OT: a debate on US health care

Don

I served 20 years in the USMC and as a result, I have Medical Insurance through DOD for the rest of my life. I opted for the Standard Plan for which I pay 25% copay and don't have to go to the military hospitals and medical facilities; we pick our own doctors. We bought a gap insurance through the Retired Officers Association that covers the copay. We are delighted with it and hope that a public option plan will not override it.

I am seeing that other countries, even liberal ones, are warning us about the direction we are heading; plus it gets bad when Hugo Chavez refers to our President as "Comrad"...that is NOT even funny.

I just noticed on Open Congress.com, that the Senate does not think they have the votes to get a public option health plan through to compete with private plans. We'll see...both my Senators are Democrats (one used to be the Secretary of the Navy), but both seem to have a sense that we are not doing the right things with expanding government. In their letters to me, they have expressed concern with our debt. My Congressman though, is another story.

Well, I certainly do keep my representatives informed...they certainly know how I feel.
_________________
Don B
Dec 07 Dx Follicular NHL, Grade I (Indolent)
Stage IIIA - No Symptoms
Watch and Wait - 6 Month Checks
Jan 09 Scan shows Progression - no symptoms
May 18, 09 - Started R-CVP
After Third Round, CT scan showed some tumor shrinkage
July 31,09 - Completed 6 Rounds R-CVP

dano

Good to hear some discussion over something that will touch every one. I pretty much am in agreement with PBJ and Don in my view point. As health Care goes it going any better than any thing else the government get a hold of. With our current system, Tort reform I believe could be the magic bullet to turn a lot of things around. I am wondering if the legal field has thought this through very well. If government gets into the health care business, and runs the doctors then who will the lawyers sue? Kind of a Tort reform sorta, can't sue the state right? Anyway my hope is not in this world and the way things are going it is a good thing it's not.
Dan
_________________
55 year old male, Diagnosed Nov. 9,2007 with NSCLC IV with Mets to the lymphs and brain
Had full brain radiation treatment in Jan 08 treatments now every 4 weeks with Alimta, taking Lovenox for blood clots, Now working full time
http://cancerforums.net/viewtopic.php?t=9993

Don

Everyone should watch these videos...in my opinion, he is right on!!

http://www.youtube.com/watch?v=jO_QGwKx_rE&feature=channel

...then watch:

http:/www.youtube.com/watch?v=fvd4HXnK788feature=channel
_________________
Don B
Dec 07 Dx Follicular NHL, Grade I (Indolent)
Stage IIIA - No Symptoms
Watch and Wait - 6 Month Checks
Jan 09 Scan shows Progression - no symptoms
May 18, 09 - Started R-CVP
After Third Round, CT scan showed some tumor shrinkage
July 31,09 - Completed 6 Rounds R-CVP

Don

Whoops...my last post had a wrong link for the second video:

http://www.youtube.com/watch?v=fvd4HXnK788feature=channel
_________________
Don B
Dec 07 Dx Follicular NHL, Grade I (Indolent)
Stage IIIA - No Symptoms
Watch and Wait - 6 Month Checks
Jan 09 Scan shows Progression - no symptoms
May 18, 09 - Started R-CVP
After Third Round, CT scan showed some tumor shrinkage
July 31,09 - Completed 6 Rounds R-CVP

Don

The second video is still wrong:

http://www.youtube.com/watch?v=hfvd4HXnK78&feature=channel

I hope it is right this time.
_________________
Don B
Dec 07 Dx Follicular NHL, Grade I (Indolent)
Stage IIIA - No Symptoms
Watch and Wait - 6 Month Checks
Jan 09 Scan shows Progression - no symptoms
May 18, 09 - Started R-CVP
After Third Round, CT scan showed some tumor shrinkage
July 31,09 - Completed 6 Rounds R-CVP

dano

That is a great video Don
_________________
55 year old male, Diagnosed Nov. 9,2007 with NSCLC IV with Mets to the lymphs and brain
Had full brain radiation treatment in Jan 08 treatments now every 4 weeks with Alimta, taking Lovenox for blood clots, Now working full time
http://cancerforums.net/viewtopic.php?t=9993

Don

Dissecting the Kennedy Health Bill by Ms. McCaughy
No, you won't be able to keep your insurance if you like it.

