Ken777
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Why Paul Ryan Is Losing The Medicare Argument

Thu Jun 02, 2011 6:27 am

Another interesting article, suitable for discussions.

Quote:

It always gets back to health care.

That’s why 2009 and 2010 were so consumed by President Obama’s push for health-care reform and why Rep. Paul Ryan’s Medicare proposals are at the center of politics in 2011. Our long-term budget problem is primarily about two things: a shortage of revenue and rising health-care costs.

The revenue and health-cost issues are intertwined. The whole debate comes down to whether we want government to absorb a significant part of the risk of insuring us against illness, which means we’ll have to pay somewhat higher taxes, or whether we want to throw more and more of that risk onto individuals.

In that situation I think we first need to establish just how much the government is already paying out on health care.

Total current annual costs would include the basics like Medicare and Medicaid. Then add in Departments like BIA and VA that provide their own health care within their departments. Now add in the odds & sods, like money to help maintain indigent clinics and hospitals.

And a big one, all the money paid out for government employee and retiree health insurance. Even Ex Congressmen and women get very expensive health care, as do ex-Presidents.

That total dollar costs should be looked at. What else can we do with that total outlay that would deliver core care at a lower cost to everyone in hte country?

Quote:

Here’s the basic difference before us: Conservatives want government to play less of a role in paying for health insurance. Progressives believe that government will inevitably play a growing role in the provision of health insurance because if it doesn’t, more Americans will lose their coverage.

The progressive view is not a theory. It is what experience has taught in other wealthy democracies, and in our own country, too. The enactment of Medicare was an admission that most senior citizens simply could not afford health coverage without government help. What was true of seniors in 1965 is now also true of many non-elderly Americans.

The inflation rate of private health insurance continues to rise faster than the Cost of Living - that is basically sucking the middle class to a point were it will be unaffordable.


One of the core reasons for this abnormal increase in costs is that there is a continual increase in patients going to hospitals. We are running around chasing our tails with current games and a public option that provides core care can be very effective in reducing these costs without ending Medicare as we know it.

Link to quotes

http://www.washingtonpost.com/opinio.../06/01/AGqThkGH_story.html?hpid=z5
 
NIKV69
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RE: Why Paul Ryan Is Losing The Medicare Argument

Thu Jun 02, 2011 7:38 am

Yet we will never have a public option or single payer so.......


Medicare has to be addressed. Vouchers are not the answer but something has to be done.
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Dreadnought
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RE: Why Paul Ryan Is Losing The Medicare Argument

Thu Jun 02, 2011 12:09 pm

Quoting Ken777 (Thread starter):

One of the core reasons for this abnormal increase in costs is that there is a continual increase in patients going to hospitals. We are running around chasing our tails with current games and a public option that provides core care can be very effective in reducing these costs without ending Medicare as we know it.

One of the principle reasons for these continuous cost increases is the segregation between the consumer's pocketbook and the services requested. Let's say there was no such thing as health insurance - at all. Do you think that doctors would be charging you $150 for a 10-minute visit, or would their prices be adjusted to what people can afford (or are willing) to pay? The prices are that high because consumers think "what the hell, insurance will pay for it." It hits the pocketbook eventually but not in the immediate way that gets people's attention.

Adding the government as an insurer just makes it worse. Providers see insurers (and the government) as dupes to be fleeced, and set their prices accordingly.

It's a catch-22 situation. We want (and need) insurance, but insurance drives up costs as a natural effect.

Back to the OP topic. The reason the Ryan plan is being trashed is pure propaganda. Dems are intent of scaring the crap out of old people. Mediscare. Ads about grannies getting literally thrown off the cliff. It is a shameful indictment of how rotten politics have become when a serious proposition is put forward to solve a serious problem, and the opposition resorts to such scare tactics based purely on emotion and no facts. Republicans are fighting propaganda with facts, and history shows that facts lose every time - facts are so dull.

The more I look at it, the more I am convinced that Dems actually want and intend to cause the medicare/medical insurance system to collapse in the next decade, so that the only way out will be complete nationalization of the healthcare system. Obama and others said in 2007 and 2008 that was what they wanted in the end "but it will take a few years to get there".

The question is whether the American people - assuming that they are informed of the costs and consequences - are willing to go through that pain, or would they accept a deep reform such as the Ryan plan. Unfortunately I don't think the majority of people are educated enough to understand the problem.
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FlyPNS1
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RE: Why Paul Ryan Is Losing The Medicare Argument

Thu Jun 02, 2011 12:54 pm

Quoting Dreadnought (Reply 2):
It is a shameful indictment of how rotten politics have become when a serious proposition is put forward to solve a serious problem,

Ryan's proposal wasn't serious. It was a joke that dumped all the rising costs of healthcare on the poor/middle class.

Quoting Dreadnought (Reply 2):
The question is whether the American people - assuming that they are informed of the costs and consequences - are willing to go through that pain, or would they accept a deep reform such as the Ryan plan.

It leads to the fundamental question....do you want government care for all or a private system that leaves many without care?
 
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par13del
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RE: Why Paul Ryan Is Losing The Medicare Argument

Thu Jun 02, 2011 1:13 pm

Quoting FlyPNS1 (Reply 3):
It leads to the fundamental question....do you want government care for all or a private system that leaves many without care?

I would hope that many Americans would look at the full government systems in Europe and possibly the semi-private system in Canada to get a better understanding of what National Health Care is all about including the cost and new services that will be created, it is much more than folks being able to get prescription drugs at a reasonable cost.

A massive debate is presently ongoing in the UK on their health care system cost, makes for interesting reading.
 
mt99
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RE: Why Paul Ryan Is Losing The Medicare Argument

Thu Jun 02, 2011 1:37 pm

Quoting Dreadnought (Reply 2):
Dems are intent of scaring the crap out of old people. Mediscare. Ads about grannies getting literally thrown off the cliff.

Wait - i thought fear was a GOP tactic.. do i need to remind you of the "Death Panels" Obama was going to institute?
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Dreadnought
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RE: Why Paul Ryan Is Losing The Medicare Argument

Thu Jun 02, 2011 1:39 pm

Quoting FlyPNS1 (Reply 3):
It leads to the fundamental question....do you want government care for all or a private system that leaves many without care?

Neither. I favor an individual mandate (authorized properly via a constitutional amendment, if we can get that passed) requiring everyone to have catastrophic health insurance which includes hospitalization for more than 24 hours, accidents, and chronic disease treatment such as Cancer, AIDS, etc. That way at least the rest of us are not on the hook when people spend a month in the hospital and can't pay.

For doctor visits for the flu, dental and other such stuff, that is up to the individual whether they want to insure for that.

For the basic package I would like to see some strong regulation around it, which I've described before in other threads. Government would police it, but not manage it.

That's what I want.

Quoting mt99 (Reply 5):
Wait - i thought fear was a GOP tactic.. do i need to remind you of the "Death Panels" Obama was going to institute?

Sorry, but the Dems are experts at the Politics of Fear. As soon as anyone says that we need to adjust Social Security, Medicare, Medicaid, Union Rights, or any other pet entitlement program, the immediate reaction is "Republicans want you to die!". They have been doing this for many years. Appeal to emotion, not reason.

