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| Name: |
Barneget
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| Subject: |
They Will NEVER UNDERSTAND...
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Date:
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8/3/2009 7:02:16 PM
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...why we wish certain initiatives of the current administration will fail. Check out the article, written by the lead Alabama Democrat. Pay particular attention to point #5.
Joe Turnham: Reform is only way to save health care system in America
Joe Turnham
Alabama Democratic Party Chairman
Published: August 3, 2009
In less than a decade, the Medicare Trust Fund will be out of money. Health care costs and the private premiums for insurance are rising much faster than real wages.
Today, more than 50 million Americans have no health care insurance and bankruptcies associated with the lack of health care coverage are rising exponentially. More and more seniors are being forced to take on credit card debt to pay drug bills. Rural hospitals and clinics are closing at alarming rates. The contingent liability of entitlements and federal obligations now tops a whopping $54 trillion.
Denial of insurance to a citizen based on pre-existing condition and the overall lack of portability of your health insurance dooms many families. Being laid off from a job not only means loss of income; but more especially, it catapults a worker into an unaffordable COBRA; or, more likely, means loss of a family’s insurance altogether.
Health care spending as a percentage of GDP is approaching 30 percent and is eating more deeply each day into America’s industrial competitiveness. While America still offers the best health care and medical research in the world, it is costing more and more to deliver. In short, our system is broken and to maintain the “status-quo” or to “nibble around the edges” of reform will likely paralyze our economy long-term and force dramatic rationing of care.
President Obama and many diverse leaders of Congress today are pushing a comprehensive health care reform package that will keep our system from collapsing and give our country a way to balance our budget within a decade and allow universal coverage. There are five committees (three in the House and two in the Senate) with legislative jurisdiction over health care. President Obama has set forth primary objectives for reform but legislative efforts are being made as Congress goes into its August recess to reach broader consensus on a package for September consideration.
I support overall health care reform and the Presidential and Congressional efforts. The broader principles of reform are as follows: 1) Front load investment in health care prevention and wellness instead of only on treatment. 2) Intensively manage chronic disease groups such as diabetes/obesity that account for the bulk of health care expenditure. 3) Make health care coverage universal without eliminating some for pre-existing condition. 4) Create cooperatives, or insurance pools underwritten by the government for those individuals that cannot qualify or afford private coverage. 5) Demand personal accountability and responsibility from each American relative to achieving and maintaining healthier lifestyles and habits. 6) Close loopholes in drug coverage for seniors and allow competition to lower overall health care costs. 7) Utilize technological innovation by computerizing medical records and bringing drugs to market faster. 8) Guarantee choice, portability and universal access to affordable coverage.
Polls show the vast majority of Americans believe that we cannot afford to do nothing on health care reform. When fully informed about the President’s plan, a solid 58 percent of them support his initiatives.
Blue Dog Democrats, Republicans and others will offer modifications that should be considered. The costs of implementing health care reform must be spread out and become revenue neutral through savings, innovation and new fees.
Recently, our state passed mandatory automobile liability laws. In the past, those of us with car insurance paid a line item for those who did not have it. We changed that policy requiring everyone to purchase coverage.
Those without coverage or with poor coverage are costing the system every day already. Shared responsibility through health care reform is our only way to save the healthcare system.
Joe Turnham lives in Auburn and is Alabama Democratic Party Chairman
Barneget's thoughts --
This is yet another example of Prius drivers writing the rules for the road. Like Mr. Turnham, I too support overall health care reform. Included among my concerns with the Presidential and Congressional efforts, is the broader principle of reform, highlighted by the Democrats, and included by Joe as point #5) “Demand personal accountability and responsibility from each American relative to achieving and maintaining healthier lifestyles and habits.“
At the risk of sounding like some right wing extremist, I am left with the following question—where do the Democrats begin to define intrusion? How much government intrusion is too much?
URL: http://www2.oanow.com/oan/news/opinion/joe_turnham/article/joe_turnham_reform_is_only_way_to_save_health_care_system_in_america/85992/
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| Name: |
wix
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| Subject: |
Understanding the past..
