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Health care “reform”: when Obama said… — 37 Comments

  1. I am an RN at a county hospital. A hospital that treats everyone, regardless of insurance or ability to pay.
    Health care reform is a huge concern for me. I never held much faith in Obama’s “You’ll be able to keep your current doctor.” Well, what if my doctor doesn’t want to subscribe to Obamacare? What if my doctor decides to abandon the practice of medicine alltogether?
    Everyone knows we are in the grips of a crippling nursing shortage-which shows no sign of slowing as our population is aging out of the profession and there aren’t enough nursing instructors to create new nurses…
    I love being a nurse-this was what I was meant to do with my life. I would hate to leave this profession, but I don’t believe that this wouldn’t eventually affect our paychecks and working conditions. The money has to come from somewhere, and simply taxing “the rich” isn’t going to cover it all.

  2. I suspect that it will be illegal to practice/procure medicine outside of ObamaCare.

    That’s what HillaryCare contained, and this is just a revamped version of that I’m sure.

  3. It is almost unbelievable what this Obamagang gets away with! This nobody from Chigago is allowed to alter and destroy the greatest nation on earth in a few months, and all these suckers are taking it sweetly! You cannot believe what your own eyes are telling you! Cap and trade, healthcare-reform, huge, drastic laws, and those suckers in Congress accept not to be able even to READ THE DAMN NEW LAW before agreeing with it! And the Media are saying nothing about this! Americans are losing their country AND THEIR LIBERTY and they don’t even know it!
    It is very difficult to find a parallel in human history with this. Some compare it with the Nazi-takeover in 1933 and I would certainly know not a better parallel.
    But still it is different. It is totally different. These wealthy, unthreathened people of the US today are allowing to get themselves all pulled down for no reason! There is no huge crisis in the US, people are not starving, what is the matter with these people? Or is it this then: their very wealth has made them apathetic?

  4. Next comes the removal of the conscience clauses that allows doctors to not be forced to perform abortions. You think there is a shortage of health care providers now— just wait and see.

  5. Wandriaan: You ask some very good questions. I ask them myself, continually, because the people I know (friends, family) fit the description of what you are describing. They don’t know what’s happening, although I think they would care if they did know.

    I may try to take this topic up in a post—the answers are complex and partly psychological, I think.

  6. I’m very very very pissed about this stuff.

    I remember 3 conversations at the work lunch table in a conference room that we frequent.

    I made the case that Obama is Marxist and I did so with Obama quotes about oil profits (this was before Joe the Plumber).

    I don’t know how so many people were dumbified. My neighbor told me that she votes Republican all the time and she was going to vote Obama. This is BEFORE the Sarah Palin pick.

    What in the world is going on in this country that so many people could not understand what Obama was all about economically. He tried smooth talking his way out of conservative accusations….

    NOW…

    There is no excuse. All Republican and Independent Obama voters need to say SORRY.

    I can’t even read the news these days…

  7. I forgot to mention that one coworker felt that the Marxist assertion was extreme.

    Guess what now.

    Now she says she doesn’t care and isn’t watching the news.

    To her.. she means well and isn’t interested in politics.

    Isn’t interested in politics???? Lordy . She voted for the man that is making misery and poverty a way of American life!!!

  8. I just emailed the link to the IBD article to some friends and relatives who I think might be receptive to Obama criticism. Some of them voted for Obama but might be open minded enough to see the light.

  9. I disagree with those who think the silence about BO (oh, where is that old Lifebuoy commercial when we need it?) among the Obamabots indicates buyer’s remorse.

    I think it’s the silence of the sated. They’ve gorged on everything they wanted with this guy, and they’re replete, and content. They’ll only speak up if there’s Bitching to Do.

  10. Well, I found one. An old Lifebuoy commercial: how to stop that old B.O.!

    http://www.youtube.com/watch?v=astrjgUhc2I

    This is for the kiddies who didn’t grow up in the 1960s, when they apparently changed to a “subtler” pitch than that two-note foghorn. But when I was a kid, we still used it as a taunt on the blacktop. I’d like to let one fly in BO’s general direction! (god, how I loathe that man).

