Town Hall with Obama

[quote]pushharder wrote:
Gambit_Lost wrote:
Here’s a post from the other healthcare thread:

DrSkeptix wrote:

The parallel fallacy entertained by some, here, in “macho” style, is that they do not want to be compelled to buy insurance, or they do not need insurance because they can save and pay for it when needed. I do not intend a run through of the general theory of risk. But anyone with life experience knows that rare things nevertheless happen: meteor showers, bus crashes, colon cancer.

These are expensive events, and we are all doomed to get something, sometime, when we are least prepared. The 26 year old man I saw tonight in the ER, whom I predict will have Stage II Hodgkin’s Disease, wasn’t planning on $100,000 bill to save his life this year.

For those of you who still think you can avoid insurance premiums and save up, guess what? You will compete with the indigent for attention, and you may get the care you need, and the rest of us will foot the bill.

Medical insurance–to mitigate the risk of the unpredictable catastrophe–is absolutely necessary. “Health care plans,” not so much.

I agree with what Doc wrote here and I do have some perspective in this field as I used to be in the health insurance field. However, in spite of all the valid points made I draw the line at bureaucratic/government mandated programs.[/quote]

You…were…one of THEM!!!

I will have to reconsider the honorary title I bestowed on you…the Paragon of eRectitude.

Would I be able to choose to take my own chances and not see one cent of my paycheck go to this public option?

[quote]Gambit_Lost wrote:
John S. wrote:
Gambit_Lost wrote:
Exactly. John, what happens if, again god forbid, it’s no fault of your own, but you are injured horribly. I walk a lot to increase my NEPA, and my god are there a lot of bad drivers. It would only take one to put you or me into a situation where we were completely unable to pay for our hospital bills. But we would be treated. Period. If you or I were hit by a car tomorrow, we’d be rushed to the hospital and treated immediately. How could you stop them from treating you?

Also, do you honestly think you’ll “accept the consequences” if an accident actually occurs? In the case of a terrible, painful accident, I think just about everyone would accept treatment. Pain is a powerful motivator.

That it is, but to me at least the thought of having to steal from someone else to get by is even more painful.

And like I said the Hospital does give 7 years to pay something off, so if it comes to something like a broken bone or anything like that I can easily pay that off. Now if anything comes up like I am on a breathing machine or anything like that I have told my doctor and my family I do not wish to be put on it.

To me it makes sense, given the chance of something catastrophic happening to me I am not worried about it.

Why aren’t you addressing the point and just dancing around? [/quote]

What point are you trying to make?

[quote]pushharder wrote:
DrSkeptix wrote:

I agree with what Doc wrote here and I do have some perspective in this field as I used to be in the health insurance field. However, in spite of all the valid points made I draw the line at bureaucratic/government mandated programs.

You…were…one of THEM!!!

I will have to reconsider the honorary title I bestowed on you…the Paragon of eRectitude.

I’ll bet big money you’ve put many a vittle on your table as a direct result of eeeeeevillll health insurance companies, Monsieur Docteur Medical.[/quote]

My ethics are twofold: small bills…unmarked.

http://briefingroom.thehill.com/2009/08/13/finance-committee-drops-end-of-life-provision/

Finance Committee drops end-of-life provision
@ 1:59 pm by Michael O’Brien

The Senate Finance Committee will drop a controversial provision on consultations for end-of-life care from its proposed healthcare bill, its top Republican member said Thursday.

The committee, which has worked on putting together a bipartisan healthcare reform bill, will drop the controversial provision after being derided as “death panels” to encourage euthanasia by conservatives.

“On the Finance Committee, we are working very hard to avoid unintended consequences by methodically working through the complexities of all of these issues and policy options,” Sen. Chuck Grassley (R-Iowa) said in a statement. “We dropped end-of-life provisions from consideration entirely because of the way they could be misinterpreted and implemented incorrectly.”

The Finance Committee is the only congressional committee to not report out a preliminary healthcare bill before the August congressional recess, but is expected to unveil its proposal shortly after Labor Day.