[Edited 2011-06-02 06:44:32]
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mt99
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RE: Why Paul Ryan Is Losing The Medicare Argument

Thu Jun 02, 2011 1:48 pm

Quoting Dreadnought (Reply 6):
Sorry, but the Dems are experts at the Politics of Fear. As soon as anyone says that we need to adjust Social Security, Medicare, Medicaid, Union Rights, or any other pet entitlement program, the immediate reaction is "Republicans want you to die!". They have been doing this for many years. Appeal to emotion, not reason.

How do you explain the "Death Panels" claims by the Right then?
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AGM100
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RE: Why Paul Ryan Is Losing The Medicare Argument

Thu Jun 02, 2011 1:49 pm

Quoting Dreadnought (Reply 2):
Unfortunately I don't think the majority of people are educated enough to understand the problem.

Good post ... and absolutely correct. The problem is our way is not easy ... it takes self disipline and self motivation . We can not expect that from Americans any more.

Quoting mt99 (Reply 5):
"Death Panels" Obama was going to institute?

I agree , "death panel" was a pretty direct way of putting it ., In the Bill it is called something like "cost containment panel". And frankly, if we are going to have single payer system (that is what they want) , I want death panels. I dont want my taxes going to keeping non productive citezens alive and costing the collective money . You cant have it both ways ...
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Aaron747
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RE: Why Paul Ryan Is Losing The Medicare Argument

Thu Jun 02, 2011 1:58 pm

Quoting Dreadnought (Reply 6):
That way at least the rest of us are not on the hook when people spend a month in the hospital and can't pay.

Ryan's plan didn't address this issue adequately at all. Surprisingly enough, the rest of what you propose is highly practical and just might work, if it were a realistic political proposition.

In any case, the US is screwed on this issue for at least the next couple of decades with numbers like this:

http://topforeignstocks.com/wp/wp-content/uploads/2010/07/oecd-health-expenditure-gdp-per-cpita.PNG

Clearly, the US is doing something wrong. The conflated interests between providers covering inflated incomes, lawyers chasing malpractice suits, insurers delaying or deferring treatments to force providers into cost control corners, and employers and individuals stuck with massively increasing bills is a perfect storm of melancholy.



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StarAC17
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RE: Why Paul Ryan Is Losing The Medicare Argument

Thu Jun 02, 2011 2:12 pm

Quoting par13del (Reply 4):
A massive debate is presently ongoing in the UK on their health care system cost, makes for interesting reading.

A lot of the issues about cost now are due to the aging population of all the developed nations, the same with things like social security. Older people require more health care and there is not enough younger people to support them, this has been on the horizon for decades and is now an huge issue.

Quoting Dreadnought (Reply 2):
Adding the government as an insurer just makes it worse. Providers see insurers (and the government) as dupes to be fleeced, and set their prices accordingly.

In countries with a universal healthcare even if the care is 100% private, the government in most if not all of these countries dictates what a doctor receives for a specific service. A doctor is unable to under OHIP in Ontario Canada as an example charge whatever they want for a check up because the government is going to pay them x.

Quoting Dreadnought (Reply 6):
Sorry, but the Dems are experts at the Politics of Fear. As soon as anyone says that we need to adjust Social Security, Medicare, Medicaid, Union Rights, or any other pet entitlement program, the immediate reaction is "Republicans want you to die!". They have been doing this for many years. Appeal to emotion, not reason.

Both sides do it and its done because it works.

Quoting Dreadnought (Reply 6):
Neither. I favor an individual mandate (authorized properly via a constitutional amendment, if we can get that passed) requiring everyone to have catastrophic health insurance which includes hospitalization for more than 24 hours, accidents, and chronic disease treatment such as Cancer, AIDS, etc. That way at least the rest of us are not on the hook when people spend a month in the hospital and can't pay.

For doctor visits for the flu, dental and other such stuff, that is up to the individual whether they want to insure for that.

That in a nutshell is the Canadian system (universal for general care, private for extended health usually provided by employers). Also the Australian system and the British systems are similar (public system with a private option available).

The right wing media in the US painted these systems as essentially commie systems where people were dying in the street.

Quoting Dreadnought (Reply 2):
One of the principle reasons for these continuous cost increases is the segregation between the consumer's pocketbook and the services requested.

I think one of the main reasons that care in the US costs nearly double what it does per capita than in other developed countries is the fact that uninsured people do not have easy access to general care where they can see a GP who can diagnose early signs of health problems.

Examples being things like high blood pressure, high cholesterol, high blood sugar etc which can be determined through a simple blood test. Because of this most people go to the ER which costs the most out of all treatments and often these issues have long been undetected and end up costing heaps more in the long run.
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FlyPNS1
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RE: Why Paul Ryan Is Losing The Medicare Argument

Thu Jun 02, 2011 2:26 pm

Quoting Dreadnought (Reply 6):
Neither. I favor an individual mandate (authorized properly via a constitutional amendment, if we can get that passed) requiring everyone to have catastrophic health insurance which includes hospitalization for more than 24 hours, accidents, and chronic disease treatment such as Cancer, AIDS, etc. That way at least the rest of us are not on the hook when people spend a month in the hospital and can't pay.

For doctor visits for the flu, dental and other such stuff, that is up to the individual whether they want to insure for that.

For the basic package I would like to see some strong regulation around it, which I've described before in other threads. Government would police it, but not manage it.

That's what I want.

And it's not a bad idea and I might be able to support it, HOWEVER the GOP (and particularly the Tea Party) would vehemently oppose it.

Plus, you'd have to come with a way of providing an affordable catastrophic plan for the poor which would be difficult without government providing it. No private entity is going to provide affordable catastrophic care to poor people since they are actually the highest risk group for needing catastrophic care to begin with. It would be like offering really cheap car insurance premiums to really bad drivers...no private company will do it.

Quoting Dreadnought (Reply 6):
"Republicans want you to die!". They have been doing this for many years. Appeal to emotion, not reason.

And Republicans are any different? Try making a cut to all the defense pork and the Republicans will scream that terrorists will kill us all if we do!!! We're spending $800+ billion annually on defense (and related functions) and Republicans have steadfastly refused to make any cuts even though it will be almost impossible to balance the budget with signficant DoD cuts.
 
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RE: Why Paul Ryan Is Losing The Medicare Argument

Thu Jun 02, 2011 2:31 pm

Note the statement in the original opening which is the simplest of concepts, the issue is about revenue shortage and cost cutting. Those two things need to be addressed simultaneously. The last time they were, under Clinton and Newt, we were very quickly on our way towards becoming a debt free society.

The reason Ryan's plan is doomed to failure is that it targets cost cutting that impacts a MASSIVE voting block, OLD people. Republicans don't understand that until they raise revenue on a very SMALL voting block, RICH people, anything they say or recommend will NEVER work. Simple math folks, a bitter pill for 50% of the country to swallow but them's the facts Jack. The problem requires hard action on both ends of the equation where each party only wants to focus on one. It is a black and white issue and anyone who refuses to understand this third grade mathematical solution is either delusional or missing their thinking cap. I hope it doesn't take a default for our political leaders to see the light.
 
Ken777
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RE: Why Paul Ryan Is Losing The Medicare Argument

Thu Jun 02, 2011 2:45 pm

Quoting NIKV69 (Reply 1):
Yet we will never have a public option or single payer so.......

If you want to get rid of the insurance mandate then you will need a public option financed with taxes. That is the only avenue of breaking our excessive medical inflation rate.