  11. Wow! Every screen-writer knows that you don’t get the girl naked or win the drag race by page 16 unless it’s just a setup for something much more spectacular on page 45. And then stuff really starts happening!

    Gotta hand it to this guy. He has redefined “blitzkrieg.”

  12. I just checked out Lifebouy at Wiki and Amazon. It is no longer mannufactured in the US, but you can get it at Amazon. It might make a nice gift for congressional reps.

  13. Universal health coverage sounds so good to most people, who won’t make the effort to read the small print. I think an effective tactic might be to take on malpractice. Show how much defensive medicine costs. Show the effects of malpractice insurance on MDs. Emphasize that the Dems are unwilling to tackle this. Use the grievance tactic: Why should John Edwards get rich and nurses suffer? Will we have rationing because the Dems are afraid of lawyers?

  14. When Obama said you can keep your health insurance he was only talking to Congress and other elected officials in the palace. Oddly enough, the group imposing this nightmare on us have exempted themselves from the consequences of their actions.

    Don’t tell me this isn’t a monarchy.

  15. This is a good example of why I read your site even though I disagree with your basic political orientation. It’s worth knowing.

  16. The problem junior is having is catch-up. He’s unprepared for the challenge of the Presidency. He, nor any one around him, until around march of last year, realized that, omg this isn’t going to be a prep for 2012 this is happening now omg!!! It was about that time they realized that the zeitgeist was a virtually unstoppable juggernaut. What the Obama administration is facing now is like a kid who planned on cramming for the final exam, but fell asleep and is rushing in late for the class.

  17. Wandriaan is dead right.
    I am still scratching my head, though, about the collegiality of GOP Senators toward the Dems. Where are the Jesse Helmses? We need them desperately. There is more fortitude among Honduran senators than US Senators.

  18. And here is the thing. Why is it SO important for this thing to jammed through? Well – of course because (and we all know this but I have to say it) if it is not rammed through it will, like a vampire, die when exposed to sunlight.

    I am more than a little upset with the republicans who, so far, have only seemed to focus on the cost and not the insidious details – hopefully now they will do so.

  19. Instapundit reports that a reader says it’s not really that bad:

    Investor’s Business Daily did not continue to read the bill to page 19. “Individual health insurance coverage that is not grandfathered health insurance coverage under subsection (a) may only be offered on or after the first day of Y1 as an Exchange-participating health benefits plan. ” It does not outlaw individual private coverage — you can still buy the plan on the Exchange where they will compete with the public option, not be replaced by it. The advantage of the Exchange, is that the coverage no longer has one of the problems of individual coverage — skyrocketing premiums should you become ill.

    I have no idea what “the Exchange” is – the name reminds me of Ernestine – so I don’t really know how good this news is. I keep thinking I should read the whole bill but it makes my head hurt to even think about doing so.

  20. My own concern is that the Republicans may have the idea that if they let this go through without opposition it will be such a slap in the face of the American public that it will get their attention and 2010 will be a watershed year for Republicans regaining control of Congress.

    Keep in mind that roughly 1/5 of the economy is tied up in healthcare – which is a lot of money.

    What may have been forgotten in all of this is that it also represents a lot of VOTERS! Nurses and doctors may not take too kindly to being treated in such a fashion.

    The Democrats, on the other hand, could be thinking the Republicans will pitch a fit and they will have to “negotiate” downwards to placate the political opposition, using the republicans as scapegoats.

    If successful, they get to have it both ways in that they can claim they *tried* to pass this bill but the evil republicans wouldn’t let them, and it gets them off the hook with their constituents for not actually passing anything.

    Unfortunately, such a scenario leaves us screwed as the bill hits Obonga’s desk for signature….

  21. I spent too many years married to an actuary not to notice this bit from IBD: “Drawn by a public option that will be 30% to 40% cheaper than their current premiums because taxpayers will be funding it…” That is to say, paying for it no matter what it costs. Actuaries? We don’ need no steeeenkin’ actuaries! The taxpayer will pay, and the only way to save money is to consume less. Oh, you have some kind of chronic condition? Pity.