Grassley said that bill would hold up better compared to proposals crafted in the House, which he asserted were “poorly cobbled together.”

“The bill passed by the House committees is so poorly cobbled together that it will have all kinds of unintended consequences, including making taxpayers fund health care subsidies for illegal immigrants,” Grassley said. The veteran Iowa lawmaker said the end-of-life provision in those bills would pay physicians to “advise patients about end of life care and rate physician quality of care based on the creation of and adherence to orders for end-of-life care.”

“Maybe others can defend a bill like the Pelosi bill that leaves major issues open to interpretation, but I can’t,” Grassley added.

[quote]Gambit_Lost wrote:
Here’s a post from the other healthcare thread:

DrSkeptix wrote:

The parallel fallacy entertained by some, here, in “macho” style, is that they do not want to be compelled to buy insurance, or they do not need insurance because they can save and pay for it when needed. I do not intend a run through of the general theory of risk. But anyone with life experience knows that rare things nevertheless happen: meteor showers, bus crashes, colon cancer.

These are expensive events, and we are all doomed to get something, sometime, when we are least prepared. The 26 year old man I saw tonight in the ER, whom I predict will have Stage II Hodgkin’s Disease, wasn’t planning on $100,000 bill to save his life this year.

For those of you who still think you can avoid insurance premiums and save up, guess what? You will compete with the indigent for attention, and you may get the care you need, and the rest of us will foot the bill.

Medical insurance–to mitigate the risk of the unpredictable catastrophe–is absolutely necessary. “Health care plans,” not so much.

[/quote]

On the surface I agree with you. I would argue that one that has no sort of insurance policy against a catastrophic medical crisis is a fool, but there are two points that I would like to make in response to this.

We all still have the right to be foolish, as shown last November. I think it would be an incredibly difficult, arguably cruel, lesson to learn, but if someone chooses to go through life without insurance they have every right to do this and also every right to live with the consequences. You will never be able to protect people from themselves, and this is just another example.

Of course, this doesn’t change the fact that an unconscious 26 year old will still be treated in the ER after an accident before the hospital even inquires about health insurance. There’s a solution to this: Bill them. Don’t let them leave the hospital until they give their identity for billing purposes. They can legally be detained in this case for theft of services if they fail to pay or provide an identity to bill. Yes, I realize some of these will be unable to pay, for them the outcome should be bankruptcy or jail. Those of us who can pay will end up footing their bill in the same way we do at any retailer in the case of theft. Don’t want to be treated? Wear a tag or notify your loved ones in writing. The only reason this issue has become so complicated is because some of us out there are too concerned with protecting the so-called less fortunate. I’m sure the fools that get in an accident without insurance will gladly accept some charity to help pay their bills.

My other point is that you fail to distinguish those that are able to pay in the case of a catastrophe and those that have their own private welfare to take care of themselves. The Amish seem to do just fine without insurance or government assistance. Why can’t I be allowed, if I so choose in the case of private insurance, to do the same?

[quote]tedro wrote:
Gambit_Lost wrote:
Here’s a post from the other healthcare thread:

DrSkeptix wrote:

The parallel fallacy entertained by some, here, in “macho” style, is that they do not want to be compelled to buy insurance, or they do not need insurance because they can save and pay for it when needed. I do not intend a run through of the general theory of risk. But anyone with life experience knows that rare things nevertheless happen: meteor showers, bus crashes, colon cancer.

These are expensive events, and we are all doomed to get something, sometime, when we are least prepared. The 26 year old man I saw tonight in the ER, whom I predict will have Stage II Hodgkin’s Disease, wasn’t planning on $100,000 bill to save his life this year.

For those of you who still think you can avoid insurance premiums and save up, guess what? You will compete with the indigent for attention, and you may get the care you need, and the rest of us will foot the bill.

Medical insurance–to mitigate the risk of the unpredictable catastrophe–is absolutely necessary. “Health care plans,” not so much.

On the surface I agree with you. I would argue that one that has no sort of insurance policy against a catastrophic medical crisis is a fool, but there are two points that I would like to make in response to this.

