What do you think of this for a healthcare plan? -

[jillan]

Health care for every American based on a sliding cost scale.

And to reduce the cost of health care by focusing on prevention, investing in information technology and negotiating for lower-cost prescription drug programs, which includes revamping the current Medicare prescription drug program.

That way no new bureaucracies will have to be created.

I'm not going to comment, I am just curious to hear what you have to say.

[Cleita]

1. Too RW for me.

New bureaucracies will not need to be created with single payer universal health care because they are already in place with Medicare, Medical, the VA and other govt. programs. They will need to be expanded and consolidated, maybe even reducing the present bureaucracy. Think about that and don't let the RW conservative think tanks influence you. This idea I know comes from that camp. I study this a lot.

[jillan]

2. Not from a rw at all. Just something I heard being discussed.

While Dennis' plan won't make a new beureacracy, other's would.

[Cleita]

3. Anything that includes the present players, insurance cos. and

HMOs will be a candy store for them to rob the treasury and that will probably create a bureaucracy but I wonder because that bureacracy is also already in place as well with health coverage for federal employees. Sliding scale does not eliminate these players either and since they are the problem, they really can't be part of the system. They could exist outside of the system like they do in various European countries but they can't be included.

[ginchinchili]

9. You can't expand Medicaid and reduce the current bureaucracy.

That sounds good, but our present system is barely adequate as it is.

[Cleita]

11. Oh dear! I do get tired of repeating myself.

Medicare costs 2% to 3% for administration. Private insurance averages 20% administrative costs anywhere from 8% to a high 30%. If NHC were administered under Medicare/Medicaid the cost of it would be less not more. If you want some facts instead of BS, go to this website Physicians for a National Health Plan. http://www.pnhp.org. They have all the stats and studies there for you.

[ginchinchili]

24. You apparently are misunderstanding my position.

I'm a strong proponent of revamping our national health care system. Why don't you state exactly what it is that's getting you in such a tizzy about my posts? You jump on me in another post for mentioning something I heard the other day on NPR. Is that against your rules? If so, just shoot me, why don't you. You criticize me for not stating sources. Well I responded to your post by stating that I heard it on NPR, I just didn't consider it to be such a controversial topic requiring a source. Then you start throwing out statistics (your post above) but your only "source" didn't have these statistics (not that I could find) and it isn't exactly an unbiased source. But I'm glad you turned me on to it because it looks informative. So unless your going to give me sources to your statistics, don't demand the same of me for mentioning Medicaid fraud. Don't you really believe that it's non-existent?

Now, regarding your points, you state that Medicare's administration costs are 2% - 3%. That sounds low, but I have no reason not to believe you, so I tentatively accept that figure. But assuming it's true, that's not necessarily a good thing. It could mean, and I think it does, that the program isn't being adequately run, and that's the point that I've been trying to make. That's not the same as saying money is being squandered on running the program. I do believe that money is being lost from fraud, but not in the running of Medicaid, and I assume Medicare as well. And I say that not to criticize that program or to advocate getting rid of it. It's not necessarily the less money spent on administration costs the better. You also have to factor in the quality of how the system is run as well. That's where the fraud issue comes in. You have to pay people to insure that the programs are being run adequately and that providers and participants are compliant with Medicaid's regulations. Otherwise, money is squandered. If you wish to lambaste me for that position, go ahead. But I see it first hand. I'm just saying that improvements need to be made and they will cost money. Your responses to my posts feel like you're responding to someone else's posts by replying to mine. It feels like a disconnect.

[bobbolink]

26. First off, "medicaid fraud" is perpetuated by DOCTORS and HEALTH CARE COMPANIES!

Not individual people.

Second, you mention that someone else is in a "tizzy", then you proceed to have one.

[ginchinchili]

31. If you're going jump in here to attack me, at least have the decency ...

to quote what it is you're attacking. Is it this statement I made on another post in this same thread? "Personally, I'm more worried about the care and medical equipment providers than the ex-drugdealers." You're implying that I stated that medicaid fraud is carried out by "individual people," by which I guess you mean the recipients. Is that what you mean? Would you at least show me my quote where I make that statement? I'll give you a chance to do so, assuming your a pretty decent person.