    [For the record, the Social Security Administration does have actuaries, and doesn’t pay them any more mind than private health insurance companies do theirs. Actuaries are paid a lot of money to be ignored.]

  22. OK, I’m going to be a contrarian here. I expect to get some grief about this but here goes.

    First, just let me preface this wtih the fact that I do not support obama, nor do I support the stimulus, cap & trade or card check. Anyone who reads my comments knows my views.

    Nor am I for Obamacare.
    However, I shed absolutely no tears for the insurance companies who are equal if not worse ghouls than the govenment.
    I have wathced employers have to scramble to find a way to get coverage for their emplpoyees every year. Each year the premiums go up and the coverage goes down.
    I have seen insurance companies routinely refuse to cover specific procedures on the first submission for benefits. They force you to resubmit again and possibly more, provideing ever more documentation, all in the hopes that you’ll just accept it and pay for what is rightfully covered in your policy.
    My wife is an attorney who has represented folks who have had their insurance companies refuse to pay what they rightfully owe, drop an insured during the middle of a course of treatment for an illness, neglect to tell an insured that they have reached their policy limit until after it has been exceeded (and don’t say the patient should have known because the that means you’ve never looked at medical billings), and worse.
    The insurance companies are partially responsible for the sky high medical costs we are burdened with today.
    They are no friends of ordinary people. They are trying to coopt the argument for health care reform, for which there is a real need, into a referendum on private versus government insurance. The problems are far broader and deeper. They remind me of republicans trying to coopt Tea Parties.
    Here’s a quote from an interesting link, ” Measures such as the number, and total value, of malpractice
    payouts to patients have been flat since 1991 and show a significant decline since 2001,
    when the so-called “crisis” of escalating insurance rates began.”
    Yet the rates we pay for insurance continue to spiral upward at a pace that outstrips inflation. Medical malpractice being out of control is a myth.

    As for the government dictating which physician you can see, the insurance companies already do that with their preferred provider lists. You want to see a doctor whose not on the list, you pay more. There are a growing number of doctors who are opting out becuase to join a preferred provider group is to agree to only charge so much for a certain procedure, regardless. How is that different from what the government is proposing.

    There is a very real need for serious fundamental reform of how health care is delivered in this country. There is also very much that is right and good with our medical care. However, the insurance companies are not innocent victims, as they seem to be portrayed. That being said, neither is Obamacare the cure. The solution? Hell, if I knew, I’d be on it and probably very rich. All I do know for certain is that insurance companies are more the problem (or one of), than victims.
    Fire away.

  23. Tim wrote, “I shed absolutely no tears for the insurance companies who are equal if not worse ghouls than the govenment

    How can a company with hundreds or thousands of employees be a ghoul?

    Doesn’t make sense…

    You can’t as an insurance compamy pay out benefits that are equal to or less than the premiums they take in.

    Insurance over the years has morphed from catastrophic coverage to everything coverage. That is the fault of the buyers… the consumer. We want the insurer not to take care of us during a catastrophic event. We want them to pay for every doctor visit and only have a $10 co-pay.

    The SYMPTOM you write about of premiums going up and coverage going down is because:
    1) Malpractice
    2) Health costs going up
    3) Unhealthy – overweight – americans not taking care of themselves
    4) An ever advancing medical technology that costs more.
    5) illegal immigrants.

    So…. lumping that onto the insurance companies makes zero sense.

    Especially since ALL insurance companies have the same issues on their plates. Don’t you think one of them could be the maverick of Insurance companies and offer more coverage and charge less premiums if it was possible?

  24. Baklava says, “How can a company with hundreds or thousands of employees be a ghoul?”

    That’s not a real argument. The fact that any enterprise has many employees does not make that enterprise good. Nor does it absolve it from being evil. Example, I.G. Farben was a giant conglomerate with hundreds of thousands of employees, but they supplied the concentration camps with gas. Were the individual employees guilty or was the company?

    Baklava says, “You can’t as an insurance compamy pay out benefits that are equal to or less than the premiums they take in.”

    Sure you can. Understand how insurance companies make money. Understand the concept of shared risk and why insurance companies bother to have actuarial tables.