Last September Sen. Barack Obama promised that under his health-care proposal "you'll be able to get the same kind of coverage that members of Congress give themselves." On Monday, President Obama repeated that promise in a speech to the American Medical Association. It's not true.

The president is barnstorming the nation, urging swift approval of legislation that is taking shape in Congress. This legislation -- the Affordable Health Choices Act that's being drafted by Sen. Edward Kennedy's staff and the Health, Education, Labor and Pensions Committee -- will push Americans into stingy insurance plans with tight, HMO-style controls. It specifically exempts members of Congress (along with federal employees; the exemptions are in section 3116).

Members of Congress "enjoy the widest selection of health plans in the country," according to the U.S. Office of Personnel Management. They "can choose from among consumer-driven and high deductible plans that offer catastrophic risk protection with higher deductibles, health saving/reimbursable accounts and lower premiums, or fee-for-service (FFS) plans, and their preferred provider organizations (PPO), or health maintenance organizations (HMO)." These choices would be nice for all of us, but they're not in the offing. Instead, if you don't enroll in a "qualified" health plan and submit proof of enrollment to the federal government, you'll be tracked down and fined (sections 3101 and 6055).

For a health plan to count as "qualified," it has to meet all the restrictions listed in the legislation and whatever criteria the Secretary of Health and Human Services imposes after the bill becomes law. You may think you're in a "qualified" plan, but the language suggests that only plans with managed-care controls such as the "medical home" will meet the definition (sections 3101 and 2707).

"Medical home" is this decade's version of HMO-style insurance, according to the Congressional Budget Office, with a primary-care provider to manage your access to costly services such as visits to specialists and diagnostic tests. Medical home providers in "qualified" plans, states the Kennedy bill, will have a "payment structure" based on "incentives" rather than payments for each doctor visit or procedure (section 3101).

These requirements are reminiscent of the unpopular controls HMOs imposed two decades ago that caused public outrage and led to state laws reining in abuses. In December 2008, a Congressional Budget Office report evaluating early drafts of major federal health insurance proposals noted that "medical homes" were likely to resemble the HMO gatekeepers of 20 years ago if cost control is a priority.

That report specifically referred to a payment incentive called the "withhold." When HMOs became dominant in the early 1990s, they would withhold 10% or more of physicians' fees until the end of the year and give it back only to the physicians who met targets for limiting how many referrals to specialists or diagnostic tests their patients used.

The targets were so stringent that, if they were exceeded, what a doctor prescribed for you came out of your doctor's own pocket at the end of the year. This set up a conflict of interest between you and your doctor.

Mr. Obama tried to put a positive spin on such cost controls in his June 13 weekly radio address. He said "if doctors have incentives to provide the best care, instead of more care, we can help Americans avoid unnecessary hospital stays, treatments and tests that drive up costs." Fair enough -- if you want your doctor paid to police your care and to be financially penalized for that extra test or referral you get.

It is reasonable to require that people who accept a government subsidy for health insurance tolerate cost controls to protect taxpayers. But according to the terms of the Kennedy bill, you must enroll in a "qualified" plan or face a fine, even if you and your employer are paying the entire cost of the plan you already have (section 161).

The president has promised that if you like your plan you can keep it. Mr. Kennedy's bill says that too. It's doubletalk, as the consequences of nonenrollment make clear. How big a fine will you face? The bill doesn't specify or set a limit. It says the fine will be enough to "accomplish the goal of enhancing participation in qualifying coverage" (section 161).
If legislation similar to the Kennedy bill lands on Mr. Obama's desk, he has an obligation to keep his promises to the American people and veto it. And whatever health-insurance law is passed should apply to members of Congress. If it isn't good enough for them, it shouldn't be imposed on the rest of us.