[bobbolink]

34. Chill.

[ginchinchili]

37. I've chilled....now the quote, please.

[ginchinchili]

42. I'm still waiting for that quote where I attack Medicaid recepients

You weren't just blowing smoke, were you?

[bobbolink]

43. After seeing your post #27, I will not respond to your ugly sexism.

Good bye. "Liberal".

:puke:

[ginchinchili]

52. How can it possibly be sexism when I don't even know the poster's gender?

You can make that comment to either gender. And I don't appreciate someone purposely misrepresenting things I post and then attacking me on those falsified points. I say "purposely misrepresenting" me because all they would have to do is take a quote from my post and refer to it, like I ask of you, but they don't because that would take away the argument they wish to make.

But you're refusing to respond because I called you on your b.s. and you know I'm right. Otherwise, make a fool of me by showing DU a quote from me where I'm putting down Medicaid recipients, like you have claimed. Then I'll apologize and you'll have the last laugh. But I know you won't because I've never posted anything like that, and that's what pisses me off. You see, I don't take kindly to someone publicly lying about me in a way that would paint me as someone who would put down Medicaid recipients. I have my reasons for finding such dishonest slander so repugnant. In case you haven't noticed, it really pisses me off. I'm just so sick and tired of dishonest people. It's why the world is so fucked up.

[ginchinchili]

44. Just as I thought, groundless attacks w/o backing them up. Shame on you.

[Cleita]

30. The administrative costs are well documented especially in

the campaigns of our presidential candidates John Edwards and Dennis Kucinich. There is plenty of information out there on the SS website about this and other government sources. Your positions are talking points that have been spread through the media since the Harry and Louise days but have been proven to be false. Please go to this website and spend some time reading their research and news articles they have gleaned from all over the media about this. You will find more truth there than what you are hearing from publicists on NPR and elsewhere who are working for the health insurance lobby.

http://www.pnhp.org

[ginchinchili]

33. Once again, what "talking points" are you referring to?

At least give me a chance to defend myself. And please be specific, like, quote me.

[pinto]

4. I favor Medicare for all.

With an update on the outdated reimbursement formulas, and the ability to negotiate bulk drug pricing as some minimum adjustments.

[Cleita]

5. This would be the easiest way to do it.

The transition would be much smoother.

[Lydia Leftcoast]

6. Somebody would still have to administer and fund and require

that focus on prevention, those investments in info technology, and those negotiations for lower-cost drugs.

That would be...a bureaucracy.

My brother complains that Medicare's reimbursements are too low and so ridden with picky little rules that you can end up being accused of cheating without intending to.

The rules need simplifying, the reimbursements need to be adjusted for inflation, and people under 65 should have the option of buying in.

[ginchinchili]

7. Keep in mind that one of the fastest rising crimes is Medicaid fraud.

I heard a report the other day stating that drug dealers are abandoning dealing drugs in favor of easier, more lucrative, Medicare fraud. The rules have to be "picky" to minimize fraud. If anything, they're not thorough enough. Whatever we decide to do with our healthcare system, we always have to keep in mind the cost. If not, it won't be long before only the wealthiest Americans will have healthcare.

[Lydia Leftcoast]

10. "Drug dealers are abandoning drugs in favor of Medicare fraud"?

Drug dealers with MDs?

Funny thing, other countries don't seem to have this problem to any significant degree.

[ginchinchili]

16. LOL, I can't comment on other countries, but it's happening here.

I work in the industry and see it. With the present system there's little that can be done about it. There just isn't the money or personnel. There's just a small company, us, who screens Medicaid requests for payment for, well, everything Medicaid pays for. There are so many review requests coming through every day it's all we can do to get the info into the computer. Then a nurse reviews it and, if necessary, a doctor. But the outcome is usually determined by the nurse. The main requirement is that they answer all the questions regarding medical necessity correctly. It doesn't take long to figure out what the correct answers are. It's crazy, but that's our Medicaid system. It needs work. But I'm not necessarily against using our current Medicaid system as part of a revamped healthcare plan.

