector. As soon as the test comes back "positive" for diabetes, etc., the health insurance company starts looking for ways to remove that person from their plan; further, competing plans have procedures in place to prevent the chronically ill from joining their plan.
Any workable solution to the health care crisis in this country has to deal with the question: what do the chronically ill do? (Maybe, under your plan, the healthy can have private insurance, while the chronically ill have government insurance?? That's what the insurance companies would prefer, I've heard them on CSPAN saying that they want to insure against "unexpected events", and treatment for chronic ailments like diabetes are "expected events".)

True American,
try something new. There are plenty of jobs out there that offer healthcare (and allow for sick days). We're all having to do extra things to make ends meet so you're not alone there.

Math, Ethics, Long Waits
Am I missing something here? If the yearly deductible for a person with a Health Savings Account is the lowest figure named in an above post, $5000 a year, and the patient is a retired low-wage worker with no income but Social Security of $800 a month, that would be $9600 a year, then paying the deductible would take more than 50% of gross income during the years when major illness is likely? Or suppose the patient is employed full-time as a hotel porter or kitchen help making $12 an hour; his gross annual pay will be just under $25,000 and that $5000 will represent 20% of his gross? Meanwhile people have no choice about paying for food, clothing, and shelter, and transportation to work, so what would inevitably happen is that they would not spend for medical care---they would go without treatment because they couldn't afford it. I have heard the Republican argument that if people have to pay out-of-pocket they won't go to the doctor so often. Probably not, but is this in the best interests of public health? Should medical care be a luxury unaffordable by the many? If a society can be said to have ethics, that doesn't seem to me to be an ethical position.

As for the usual anti-Hillary bugaboos presented, I suspect some of them are myths. 1) We have the highest standard of care in the world? My newspaper the other day said the Western European countries deliver better emergency service, better care to heart attack patients, and better post-hospital discharge care. 2) Waits are unconscionably long in the socialized medicine countries? Last year I (with good insurance and good access to doctors) waited four months for an appointment with a specialist. For another doctor I see four times a year I must make the appointment six months in advance each time. In May my husband's heart surgery was postponed four times (and the situation was indeed life-threatening as he couldn't breathe) because a prima-donna surgeon complained he'd been "overscheduled".




True American, my husband DOES
have to factor in health care insurance costs into what he charges clients. To be fair though he is not in landscaping; although believe me, he gives plenty of free (meaning never gets paid) services. I agree with CT, try to find a job that offers health care benefits and then don't lose it. Someone told me that people who take people (in wheelchairs to their room, etc.) around the hospital (transport)earn as much per hour as you do, and many hospitals offer healthcare benefits. The other thing for you to do would be go to community college and try to get some further education so you could get a higher paying job with benefits. From what I understand even Walmart offers employee health insurance benefits.

GeorgiaGal, you are right about
insurance companies, and you bring up some excellent points. Right now if one has group insurance coverage the company has to accept the person. But like I posted earlier, HSA's are individual and companies can call the shots pretty much all the way (although you can look into as many companies as possible that offer insurance for your area and then try to get the best deal.) I don't know what the answer is other than the companies being forced to accept everyone who is willing to pay the premiums (and the premiums should be reasonable even for people with chronic illnesses.)But like someone else pointed out, insurance is business.

I have a relative who has used up hundreds of thousands, if not millions, on Medicaid with his chronic illness. Some of his problems are a result of not taking the best care of himself, but a lot of them are just having the disease for over 45 years and the technology that now exists to prevent death from this disease.

We pay more for our HSA premiums because of certain risk factors which supposedly increase our chance of coming down with a serious illness. Despite the fact that we have adopted lifestyle habits (exercise, supplements, etc)to minimize that risk, the insurance company does not give us any breaks.

Georgia Gal
Nowhere did I suggest that there wasn't room for improvement, or that we could not benefit from legislation that prevented insurers from carrying only the "healthy" among us.

I don't profess to have all the answers. I simply know that socializing the system and trying to emulate Canada, Cuba, or especially Britain, will cause more problems than it solves.

Lilly
And what makes you think that having the federal government involved will shorten the waiting line or streamline the process? At least today, if you have a 5 month wait for a specialist, an enterprising doctor can ascertain that demand exceeds supply, hang our his/her shingle, and shorten that line. Or you can go to another city or state for your care. Often doesn't work that way under UHC. Canada, for example, has geographic constraints on where you can/cannot seek care. Provinces are like mini empires.

You need to take a look at some posts by AudiR10, a frequent poster on TH, and see how she has fared within the Canadian system (she lives in Toronto). It took her months to find a family doctor because most were not accepting new patients. Then, it took her 5 months to see a specialist and she could only visit him once per year due to "rules" within the system that only paid for one visit per year. By the time she saw the specialist, the macular degeneration problem she had could no longer be treated. A true model of efficiency and compassion. NOT.