Ms. McCaughey is chairman of the Committee to Reduce Infection Deaths and a former lieutenant governor of New York state.
_________________
Don B
Dec 07 Dx Follicular NHL, Grade I (Indolent)
Stage IIIA - No Symptoms
Watch and Wait - 6 Month Checks
Jan 09 Scan shows Progression - no symptoms
May 18, 09 - Started R-CVP
After Third Round, CT scan showed some tumor shrinkage
July 31,09 - Completed 6 Rounds R-CVP

Don · Posted: Mon Jun 22, 2009 9:30 am Post subject: My Congressman's Response

This is a response I got from my Congressman...he forgot to fill in the blank with the issue that I contacted him about. So much for thinking that they are really listening to us. I feel like I am being backed up against a wall...defenseless! This is NOT a good feeling.

June 22, 2009

Mr. Donald BXXXXX
XXXXXXXXXXXX
XXXXXXXXXXXX

Dear Mr. BXXX,

Thank you for contacting me about _________. I appreciate your interest in this issue and your views are important to me.

As a Member of Congress, it is essential that I know my constituents' thoughts and concerns so I can best represent their interests in Congress. I will continue to watch this issue closely going forward to determine if any Congressional action is necessary.

Once again, thank you for expressing your concern on this very important issue. I enjoyed hearing from you. For more information on my views on other issues, please feel free to visit my website at http://connolly.house.gov. I also encourage you to visit the website to sign up for my e-newsletter.

Sincerely,

Gerald Connolly
Member of Congress
_________________
Don B
Dec 07 Dx Follicular NHL, Grade I (Indolent)
Stage IIIA - No Symptoms
Watch and Wait - 6 Month Checks
Jan 09 Scan shows Progression - no symptoms
May 18, 09 - Started R-CVP
After Third Round, CT scan showed some tumor shrinkage
July 31,09 - Completed 6 Rounds R-CVP

pbj11 · Site Admin Joined: 12 May 2007 Posts: 2367

Hey Don,

At least you hear back in a timely manner.

Between Sens. Durbin and Obama, it took months for Durbin to reply and it was still a form type letter, but at least it was prepared to address the particular issue I had written about.

Obama's was an ultra generic type of acknowledgment like yours and then I was automatically signed up to receive his campaign literature. I'm still on that email list, as it is now being used to generate emails for contributions to the DNC.

Fortunately my Congressman lives in the same town as me and he well represents my stance on all issues, so I don't need to write to him.

I'm not seeing anything forthcoming that will really address the issue of health care reform and think it's DOA. The cost is too high in the face of all the frivolous "non-spending" spending of the stimulus, buying up car companies, and it's not going to cover the numbers of people that they envisioned. In addition, there have been numbers bandied about that say more people will end up losing their current coverage than people will gain coverage. It's hard to get a real reading of this whole ball of wax because so little is being released with hard facts and figures. I still say, and have said for years, the best place to start is Tort Reform. Period. Go from there.

Ain't Washington grand?

I keep writing though.

PBJ
_________________
Husband diagnosed with NSCLC Stage IV. (Non-Small Cell Lung Cancer) Fought & lived 2 1/2 years with multiple lines of treatment.

Post describing our battle: http://cancerforums.net/viewtopic.php?t=7026&postdays=0&postorder=asc&start=0

Don

Thank God for Fox News. If it wasn't for them, we would already have BHO's Birthday designatd as a Federal Holiday. Think of it: "Obama-Chavez Day".

Well...I hope that we will "see you" (spiritually) at a Protest Rally on July 4th. My wife and I will be attending one here in Prince William County, Virginia. We have a big "Don't Tread on Me" flag. We'll see how the news media covers these protests (or doesn't).

Goggle "4th of July Protest" and find one nearest you.

I also think that this ambitious US Health Care Plan is fizzling. Even Senator Feinstein is having second thoughts. I see the same parallels as "HillaryCare" in the early 90's. This failed in Congress because there were too many US Government edicts in it than is confortable for Americans; and if you think back, it was the spark which touched off the revolution leading to both Houses of Congress reverting to Republican control and for Presidenet Clinton to state: "The era of Big Government is over!"
_________________
Don B
Dec 07 Dx Follicular NHL, Grade I (Indolent)
Stage IIIA - No Symptoms
Watch and Wait - 6 Month Checks
Jan 09 Scan shows Progression - no symptoms
May 18, 09 - Started R-CVP
After Third Round, CT scan showed some tumor shrinkage
July 31,09 - Completed 6 Rounds R-CVP