Quoting Dreadnought (Reply 2):
One of the principle reasons for these continuous cost increases is the segregation between the consumer's pocketbook and the services requested

And that is a never ending cycle. Has been for years now and it will only get worse as long as we stay on our current path of putting health insurance companies first.

Quoting Dreadnought (Reply 2):
Let's say there was no such thing as health insurance - at all.

Then the number of medical bankruptcies would explode and ERs would see even greater increases in people using them as a visit to their GP they can't afford.

Quoting Dreadnought (Reply 2):
Providers see insurers (and the government) as dupes to be fleeced, and set their prices accordingly.

Which is why Medicare pays set fees that avoid being fleeced. The real fleecing is the Medicare/Medicaid fraud. That needs more funding, more prosecuting and permanent expulsion from medicine if found guilty.

Quoting Dreadnought (Reply 2):
The reason the Ryan plan is being trashed is pure propaganda.

Or it is the fact that the Ryan Rape is to pay "vouchers" (there will be no paper voucher) directly to insurance companies, with no controls on how much care they deny. It is also a fact that the Ryan Rape is needed in order to drop the top tax rte to 25% - keeping the billionaires far healthier than the middle class who will have their assets stripped out by the Ryan Rape.

Quoting Dreadnought (Reply 2):
Ads about grannies getting literally thrown off the cliff.

I took that as a spoof. LMAO when I saw it.

Quoting Dreadnought (Reply 2):
Republicans are fighting propaganda with facts,

Republicans are fighting propaganda with propaganda

Quoting FlyPNS1 (Reply 3):
It was a joke that dumped all the rising costs of healthcare on the poor/middle class.
Quoting Dreadnought (Reply 6):
That's what I want.
Quoting StarAC17 (Reply 10):
I think one of the main reasons that care in the US costs nearly double what it does per capita than in other developed countries is the fact that uninsured people do not have easy access to general care where they can see a GP who can diagnose early signs of health problems.

Easy access to GPs would require universal care at the core levels and investments to train more GPs. We keep moving further away from that each day.
 
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Aaron747
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RE: Why Paul Ryan Is Losing The Medicare Argument

Thu Jun 02, 2011 2:53 pm

Quoting Ken777 (Reply 13):
Has been for years now and it will only get worse as long as we stay on our current path of putting health insurance companies first

It is a pipe dream to end the influence of the big insurers and big pharma. Despite their occasional poor margins, they simply have more money to wield with both major parties than any coalition of physicians or patients could ever hope to.

Quoting Ken777 (Reply 13):
Rape

I'm pretty tired of witnessing how the current vein of political discourse has taken a word of considerable specific meaning and broadened it for use against any perceived injustice.

Quoting Ken777 (Reply 13):
Easy access to GPs would require universal care at the core levels and investments to train more GPs

Strangely this is more or less what Charles proposed, without using those exact words.
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seb146
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RE: Why Paul Ryan Is Losing The Medicare Argument

Thu Jun 02, 2011 4:12 pm

Quoting Dreadnought (Reply 2):
The prices are that high because consumers think "what the hell, insurance will pay for it." It hits the pocketbook eventually but not in the immediate way that gets people's attention.

Right. That is pure capitalism with no government control. I am all for capitalism to a point. But, when the common folk (read: We The People) can not afford basic health care, basic schools, basic fire protection, basic air traffic control protection, there is something wrong.

Quoting Dreadnought (Reply 2):
The reason the Ryan plan is being trashed is pure propaganda.

It is already established that the Ryan deal would not be solvent until 2041. The Progressive Caucus plan would not be solvent until 2027, IIRC.

Quoting Ken777 (Reply 13):
Ryan Rape

Ken, I agree with 90% of what you say overall, but this is a bit much, don't you think?
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cargolex
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RE: Why Paul Ryan Is Losing The Medicare Argument

Thu Jun 02, 2011 5:25 pm

Quote:
The reason the Ryan plan is being trashed is pure propaganda.

Ryan's plan is being trashed because it's a bad plan, pure and simple. It addresses the looming financial issues, but does so by basically dismantling medicare altogether and putting the costs on seniors - who in many cases would no longer be able to get medical coverage without medicare.

Medicare was created for a reason - because old people couldn't get health coverage, because it is not economical to provide coverage for people who routinely suffer serious illnesses and are statistically likely only to deteriorate - not get better. The concept of "health insurance" as a purely capitalist business doesn't work for people who are not good candidates for the business plan.

Health Insurers are out to make money - not to take care of people. They'll go with the customers who can pay and who cost less to take care of. Old people don't fit well into a model like that and so Medicare was created because the private market simply refused to cater to old people unless they were of extraordinary means.

It's businesses' right to not serve markets where they know they will lose money - but it's also the responsibility of society to make sure people don't die before their time.

Ryan's plan is an abdication of that responsibility, and that's why it gets (deservedly) derided as being bad for seniors. it is bad for Seniors.
 
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RE: Why Paul Ryan Is Losing The Medicare Argument

Thu Jun 02, 2011 5:37 pm

Quoting CargoLex (Reply 16):
Ryan's plan is being trashed because it's a bad plan, pure and simple. It addresses the looming financial issues, but does so by basically dismantling medicare altogether and putting the costs on seniors

Considering that those over 55 would not see any change to their benefits, that's a load of bull, and you know that. That's why the Mediscare tactics are so nasty, because they are designed to frighten current seniors that Ryan wanted to change their benefits, which is a lie.

Quoting CargoLex (Reply 16):
The concept of "health insurance" as a purely capitalist business doesn't work for people who are not good candidates for the business plan.

Not if you require all persons over the age of, say, 25 years, all must be charged the same rate. Flat rates for all adults, regardless of age, prior history etc. Force the insurance companies to actually create a large risk pool rather than treating each individual as an individual risk/benefit calculation. This is what I have suggested for basic, minimum coverage (not for the optional extras).
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RE: Why Paul Ryan Is Losing The Medicare Argument

Thu Jun 02, 2011 5:45 pm

Quote:
Considering that those over 55 would not see any change to their benefits

That's only half the equation. The system of how those benefits would be paid for is fundamentally changed under the plan, and the burden of payment is shifted to the seniors with a declining amount of federal support.

Quote:
Not if you require all persons over the age of, say, 25 years, all must be charged the same rate.

So you are in favor of the government getting involved price fixing - e.g. telling private companies what they can and cannot charge and who they can charge it to?

Quote:
Force the insurance companies to actually create a large risk pool rather than treating each individual as an individual risk/benefit calculation

Well that's exactly what they need to do, you're right on that. But I don't think the current system, or really the system passed last year, will do that.

I can, however, see the merits in your argument - your proposed system would work something like the system in Belgium - which is very good and basically comprised of private companies that are heavily regulated by the government with, essentially, mandated pricing.

But if you tried that, you'd get alot of conservatives shouting about Socialism, and we'd be right back to where we were 12 months ago.

What you are proposing is not what Paul Ryan is proposing.
 
NIKV69
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RE: Why Paul Ryan Is Losing The Medicare Argument

Thu Jun 02, 2011 5:47 pm

Quoting par13del (Reply 4):
I would hope that many Americans would look at the full government systems in Europe and possibly the semi-private system in Canada to get a better understanding of what National Health Care is all about including the cost and new services that will be created, it is much more than folks being able to get prescription drugs at a reasonable cost.