Everyone is under the impression that universal health care will somehow magically circumvent all of the inefficiencies and bureaucracy inherent within "managed care." Please understand that universal health care is nothing more and nothing less than a single, mandatory HMO program from which you cannot "opt out." It will be all of the things we hate about our present HMO programs, except without competition of any kind to make it better.

Few would argue that the USPS has not benefitted from the competition offered by UPS and FedEx. But UHC doesn't permit any of these things. In order for it to work as its proponents intend, it must be mandatory, it must be universal, it must be equal, and it must be a monopoly.

Don't tell me how bad things are now in the US. Look at the other countries where UHC is a reality - look deeply, not superficially - and you will see that it makes things worse, not better.

So let's take your specifics:

1. Husband was rescheduled by his heart surgeon.

Under the current system, your surgeon has competition. You can go elsewhere. You can seek second opinions. Under UHC, the surgeon gets paid the same, strictly based on the procedure, not the quality of service he delivers. There is no incentive for him to improve his service, and he has no control over his prices. They are set by the government. Want to go elsewhere, such as another state or city? You may not be able to. Big Brother is calling the shots, administrating supply, and it may have nothing to do with demand.

2. Have to schedule 6 months in advance for 4 appointments per year.

Get prepared to be told that you can't see that specialist 4 times per year because some bureaucrat has determinine in his omniscience that 2 visits or perhaps even 1 per year is adequate. Likewise, get prepared to wait in line for 12 months instead of six because this specialists can no longer see patients as often as the patient/physican agree is appropriate and demand for his services has gone up...too many patients, not enough slots. Someone else (the federal govt.) has now made that decision. Government has artificially modified demand for the specialists services, and this will eventually affect the number of people that pursue that specialty in school. UHC programs often appear robust for a decade, then they start crumbling - badly. Look to Britain for evidence. It is the oldest of the socialized health care schemes, and it is in the worst shape.

3. You newspaper said we don't have the highest standard of care in the world.

Since you have decided to believe everything you read, I have decided to offer you some prime property in the Everglades on eBay. You must believe it because it is presented here in black and white. I'll provide the URL separately.


To CVN65
RE "It [medicine] is a business": Several years ago I used to go to a specialist who was very much a capitalist-type doc, in fact he ran for public office several times as a conservative Republican and had pictures of Ronald Reagan all over his office. I needed procedure X which he insisted could be done only in a hospital operating room. I told him I had had procedure X multiple times in the office and it was no big deal. He insisted. So I had it his way and the bill for Himself was $650 plus the bill for the OR etc came to another $1500 (BTW this doctor was also part-owner of the hospital where he worked). Soon I switched to a university health center where the doctors are on salary and, in the fullness of time, saw a specialist in the same field as Dr Capitalist, in fact a full professor, who did procedure X in his office in five minutes (just as I had had it many times before) and the bill was $125. There's a lesson here. I avoid like the plague any physician who sees medicine as a business. And the idea that profit-driven doctors will be the salvation of our health service delivery system is nonsense.

To nevadamistetc
People are NOT always free to go shopping around for a better price or even a different doctor. Choices are limited by geographical location, insurance plans, availability of specific medical expertise, patient's lack of familiarity with medical matters, patient's inability to navigate for reasons of age or frailty or competence, and by urgency. And even with the system we have now, which I gather you think is perfect, people make some incredibly stupid choices when arranging their medical care; I don't see their skills improving when they also have to shop for price. Then into the vacuum will inevitably step, what else, the free market, with whatever hype and seduction it takes to lure the unsophisticated patient into somebody's profitable net.

You think that liberals are wide-eyed babies ready to believe that government-run health care is a panacea. And yet you have the same trust in market-driven health care. And if you don't want the government making your health care decisions, I don't want Corporate America making mine.

I Kid You Not - The Government Cheats On
the poverty levels. The poverty level is "set" every year, but only "adjusted" every 5-6 years. It actually allows them to write people off. That 300% of poverty level may just be the real figure...

Congress' Financing Healthcare is Uncons
Congress'financing healthcare is unconstitutional and thus, a tyrannical act. See Art. I, Sec. 8, U.S. Constitution.
"Another not unimportant consideration is, that the powers of the general government will be, and indeed must be, principally employed upon external objects, such as war, peace, negotiations with foreign powers, and foreign commerce. In its internal operations it can touch but few objects, except to introduce regulations beneficial to the commerce, intercourse, and other relations, between the states, and to lay taxes for the common good. The powers of the states, on the other hand, extend to all objects, which, in the ordinary course of affairs, concern the lives, and liberties, and property of the people, and the internal order, improvement, and prosperity of the state."- Joseph Story (Commentaries on the Constitution, 1833)

Lilly, did you even read
nevadamistermom's last post to you? If you had then I do not believe you would have said the following: "You think that liberals are wide-eyed babies ready to believe that government-run health care is a panacea. And yet you have the same trust in market-driven health care."

