Arnie, perhaps your last point can be debated. What you have stated is of course one of the arguments that those opposed to the public option used. I really have serious doubts that that argument holds much water. Most people on medicare, and the public option as it was planned was a medicare like program, seem to be OK with the degree that medicare "controls access". The only tool medicare has to control access is what they will pay for and what they won't, and of course for some this does have the indirect effect of controlling access. It seems the political rhetoric has not done any of us a favor. Much of the time it just muddies the water with half truths and misleads.
medicare is one of the most popular programs the government runs. after having 4 parents go through it i can say it works very well. it needs to be reformed to make it more cost effective but not destroyed. it should be means tested. something should be done about the huge cost of end of life care where huge expense is incured for a futile attempt to keep a terminal person alive. those things are easily fixable if those dam republicans would stop screaming "death panels" at any hint of someone making a decision to stop treatment. as to medicare price setting. it does exactly the same thing as every insurance company does. it sets a rate its thinks fair and offers it out. doctors are free to decline if they feel they can do better without medicare. completely voluntary. insurance companies do the exact same thing. i have blue cross. there are many doctors who are not in the blue cross network because they refuse to accept the rate blue cross will pay. if you use those doctors you have to pay the difference. exactly like medicare. you just seem to have a thing about anything government. i suspect too much time listening to glen beck types?
I am for a public option. The objection about choice has some holes. The way it is now if a person has no insurance then they have no choice and with insurance the choices are dictated by the companies, chose your posion. The argument is if you don't like the choices go to another company. That is fine until you have a health problem, then you are stuck with the company you are with or stuck without insurance. Lets get a public option and let the market chose, if consumers like the insurance companies better then they have nothing to worry about. From watching the debate I heard Perry talk about the state of Texas small business health insurance plan (kinda like a public option), it looks good, I'm going to see if my company qualifies, I don't think it does but there might be a way to get into it.
This is a hugely important point raised by bigarrow. I have little doubt that if you were to survey small business owners across the U.S. you would find nearly 100% concurrence. This problem of health insurance costs for small businesses is crying out to be addressed now, not 5 years from now. Giant corporations are in a much better position to handle the costs, though it still hurts them, because they can operate on much lower margins due to size. Small businesses can not survive on such low margins. Fixing this health insurance cost problem for small businesses might be the single most important element needed to get this economy turned around. Oh, and MAV, it's beginning to sink in, apparently your not a Robert Reich enthusiast.
Large companies have and economy of scale and their profits can be larger than a competiting small company. And hiring and health insurance is like night and day compared with large and small companies. A large company wants to hire someone, they hire them and the group plan takes the new employee no questions asked, again because of the economy of scale. A small company hires someone and the small business owner doesn't know what the cost of that individuals insurance will be and with some small business plans the new employee may not even be able to be covered.
Robert Reich is awful. A couple of decades ago, when i was early teens, i still recall some news or something where he was saying stuff like we need to focus on teams and not on the individual etc. Sounded horrible then (probably more to me being a non team player, i preferred more solitary sporting activities like tennis, than anything to do with economics). If anyone had listened, there would have been no Apple, Microsoft , Facebook etc. Total communist. You Yanks should send him to North Korea.
Reich is a pos... from the article: " 3. Shrinking government generates more jobs. Wrong again. It means fewer government workers â everyone from teachers, fire fighters, police officers, and social workers at the state and local levels to safety inspectors and military personnel at the federal. And fewer government contractors, who would employ fewer private-sector workers. According to Moodyâs economist Mark Zandi (a campaign advisor to John McCain), the $61 billion in spending cuts proposed by the House GOP will cost the economy 700,000 jobs this year and next. " He does not admit to the notion that public sector jobs are paid for by the private sector and that if there are too many public sector jobs there won't be private sector tax payments to fund it all [as is the current situation with the US public sector]... Our current POTUS is of the same mindset.. they must believe in the Credit Fairy or something. For my entire life Liberals have remained in fantasyland with regard to how their programs are to be funded...
Two excellent points in my opinion. Re the first, is it Oregon that allows physician assisted, planned death for terminally ill patients, at the patients direction of course? This is available in the Netherlands also, as far as I'm aware. What a great help that would be to many who are dying in pain and just want to end their lives peacefully. I believe this is a fundamental right that all of us should enjoy, but sadly don't. On the second point, many insured by the Blues are unaware that the Blues (supposedly non-profit!!!) negotiate discounted rates with both physicians and hospitals, and this is the reason for the different payout "in network" and "out of network". Unfortunately the way this was implemented was fraudulent, and may still be in some states. The blues were basing patient billing on the non-discounted charge and not revealing to patients that the actual charges were less. Thus the patient was billed for 20% of the non-discounted charge when 20% of the actual charge would have been less. Significantly less in some cases. The Blues were sued in many States and lost every suit. However because insurance is exempt, by long standing Federal law, from anti-trust, and restraint of trade regs and other Department of Commerce regulation, they had to be sued in each State separately. I'm not sure that all States pursued them. Perhaps someone here knows. I have long been an advocate for ending this exemption of insurance companies from anti-trust, and restraint of trade regulation as well as requiring full financial disclosure as required of other corporations. Insurance companies, being sate regulated, are exempt from federal requirements. In fact, i thought that ending that cozy relationship for at least the health insurance industry was part of the Health Care Bill. Does anyone here know if those provisions made it past the chopping block? Insurance company exemption from restraint of trade laws was specifically what allowed them to reimburse less for out of network and out of State treatment even when the actual out of network costs were lower than the stated in-network cost (about which they lied of course). I corresponded with the Commerce Secretary over this very point some years ago, and everything boiled down to the insurance industry's exemption from federal regulation. End that, and a lot of abusive insurance industry practices will end as well. In fairness, I should point out that most policies allow for regular reimbursement rates on out of network services in emergencies and in non-emergency situations where an equivalent treatment is not available in network, so long as the out of network service is pre-approved. Some companies require that any non-emergency hospitalization be pre-approved or they will not reimburse the full amount. Even in emergency admissions, some require that approval be obtained within a fixed number of hours after admission, or the reimbursement rate is decreased. There are seemingly endless hurdles to receiving full reimbursement in much of the health insurance industry. Many are living the nightmare that is the U.S. medical services delivery system everyday of their lives. These insurance hurdles are a huge annoyance to physicians as well.