Don

There is another Lymphoma forum in which the moderator is a "bit" more left wing than me. Perhaps I shouldn't make any posts while I am on Prednisone...I am sure I am about to get "kicked-off".
_________________
Don B
Dec 07 Dx Follicular NHL, Grade I (Indolent)
Stage IIIA - No Symptoms
Watch and Wait - 6 Month Checks
Jan 09 Scan shows Progression - no symptoms
May 18, 09 - Started R-CVP
After Third Round, CT scan showed some tumor shrinkage
July 31,09 - Completed 6 Rounds R-CVP

Don

This article was posted on Powerlineblog:

Does the Democratic Health Care Plan Ban Private Insurance?

July 17, 2009 Posted by John at 7:41 PM on Power Line Blog

That's a claim that is making the rounds these days, based on this editorial by Investors Business Daily:

• It didn't take long to run into an "uh-oh" moment when reading the House's "health care for all Americans" bill. Right there on Page 16 is a provision making individual private medical insurance illegal.
• When we first saw the paragraph Tuesday, just after the 1,018-page document was released, we thought we surely must be misreading it. So we sought help from the House Ways and Means Committee.
• It turns out we were right: The provision would indeed outlaw individual private coverage. Under the Orwellian header of "Protecting The Choice To Keep Current Coverage," the "Limitation On New Enrollment" section of the bill clearly states:
• "Except as provided in this paragraph, the individual health insurance issuer offering such coverage does not enroll any individual in such coverage if the first effective date of coverage is on or after the first day" of the year the legislation becomes law.

Is this a fair reading of the current House health care plan? Not quite. The bill doesn't exactly "ban" private insurance. Rather, the quoted provision is a "grandfather" clause that allows insurance plans that are not "qualified health benefits plans" to remain in existence for a limited time after the "reform" bill is enacted. Those plans--the ones that don't provide all the coverages demanded in order to "qualify" under the proposed statute--are indeed prohibited from enrolling new members.

So Barack Obama's constant assurance that, if you like your current coverage you can keep it, is misleading at best. You can keep it for a while, but your company can't enroll any new members in the plan, and if you change jobs, you're probably out of luck. "Non-qualifying" plans are obviously slated for extinction; if they can't enroll new members, they can't survive for long. When the "non-qualifying" plan that you like ceases doing business, you, too, are out of luck.

The Democrats would say, of course, that this doesn't mean they are "banning private insurance." Rather, once their plan goes into effect, all private insurance will have to "qualify" by meeting the criteria that are partly set out in the statute, but are to be developed more fully by a panel that will be appointed by the government. What that means in practice is that a private insurance plan will be allowed to exist only if it is the same as the government plan. Since the government plan will be taxpayer-subsidized, no private plan will be able to compete effectively with it if the private plan is required to provide the same coverages. So the consumer--you--will have no choice. You will have to buy the plan the government designs.

Private insurance companies would easily be able to compete with the government plan if they could offer coverages tailored to the needs of consumers. For example, you might not plan on getting an abortion, so you don't need abortion coverage. You might be willing to forgo mental health coverage. But you won't have any such choice: "qualified" plans, the only ones who can legally enroll new members, will have all the features required by the federal government.

The Democrats' intention, obviously, is to drive private insurance into extinction so that we wind up with a "single payer" system, i.e., socialized medicine. In fact, in the health care proposal that Barack Obama put up on his web site during the campaign, he made it explicit that no private carrier would be allowed to compete with the government by offering a cheaper health insurance policy. That goal is achieved in a slightly different way by the proposals the Democrats are now debating.

So, while it isn't quite correct to say that the House bill "bans private insurance," it certainly is correct that the bill is intended to destroy competition and your opportunity to pay for your health care through a private carrier.
_________________
Don B
Dec 07 Dx Follicular NHL, Grade I (Indolent)
Stage IIIA - No Symptoms
Watch and Wait - 6 Month Checks
Jan 09 Scan shows Progression - no symptoms
May 18, 09 - Started R-CVP
After Third Round, CT scan showed some tumor shrinkage
July 31,09 - Completed 6 Rounds R-CVP

Don

Ask your Senators and Congressman to take this pledge:

My Pledge to My Constituents on National Health Insurance

1. I will not vote to expand the bankrupt Medicare program unless and until it is first placed on a sound actuarial basis.

