Govt. to REQUIRE adults to carry Health care insurance

NEW -> Contingent Buyer Assistance Program
<a href="http://www.npr.org/blogs/health/2009/07/as_congress_tries_to_hammer.html">http://www.npr.org/blogs/health/2009/07/as_congress_tries_to_hammer.html</a>



<blockquote>But as NPR's Congressional Correspondent David Welna points out, it's important for reporters writing about the plans to put all those zeros in perspective. He writes:



These are estimates that cover a ten-year period. Better to say "the cost of the plan is a trillion dollars over the next ten years" than "the plan would cost a trillion dollars", which many people (I've asked) assume is the annual price tag of a healthcare revamping.

Averaged out over a decade, a trillion dollar healthcare scheme costs $100 billion a year. <em>That's about a 4% increase over what's currently being spent on healthcare annually, whereas $1 trillion would be a 40% increase.</em></blockquote>


4% extra to cover 40-odd mil? Me and TR are arguing over 4%!!!????!!!
 
[quote author="EvaLSeraphim" date=1247657232][quote author="three sheets" date=1247620335]There is no doubt that malpractice risk mitigation is a significant cost affecting health care costs. I agree that it is a serious problem.



Another huge cost is R&D. I think someone already posted the outrageous cost and time associated with bringing a drug to the US market. I've read that 1 in 250 drugs actually make it to market. US drug prices are higher than any other country and US based private research companies are by far the largest innovators. It makes sense. The US has fostered the greatest incentive to invent new drugs (specifically because of our health care system and IP protections), therefore more drugs will be produced here.



I think if we have national health care, then we must acknowledge that every person cannot be afforded the most innovative technology. If we want the Cadillac of health care, then we can't complain about paying the Cadillac price. I envision low cost health insurance (or government provided health care) which buys lower grade health care. If you get sick and there is a new drug on the market that can cure you, you shouldn't get the benefit of the drug without paying for it. If you get sick and there is a specialist that demands a high price for his services, he shouldn't be compelled to perform without being paid what he wants.



If we want low cost health care, then we must be willing to accept that we can't sue a doctor for mere negligence.</blockquote>


Oh, three sheets, you are making my head hurt.



<a href="http://www.boston.com/business/globe/articles/2005/06/01/rising_doctors_premiums_not_due_to_lawsuit_awards/">Not all premium increases are due to lawsuit awards.</a> Here is <a href="http://www.kaiseredu.org/topics_im.asp?id=226&parentID=59&imID=1">another discussion</a> of same.



Of course, in California we have MICRA, which caps pain and suffering damages at $250K, and the limit has not been increased since MICRA was passed in 1975. And while in some instances that cap seems sufficient, imagine an instance where a surgeon amputates the wrong leg or screws up back surgery, especially on someone fairly young. In such an instance, $250K for a lifetime of ongoing pain isn't nearly enough. Yet, despite the cap, and the cap not being increased over the years, malpractice premiums in California have continued to climb. Fancy that.



Further, in med mal cases, it's not "mere negligence." The plaintiff must prove that the doctor (or nurse, or other medical professional) failed to use the level of skill, knowledge, and care in diagnosis and treatment that other reasonably careful doctor would use in the same or similar circumstances - and often in the same community, such that docs in Bakersfield cannot be compared with docs in La Jolla. That the doctor's acts which fell below the standard of care caused plaintiff's harm must be established with a degree of medical certainty. Both the standard of care and causation can only be proven by experts, which are usually expensive to hire.



Moreover, a doc is not considered negligent simply on the basis that the doc's efforts are unsuccessful or the doc makes an error that was reasonable under the circumstances, or because the doc chose one medically accepted treatment over another.



<a href="http://www.courtinfo.ca.gov/jury/civiljuryinstructions/documents/caci.pdf">Here</a> are the jury instructions. (Start at #500 - "Medical Negligence.")



I'll get to R&D later, and how patients in other countries are paying lower prices because patients, or rather, insurance companies in the US are basically footing the R&D bill.</blockquote>


Eval - I'm not quite sure what made your head hurt. I never suggested that medical malpractice was the sole or a main reason for increase in costs. Awards are a very small part of "malpractice risk mitigation" (i.e. the cost associated with litigation, insurance and, to a much lesser extent, actual damage awards). I'm not an expert and frankly too lazy to look up any proof but I would venture to guess that the increase in premiums are <em>partly</em> due to the increased cost of litigation. Also, as I am sure you know, the cap of $250,000 only applies to non-economic damages, so, for instance, in addition to any non-economic damages, a litigant will probably collect a significant amount of money from a malpracticing doctor for the medical bills incurred in connection with such negligence - so your example litigant may only have $250,000 to compensate him for a lifetime of pain and suffering but the defendant will be on the hook for the cost associated with treating the pain.