We all still have the right to be foolish, as shown last November. I think it would be an incredibly difficult, arguably cruel, lesson to learn, but if someone chooses to go through life without insurance they have every right to do this and also every right to live with the consequences. You will never be able to protect people from themselves, and this is just another example.
[/quote]

True, people do have the right to be foolish, but again, many times crisis happen to people who are doing everything right. It’s a fallacy to believe that only those who are foolish or don’t have insurance are the one’s who are going bankrupt or without care.

Of the bankruptcies filed due to medical bills in 2007, 75% of the filing citizens had health insurance.

Health care costs have become increasingly more expensive with little to no increase in the quality of care. Insurance companies also make their money by collecting money and not providing care. As a result there are countless accounts of people who are long time members and consistently pay their insurance being denied care. Or if they do receive care, being rushed out of the hospital as soon as possible to cut down on costs, regardless of if it’s in their best interest or not.

So what if they get put in jail, we as tax payers pay for those as well. In the end we’re already paying for other people’s medical bills. The difference if there were a public option however would be that people would be able to receive prevantative care and therefore less emergency room care (which is considerably more expensive). Obviously there is no way to completely eliminate emergency room care, but preventative procedures would to a long way in lessening the amount.

[quote]
My other point is that you fail to distinguish those that are able to pay in the case of a catastrophe and those that have their own private welfare to take care of themselves. The Amish seem to do just fine without insurance or government assistance. Why can’t I be allowed, if I so choose in the case of private insurance, to do the same?[/quote]

The Amish also live in small scale farming communities and are essentially self sufficient. On such a small scale that might work, but on a large scale it just won’t. It would be nice if it did, but it doesn’t.

Honestly I would think that more people on this site would be for a public option, what with all of the free market supporters. Isn’t the idea of the free market that competition will drive down prices and force companies to compete with each other? Well, isn’t that kind of what they’re proposing here? A public option to drive down prices and keep the other insurance companies honest/competitive?

I’ve read that preventative care would actually cost us more.

[quote]Sloth wrote:
I’ve read that preventative care would actually cost us more.[/quote]

Where? Not saying that you’re wrong, just not what I’ve heard/read.

[quote]Sentoguy wrote:
Honestly I would think that more people on this site would be for a public option, what with all of the free market supporters. Isn’t the idea of the free market that competition will drive down prices and force companies to compete with each other? Well, isn’t that kind of what they’re proposing here? A public option to drive down prices and keep the other insurance companies honest/competitive?[/quote]

Does the public option have to make a profit? Or at least break even? I mean, are they going to have the backs of the taxpayer to coverup shortcomings? If so, how do you compete with that? “We’ll give you the best, top of the line treatment, guaranteed by the US Treasury. Come one, come all!”

[quote]Sentoguy wrote:
Sloth wrote:
I’ve read that preventative care would actually cost us more.

Where? Not saying that you’re wrong, just not what I’ve heard/read.[/quote]

Although different types of preventive care have different effects on spending, the evidence suggests that for most preventive services, expanded utilization leads to higher, not lower, medical spending overall.
http://cboblog.cbo.gov/?p=345

[quote]Sloth wrote:
Sentoguy wrote:
Honestly I would think that more people on this site would be for a public option, what with all of the free market supporters. Isn’t the idea of the free market that competition will drive down prices and force companies to compete with each other? Well, isn’t that kind of what they’re proposing here? A public option to drive down prices and keep the other insurance companies honest/competitive?

Does the public option have to make a profit? Or at least break even? I mean, are they going to have the backs of the taxpayer to coverup shortcomings? If so, how do you compete with that? “We’ll give you the best, top of the line treatment, guaranteed by the US Treasury. Come one, come all!”[/quote]

LOL. Good jab at the U.S Treasury.

Your question on the public option making a profit is a legitimate one. You could offer more benefits, more specialty procedures, basically things that aren’t offered in the public option. Those who can afford the higher costs and want special treatment will likely still buy private insurance if it’s worth it and available.