We don't want the Euro or Canada system but allowing us to use Canada for prescription drugs and letting people go over state lines in the US for competition will lower prices is a good start.
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RE: Why Paul Ryan Is Losing The Medicare Argument

Thu Jun 02, 2011 5:48 pm

Quoting CargoLex (Reply 18):
So you are in favor of the government getting involved price fixing - e.g. telling private companies what they can and cannot charge and who they can charge it to?

I'm not a libertarian. Simple, sharp regulation is not an evil.

Such a pricing policy should fall under the same logic as a restaurant not being allowed to charge different people different prices because of their sex or skin color.
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RE: Why Paul Ryan Is Losing The Medicare Argument

Thu Jun 02, 2011 6:21 pm

Quoting Ken777 (Thread starter):
The inflation rate of private health insurance continues to rise faster than the Cost of Living - that is basically sucking the middle class to a point were it will be unaffordable.

This is why I am against any mandate to purchase insurance. Today, insurance is affordable through my wife's employer. However, this a limit to what we can afford if the rates continue to rise. Eventually, people are going to reach the point where they can no longer be able to purchase health care insurance without giving up the basics (food, clothing, shelter). Wages are clearly not going up, at least where I live. Under Obamacare, if we fail to buy insurance, we get penalized with a fine. When the cost of insurance gets too high, this is going to break the last straw that breaks the camel's back for many.
 
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RE: Why Paul Ryan Is Losing The Medicare Argument

Thu Jun 02, 2011 10:25 pm

Quoting Dreadnought (Reply 20):
Such a pricing policy should fall under the same logic as a restaurant not being allowed to charge different people different prices because of their sex or skin color.

But that is exactly what is happening with private insurance and what will happen under the Ryan plan: Seniors and those who can least afford it will be charged the most out of pocket. Why not have a system where everyone pays in and everyone gets care based on their needs? Especially so that things like boob jobs and Viagra are paid for out of pocket or through private insurance but things like knee surgery and cancer treatment are paid for by all of us.

Quoting NIKV69 (Reply 19):
We don't want the Euro or Canada system but allowing us to use Canada for prescription drugs and letting people go over state lines in the US for competition will lower prices is a good start.

We? Who are these "we" you are taking about? Prices have not lowered yet even with people going to Asia for major surgery and to Canada and Mexico for prescriptions and even across state lines for routine things. Prices are still going up. What a great plan!
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Dreadnought
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RE: Why Paul Ryan Is Losing The Medicare Argument

Thu Jun 02, 2011 11:28 pm

Quoting seb146 (Reply 22):

But that is exactly what is happening with private insurance and what will happen under the Ryan plan: Seniors and those who can least afford it will be charged the most out of pocket

Firstly: I never said the Ryan plan is ideal. But it's better than the "everything is fine, don't worry about it" approach of the Democrats.



Secondly, you seem to be under the false impression that people should not have to pay for stuff. The argument that Seniors paid in the past for what they are getting now is bogus - taking into account what they paid in the past, plus interest, is on average only one third of what they receive today in benefits. I can't find the chart right now, but I saw it earlier today that the average contribution, including presumed interest for today's retirees over their careers is about $84,000, but they will cost, on average in today's dollars, $260,000.

This has to stop. People will have to pay more for themselves. There are a number of reforms that can help them do that (such as my suggestion to flatten all premiums), but the first step is to stop the hemorrhage.

And to repeat, Ryan's plan correctly does not affect those who are at or near retirement age who cannot make alternative arrangements. But those of us younger than 55 will have to face the fact that we will not get the incredible bargain our parents got.
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RE: Why Paul Ryan Is Losing The Medicare Argument

Thu Jun 02, 2011 11:41 pm

Quoting NIKV69 (Reply 19):
We don't want the Euro or Canada system but allowing us to use Canada for prescription drugs and letting people go over state lines in the US for competition will lower prices is a good start.

Funny -- you think our system is bad (despite the fact that it offers better outcomes for about half the per capita cost) but you're eager to let US citizens get the benefits of cheap prescription drugs obtained through our "bad" health care system.

No thanks. You want cheaper drugs? Fix your health care system. Americans flooding across the border to raid our low-cost drug supply would probably wipe out our low cost drug supply. You want to make it legal in the US? I'll recommend we make it illegal here.

You need to go to a single-payer insurer and spread the cost and risk across the entire population. That's why everybody else's health care system is far far cheaper than yours. It's a fundamental tenet of all insurance -- spread the risk as widely as possible and you reduce the unit cost.
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RE: Why Paul Ryan Is Losing The Medicare Argument

Thu Jun 02, 2011 11:55 pm

And here is a perfect display of the effect of the rhetoric and propaganda.

http://www.pollingreport.com/health.htm

CNN/Opinion Research Corporation Poll. May 24-26, 2011. N=1,007 adults nationwide. Margin of error ± 3.
Asked ONLY of people 65 or older
"Under the Republican plan to change Medicare, do you think you, yourself would be a lot better off, a little better off, a little worse off, a lot worse off, or will the plan have no effect on you?"

A lot better off 4%
A little better off 9%
A little worse off 25%
A lot worse off 33%
Will have no effect 24%
Don't know enough (vol.) 5%

So only 1 out of four seniors were informed enough to know that the Ryan plan does not affect their benefits AT ALL.

Some 60% bought into the "throw granny off the cliff" campaign. Aren't you proud?
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ImperialEagle
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RE: Why Paul Ryan Is Losing The Medicare Argument

Fri Jun 03, 2011 12:47 am

Glen Kessler who writes the "Fact Checker" op/ed for the Washington Post had some interesting things to say about Ryan in an article from a week or so ago.

Here's the Link:

http://www.washingtonpost.com/blogs/...rate/2011/05/20/AFr1V27G_blog.html

Perhaps Ryan is not the devil incarnate after all?
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seb146
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RE: Why Paul Ryan Is Losing The Medicare Argument

Fri Jun 03, 2011 5:14 am

Quoting Dreadnought (Reply 23):
But it's better than the "everything is fine, don't worry about it" approach of the Democrats.

No Democrat has ever said that. They all say we need to scrap the whole Part A/B/C/D thing and also put prices back in check.

Quoting Dreadnought (Reply 23):
you seem to be under the false impression that people should not have to pay for stuff

Actually, if you read what I wrote, I said people need to pay into a system and take out when they need it.

Quoting Dreadnought (Reply 25):
So only 1 out of four seniors were informed enough to know that the Ryan plan does not affect their benefits AT ALL.

Vouchers to give to insurance companies when they need to use them? So insurance companies can deny them AND take away the vouchers? Good plan!
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NIKV69
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RE: Why Paul Ryan Is Losing The Medicare Argument

Fri Jun 03, 2011 5:38 am

Quoting Arrow (Reply 24):
Funny -- you think our system is bad (despite the fact that it offers better outcomes for about half the per capita cost)

Sure after paying much more taxes to wait longer for a lower level of care. No thank you.

Quoting Arrow (Reply 24):
Americans flooding across the border to raid our low-cost drug supply would probably wipe out our low cost drug supply.

We don't have to cross anything we could buy them on the internet like we do know.

Quoting Arrow (Reply 24):
You need to go to a single-payer insurer and spread the cost and risk across the entire population

Never happen.

Quoting Arrow (Reply 24):
why everybody else's health care system is far far cheaper than yours

Not cheaper, we don't want to pay 50-60% of what we make. That doesn't sound very cheap.
Hey that guy with the private jet can bail us out! Why? HE CAN AFFORD IT!
 