You caught a bit more of my laziness. I am aware of the standard of negligence for professionals. Regardless, my point had little to do with the actual negligence standard. My point was simply that granting a higher level of civil immunity (not unlike sovereign immunity) to the medical profession by increasing the level of negligence necessary to find malpractice would go a long way to decrease costs associated with medical malpractice litigation, which should in turn, decrease med mal insurance premiums and ultimately health care costs.
 
Eval,



<blockquote>Litigation in the U.S. has at least four distinctive procedural features that drive up malpractice costs. The first is jury trials, which can veer out of control and in any case introduce significant uncertainty. The second is the contingency-fee system, which allows well-heeled lawyers to self-finance litigation. The third is the rule that makes each side bear its own costs. This induces riskier lawsuits than are undertaken in most other countries, such as Canada, England and most of Europe, where the loser pays the legal costs of the winner. The fourth is extensive pretrial discovery outside the direct supervision of judges, which occurs far more readily here than elsewhere.



Even these features aren't the whole story. American judges frequently let juries decide whether honest mistakes are negligent. Judges in other nations are less likely to do so. American courts commonly think it proper for juries to infer medical negligence from the mere occurrence of a serious injury. European judges usually will not.



American plaintiffs are sometimes spared the heavy burden of identifying particular acts of negligence, or of showing the precise causal connection between a negligent act and an actual injury. Lastly, damage awards for lost income and medical expenses in the U.S. tend to dwarf awards made elsewhere -- in part because governments elsewhere provide this medical care from their nationalized systems. In sum, the medical malpractice system provides incentives for plaintiffs that really do matter. Americans, for example, file claims about 3.5 times more often than Canadians.</blockquote>


The Cap on the damages is also being proposed federally either 250k or 500k but other reforms need to be made as well.



This is the legal reform we need.



About cutting the wrong foot off.



I know someone who is a doctor. They had a patient with severe diabites and they were going to amputate BOTH feet. For whatever reason they didn't want to amputate both at the same time. So the plan was to amputate the left foot first and wait for it to heal then amputate the right foot.



There was no rhyme or reason they were both bad enough to be the first foot to go. Well when they got into surgery the amputated the wrong foot (which was the right foot). Again remember they were going to amputate both feet anyway. So it was really irrelevent which foot they took first because they were both going anyway.



The patient sued. They settled out of court. Easier to settle for less then the time and energy and the legal bills.



Before the Lawsuit would have even hit the court system the other foot would have been amputated.



I doubt the person would have won the case but it is cases like this that will kill the medical system.
 
Under MICRA a patient can still sue for Unlimited:



Economic damages for all past and future medical bills.

Economic damages for lost wages, lifetime earning potential and for any other conceivable economic losses.

Punitive damages, which seek to punish a defendent.



The only thing that is capped is the "Pain and suffering" awards.



If it isn't working here and I haven't done the research we are really in trouble because I believe that is part of the Federal Plan.
 
[quote author="stepping_up" date=1247694696]I kept thinking TR was EvaL when I saw the avitar... always loved that one and am so glad to see her back.</blockquote>


I haven't quite gotten used to it either.
 
[quote author="trrenter" date=1247711554]I can leave this one.</blockquote>


I didn't say I hated it - I said I hadn't gotten used to it!



lol you rock boss.
 
[quote author="no_vaseline" date=1247659878]<a href="http://www.npr.org/blogs/health/2009/07/as_congress_tries_to_hammer.html">http://www.npr.org/blogs/health/2009/07/as_congress_tries_to_hammer.html</a>



<blockquote>But as NPR's Congressional Correspondent David Welna points out, it's important for reporters writing about the plans to put all those zeros in perspective. He writes:



These are estimates that cover a ten-year period. Better to say "the cost of the plan is a trillion dollars over the next ten years" than "the plan would cost a trillion dollars", which many people (I've asked) assume is the annual price tag of a healthcare revamping.

Averaged out over a decade, a trillion dollar healthcare scheme costs $100 billion a year. <em>That's about a 4% increase over what's currently being spent on healthcare annually, whereas $1 trillion would be a 40% increase.</em></blockquote>


4% extra to cover 40-odd mil? Me and TR are arguing over 4%!!!????!!!</blockquote>


I read the $1 Trillion over 10 years and say bullpucky. Medicare today, spends $235 Billion per year. But that's just my gut.