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Date:
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8/3/2009 10:52:09 PM
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Having spent the past 30 odd years in and around the health care industry, I can share a few observations that may explain how we got in this mess. From Medicare's inception the government paid hospitals on a cost plus basis. If a bottle of IV fluid cost the hospital $1.00, the Fed's would pay $1.08, 8% as the + factor. Medicaid was non-existant and insurance companies paid billed charges or close to it. Hospitals soon learned that cost plus was pretty good as long as they could keep ratcheting up the costs; the + factor, while low, wasn't too bad. Insurance companies and personal pay made up the difference.
Then in the 80's Congress gets really smart and changes the reimbursement system. Now Hospitals would be paid under the DRG Program. Diagnosis Related Groupings were the magical way the Feds could get ahead of the industry by paying a set amount for a patient's hospital stay based on the diagnosis of the patient. If the patient was admitted for a stroke the hospital knew up front they would receive, say $10,000 from Medicare, regardless of how long they had to warehouse the patient. For the hospital to make money they had to get that patient out of the hospital ASAP. So they ship the patient off to Health South for re-hab. Notice HS was born about this time. Now the Feds have to pay the hospital, plus they have to pay Health South, plus home health care, ++++. A whole new facet of the industry is born out of the wonderful DRG program. Ain't they smart.
Outpatient Surgery Centers are born about this time to move procedures out of the hospitals, so that reimbursement is greater. Now the surgical patient gets sent home sick, to save money.
Next the experiment in socialized medicine called HMOs is born. This experiment lasts about 10 years and is largely rejected by Americans, or is hated by those still inflicted with HMOs. As more and more procedures are moved out of the now poor hospitals, physicians gain more and more power (and money) by having control over the patient. The physicians also own surgery centers, imaging centers, re-habs, etc. Since they control the patient they also control what happens to the patient, where he has MRIs, what lab tests are necessary, where surgery is conducted, etc. Get the picture; it ain't pretty. Yes, there are "safe harbor laws" that are supposed to prevent the above, but these laws are useless.
The above is a very simplistic explanation with many steps left off for brevity, but it'll give an idea of the problem.
What to do to correct the mess? I'm not nearly smart enough to make a suggestion, but o-BAMA is not even addressing the problem. All he is advocating is giving a bunch of his sorry, lazy, worthless followers free insurance so they will vote Democrat every time. Yes, the system needs fixing, but not his way.
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| Name: |
Barneget
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| Subject: |
Understanding the past..
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Date:
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8/3/2009 10:57:36 PM
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wix, great post, thanks for sharing some results of prior, short sighted, government decision making.
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| Name: |
Council Roc Doc
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| Subject: |
Understanding the past..
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Date:
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8/4/2009 11:35:38 AM
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Wix, while I appreciate your historical perspective, your comments regarding out-patient surgical centers, doctor owned imaging centers etc seems to indicate that these were developed with only profit in mind. In my specialty, private insurance companies began to eliminate certain procedures from their coverage list, procedures that patients, quite matter of factly, benefit from and need that vastly improve the quality of life. Patients who need these procedures could not afford to pay out of pocket for the procedures not covered as well as hospitalization. Out patient surgical centers provided a cost effective option for these patients. They could operate more efficiently than hospital OR's and charge the patient a fraction of the cost, and the patient could still afford the surgical package. Physician owned imaging centers attempt to keep billings in house. What is so wrong with that if it is more efficient, convenient and cheaper than hospital imaging centers? To suggest that the medical community on the whole has developed an off site medical community only for control and dollars is disingenuous.
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| Name: |
wix
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| Subject: |
CR Doc..
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Date:
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8/4/2009 3:10:17 PM
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I agree the surgery centers have been a great addition to the medical community. If I remember correctly, surgery centers were developed by hospitals so that they could operate without the high overhead of the hospital based OR. With the advent of minimally invasive surgery, plastic surgery, and other well patient procedures the surgery center has flourished, while the hospitals have floundered.
My experience includes business development and building of physician owned surgery centers and imaging centers and I do not recall meeting with any potential physican investors who did not have a profit motive as the primary reason for starting the business.
Nothing wrong with that, unless it clouds your priorities. It does bother me that the 2.0 MRIs and 64 slice CTs are almost all in hospitals while much cheaper equipment in off site centers receive pretty much the same reimbursement.
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