RVV2011
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RE: Why Paul Ryan Is Losing The Medicare Argument

Fri Jun 03, 2011 7:41 am

Quoting NIKV69 (Reply 28):
Sure after paying much more taxes to wait longer for a lower level of care.

Lower level of care? Beats having no care at all, like many of your fellow citizens, or those that must go bankrupt.

I have a solution: Dear Americans, introduce yourselves to...the Value Added Tax. Coming to your neighbourhood faster than you can shout "taxes bad, private jingle good!".
 
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Dreadnought
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RE: Why Paul Ryan Is Losing The Medicare Argument

Fri Jun 03, 2011 11:07 am

Quoting seb146 (Reply 27):
Quoting Dreadnought (Reply 25):
So only 1 out of four seniors were informed enough to know that the Ryan plan does not affect their benefits AT ALL.

Vouchers to give to insurance companies when they need to use them? So insurance companies can deny them AND take away the vouchers? Good plan!

Do you even bother reading stuff?
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NWAESC
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RE: Why Paul Ryan Is Losing The Medicare Argument

Fri Jun 03, 2011 11:56 am

Quoting Aaron747 (Reply 9):
Maybe everyone back home should just start eating more fish and stop driving to work...

YES!

Quoting Ken777 (Reply 13):
Then the number of medical bankruptcies would explode and ERs would see even greater increases in people using them as a visit to their GP they can't afford.

  

Quoting Ken777 (Reply 13):
Easy access to GPs would require universal care at the core levels and investments to train more GPs. We keep moving further away from that each day.

I have a friend who was born and raised in Rwanda. He says that the system in place there for basic care (anything less than a broken leg, in his words) was far more accessible than it is here. I think that's a telling statement.

Quoting CargoLex (Reply 16):
Ryan's plan is being trashed because it's a bad plan, pure and simple.

Yep.

He's learning that the hard way, I think, as he tries to peddle it on a tour across his home state.

Quoting Dreadnought (Reply 17):
Considering that those over 55 would not see any change to their benefits, that's a load of bull, and you know that. That's why the Mediscare tactics are so nasty, because they are designed to frighten current seniors that Ryan wanted to change their benefits, which is a lie.

... Or maybe they realize that the plan would be detrimental to their children and grandchildren... The nice thing about older generations is that for the most part they haven't adopted the "I got mine, F you" mindset that the subsequent ones have.
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Dreadnought
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RE: Why Paul Ryan Is Losing The Medicare Argument

Fri Jun 03, 2011 12:05 pm

Quoting nwaesc (Reply 31):

... Or maybe they realize that the plan would be detrimental to their children and grandchildren...

That was not the question! There were other questions around that, but this question was: "Under the Republican plan to change Medicare, do you think you, yourself would be a lot better off, a little better off, a little worse off, a lot worse off, or will the plan have no effect on you?"

That shows ignorance, not a principled stand (which I would understand)
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FlyPNS1
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RE: Why Paul Ryan Is Losing The Medicare Argument

Fri Jun 03, 2011 12:52 pm

Quoting Dreadnought (Reply 32):
That was not the question! There were other questions around that, but this question was: "Under the Republican plan to change Medicare, do you think you, yourself would be a lot better off, a little better off, a little worse off, a lot worse off, or will the plan have no effect on you?"

That shows ignorance, not a principled stand (which I would understand)

Except that as Ryan's plan kicks in those seniors left on "old Medicare" will become pariahs. All the new seniors will be paying higher amounts via private insurance so doctors will gravitate toward those patients and simply stop taking "old Medicare". You'd be a fool to think Ryan's plan won't affect everyone....regardless of age.

Quoting Dreadnought (Reply 17):
Force the insurance companies to actually create a large risk pool rather than treating each individual as an individual risk/benefit calculation. This is what I have suggested for basic, minimum coverage (not for the optional extras).

Sounds like socialism to me. Not to mention that no private insurance company will price that way as it's a guaranteed way to lose money. There's a reason why homeowner's insurance, car insurance, life insurance, etc are all priced to an individual's risk level.

Quoting Dreadnought (Reply 23):
This has to stop. People will have to pay more for themselves. There are a number of reforms that can help them do that (such as my suggestion to flatten all premiums), but the first step is to stop the hemorrhage.

But Ryan's plan does nothing to actually stop the runaway costs of healthcare. His plan is simply dumping those runaway costs on those who can least afford them. How about some reforms that encourage people to live healthier lifestyles? How about reforms that encourage people to do end of life planning? Much of the explosion in healthcare costs is driven by people in their last years of life fighting a battle they cannot win.

Even worse, Ryan's plan could even make costs worse. Those who cannot afford the private health premiums will simply be uninsured in their old age....meaning that instead of seeing a GP, they will go to an ER for their care!
 
seb146
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RE: Why Paul Ryan Is Losing The Medicare Argument

Fri Jun 03, 2011 3:54 pm

Quoting Dreadnought (Reply 30):
Do you even bother reading stuff?

Like Ryan's plan? Adding to the deficit? Putting high medical costs onto people who can not afford it? And giving private insurance the power to raise their prices and deny anyone they wish? Yes, I have read it. What of it?
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StarAC17
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RE: Why Paul Ryan Is Losing The Medicare Argument

Fri Jun 03, 2011 4:09 pm

Quoting NIKV69 (Reply 28):
Sure after paying much more taxes to wait longer for a lower level of care. No thank you.

Much less in taxes that actually go to healthcare than your insurance premiums are.

Also in the US you only get better care if you have money, and in Canada the wait times are for non-essential things, if you need something that is urgent and life-threatening you are getting that care.
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Flighty
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RE: Why Paul Ryan Is Losing The Medicare Argument

Fri Jun 03, 2011 7:48 pm

Quoting Ken777 (Thread starter):
That total dollar costs should be looked at. What else can we do with that total outlay that would deliver core care at a lower cost to everyone in hte country?

Plenty. We already pay enough for a WONDERFUL 100% coverage health care plan for the USA. The problem is, corruption and duplication steal that health care from the people.

It's not a money problem. We are already paying good money. It is a health care delivery problem.



Similarly, in my city, the public school budget is $20,000 per student per year. The schools are OK but not good. Is it a money problem? Hell no. $20k is enough for education that is fantastic. It is an education delivery mechanism problem. Or, teachers would say it is a "parenting" problem or something. Which I kind of agree with, but it suggests that school quality does not matter. Maybe schools are not important. My kid would do OK even without basic schooling, which can be provided at home or via internet.
 
AGM100
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RE: Why Paul Ryan Is Losing The Medicare Argument

Fri Jun 03, 2011 10:19 pm

Quoting Ken777 (Thread starter):
Why Paul Ryan Is Losing The Medicare Argument



Because half or more of America believes Nancy Pelosi ..... its that simple. They believe nanny can save them ... and don't understand where the money comes from, or care . Despite a 14 trillion dollar deficit ... Rep. Van Hollan still is trying to sell the idea of another $500 B dollar annual entitlement program .... that's it.

It is the willing suspension of disbelief . A good point I heard " Their is not enough money in the entire world to support the entitlement state the democrats want " hundreds of trillions of dollars they promise without a thought ....
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Arrow
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RE: Why Paul Ryan Is Losing The Medicare Argument

Fri Jun 03, 2011 10:45 pm

Quoting NIKV69 (Reply 28):
Sure after paying much more taxes to wait longer for a lower level of care. No thank you.