[Cleita]

21. And which part of the industry is that?

The provider, the biller, the Medicare office or an insurance company?

[ginchinchili]

25. We're a medicaid subcontractor

We're in charge of screening utilization review requests for medical necessity.

[Cleita]

28. You're the gate keeper. That's why you are so suspicious that

people who don't belong in Medicaid are going to slip through. I honestly hope you don't screen out needy people because you think you can't trust them. I have to tell you I really don't like the privatization and sub-contrator deals. It's very corporate, RW thinking and it diverts tax dollars into corporations that belong to the programs they are supposed to cover. Also, if you guys do screw up they can blame you. Very clever those govt. Republicans. I'm not blaming you. It's your job, but I sure don't like how we got here. In the end everyone will have to be covered. The majority of Americans want it and there will be no need for people like you. Hopefully, another job will open up for you processing recipients and issuing cards to everyone. You won't have to bother with screening because everyone will be eligible.

[bobbolink]

29. "You won't have to bother with screening because everyone will be eligible."

And that's the ESSENCE, right there!

ALL HUMAN BEINGS DESERVE ADEQUATE HEALTH CARE!

Yes, I'm shouting! (Getting some weird looks in the library, I'll tell ya..hehehe)

I;m so sick of all this suspicion against poor people!

I wish all who thinks that way would have to go through that suspicion themselves!

I can tell you, many poor people don't even try to get in to see a doctor because of those damned stereotypes!

Wadda country. :(

[ginchinchili]

40. I thought you supported Medicaid? Now you're not making sense.

If Medicaid is expanded to everyone, the last thing we'll be doing is going out of business. We would have to expand. We are, in effect, an arm of Medicaid.

Yes, I hope we don't screen out needy people as well, of course, but it has nothing to do with being suspicious. And where do you get the idea that I'm "so suspicious that people who don't belong in Medicaid are going to slip through"? Where are you getting this stuff from? Why not quote me and then freely disagree with my points. This stuff you're criticizing me about isn't coming from me nor are they my positions. At least make an attempt to be fair and intellectually honest.

When the government has a program, there has to be controls. That's not a RW thing, that's reality. If we expanded Medicaid and Medicare for everyone, for example, there would have to be controls, including screening processes, or the program would go broke. You'd have requests to pay for more power wheelchairs than there are people. These are the kinds of controls that will protect and enable such a program to survive. If we just open the spigot for everyone to take whatever we want, we would soon lose our dream of a health care system that covered everyone. I'm just trying to be realistic.

[Cleita]

13. Ha ha. Please put up your sources.

Blanket statements against the facts are not acceptable here. I get Medicare and I know for a fact that the medical care I get is what get's billed for and nothing more. Medicare advises you of what has been billed to your account and they have forms attached to report Medicare fraud if you encounter it.

[ginchinchili]

18. My source is NPR, early this past week.

You'll have to do the search yourself. Just go to their website and do a search on "Medicaid fraud." It's fascinating, in a bad kind of way. I work in the industry and it wouldn't be hard to do. Personally, I'm more worried about the care and medical equipment providers than the ex-drugdealers. A lot of people on Medicaid do not scrutinize their statements. Because you have to get your Medicaid reinstated every so often many Medicaid recipients don't even know when their Medicaid runs out. I see that almost daily. They just don't give the system enough money to run it properly and to have adequate oversight.

[Cleita]

20. No I didn't make the statement. You need to put up the link.n/t

[Name removed]

27. Deleted message

Message removed by moderator. Click here to review the message board rules.