2. I will not vote for any national health insurance legislation that includes a public plan unless I am prepared to enroll myself and my family in the public plan. If a national health insurance bill with a public plan passes the Senate with my vote in support, then I pledge to enroll myself and my family in that public plan.
_________________
Don B
Dec 07 Dx Follicular NHL, Grade I (Indolent)
Stage IIIA - No Symptoms
Watch and Wait - 6 Month Checks
Jan 09 Scan shows Progression - no symptoms
May 18, 09 - Started R-CVP
After Third Round, CT scan showed some tumor shrinkage
July 31,09 - Completed 6 Rounds R-CVP

Don

I just got an e-mail from my brother who is the Director of Transportation for a growing county near a major East Coast city. As such, he has to negotiate contracts with suppliers of goods and services. I did not edit his message for grammar, but here is a synopsis of what he is saying:

1. Suppliers will not sign any contract unless it has an “opt-out” clause should the Health Care Bill be enacted.

2. They perceive that the proposed additional costs and taxes associated with the proposed bill will extend beyond their calculated profit margin, thus putting them out of business. I don’t know how they figure this but I suppose, like any industry, they have their “watchdogs” on Capital Hill.

3. They calculate their profit margin to be 10% of their gross receipts; fair enough for such an industry. He worked for such a private firm before he got his County job, so he is aware of the profit margin of that particular industry.

4. The wife of one of his friends is from Sweden, where they have National Health Care, and their National Income Tax is a flat 60% (I did not check this out…I suppose it is true).

Here is the text of his message:

I had a meeting today with the president of the transit contracting firm that provides our services for the county - we just renegotiated a three year deal and were signing off on the amendments. He said they are not signing any further contracts that do not include provisions to reopen them pending the outcome of the national health plan, which I really had no choice but to agree to. He said that several versions will simply put them out of business. They are a $750 million a year company and some versions will cost them an additional $80 million. I was in that business until this year and know that about 10% profit margins are what you shoot for. Think of what this is going to do to small business. We had friends over Saturday night and one couple, the wife is from Sweden. She said that there, they have a 60% flat tax, no deductions of any kind. Talk about redistrubuting the wealth.
_________________
Don B
Dec 07 Dx Follicular NHL, Grade I (Indolent)
Stage IIIA - No Symptoms
Watch and Wait - 6 Month Checks
Jan 09 Scan shows Progression - no symptoms
May 18, 09 - Started R-CVP
After Third Round, CT scan showed some tumor shrinkage
July 31,09 - Completed 6 Rounds R-CVP

Don

--------------------------------------------------------------------------------

AMA on the health care changes--
Apparently the American Medical Association has weighed in on the new
economic health care proposals.......
The Allergists voted to scratch it, but the Dermatologists advised not to
make any rash moves.
The Gastroenterologists had sort of a gut feeling about it, but the
Neurologists thought the Administration had a lot of nerve.
The Obstetricians felt they were all laboring under a misconception.
Ophthalmologists considered the idea shortsighted.
Pathologists yelled, "Over my dead body!" while the Pediatricians said,
'Oh, Grow up!'
The Psychiatrists thought the whole idea was madness, while the
Radiologists could see right through it.
Surgeons decided to wash their hands of the whole thing.
The Internists thought it was a bitter pill to swallow, and the Plastic
Surgeons said, "This puts a whole new face on the matter."
The Podiatrists thought it was a step forward, but the Urologists were
pissed off at the whole idea.
The Anesthesiologists thought the idea was a gas, and the Cardiologists
didn't have the heart to say no.
In the end, the Proctologists won out, leaving the entire decision up to the a--holes in Washington.
_________________
Don B
Dec 07 Dx Follicular NHL, Grade I (Indolent)
Stage IIIA - No Symptoms
Watch and Wait - 6 Month Checks
Jan 09 Scan shows Progression - no symptoms
May 18, 09 - Started R-CVP
After Third Round, CT scan showed some tumor shrinkage
July 31,09 - Completed 6 Rounds R-CVP

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