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And the Alternative is ... ... ... Lacking?

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Tort reform is indeed a state issue, so I am confused why so many people that should know that (our legislators) keep bringing up tort reform in a national bill. Go back to your states and get your state legislators to step up and write a bill.


One question I have for those that propose we be allowed to purchase health insurance across state lines.


Since I keep hearing the statistic that 85% of Americans with insurance are happy with their healthcare, and figuring that the vast majority of those people with jobs are getting their health insurance through their employer, how does allowing Americans the ability to buy insurance across state lines help?


Does this mean my employer could decide to get us all on BC/BS of North Carolina instead of BC/BS of South Carolina. Or, does it really come down to everyone that has insurance through their employer would no longer get employer-provided insurance and we would all have the privilege of going out on our own, as individuals, into the nationwide free marketplace to buy our insurance?


I don't think the 85% of Americans happy with their insurance would be too happy about the prospect of being on their own to go out and shop for insurance.


And, oh yeah, the Republican bill that some of them last night were waving around during the President's Speech is H.R. 3400. Haven't read anything about it yet.




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"H.R. 3400 is the Small Business Health Fairness Act. It calls for small businesses to offer employees health insurance through group health plans."


"The thing that's killing me is that those very members on the Republican side have over the course of the last five months offered some 800 amendments and individual pieces of legislation to the -- to the president and to (House Speaker) Nancy (Pelosi) and Harry Reid, to say, 'Hey, this is our contribution.' Every last piece has been rejected," said Republican National Committee Chairman Michael Steele."

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How does offering tax incentives help my uninsured sister Brent? Her only income right now is unemployment. And all of that is going to pay her mortgage and living expenses. She is looking for work. If she finds it (full time), she will probably be held from getting the company plan for 3 months. If she is part time, there will be no benefits offered.

What do the republicans offer that will keep her from bankrupcy if she gets sick or injured during this period?

Give me concrete solutions, not wishy washy tax benefits. What keeps my sister from declaring bankrupcy if she gets sick?

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To suggest that HSA's are "public options" is ridiculous.


Well, they're certainly not revenue-neutral, eh? ;) How much are yeh willing to increase our deficit by continued spending ... I mean "tax incentivizing"? Somebody has to pay for da INS and the Army, eh?


You need to talk to more young workers in their 20's. Many of them choose not to participate in their company health insurance plans because they would rather keep the money.


Of course they would. Most of 'em would rather not pay FICA or Medicare either, eh?


Problem is, old folks like you want your health insurance to be affordable with "tax incentives". That means yeh need those lower-risk young people buyin' in. Otherwise your premiums go sky high. And da Republicans now seem all in a twitter to protect Medicare and Social Security from any fiscally responsible changes, eh? Which means we definitely need those young folks AND a whole bunch of immigrants to keep payin' in to da Ponzi scheme.


And some of those uninsured 20-somethings contract H1N1 or get MS or leukemia, eh? Are yeh ready to watch 'em die of the flu because they can't afford hospitalization? Ready to have 'em drop out of the taxpaying workforce that's supportin' you and your parents because of lack of care for their condition?


I don't understand your statement about a high deductible plan being ok until someone gets sick. My max out of pocket is $2,900 per year. I've got that covered with my HSA. What am I missing?


That yeh could be Gern's sister. Yeh lose your job. Or change jobs. Now yeh don't have an employer-provided high deductible insurance plan any more. You or your wife gets sick or seriously injured. Maybe yeh lose your job because you get sick or injured. Your HSA I reckon would be wiped out by even a short stretch of tryin' to pay for chronic care.


People in da stock market often confuse a bull market for their own genius. Don't confuse personal lucky circumstances for genius either, eh? Just like da market may hit a downturn, your personal circumstances could hit a downturn. Lots of folks' have, eh?


Why can't all the small business owners in a city or county group together and get a group plan?


Yeh need to understand how these things are negotiated and bid, eh? Da demographics and claim history of a company are big factors in the costing. Small businesses tend to have older workers, no claims history, and less stability, eh? Most insurers won't get anywhere near 'em with affordable rates, pooled or not.


That's what I mean by demographic skimmin', eh? You're gettin' semi-affordable private insurance only by virtue of denying coverage to other businesses and citizen workers with unclear or riskier profiles.


That's killin' family businesses and small business innovation in the country, along with all our mature manufacturin' businesses with demographically older workers.




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"That means yeh need those lower-risk young people buyin' in."


Exactly. When they buy in, we don't have "to watch 'em die of the flu because they can't afford hospitalization," right? They are doing the right thing. They have insurance. So, how do you get them to buy in, and make the system work? Just like we encourage home ownership and other behaviour that makes our society stronger - encourage them to buy in with tax incentives.


Dems are going to get the lower-risk young people to buy in - with higher taxes and penalties. Under their plan, if you don't buy insurance, you are going to pay a hefty tax. I prefer a carrot to a stick. Which do you prefer?



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Looks like FactCheck needs....well, a FactCheck of itself.