[Cleita]

32. Okay that's uncalled for. This conversation is over. n/t

[ginchinchili]

8. Sounds pretty reasonable.

I think we would do well to make use of much of what is already in place. Someone else on this thread stated pretty much the opposite, but it would be devastating, in effect, close down all the "present players" kicking tens, if not hundreds, of thousands out of their jobs. Not only would that be a bad idea, but it would never pass, not even if the entire congress was Democrat. Their constituents would be very, very pissed.

The answer will have to be multi-faceted and the plan you outline meets that criteria. Of course, the details would determine how practical it is.

[Cleita]

15. Please put up your sources for your outrageous comments.

I will advise you that DU doesn't like RW think tank source disinformation to be linked to the website, but any neutral news stories or stats would be welcome to back your claims.

[ginchinchili]

19. What the hell are you talking about?

[Cleita]

22. This is a pretty worn talking point that you brought up:

"Someone else on this thread stated pretty much the opposite, but it would be devastating, in effect, close down all the "present players" kicking tens, if not hundreds, of thousands out of their jobs."

It's been debunked pretty much. New jobs will open up where old jobs could be downsized. Also, a little known fact is that private insurance companies are contracted to do much of the billing and administrating of those plans. It's the government that controls the money though not them. If anything it would increase jobs if they keep their contracts.

[bobbolink]

35. Not to mention... jobs being more important that people suffering and dying from lack of health care

We're going to be seeing more and more of this drawing lines and demonizing people, especially poor people.

The dying health care system is going to go with a lot of fire.

[ginchinchili]

39. Who's demonizing people? Who's saying jobs are more important than health care?

Again, show me the quotes. You people are freaked out. See you later.

[ginchinchili]

36. I'll use your line: give me your sources.

I find it hard to believe that you can shut down the insurance companies and it won't cause a disruption in the job market. But if you can give me a good factual source, I'm open-minded.

My position is to use what we have in place but rewrite the regulations so that the care providers and insurance companies are working for us, not their own profits. But that includes expanding Medicaid and Medicare, and improving these programs. You don't have to agree with me, but don't act like I just nominated Rush Limbaugh for president. I just don't understand where you're coming from. Why do you have to get mad at someone just because you don't agree with their position? That's certainly more republican-like than anything I've stated.

[Cleita]

38. I have put up a source with a link twice now. That website has

all the information and the sources for it like SS and the government. I will give it to you again.

http://www.pnhp.org

[ginchinchili]

41. OK, now here's the link I directed you to, only I did one step better

I actually did the work for you. This link will bring you to the specific story that I was referring to.
http://www.npr.org/templates/story/story.php?storyId=15178883

Now, since you're so big on sources, could you please give me the link that states that Medicaid administration costs 2% - 3%? Thanks.

[Cleita]

45. ...

http://news-info.wustl.edu/news/page/normal/4981.html
http://www.commondreams.org/news2007/0921-04.htm

[Cleita]

46. Your source is a conservative radio talk show host.

http://www.therightbalance.org/host.html

[ginchinchili]

48. You're simply intellectually dishonest.

My source is as I stated; don't misrepresent me. My source was National Public Radio, hardly a right wing radio broadcast, and you know that was my source because that's exactly where my link took you. But you chose to put as your subject heading, "Your source is a conservative radio talk show host." What you're referring to is an article you found about the man who did the piece for NPR, which I trust to be fair (though I take everything with a dose of skepticism) that states: "Though his roots are conservative, he enjoys interviewing people who represent a variety of political and social perspectives, allowing his listeners, whom he credits with having a functioning IQ, to make their own informed decisions." This doesn't mean that he can't do unbiased reporting any more than someone with liberal roots can't do good balanced reporting. Perhaps it's you who can't be objective, because when I listened to the report nothing at all political crossed my mind, nor did I see it as an attack on Medicaid. I saw it as a report on Medicaid fraud, nothing more, nothing less. You can pretend that it doesn't exist; I happen to know it does. I prefer reality over just hearing what I want to hear, even if I'm not liking what I'm hearing. Report the weaknesses in Medicaid and they can be addressed and Medicaid can be made more efficient, a better program for the people. Ignore the problems, and we all suffer.