You need to read more -- and by that I mean some disinterested analysis of how the system works and what it costs -- not Glenn Beck's ravings.. Annual MSP premiums in BC for a family of 3 or more are about $1500. The tax portion (through federal/provincial income tax) adds another $1500 for about $3000 total -- ANNUALLY. The numbers will be different in other provinces (some less, some more). So based on your assertion that we pay 50-60% of what we make for health care, I guess the average annual income in Canada is about $6000.

Can you find me a US private health insurance policy that provides matching coverage for a family of 3 or more for $3000 a year?

From wiki:

Comparison of the health care systems in Canada and the United States are often made by government, public health and public policy analysts.[1][2][3][4] The two countries had similar health care systems before Canada reformed its system in the 1960s and 1970s. The United States spends much more money on health care than Canada, on both a per-capita basis and as a percentage of GDP.[5] In 2006, per-capita spending for health care in Canada was US$3,678; in the U.S., US$6,714. The U.S. spent 15.3% of GDP on health care in that year; Canada spent 10.0%.[5] In 2006, 70% of health care spending in Canada was financed by government, versus 46% in the United States. Total government spending per capita in the U.S. on health care was 23% higher than Canadian government spending, and U.S. government expenditure on health care was just under 83% of total Canadian spending (public and private) though these statistics don't take in to account population differences.[6]

Note the boldface -- the private sector driven US government spends more per capita on health care than Canada's commie/pinko system -- and it leaves 50 million folks uncovered. The data is 2006 -- but it's unlikely the proportions have changed much since then.

Lower level of care? Outcomes are mixed, depending on what you look at. But on average, Canada's outcomes are slightly better than the US -- at half the cost. Why aren't Americans outraged at that?

Quoting NIKV69 (Reply 28):
Never happen.

You may be right -- and it will eventually bankrupt you.

Our system is far from perfect and it will need a significant overhaul (just like everyone else) to cope with us aging baby boomers. And unfortunately, our politicians are showing a little of the "head in sand" proclivities that yours are. But not under any circumstances would they throw out that commie/pinko universal healthcare system and re-instate the old costs-through-the-roof private sector insurance and delivery system that is rapidly becoming an albatross around the US' neck.
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Aaron747
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RE: Why Paul Ryan Is Losing The Medicare Argument

Fri Jun 03, 2011 10:54 pm

Quoting NIKV69 (Reply 28):
Not cheaper, we don't want to pay 50-60% of what we make. That doesn't sound very cheap.

Total absurdity. This country spends 1/3 of the US per capita to look after 125 million people. My nominal tax rate is 20% here before deductions with a $200 national health insurance premium taken out of my salary monthly that covers my family, with my employer picking up a bit on the top. When I go to a doctor - any doctor of my choice - I pay 30% out of pocket and the system picks up the rest. My employer has supplemental private insurance they offer to us that covers the out of pocket cost. What's the difference?? Doctors' salaries top out around $175K, there are no unionized nurses making $125K (and certainly no anesthetic nurses making $250K), and there is zero administrative overhead for private health plans' claim denial shenanigans and malpractice protection. While there are private hospitals that are for-profit, the majority of hospitals are run as non-profit organizations. Outcomes are as good, or better. Sure, there are some exceptionally rare disorders you can't get treatment for here, but they'll cover your trip to the Mayo Clinic too. Multipayer is an amazing system.
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Aesma
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RE: Why Paul Ryan Is Losing The Medicare Argument

Sat Jun 04, 2011 12:48 am

Quoting Dreadnought (Reply 2):
Let's say there was no such thing as health insurance - at all. Do you think that doctors would be charging you $150 for a 10-minute visit, or would their prices be adjusted to what people can afford (or are willing) to pay? The prices are that high because consumers think "what the hell, insurance will pay for it." It hits the pocketbook eventually but not in the immediate way that gets people's attention.

Adding the government as an insurer just makes it worse. Providers see insurers (and the government) as dupes to be fleeced, and set their prices accordingly.

The government has to fix prices, of course. Here, it's currently 23€ for a doctor's visit. There are doctors that charge higher in rich neighborhoods, the public insurance reimburses the same, and you can have a private insurance on top to cover the difference, but finding a doctor at the fixed price is no trouble. Personally I have a private insurance to cover things like expensive dentistry and glasses, it costs me 30€/month. It's private, but not for profit.
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Ken777
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RE: Why Paul Ryan Is Losing The Medicare Argument

Sat Jun 04, 2011 12:14 pm

Quoting seb146 (Reply 15):
but this is a bit much, don't you think?

Bit less than the Death Panels hurled against Obama. And, as someone on Medicare it's easy for me to see that a lot of elderly people can be stripped of their assets very quickly under a program that embraces the health insurance industry more than the elderly. It is, for me, a financial rape of the elderly and could easily have been written by the insurance companies. Actually, it might have - those "vouchers" are basically payments paid directly to the insurance companies, not the patient. That's a real Die Fast situation as well as a financial rape.

Quoting Dreadnought (Reply 17):
Considering that those over 55 would not see any change to their benefits, that's a load of bull, and you know that.

Sure of that? What about the doughnut hole in Part D? And how long do you trust the Republicans will go before they drive the screws down even harder?

IMHO there is no way that the Republicans would allow even the Ryan Rape to go 10 years without "adjusting it" in favor on more tax cuts (or more loopholes) for the top tax rate and for large companies.

Quoting Dreadnought (Reply 17):
This is what I have suggested for basic, minimum coverage (not for the optional extras).

I believe that the difference between your minimum coverage and my "core care" is that I'm a strong believer in preventive care, which would include periodic "wellness visits". I would also want patients to have rapid access when they get sick - delaying seeing the Doctor or Nurse because of a lack of funds is more costly in the long term.

Quoting FlyPNS1 (Reply 33):
Sounds like socialism to me.

Old US socialism or new US socialism? The public health system in the US that distributed the Salk Vaccine for Polio back in the late 50s was a socialized medicine operation and it was done exceptionally well.

Quoting FlyPNS1 (Reply 33):
There's a reason why homeowner's insurance, car insurance, life insurance, etc are all priced to an individual's risk level.

Medicare provides an excellent guide to what could be done with "Plans" - the Medicare supplemental insurance plans are well defined and those definitions provide the base for competitive bidding even at the individual level.

The only way that would work, however, is if everyone pays the same rate and there are no "existing conditions" exemptions or extra premiums. Do you think that will happen?

Quoting Flighty (Reply 36):
The problem is, corruption and duplication steal that health care from the people.

I'll agree on the corruption side. There are computer systems that can identify if a doctor or other provider is charging for 30 hours of treatments pert day to identify that type of fraud. Arrest, trial, prison & permanent loss of license works. It has to be aggressive and there needs to be some examples set early on in the process.

As for the crooks that set up shop to rip off Medicare on the medical equipment side we need to get aggressive there. Background checks on the owners 9including using fingerprints), no felons owning or employed, verification of physical address and inventory. Periodic "visits" to review invoices (received & sent) as well as verifying that they are still around. The last bit can, I believe be handled by local police.

Quoting AGM100 (Reply 37):
They believe nanny can save them ... and don't understand where the money comes from, or care .

Including employer nanny care that you are getting tax free?

Oooops!

Employer nanny care is not only the most expensive in the world, but impacts corporate performance (lowering international competitiveness and reducing funds for increasing employment) and rips the government off of those tax revenues that you should be paying on that tax free compensation.