Similar to public schools and private schools. Public schools haven’t put private schools out of business, even though public schools don’t have to make a profit.

[quote]Sloth wrote:
Sentoguy wrote:
Sloth wrote:
I’ve read that preventative care would actually cost us more.

Where? Not saying that you’re wrong, just not what I’ve heard/read.

Although different types of preventive care have different effects on spending, the evidence suggests that for most preventive services, expanded utilization leads to higher, not lower, medical spending overall.
[/quote]

Thanks for the link. Some interesting info there.

Like you and the article said though, different types of preventative care have different effects on spending and different levels of likelihood.

For instance, something like regular cleanings and Floride treatments at the dentist would prevent a great deal of cavities, as well as much more expensive procedures such as root canals, dental implants, and dentures. Without such preventative care there would be a very high chance that such procedures would eventually be required.

I’m not suggesting they run every test in the book on every person in existence, they’re got to figure out which tests are beneficial to the highest number of people and do them. Then, anyone who is at a higher risk for a condition should get the appropriate tests. Efficiency is obviously going to be important.

Also, like the article said, although preventative care might raise costs in some cases on the books, the results often render the increases as “cost effective” investments.

[quote]tedro wrote:
Gambit_Lost wrote:
Here’s a post from the other healthcare thread:

DrSkeptix wrote:

The parallel fallacy entertained by some, here, in “macho” style, is that they do not want to be compelled to buy insurance, or they do not need insurance because they can save and pay for it when needed. I do not intend a run through of the general theory of risk. But anyone with life experience knows that rare things nevertheless happen: meteor showers, bus crashes, colon cancer.

These are expensive events, and we are all doomed to get something, sometime, when we are least prepared. The 26 year old man I saw tonight in the ER, whom I predict will have Stage II Hodgkin’s Disease, wasn’t planning on $100,000 bill to save his life this year.

For those of you who still think you can avoid insurance premiums and save up, guess what? You will compete with the indigent for attention, and you may get the care you need, and the rest of us will foot the bill.

Medical insurance–to mitigate the risk of the unpredictable catastrophe–is absolutely necessary. “Health care plans,” not so much.

On the surface I agree with you. I would argue that one that has no sort of insurance policy against a catastrophic medical crisis is a fool, but there are two points that I would like to make in response to this.

We all still have the right to be foolish, as shown last November. I think it would be an incredibly difficult, arguably cruel, lesson to learn, but if someone chooses to go through life without insurance they have every right to do this and also every right to live with the consequences. You will never be able to protect people from themselves, and this is just another example.

Of course, this doesn’t change the fact that an unconscious 26 year old will still be treated in the ER after an accident before the hospital even inquires about health insurance.
[/quote]
Yes. That is an obligation.

So let me see if understand…You would have a hospital keep a non-paying patient? At 1 or 2 thousand bucks per day?
I have personal experience with uninsured–and undocumented aliens–who have been hospitalized in acute care hospitals because they cannot be moved.
Guess who pays the bills.
People don’t go to jail for not paying their hospital bills. In bankruptcy, lawyers and accountants are paid before hospitals and doctors, so you can see how that works out. No creditors win in bankruptcy.

[quote]

My other point is that you fail to distinguish those that are able to pay in the case of a catastrophe and those that have their own private welfare to take care of themselves. The Amish seem to do just fine without insurance or government assistance. Why can’t I be allowed, if I so choose in the case of private insurance, to do the same?[/quote]

The Amish do not rely on technology; home remedies serve them, and when they must go to the “English” for medical care, they have a community fund–insurance–for that purpose. But catastrophes still visit the righteous; the Amish are not immune:

[quote]Sentoguy wrote:
Sloth wrote:
Sentoguy wrote:
Sloth wrote:
I’ve read that preventative care would actually cost us more.

I’m not suggesting they run every test in the book on every person in existence, they’re got to figure out which tests are beneficial to the highest number of people and do them. Then, anyone who is at a higher risk for a condition should get the appropriate tests. Efficiency is obviously going to be important.