"Wilson apologized again Thursday morning, though he also says a massive loophole could wind up in the health care bill: no requirement to prove citizenship for health care coverage.


Among three House committees to pass bills for health reform, only one expressly bans federal funding for proving health coverage to illegal immigrants.


"The Congressional Research Service has indicated that indeed the bills that are before Congress would include illegal aliens," Wilson said. "And I think this is wrong."


Indeed, the nonpartisan Congressional Research Service study found that the House health care bill does not restrict illegal immigrants from receiving health care coverage.


In the Senate, Democrats in the so called "Gang of Six," a group of bipartisan senators on the Senate Finance Committee which is the last panel yet to release its bill, began moving quickly to close the loophole that Wilson helped bring greater attention to."

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"Among three House committees to pass bills for health reform, only one expressly bans federal funding for proving health coverage to illegal immigrants."


And that only works until they're granted amnesty. Then they're "legal", aren't they? All of these issues are intertwined, with myriad unintended consequences, but the administration wants us to consider them and approve of them individually.


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I have to wonder how many of the oposition party oppose health care reform simply because a Democrat is President. They don't want any legislative successes. Period.


I mean many of the reforms proposed are similar to those developed and enacted by Massachusetts Republican Governor, Mitt Romney, working with state Democrats. Would the roles be reversed if Mitt Romney had somehow won the Republican nomination and general election? Romney would likely have proposed very similar legislation, although the public option I'm certain would not be included. Would Democrats be having the same kind of hissy fit? To be honest I suspect some would. They would probably stonewall it because of a lack of a public option. But many Republican currently opposed to the plan would be completely supportive because it would have come from one of their own. Sad, Sad, Sad.





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Which do you prefer?


Fiscal responsibility.


And success at achievin' at least some of da things on my list.


I figure both will make America stronger.


I'm willin' to sacrifice for that. Reckon most Americans are.




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Calicopenn wrote:


"... And controls on medical schools? Heck, that's not even a government issue - that's a matter between medical schools and the American Medical Association, a private, non-profit organization - in a sense, a "union" for doctors. "


This is a commonly held misconception. The Federal government is alone responsible for the the physician shortage. The Federal government controls the number of seats in every medical school in the country. If a school wishes to increase or decrease the number of seats, it must ask for permission to do so from the Federal government. In the mid 1980's, the Federal government commissioned a study on physician manpower needs called GMENAC I believe (I read it at that time so that may just be close). It predicted the physician shortages that we are experiencing now and it also predicted that those shortages will get considerably worse as the large number of baby boom generation physicians retire. The Federal government did nothing even though many medical schools asked to increase the number of seats. The Federal government also controls the total number and distribution of residency positions in the country. So when a politician in Washington complains that there are too few primary care physicians - they control it. If they complain about too many specialists - they control the numbers.


The AMA is a professional organization. In the mid 1990's the Federal government had a 'cram down' as it was called of certain payment options with medicare (participating versus non-participating). The AMA was going to publish a set of pro's and con's for both positions but was blocked by the FTC. The AMA is strictly prohibited from discussing financial issues on that level with its members. A union can do so. The AMA has nothing to do with physician licensing, the number of seats in medical school, the number and kind of residency positions, and represents a minority of physicians. After the current stance in the medical care debate, those numbers will drop even more (a recent past president just resigned).


So as you call for the Federal government to control all of medicine, just remember that it is the same organization who cannot run the medical education system well. You wish it to control your health care with no comparison to a private system to see how bad it WILL become?

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could you expand on the claim that the Federal Government determines residency distribution?

I'm only aware of the NRMP which is non-governmental.


From nrmp.org ....

The National Resident Matching Program (NRMP) is a private, not-for-profit corporation established in 1952 to provide a uniform date of appointment to positions in graduate medical education (GME) in the United States.

From the wiki ...

The National Resident Matching Program (NRMP) is a United States-based non-profit non-governmental organization created in 1952 to help match medical school students with residency programs. The NRMP is sponsored by the American Board of Medical Specialties (ABMS), the American Medical Association (AMA), the Association of American Medical Colleges (AAMC), the American Hospital Association (AHA), and the Council of Medical Specialty Societies (CMSS).

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The NRMP only determines which the program the physician will train. The Federal government determines how many total residency positions are offered and in what areas: internal medicine, surgery, family practice, etc. as well as sub-specialities and fellowships. So if you have problems with that system, do not blame physicians - blame the government.

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So let me get this straight. The number of doctors is mandated by the Federal Government. But not because of some arbitrary quota, but because of the level of Medicare funding. So in order to increase the number of doctors residencies, the Federal Government needs to increase Medicare funding. Well, doesn't that just support an argument that single payer or a public option will further fund doctors and increase the number of them practicing?

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The number of doctors is determined by the number of seats in medical schools controlled by the Department of Education. The specialities of those doctors is controlled by Medicare pass throughs to teaching hospitals. A government controlled system will not affect the number of doctors. Since to pay for socialized medicine, medicare funding will be cut, the number of residencies will decrease.

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