I might add that your source isn't exactly unbiased considering it's an article in a college newspaper and the man whose opinion you presented as accepted fact is on the college's faculty. But unlike you, that doesn't make me discount his obviously well-informed opinion. I take everything with a measure of skepticism, but I think he makes some valid points.

You really shouldn't be so quick to attack people who have differing opinions than yours, especially since our opinions really aren't that different. You just chose to present my opinion as antipodal to yours, I guess so that you could have someone to rail against. But I get the same thing from some conservatives so I figure I must be in the right place.

[Cleita]

53. This guy is on NPR but his opinion is conservative and not

really based on actual fact.

[LWolf]

12. HR 676 is by far better. n/t

[gateley]

14. I think it's the logical first step. Everyone having coverage is the most urgent

need and this plan would address that quickly without having to create an entire new system.

Ultimately I'm for a single payer system, but not convinced that's the most effective option at this time to ensure coverage for all as soon as possible.

[Dewlso]

17. Sliding Scale

What would be the rates on the sliding scale. Give examples. Would it be based off current earnings or year to date?

I would rather see a universal health care plan whereas the insurance companies would not dictate coverage. That is the reason the cost is so high. Remove them from the equation. Let the government negotiate prices with the hospitals and doctors directly. Contrary to republican beliefs universal health care (or socialized medicine as they call it) would benefit everyone. Health care should not be a business of profit margins. One of the reasons why young people are choosing not to have children is because of the cost. If you dont have health care it is astronomical. Cancer rates in America have gone down as a whole but went up in Tennessee, partly because people dont have the insurance to pay for preventive medicines and check ups. The truth is that we need some kind of insurance for ALL Americans. America used to lead the way in alot of areas. Now we are falling behind. We are the only world power that does not have a National HealthCare Plan. Why is that? Could it be that the politicians that are against it are more interested in profits rather than healthy Americans?

[Cleita]

23. Exactly.

And welcome to DU. The insurance companies are the cause of the problem. Why would we want them in the equation?

Welcome to DU!

:toast:

[Hieronymus]

47. It sounds a lot like the system in France. They pay according to income.

[jillan]

49. Do you know how well it is working there?

[Froward69]

50. world Health org = France #1

However they are having to bolster income to offset cost. mismanagement.
http://news.bbc.co.uk/2/hi/europe/3423159.stm

[jillan]

54. Very interesting!

It seems so simple. And I imagine with any healthcare system, there will be management issues.

[Hieronymus]

56. It costs France half as much per capita as it costs the US ..

Medicare in the US costs even less to administer.

May 20, 2004

FRENCH HEALTHCARE....The Economist provides a capsule summary of healthcare in France:

Its hospitals gleam. Waiting-lists are non-existent. Doctors still make home visits. Life expectancy is two years longer than average for the western world.

....For the patient, the French health system is still a joy. Same-day appointments can be made easily; if one doctor's advice displeases, you can consult another, a habit known as nomadisme médical. Individual hospital rooms are the norm. Specialists can be consulted without referral. And while the patient pays up front, almost all the money is reimbursed, either through the public insurance system or a top-up private policy.

For family doctors too, liberty prevails. They are self-employed, can set up a practice where they like, prescribe what they like, and are paid per consultation. As the health ministry's own diagnosis put it recently: “The French system offers more freedom than any other in the world.”

And despite the Economist's scary headline, which proclaims that "crisis looms," the French system provides this service to everyone in the country and does it for less than half the cost per person of the U.S. Even if they decide to raise taxes to cover a growing deficit in their healthcare fund (the subject of the Economist's article) their costs will still be less than half ours per person.

Now, there are undoubtedly drawbacks to the French system. They probably have fewer high-tech machines than we do, and the comparative cost figures may be skewed by the American love of elective procedures. Still, there would have to be a lot of drawbacks to make their system less attractive than ours.

So why not adopt it? Well, that would be socialized medicine. Can't have that, can we? After all, everyone knows that when you socialize something it automatically declines slowly into anarchy and uselessness. Right?