Also, like the article said, although preventative care might raise costs in some cases on the books, the results often render the increases as “cost effective” investments.

[/quote]

Screening and prevention are currently performed on those at risk, and are still expensive. Whether they are efficient is largely in the eye of the beholder.
For example, in the current Bulletin of the NCI, there are two charts. In one, in women age 50 to 60, to save 1 women in 1000 death by breast cancer requires yearly mammography. 10x1000x($100 to $200). This does not count the false positive tests, subsequent expensive MRI mammograms, painful or risky biopsies, etc.
A similar estimate for men and prostate cancer is that screening spares only 7 in 10000.

I am not against preventive health. Screening? just has to be sensible. The Pap smear was always the best example; but it had a startling high false negative rate, too. (A better test is 5 to 10 times more expensive, and it is worth it.) But what about “an investment” in prevention? Value is in the eye of the beholder; here, an example from Holland (in the JNCI):

[i]
"Cost-Effectiveness of HPV Vaccination in the Netherlands

The cost-effectiveness of vaccinating women in the Netherlands against the human papillomavirus (HPV) might be limited because cervical cancer incidence and mortality rates in that country are low. In this study, de Kok et al. (p. 1083) used a simulation model to estimate the costs and effects of adding HPV vaccination to the current screening situation in the Netherlands. They also examined the impact on cost-effectiveness of changes in the price of vaccination, number of booster vaccinations, vaccination attendance rate, vaccination efficacy, cervical cancer incidence level, and quality-of-life assumptions. Adding HPV vaccination to the current Dutch screening situation at the current over-the-counter per-dose price of e118 had a cost-effectiveness ratio of e53 500 per quality-adjusted life-year gained. To achieve a cost-effectiveness acceptability threshold of e20 000 per quality-adjusted life-year gained, the threshold price per vaccine dose would have to be 40. With one additional booster vaccination for lifelong protection, the price per initial vaccination would have to be e33 per dose and with four booster vaccinations, e16 per dose. If the cervical cancer incidence doubled, the cost-effectiveness ratio would be e24 400 per quality-adjusted life-year gained and the maximum price per dose at threshold of e20 000 would be 97. Threshold prices were even lower under less favorable effectiveness assumptions. The authors conclude that in the Netherlands, HPV vaccination is not cost-effective even under favorable assumptions."[/i]

In short, the value of a human life in the Netherlands is set at 20,000 euros ($28,000) per year, and prevention had better be priced below that. (In the US, HPV is recommended freely to women in before their early 20’s.)

I don’t object to this type of research, or this line of thinking. But we live in a country for which life never has limits and money is no object. We are not prepared–politically and perhaps ethically–to live within limits. And it is going to happen faster than any of realize.

[quote]DrSkeptix wrote:
So let me see if understand…You would have a hospital keep a non-paying patient? At 1 or 2 thousand bucks per day?
[/quote]

No, patients that are cognizant enough to decide for themselves if they want to continue treatment will have the choice to stay until a doctor releases them or leave immediately. If they choose to leave, they will be required to pay for the services at that point or identify themselves to the point that a hospital can send a bill and/or set up a payment plan. If they fail to do this the hospital will have the right to detain them, in the same manner that a shop keeper can detain a customer in the case of theft.

For the sake of this argument, I am going to ignore the issue of illegal immigrants. Their strain on the health care system can be fixed through mechanisms independant of health care. If we want to consider them in this case, we must get to the root of the cause. If we would allow ourselves to do this, the cost of health care for illegals is moot.

I realize people don’t go to jail for not paying their bills. I also realize bankruptcy won’t recoup the cost of treatment. The idea here isn’t to make hospitals 100% efficient. It is to allow a hospital to operate just like any other business with minimal government involvement. If a patient steals services, they need to be punished to the full extent of the law. If they take services that they are unable to pay for they should be fully prepared to face the consequences to their credit.

It is also important to note that when illegals are excluded from this group, the group becomes amazingly small. We are simply talking about those that choose to not carry insurance that also have no other way of paying for a catastrophe.