Nevadamistermom said nothing of the kind. He acknowledged that the present system is NOT perfect, but it is far, far more perfect than socialized medicine could ever be. And AudiR10 as well as canuck have both posted as to the
Canadian system failure. The government is NOT the answer to the problems. You seem to have quite a negative attitude towards corporate America (or doctors, especially ones with pictures of Reagan.) And that doctor at the university where you went? He is paid by capitalist America, no different than the other doctor who insisted you do things his way instead of being told by you how to do his job.
It was within his right and of course within yours to seek another doctor (one who agreed with treat you in the office per your wishes.)

As for people making "stupid choices with their health care"...how pray tell will the government make that better other than by taking it away completely.

Lilly
I don't mean to be uncharitable, but as I look at the posts you leave here and elsewhere, they rarely make much sense. I appreciate your willingness to engage with people, and your views certainly subject you to more than your fair share of criticism, but you have made the health care situation into an all-of-nothing proposition and have engaged in exactly the type of behavior that stereotypes liberals: 99% emotion, 1% reason.

All the points you bring up about frustration with HMOs and geographic restrictions and the inability to shop around are valid. But please understand that they will get WORSE under a government-run program, not better.

I have yet to find very many on the left who are in love with their HMOs. Where they make the fatal error is in assuming that UHC is somehow a totally different concept than an HMO. I took great pains to explain that it IS NOT. Take some time, for your own sake, to examine the programs that are in place in these other countries. They have all the attributes of an HMO - because that is what they are:

* Somebody else will decide what is and is not covered.

* Somebody else will decide what doctors you can see and how frequently

* Somebody else will decide how much that doctor's services are worth

* Somebody else will artificially modify supply and demand. Wait times will go up, quality will go down, choices will decrease.

I could go on, but somehow you just aren't getting the fundamental message here. Namely, that UHC is nothing more than a government-run HMO. You appear to be quite eager to run in that direction, under the delusion that all the difficulties you face today will be diminished or absent. They will not.

I never said I trusted private enterprise to deliver a flawless system. There is clearly need for intervention in terms of rules (such as denying insurance to those with pre-existing conditions). What I *did* say is that I have no confidence whatsoever that totally government-run healthcare in the USA will fare any better than it has in Canada or Britain. Britain already IS a disaster. Canada is well on its way.

P.S. Please try to get my username right. It isn't hard. Just use cut and paste.

nevadamistermom, good try with lilly.
Not sure it will do much good since I do not believe she actually reads much to educate herself on various issues. I stopped posting back and forth with lilly long ago, other than an occasional one such as above. I do completely agree with your post that she rarely makes sense.
But posters seem to enjoy engaging (albeit many of them do so briefly) with her, hoping somehow they can get through the fog with actual facts.

Personally, I think quite a few of the liberal minded TH posters just come here to make trouble, never really intending to listen to anything a conservative minded person has to say.
Critical Bill is an example. He just likes to say things to get posters all worked up, and has no interest in ever changing his liberal viewpoints.

Health Care
I'm in an HMO (Kaiser) and its pretty good. I bet 90+% of those without insurance would be awfully happy with something like it.

The US is now 21st in life expectancy. Why be so arrogant and not look at what 20 countries where people live longer than we do? I got in an accident in France and got good medical coverage. Although I almost fainted when I saw how small the bill was.

Some people in my area fly to India for surgery now, to save money.

The US is also 40th or something like that in infant mortality.

Then again, last year I heard Dinesh D'Souza say on TV that Social Security was bad, even though when it started 50% of older Americans lived in poverty, and now only 1/4 as many do, with many of those living on their Social Security. He said, in so many words, that if his grandma didn't save for retirement she deserved to live in poverty rather than get social security. If that's your kind of "compassionate conservatism" then don't try improving health care.
Sign Up to Post Your CommentsSign Up to Post Your Comments
If you are already registered, click here to login. Otherwise, please take a few seconds to register with Townhall.com. Once you sign up, you’ll be able to post your comments immediately, use the action center, get podcasts, and more!
Note: Fields marked with a red asterisk (*) are required.
Salutation:
First Name:
*
Last Name:
*
Email:
*
Nickname:
*
Note: Nick name will be shown when you post comments.
Address 1:
*
Address 2:
City:
*
State:
*
Zip:
*
Phone:
      
Your daily must-read of conservative columns, cartoons and news. Coulter, Sowell, Krauthammer and more.
(Bi-Weekly) We highlight the best opportunities from our partners for surveys, action items and more.