[jillan]

57. If the RW hears that it is the same practice that they use in France -

it will never pass! They'll go back to their freedom fries and asinine comments like that.

[Hieronymus]

58. One of the most common, and least challenged, in the debate over US

health care policy is that Medicare administrative costs are about 2% of claims cost, while private health insurance companies' costs are in the 20% - 25% range.
http://72.14.253.104/search?q=cache:bBCXxpdqywYJ:www.cahi.org/cahi_contents/resources/pdf/CAHI_Medicare_Admin_Final_Publication.pdf+medicare+administrative+cost&hl=en&ct=clnk&cd=1&gl=us&client=firefox-a

[jillan]

59. All I know about Medicare is when I was taking care of my father

I had doctors tell me that they wouldn't take Medicare insurance because of all of the insurance hassles.
And that happened more than once. I was shocked.

[Froward69]

60. The issues there would

undoubtedly be the issues here. encroachment of Private insurance, Doctor fraud, padding of bills...

[WeCanWorkItOut]

51. Interesting. But medical inflation (8%hosp, 7%docs, 6%pharm, 6%admin)

--I'm not sure how much of the inflation will be controlled by the plan.
(Source of data, which I rounded off to fit into the subject line:
www.chcf.org/documents/insurance/HealthCareCosts07.pdf)
I suspect that we would still have much work to do to deal with cost inflation.

I do like a plan that is not regressive.

The prevention question is a troubling one, though. A recent study indicates that
the US is already the best of six nations (others being UK, Canada, NZ,
Australia, Germany) in the most usual kinds of preventive care.
(Source:www.commonwealthfund.org/publications/publications_show.htm?doc_id=482678)
So savings from that kind of prevention may be close to maxed out.
There are other kinds of prevention we could try, like dealing with obesity/metabolic syndrome.

[jillan]

55. Welcome to DU!!

And thanks for all of that info. :)

[WeCanWorkItOut]

67. Thank you. And . . .

thanks for raising important issues.

[Warren Stupidity]

61. No thanks. Medicare for everyone. FICA cap removed. nt.

[cilla4progress]

62. Universal health coverage

Just saw SICKO last night. Very good, I thought, though Moore, as always, does ham it up - it makes for a little bit of entertainment in an otherwise terribly dismal story.

I have always liked the idea of a two-track or parallel system, where universal health care is there and available for all, but for those (elitists who can afford it) who want private insurance, they can alternatively go that route. I'm not certain how well this works in practice and am interested in your views.

[Warren Stupidity]

64. Uh - I am sort of ok with that.

Money can't jump the line. You can spend your way to a private room, you can spend your way to a boob job, you can spend your way to private house calls from your high class physician, but you can't spend your way to get in front of me for life critical surgery, organ transplants, etc. If we are not all in the same boat, the temptation to 'thatcherize' the peasant's boat will be too great to resist.

[jillan]

63. They will need to revamp the system then. I mentioned in this thread earlier

that when I was taking care of my dad before he passed away and I was looking for doctors for him, I actually came across several doctors that would not accept new Medicare patients because of all of the hassles, and gov't red tape. I have heard the same story from someone else that lives in a different city.

[cuke]

65. I dont like it

It has no political support.

I understand the desire for a single payer, universal health care system that covers all our needs, but I can't wait for the perfect plan. I need health care now. Most of the candidates are supporting a universal health care package. Those are the ones I support

[Vinca]

66. Are you suggesting the insurance industry, out of their desire to meet

the critical medical needs of the population and their basic humanity, will take less money from some and provide the same care as to those who pay more? This will mean, of course, they forego their billions of dollars profit per quarter. The one thing missing in all the candidates' plans, except the Kucinich plan, is the part about how the insurance companies are talked into making less money for themselves. No one has consulted with the greedy bloodsuckers which makes all their plans (except Kucinich's) just so much hot air. Wait, don't tell me, we'll put it on the Chinese credit card so they can keep the corporate jets flying.