Precisely. Just like some have a bank account–insurance–or a rich uncle–insurance–or possibly other services to barter for that purpose.

[i]Mr. Martin and other Old Order Mennonites say they don’t want charity. But they want bills that reflect the actual cost of care. The government allows hospitals to charge many times the actual cost of services in order to pay for updates to technology and services.

“I want to pay my bills,” Mr. Martin says. “I just want to pay bills that are reasonable and fair.”

John Burkholder, a Mennonite farmer, was billed almost $11,400 for his two-year-old son’s single day at Lancaster General in 2005 – mostly because of a nearly $10,000 charge for an injection of a medicine to fight a respiratory virus.

After Dr. Morton talked to hospital officials, the hospital cut the injection bill by about half. He says hospitals often charge many times the actual cost of medicine.

A spokesman for Lancaster General said the hospital lowered the price of the injection for Mr. Burkholder’s son to $5,500 in response to Dr. Morton’s inquiry – and has since reduced the charges for many other expensive drugs.

All this comes as many nonprofit hospitals in the U.S. are making money. Nonprofit hospitals are exempt from taxes in exchange for providing benefits to their communities. Income they generate is supposed to be channeled back into operations.

In fiscal 2007, Hershey Medical Center had a profit of $59.3 million; Lancaster General had a profit of $137 million.

Asked whether that surplus could be put toward discounting rates for the uninsured, Mr. Beeman, the CEO, said it is better to use the money to improve services at the hospital for everyone.

Lancaster General spent $350 million on capital projects – including an 11-level garage, expanded executive offices and a lobby with marble floors and a grand piano – between 2003 and 2007. The hospital paid Mr. Beeman $1.28 million last year.[/i]

Sounds to me like Mr. Martin picked the wrong non-profit hospital to go to. Part of health care reform is to get the customer back into the process of deciding what hospital to go to and what insurance policies to purchase. Between group health, government programs, and over-regulation of the insurance industry this no longer happens. True reform will treat hospitals and insurance companies just like any other business where the customer actually has an incentive to shop around and research the product they are purchasing.

[quote]tedro wrote:
DrSkeptix wrote:
So let me see if understand…You would have a hospital keep a non-paying patient? At 1 or 2 thousand bucks per day?

No, patients that are cognizant enough to decide for themselves if they want to continue treatment will have the choice to stay until a doctor releases them or leave immediately. If they choose to leave, they will be required to pay for the services at that point or identify themselves to the point that a hospital can send a bill and/or set up a payment plan. If they fail to do this the hospital will have the right to detain them, in the same manner that a shop keeper can detain a customer in the case of theft.

I have personal experience with uninsured–and undocumented aliens–who have been hospitalized in acute care hospitals because they cannot be moved.
Guess who pays the bills.
People don’t go to jail for not paying their hospital bills. In bankruptcy, lawyers and accountants are paid before hospitals and doctors, so you can see how that works out. No creditors win in bankruptcy.

For the sake of this argument, I am going to ignore the issue of illegal immigrants. Their strain on the health care system can be fixed through mechanisms independant of health care. If we want to consider them in this case, we must get to the root of the cause. If we would allow ourselves to do this, the cost of health care for illegals is moot.

I realize people don’t go to jail for not paying their bills. I also realize bankruptcy won’t recoup the cost of treatment. The idea here isn’t to make hospitals 100% efficient. It is to allow a hospital to operate just like any other business with minimal government involvement. If a patient steals services, they need to be punished to the full extent of the law. If they take services that they are unable to pay for they should be fully prepared to face the consequences to their credit.

It is also important to note that when illegals are excluded from this group, the group becomes amazingly small. We are simply talking about those that choose to not carry insurance that also have no other way of paying for a catastrophe.

The Amish do not rely on technology; home remedies serve them, and when they must go to the “English” for medical care, they have a community fund–insurance–for that purpose.

Precisely. Just like some have a bank account–insurance–or a rich uncle–insurance–or possibly other services to barter for that purpose.