The $1 Trillion dollar for ten years price tag is not the universal coverage price tag. So the devil is in the details, and once again, they're lacking.



A quick SWAG would look at a universal price tag in the $500 Billion per year if not more. Frankly, while I believe the aged tend to cost more in services, covering the currently uncovered isn't going to be cheap.



And for anybody thinking the Government can run it, I suggest you read the OASDI and Medicare Trustee <a href="http://www.ssa.gov/OACT/TRSUM/index.html">report</a> that shows Medicare is currently going to be broke in 2017.



Yeah, eight short years from now. Our government doesn't have the will to do it right. I fear the UK's past is our future.
 
[quote author="trrenter" date=1247711554]I can leave this one.</blockquote>


Why TR, why do you pick images that nauseate us? Why did you ditch the so appropos for this thread avatar that EvaL gifted you? I'd be honored to take that from someone who was actually able to prove everyone wrong on the Internet who was, regardless of the topic. :)
 
We spend close to a Tillion playing silly little games in Iraq and now we dont want to take care of our own country ? I forgot. Its not going to help Haliburton or the Oil companies providing affordable Health Care.
 
[quote author="No_Such_Reality" date=1247737667][quote author="no_vaseline" date=1247659878]<a href="http://www.npr.org/blogs/health/2009/07/as_congress_tries_to_hammer.html">http://www.npr.org/blogs/health/2009/07/as_congress_tries_to_hammer.html</a>



<blockquote>But as NPR's Congressional Correspondent David Welna points out, it's important for reporters writing about the plans to put all those zeros in perspective. He writes:



These are estimates that cover a ten-year period. Better to say "the cost of the plan is a trillion dollars over the next ten years" than "the plan would cost a trillion dollars", which many people (I've asked) assume is the annual price tag of a healthcare revamping.

Averaged out over a decade, a trillion dollar healthcare scheme costs $100 billion a year. <em>That's about a 4% increase over what's currently being spent on healthcare annually, whereas $1 trillion would be a 40% increase.</em></blockquote>


4% extra to cover 40-odd mil? Me and TR are arguing over 4%!!!????!!!</blockquote>


I read the $1 Trillion over 10 years and say bullpucky. Medicare today, spends $235 Billion per year. But that's just my gut.



The $1 Trillion dollar for ten years price tag is not the universal coverage price tag. So the devil is in the details, and once again, they're lacking.

</blockquote>


The CBO disagrees with you.



<blockquote>The tables included in the report summarize our preliminary assessment of the coverage provisions' budgetary effects and their likely impact on rates and sources of insurance coverage for the nonelderly population. According to that assessment, enacting those provisions by themselves would result in a net increase in federal budget deficits of $1,042 billion over the 2010-2019 period. By 2019, CBO and the JCT staff estimate, the number of nonelderly people who are uninsured would be reduced by about 37 million, leaving about 17 million nonelderly residents uninsured (nearly half of whom would be unauthorized immigrants).</blockquote>


Don't take my word for it.



<a href="http://cboblog.cbo.gov/?p=324">http://cboblog.cbo.gov/?p=324</a>
 
<blockquote>4% extra to cover 40-odd mil? Me and TR are arguing over 4%!!!????!!!</blockquote>


I am still trying to figre out the 40 million plus.



On the 2007 census <a href="http://www.census.gov/prod/2008pubs/p60-235.pdf">Census</a>



On page 61 (which is 69 on the acrobat reader for whatever reason).



They peg the number at a little under 46 million people.



Then they included about 9.5 million "non Citizens" They will not be given coverage in the new plan.



That brings us down to about 36 million.



THen on page 23 (or 31 on the reader)



14.5% for housholds making 50k-75k don't have insurance

7.8% for households making 75k+ don't have insurance.



These people will be forced to get insurance but the goverment won't pay for it probably.



If my math is correc that is another 10 million.



That brings us down to 26 million people without insurance that would be covered.



Now take the CDO number which says that 17 million still will not have coverage after this plan. Then subract the illegals that gives us 8.5 million with no coverage after the plan is enacted..



Subtract that 8.5 million from 26 millon and we now have 17.5 million getting covered.



I could be wrong on these numbers so verify them.



<strong>So it will cost us 1 to 1.5 trillion to cover 17.5 million people?</strong>
 
[quote author="trrenter" date=1247804552]<strong>So it will cost us 1 to 1.5 trillion to cover 17.5 million people?</strong></blockquote>


That comes out to $8571 per person per year. $5714 if you use the CBO numbers and not the fake $1.5tr figure. This comes down to <strong>$476/month per person</strong>. In this is assuming your figures are correct.