If we had dumped that unnecessary tax free ride when Clinton was elected we probably would not have near the debt we have. Without the unnecessary Bush invasion we might not have any national debt.
 
Arrow
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RE: Why Paul Ryan Is Losing The Medicare Argument

Sat Jun 04, 2011 10:26 pm

Quoting Ken777 (Reply 41):
Employer nanny care is not only the most expensive in the world, but impacts corporate performance (lowering international competitiveness and reducing funds for increasing employment) and rips the government off of those tax revenues that you should be paying on that tax free compensation.

That's the part of this US battle that mystifies me -- given the "free market" ideology that seems to drive all the conservative arguments against universal health care coverage. When Toyota was looking to build a new North American manufacturing plant a few years ago, it narrowed it down to Alabama and Ontario, Canada. The plant went to Ontario for one reason that separated the two jurisdictions in a huge way. Company "nanny care" in Ontario resulted in something like a $1000 per vehicle savings in their manufacturing costs. That even eclipsed the exchange rate differential (since completely vanished by the way). General Motors, when it was going through its costs analysis before begging for money, pointed out that the health care cost per vehicle in the US was $1500 compared with $500 in Canada -- pretty well confirming what Toyota had discovered.

The free market and robust competition is a wonderful thing when applied to all the stuff we buy, from food to cars to houses. But it is an unmitigated disaster when applied to health care. There's a big difference between accepting, even encouraging, a free market that lets a rich guy buy a Rolls Royce while there's a Chev out there for an average Joe; and a health care system where everyone needs the Rolls Royce when their life is on the line. Most places in the world have figured that out. I wonder when corporate America is going to wake up to this.
Never let the facts get in the way of a good story.
 
dl021
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RE: Why Paul Ryan Is Losing The Medicare Argument

Sat Jun 04, 2011 10:46 pm

It's very simple why he's having difficulty with his argument. Some people believe that they're entitled to the fruits of the labor of others without having to pay for it.

It's this simple. Doctors cost money. Medical products (medicines, instruments, tools, etc) cost money. Nurses, medical assistants, receptionists, people who build doctors offices, groceries eaten by all these people, etc, all cost money.

Why is it that some people feel that they're entitled to the products and services provided by these people regardless of cost or ability to pay? At what point does that cause our society to capsize under it's own weight?


Price controls outside of free market are a sure fire way of screwing up the economics of anything (look at the farm subsidy situation). Forced over-regulation of any marketplace is always counterproductive. The whole lawsuit thing (why do lawyers deserve 30% of any payment for anything if it's one cent over their hourly rate?) drives up costs incredibly, and the people who expect free service (or subsidized service, that we taxpayers are forced to pay for) still want to sue the doctors (rich folks who can afford it, right?) for any potential issue, thus forcing doctors to buy malpractice insurance (hyper-expensive...sort of like unsubsidized flood insurance for people who live on a flood plain).

Why are people entitled to anything other than equal opportunity? Who here can share the difference between equal opportunity versus equal outcomes, and tell us which is potentially achievable, or nearly attainable, and which is either impossible or guaranteed to kill our society.
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windy95
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RE: Why Paul Ryan Is Losing The Medicare Argument

Sat Jun 04, 2011 10:55 pm

He is not losing the argument. We as a country are losing the argument. Our budget is not sustainable and if the system collapses under the weight of entitlement programs we all lose. Until we have politicians on the left and the right that find the balls to tell the US that there we will be losers when we cut and slash we are doomed. At least Paul Ryan has the strength to attempt to do what others will not. Others will not even admit we have a problem. All the fear mongering telling granny that the boogie man is out to get her will solve nothing. We have to change and until we get actual leaders that tell people that they are going to have to suffer some pain then we run the chance of all of us having to suffer when the system implodes. Pay now or pay later but we will have to pay someday. Scaremongering and sticking or heads in a hole will not change that.
 
sna752
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RE: Why Paul Ryan Is Losing The Medicare Argument

Sun Jun 05, 2011 2:18 am

Quoting Ken777 (Reply 41):
Actually, it might have - those "vouchers" are basically payments paid directly to the insurance companies, not the patient.

Right. That's exactly what they're supposed to do. Much like food stamps. It prevents the money from being used to pay the cell phone bill or something discretionary like that.

Quoting Ken777 (Reply 41):
Sure of that?

Well, are you willing to take a [sizable] benefits cut?

Quoting Ken777 (Reply 41):
I believe that the difference between your minimum coverage and my "core care" is that I'm a strong believer in preventive care, which would include periodic "wellness visits".

Preventative is rarely cost saving. There are some exceptions with immunizations, but testing for breast cancer and things that that end up costing more in the long run. It's cheaper just to treat the disease when it happens.

Quoting Ken777 (Reply 41):
I would also want patients to have rapid access when they get sick - delaying seeing the Doctor or Nurse because of a lack of funds is more costly in the long term.

Again, it doesn't make it cost-saving to have to wait less time. Rationed care is what you're going to get when you have a single payer. Or you can have a private plan and be helped more quickly. Having the best of both worlds is not an option.

Quoting Ken777 (Reply 41):
As for the crooks that set up shop to rip off Medicare on the medical equipment side we need to get aggressive there. Background checks on the owners 9including using fingerprints), no felons owning or employed, verification of physical address and inventory. Periodic "visits" to review invoices (received & sent) as well as verifying that they are still around. The last bit can, I believe be handled by local police.

What's that kind of enforcement going to cost?

Quoting Ken777 (Reply 41):
(lowering international competitiveness and reducing funds for increasing employment)

Raising tax rates does the same thing... That's pretty neat!

Quoting DL021 (Reply 43):

It's very simple why he's having difficulty with his argument. Some people believe that they're entitled to the fruits of the labor of others without having to pay for it.

To some, there is no difference between 'equal opportunity' and 'equal outcome' -but that's garbage.
Dare to think different.
 
seb146
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RE: Why Paul Ryan Is Losing The Medicare Argument

Sun Jun 05, 2011 2:35 am

Quoting DL021 (Reply 43):
Doctors cost money

Why? Only in this country they do. Look at Africa. Look at South America.

Quoting DL021 (Reply 43):
Nurses, medical assistants, receptionists

And, why do we the people have to support their lavish lifestyles just because we have the sniffles?
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Ken777
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RE: Why Paul Ryan Is Losing The Medicare Argument

Sun Jun 05, 2011 2:36 am

Quoting Arrow (Reply 42):
That's the part of this US battle that mystifies me -- given the "free market" ideology that seems to drive all the conservative arguments against universal health care coverage

The health insurance industry has sufficient funds for political contributions to avoid any common sense approach.

Until employers grow the testicles to say "Enough!" the game will still be played here. International competitiveness will continue to be reduced, wages and salaries will continue to be lower than otherwise, and unemployment will be lower than otherwise. But the private health insurance companies will make some nice plump profits.

Quoting DL021 (Reply 43):
Some people believe that they're entitled to the fruits of the labor of others without having to pay for it.

People who hit Medicare age are not asking for something without paying for it - they have paid for both Medicare and Social Security when they were working. Their contributions to the system provides their benefits today.

BTW, those old folks also pain in tax dollars that funded a lot of the medical advances that YOU can enjoy, as well as paying a big chunk of medical educations over the years.

By the time you reach retirement you will be agreeing with me on those points.

Quoting windy95 (Reply 44):
He is not losing the argument.