But catastrophes still visit the righteous; the Amish are not immune:

[i]Mr. Martin and other Old Order Mennonites say they don’t want charity. But they want bills that reflect the actual cost of care. The government allows hospitals to charge many times the actual cost of services in order to pay for updates to technology and services.

“I want to pay my bills,” Mr. Martin says. “I just want to pay bills that are reasonable and fair.”

John Burkholder, a Mennonite farmer, was billed almost $11,400 for his two-year-old son’s single day at Lancaster General in 2005 – mostly because of a nearly $10,000 charge for an injection of a medicine to fight a respiratory virus.

After Dr. Morton talked to hospital officials, the hospital cut the injection bill by about half. He says hospitals often charge many times the actual cost of medicine.

A spokesman for Lancaster General said the hospital lowered the price of the injection for Mr. Burkholder’s son to $5,500 in response to Dr. Morton’s inquiry – and has since reduced the charges for many other expensive drugs.

All this comes as many nonprofit hospitals in the U.S. are making money. Nonprofit hospitals are exempt from taxes in exchange for providing benefits to their communities. Income they generate is supposed to be channeled back into operations.

In fiscal 2007, Hershey Medical Center had a profit of $59.3 million; Lancaster General had a profit of $137 million.

Asked whether that surplus could be put toward discounting rates for the uninsured, Mr. Beeman, the CEO, said it is better to use the money to improve services at the hospital for everyone.

Lancaster General spent $350 million on capital projects – including an 11-level garage, expanded executive offices and a lobby with marble floors and a grand piano – between 2003 and 2007. The hospital paid Mr. Beeman $1.28 million last year.[/i]

Sounds to me like Mr. Martin picked the wrong non-profit hospital to go to. Part of health care reform is to get the customer back into the process of deciding what hospital to go to and what insurance policies to purchase. Between group health, government programs, and over-regulation of the insurance industry this no longer happens. True reform will treat hospitals and insurance companies just like any other business where the customer actually has an incentive to shop around and research the product they are purchasing.[/quote]

Yep…thought you would like it.

[quote]Sentoguy wrote:
So what if they get put in jail, we as tax payers pay for those as well. In the end we’re already paying for other people’s medical bills. The difference if there were a public option however would be that people would be able to receive prevantative care and therefore less emergency room care (which is considerably more expensive). Obviously there is no way to completely eliminate emergency room care, but preventative procedures would to a long way in lessening the amount.
[/quote]

I don’t deny that the tax payer will still feel the burden at this point, but it is now a matter of principal. While I would feel contempt for those that accept a service and do not pay, I am much more comfortable paying taxes to create a deterrent for the activity than paying taxes to support the activity.

[quote]
The Amish also live in small scale farming communities and are essentially self sufficient. On such a small scale that might work, but on a large scale it just won’t. It would be nice if it did, but it doesn’t.

Honestly I would think that more people on this site would be for a public option, what with all of the free market supporters. Isn’t the idea of the free market that competition will drive down prices and force companies to compete with each other? Well, isn’t that kind of what they’re proposing here? A public option to drive down prices and keep the other insurance companies honest/competitive?[/quote]

Because never in the history of “public options” has it worked this way, and the latest proposal is not designed to work this way. It is designed to force all the insurance companies to adhere to a standard created by the same people offering the public option. At the same time there is no oversight of the actuarial or accounting standards for the public option. So while the private companies have very strict regulations, the public option will be allowed to play by their own rules. Furthermore, it has already been acknowledged that the public option will rely on some sort of subsidy to operate. How in the world do you call it competition when one entity gets to take as many tax dollars as possible to remain operational?

If you wanted to create competition you would allow interstate commerce. You would then eliminate all tax incentives associated with group policies (even health benefits need to be taxed) in order to put the individual back in charge of the decision making process and directly responsible for the cost of services. If you wanted to add any regulation you would require “whole” health insurance, or at least health insurance with a long well-defined term. Getting away from the employer based system would almost certainly take care of this on its own though.