What is the cost of showing up at the ER instead of getting preventive care?
 
[quote author="trrenter" date=1247804552]<blockquote>4% extra to cover 40-odd mil? Me and TR are arguing over 4%!!!????!!!</blockquote>


I am still trying to figre out the 40 million plus. [/b]</blockquote>


The CBO says it's a little less than 40 million, so I stand corrected.



If you can't get your head around it, call them and ask.
 
[quote author="green_cactus" date=1247805439][quote author="trrenter" date=1247804552]<strong>So it will cost us 1 to 1.5 trillion to cover 17.5 million people?</strong></blockquote>


That comes out to $8571 per person per year. $5714 if you use the CBO numbers and not the fake $1.5tr figure. This comes down to <strong>$476/month per person</strong>. In this is assuming your figures are correct.



What is the cost of showing up at the ER instead of getting preventive care?</blockquote>


I wouldn't count on my figures! I would verify them if I were you.



To follow your logic though if it cost $8571 or $5714 per year or $476 a month then instead of overhauling the entire healthc care system why not take the money and buy everyone healtcare that doesn't have it that would qualify.
 
[quote author="no_vaseline" date=1247805823][quote author="trrenter" date=1247804552]<blockquote>4% extra to cover 40-odd mil? Me and TR are arguing over 4%!!!????!!!</blockquote>


I am still trying to figre out the 40 million plus. [/b]</blockquote>


The CBO says it's a little less than 40 million, so I stand corrected.



If you can't get your head around it, call them and ask.</blockquote>


Not trying to argue. I am trying to figure out the Number of people that are included in the number that when all is said and done will qualify.



In other words not everyone in that 46 million will get insurance.



Looking at the census I think I have a number.
 
[quote author="no_vaseline" date=1247806283]Have you read thier plan? Looks like thats what they are going to do via Medicare.</blockquote>


Then this could be a simple two step plan.



Everyone MUST get insurance per the rules they will establish.



Whover is left we will go to Cigna, Blue Cross, and whover else and shop a commpetitive bid for 17 million people.



It is all or nothing take all 17 million or none. No prexisiting condition exclusions.
 
[quote author="no_vaseline" date=1247801007][quote author="No_Such_Reality" date=1247737667][quote author="no_vaseline" date=1247659878]<a href="http://www.npr.org/blogs/health/2009/07/as_congress_tries_to_hammer.html">http://www.npr.org/blogs/health/2009/07/as_congress_tries_to_hammer.html</a>



<blockquote>But as NPR's Congressional Correspondent David Welna points out, it's important for reporters writing about the plans to put all those zeros in perspective. He writes:



These are estimates that cover a ten-year period. Better to say "the cost of the plan is a trillion dollars over the next ten years" than "the plan would cost a trillion dollars", which many people (I've asked) assume is the annual price tag of a healthcare revamping.

Averaged out over a decade, a trillion dollar healthcare scheme costs $100 billion a year. <em>That's about a 4% increase over what's currently being spent on healthcare annually, whereas $1 trillion would be a 40% increase.</em></blockquote>


4% extra to cover 40-odd mil? Me and TR are arguing over 4%!!!????!!!</blockquote>


I read the $1 Trillion over 10 years and say bullpucky. Medicare today, spends $235 Billion per year. But that's just my gut.



The $1 Trillion dollar for ten years price tag is not the universal coverage price tag. So the devil is in the details, and once again, they're lacking.

</blockquote>


The CBO disagrees with you.<a href="http://cboblog.cbo.gov/?p=324">http://cboblog.cbo.gov/?p=324</a></blockquote>


Again, the price tag may be $1,000,000,000,000. But it's just for the current subset of unisured that will have no recourse, no business mandated plan, no alternative plan of their own. Again, not universal health care. A one trillion dollar plan to insure the least insurable. The rest, all have to pay for their own plan. Either themselves, or forced through their employer.



So again, devil is in the details, but what exactly is that $1,000,000,000,000.00 covering and what is being forced to be covered in a unfunded mandate to business?





BTw, the budget umpire says the plan isn't doing squat but increasing deficits. <a href="the budget umpire says the plan isn't doing squat but increasing deficits.">AP link</a>



But that's not the concerning part. The political smack down and railroad by congress to stiffle transparency and debate is Orwellian.



If we're going to socialize medicine, then the Dems need to grow some balls and SOCIALIZE medicine. Own it, fix it, and make the hard choices to ration care and shift resources to where they will make a difference.
 
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