    Quoting, “If a customer pays $500 in auto insurance premiums but does not have an accident, the insurance company keeps the $500. Likewise, if a customer pays $500 in auto insurance premiums and has an accident that causes $50,000 in damage, the insurance company will pay out $50,000 regardless of the fact that the customer paid far less.
    This concept is called shared risk. In the example above, if the insurance company can get 100 customers to each pay $500 per year in premiums but have no claims for every 1 customer who has $50,000 in claims the insurance company would break even. Every customer over 100 per 1 represents a profit, or every dollar charged over $500 represents a profit.
    Of course, the real world isn’t this tidy. However, over a large number insurance customers, statistical trends emerge. With bigger numbers, these trends become increasingly accurate. ”

    Baklava also says, “Insurance over the years has morphed from catastrophic coverage to everything coverage. That is the fault of the buyers… the consumer. “

    Wrong. Nobody forced the insurance companies to offer the new coverages. They did so because they thought they could make money.

    “The SYMPTOM you write about of premiums going up and coverage going down is because:
    1) Malpractice
    2) Health costs going up
    3) Unhealthy – overweight – americans not taking care of themselves
    4) An ever advancing medical technology that costs more.
    5) illegal immigrants.”

    Baklave, you are mistaken about malpractice, read the links I provided.

    As for #2,I agree

    As for #3, the life expectancy is higher than it ever has been in history. Certainly higher in this country than it was 100 years ago. This is s symptom of a healthy population, otherwise life expectancy would not be rising. However, I think perhaps what you are alluding to is the cost of serevicing an ever older population. There I agree with you.

    As for #4, advancing medical technology is expensive. As an electrical engineer who has designed installations for medical equipment, I can agree with that. But my discussion with physicians indicate thatthe costs for getting, say an MRI for example would be around 250 to 300 dollars versus 2500 to 3000 if they could just provide the service without mark ups for say hospitals where they lease space and are affiliated with. You know, hospitals, the same people who charge you 20 dollars for an aspirin if they provide it.

    As for #5, I certainly agree that they impact the system in states that have large populations of illegals, but what about those who don’t?

    One of the reasons for our health care problem is that we have a large portion of the population, i.e. baby boomers, who are entering senior citizen status. We will soon have more people who are in their high healthcare consumption years than ever before. Government can’t pay for that without either rationing care or drastically increasing taxes.

    Another problem is physicians giving everyone the gold plated treatment, i.e. ordering comprehensive batteries of tests when a person goes in with a routine problem.

    The system as presently constructed can not cope with this large influx without serious strains. A strictly private sector solution (govt. get out altogether) will result in rationing of care through econoics, those who can pay get the care. Those who can’t, too bad.

    The government solution will still involve rationing, but we all pay more. Addtionally, with government control you gat all of the beauracracy, inflexibility and inefficiency that comes with government.
    What we do not want to do is stifle change, innovation and improvement. But how do we do that?

    I would like to know. Nobody likes what we have now, but what’s the, or a, solution?

  25. Give me more credit.

    I was talking about the company’s expenses vs. income as a whole.

    Not when broken down to an individual.

    Your $500 example did not address what I said.

    You asked, “I would like to know. Nobody likes what we have now, but what’s the, or a, solution

    Bring health costs back to the individual. People will start to make market decisions. Costs will be relevant to the consumer again.

    Allow the private sector to work. There ARE a lot of plans out there. THere are the catastrophic plans.

    Remove coverage as a benefit from employment. Make each individual pay for an individual plan.

    Companies can offer money in lieu of the health care coverage that they used to provide but it should ultimately be up to the consumer.

    Remove the employer from that equation.

    Each individual can then make the choice:
    1) Catastrophic coverage
    2) Health Savings accounts
    3) High Premium plan where there is only $10 co-pays

    Abolish health coverage from every government employee (state and federal)

    Make each person buy the plan that is right for their family.

    We have the best health care in the country.

    The only issue (solved by steps above) is cost and people wanting more than they can afford.

    Have a government plan that doesn’t cover up to 400% over the poverty line but maybe 200% max.

    Make that plan a minimum plan that gives catastrophic coverage and once a year physicals.