His arguments are dead. Totally dead.

Quoting sna752 (Reply 45):
Right. That's exactly what they're supposed to do. Much like food stamps. It prevents the money from being used to pay the cell phone bill or something discretionary like that.

What you are saying is that the government should pay out, say $6,000 a year on every old fart, regardless of their health, to private insurance companies who might not even be around when expensive care is needed?

Nope. Focus on core care, catch problems at their least expensive approach.

And get the uninsured out of the ERs around the country when they just need to see a doctor or nurse. That is a massive problem, as anyone who has waited hours at an ER can tell you.

Quoting sna752 (Reply 45):
Well, are you willing to take a [sizable] benefits cut?

Nope. I paid my taxes for years to get them and I'm not voting for younger Americans to write off those paid for entitlements simply because they don't want to pay their taxes.

Quoting sna752 (Reply 45):
It's cheaper just to treat the disease when it happens.

Depends on the disease. And sometimes it is difficult to diagnose - so a PSA is worth the money spent. Especially if you can increase testing and benefit from economies of scale.

BTW, what would the impact of economies of scale be if you dramatically reduced testing? At the provider level? At the national level?

Quoting sna752 (Reply 45):
Rationed care is what you're going to get when you have a single payer.

Look at Medicare - a "single payer", but you can either pay the deductibles or buy private insurance to cover them. I choose to pay for private supplemental insurance monthly and have no deductibles. But it is not a "single payer". There is no reason why medicare cannot be expanded, replacing Medicaid (and eliminating 50 independent administrative departments), BIA, etc.

And there is no reason to continue the excessively expensive system of having the uninsured going to an ER instead of a local clinic. Look at those costs and don't worry about finding cancer early. I trust my doctor to make decisions on testing and he is pretty conservative.

Quoting sna752 (Reply 45):
What's that kind of enforcement going to cost?

Insufficient enforcement is costing billions. periodically you will read about arrests where the fraud was hundreds of millions a year.

We might also be able to save some money by checking with other countries who have been aggressive in attacking fraud. I know the Aussies are aggressive as I know a cop who joined their program in 1985. Maybe we can get their systems designs to help. or the Canadians. Or the Brits.

Quoting sna752 (Reply 45):
Raising tax rates does the same thing... That's pretty neat!

Raising taxes on profits and incomes is less expensive than adding it into the Cost of Goods sold at each stage of production. Simple Accounting there.
 
dxing
Posts: 5859
Joined: Wed Nov 12, 2008 5:14 pm

RE: Why Paul Ryan Is Losing The Medicare Argument

Sun Jun 05, 2011 2:51 am

Quoting Aaron747 (Reply 9):
Clearly, the US is doing something wrong.



That chart does not differentiate between elective and necessary care. The United States dominates plastic surgery alone.

http://www.sherdog.net/forums/f48/pl...ic-surgery-country-numbers-976945/

Quoting StarAC17 (Reply 10):
A lot of the issues about cost now are due to the aging population of all the developed nations, the same with things like social security. Older people require more health care and there is not enough younger people to support them, this has been on the horizon for decades and is now an huge issue.



Absolutely correct. It was known back when SS and medicare were supposedly "fixed" in the 80's. The can has been continually kicked down the road until it can be kicked no further.

Quoting FlyPNS1 (Reply 11):
Try making a cut to all the defense pork and the Republicans will scream that terrorists will kill us all if we do!!!



Ryans budget leaves intact what the President has proposed.

http://www.huffingtonpost.com/2011/0...get-analysis-numbers_n_844946.html

Two exceptions are security and defense spending and spending on Social Security, the public pension program for the elderly. Both are kept steady and relatively unchanged from Obama’s proposed budget.

Quoting Aaron747 (Reply 14):
I'm pretty tired of witnessing how the current vein of political discourse has taken a word of considerable specific meaning and broadened it for use against any perceived injustice



When you have no plan of your own to promote, you have to demonize the only other plan that is being presented by your opponent as hard as you can.

Quoting CargoLex (Reply 16):
Medicare was created for a reason - because old people couldn't get health coverage



Source?

Quoting Arrow (Reply 24):
Fix your health care system.



Of course we could turn away Canadians coming to our country to get today what they have to wait for in Canada. No system is perfect, including yours.

Quoting seb146 (Reply 27):
No Democrat has ever said that. They all say we need to scrap the whole Part A/B/C/D thing and also put prices back in check.



Well if they scrap A, B, C, and D, what is left? Considering that medicare already unpays what a procedure really costs, thereby shifting the costs to private insurance and raising everyone elses rates in the process, how much more do you think they should underpay?

Quoting seb146 (Reply 27):
Actually, if you read what I wrote, I said people need to pay into a system and take out when they need it.



Unfortunately most people already out strip what they paid into SS, the same would happen using your plan for medicare.

Quoting FlyPNS1 (Reply 33):
All the new seniors will be paying higher amounts via private insurance so doctors will gravitate toward those patients and simply stop taking "old Medicare".



Doctors are already dropping medicare patients by the truckload due to the cost of keeping them on versus taking private insurance patients where the insurance does not underpay.

Quoting FlyPNS1 (Reply 33):
But Ryan's plan does nothing to actually stop the runaway costs of healthcare.



Nor does anything that the President of any other democratic leader who have voiced their thoughts do. I would point to a plan, but they have yet to present one that can be scored.

Quoting FlyPNS1 (Reply 33):
How about some reforms that encourage people to live healthier lifestyles?



That's what I want, the government telling me to eat my peas.

Quoting FlyPNS1 (Reply 33):
How about reforms that encourage people to do end of life planning?



Those were called death panels remember?

Quoting FlyPNS1 (Reply 33):
Much of the explosion in healthcare costs is driven by people in their last years of life fighting a battle they cannot win.



So you are advocating rationing? That didn't go over so well in the debate either.

Quoting seb146 (Reply 34):
And giving private insurance the power to raise their prices and deny anyone they wish?



The already can't do that under the affordable health care act. That could have been instituted 10 years ago but the democratic party members in Congress blocked it since their name wouldn't be on it.



There is simply no way that medicare as it stands now does not go bankrupt. The numbers don't lie. The majority of the savings that the affordable health care act was going to get out of medicare depended on eliminating fraud and waste, which they could have down without the AHCA as well as cutting payments to doctors that take medicare patients. That is one reason more and more of them are no longer accepting medicare patients. The situation will become intolerable in a few short years and yet we have not seen a single concrete plan from the White House or the democratically controlled Senate. The one plan we have seen, Rep. Ryan's gets called derogatory names and called a non-starter when the other side has no plan of their own period. Just amazing.
Warm winds blowing, heating blue skies, a road that goes forever, I'm going to Texas!
 
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WarRI1
Posts: 8716
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RE: Why Paul Ryan Is Losing The Medicare Argument

Sun Jun 05, 2011 3:04 am

Quoting dxing (Reply 48):
The one plan we have seen, Rep. Ryan's gets called derogatory names and called a non-starter when the other side has no plan of their own period. Just amazing.

Alright, he made, a proposal, a plan. Anyone in congress can offer a plan, Ryan's is deemed unacceptable, the death of Medicare. I do not think Republican's should hang their hat on that. Reform, not death of a plan, quite a different thing. The Democrats are no different than Republican's, they see political gain, without commiting themselves on Medicare. 2012 is coming.
It is better to die on your feet, than live on your knees.

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