    Thanks for asking 🙂

  26. Tim P,

    Is it possible that the gold-plated treatment you referred to arose out of defensive practice against malpractice suits? I’d love to hear from young doctors about the way they are taught to handle cases. Are they afraid to make a diagnosis without a whole battery of tests? Does the increase in specialists over the GPs of old mean that patients are seeing more doctors whose judgement they have not learned to trust?

  27. Baklava,

    No discredit or insult intended. But what you said was this, “You can’t as an insurance compamy pay out benefits that are equal to or less than the premiums they take in.” I did respond to it directly.
    Read the link and not just the 500 dollar example.

    I was trying get discussion going on what is the solution. We all have a pretty good idea of the problem.

    Your suggestions above make sense and I agree with them. I was going to link to an article I read over at Instapundit which basically said the same thing. But you said it just as well.

    The article’s money quote agreeing with your comment above and saying, “The health care system is a mess, largely because of perverse government incentives through its big health care programs, Medicare and Medicaid, and its tax break for employer-provided insurance. As a result, we now have a third party payment-dominated system which simultaneously encourages excessive spending and pushes insurers and providers to decide how to “ration” (i.e., limit) care.

    What people need is a medical system that allows them to make the basic rationing decisions: what kind of insurance to buy, what kind of coverage to choose, what kind of trade-offs to make between spending on medicine and spending on other goods and services.

    Such decisions are complex and people with little means will need assistance. But the specific “rationing” decisions—i.e., the inevitable trade-offs—vary dramatically by individual and family preference and circumstance. Even today’s system allows many people some choice between plans and providers. The rise in consumer-directed care is a positive development which is expanding the choices available to Americans.

    The worst strategy would be to increase the government’s authority. Washington already has to “ration” care through its own programs. Politicizing everyone’s care by increasing federal control would override the differences in preferences and circumstances which are so important for all of us. It doesn’t matter how bright or thoughtful or well-intentioned the legislators and regulators would be. They would end up getting it wrong for most Americans.

    Is rationing inevitable? Yes. Is government rationing inevitable or desirable? Neither. The bottom line is: who should control people’s and families’ medical futures? Not Uncle Sam.”

    However, I stand by my characterization of insurance companies, though not necessarilly all of the individuals who work for them. I personally know too many lawyers with way too many horror stories of insurance companies trying to not pay up when they were supposed to and having to be drug into court to do so. I’ve had friends who have had to deal with combative insurance companies trying to shirk legitimate claims for everything from cancer treatment to a burned down house. It is the insurance adjusters job and duty to seek out and find as many defenses and arguments as possible in a case to prevent or minimize payment. I’ve seen them in action. Ghouls.

    While American health care may be the best in the world, the delivery of that healthcare is not.

  28. expat,
    I do not doubt that there is some truth to what you say.

    However, go back and look at the links I provided. Better yet, here’s that same link. Please look at the statistics for malpractice payouts. It is not the huge bogey man the insurance companies want you to think it is.

    I suspect that the true cause of rising insurance costs is the loss on investment of . Again, please read the link, especially the section on reseerves, which the insurance companies invest in the stock market and elsewhere.

  29. TimP

    premiums

    you reduced it to a single premium.

    Therefore you didn’t address what i wrote.

    Thanks 4 saying you agree with the suggestions.

  30. I agree with Tim P. about the insurance companies: they’ve become real horror shows.

    My father, retired 15 years now, was an executive for a major medical insurance company. He said they didn’t dare to renege on their contracts in the old days like they do so routinely now. But he’s now fighting the Blue Cross ghouls who are refusing to pay my sister’s final expenses in the hospice.

    He said, ruefully, that ‘it might be different with individual policy-holders: [in my day] if your company was paying for the policy, they’d get on the phone and read us the riot act, and we’d pay up fast rather than lose the account.”

    Companies probably don’t go to bat for their employees like they used to, either.

    My “insurance” company, HIP, has owed me over $600 for two goddamn years, even though their “customer service” reps agree with me that I have a legitimate, documented claim.

    Yeah, they suck, and their evil behavior is driving us into this crisis.

  31. Natasha: Why of course, if you say so! The scales have fallen from my eyes.

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