Most Adventist Health Care Organizations Pleased with Supreme Court Decision
by AT News Team
Politicians reacted along party lines last Thursday when the Supreme Court announced its decision on the Affordable Care Act of 2010, the signature legislation of President Barack Obama’s administration. But almost all health institutions affiliated with the Seventh-day Adventist Church welcomed the outcome.
“We are pleased that the court has upheld the Affordable Care Act, including the individual mandate,” said a statement from Adventist Health, the organization that controls most of the denomination’s health institutions in the Pacific and North Pacific union conferences, published in the Ukiah Daily Journal and other California newspapers. “Without the mandate … we believe that the other provisions such as elimination of the pre-existing condition ban would be financially difficult to implement. We also believe that the uninsured problem would have continued to grow, putting greater pressure on hospitals to continue to subsidize care.”
Hinsdale Adventist Hospital provided a statement to the Chicago Sun-Times that said, “We look forward to the benefits that will come to our patients with the increased access to insurance coverage provided by the … Act.” The four Adventist hospitals in the suburbs of Chicago “have been implementing measures to improve the quality of care and reduce costs,” the newspaper reported.
“We recognize that the health reform bill is not perfect,” Dennis Kiley, chief executive of Emory-Adventist Hospital in the suburbs of Atlanta, told The Marietta Daily Journal. At 88 beds, this is a community hospital of modest size, but it treated more than 25,000 patients in its emergency department last year. This where hospitals end up having to care for people that the system otherwise fails to connect with.
“Our organization has provided health care for over 100 years,” the Adventist hospital in Gordon County, Georgia, told the Calhoun Times. “We will continue to work with others, including Congress, to create a system that reduces the overall cost of health care, builds a healthier community and improves outcomes and patient experience.”
Kevin A. Roberts, chief executive of Glendale Adventist Medical Center in southern California, gave the Glendale News Press one example of the improvements it is making. The recent launch of its Adventist Health Physicians Network “provides a much broader, community-based way to care for our patients and this community,” he said.
“As the largest health care provider in Montgomery County,” reported the Gazette chain of suburban newspapers near Washington, DC, Adventist Healthcare “will continue to play a key role in the community’s medical needs.” It noted that William G. “Bill” Robertson, chief executive officer of the system that includes Washington Adventist Hospital in Takoma Park and Shady Grove Adventist Hospital in Rockville, “did not comment directly on the Supreme Court ruling.”
A lengthy interview with Richard Morrison, senior vice president for government affairs at Florida Hospital and president of the Adventist Health Policy Association, was published by the Orlando Sentinel today. He sees the controversial new law “as a shot in the arm for many in the ranks of the uninsured, put no panacea,” the daily paper summarized.
As a result of more people getting care, Morrison predicted that “we can expect a rise in patients who have neglected care. This would mean longer waits for appointments or increase use of emergency departments.” Also, there will be a “significant rise in the demand for physicians,” probably faster than it is possible to recruit and train more doctors. He based his predictions on the experience in Massachusetts where Governor Mitt Romney implemented a plan much like the new law approved by the Supreme Court last week.
Even if the Republican Party gains a majority in both houses of Congress and repeals the health care law, as it has vowed to do, “many of the changes being made now … will continue,” Morrison told the newspaper’s editorial writer, Darryl E. Owens. Health professionals are “moving forward with such items as electronic medical records, care coordination and those items that improve quality and outcomes. Even if ACA were repealed in its entirety, those improvements or reforms will continue.”
Many health professionals believe that as controversial as this law is, it does not go far enough. “The real challenge of the sustainability of Medicare as it exists today has not been met,” Morrison told the journalist.
“Many of our health administrators may not be happy with the political outcome of this decision,” a retired executive from an Adventist hospital told Adventist Today, “but they really don’t have much choice other than to embrace it and try to make the best of it,” He stated that a lot of the political rhetoric is “simplistic and out of touch with reality. And these guys have to deal with reality every hour of every day. It is unrelenting. Our health institutions exist in a torrent of change that they cannot turn off or hide out from.”
“The Adventist concept of prevention and proactive health habits is needed now more than ever,” a retired health professor pointed out to Adventist Today. “But a faith-based community is a better vehicle for teaching good health than a government bureaucracy. We need to help our country set aside the political games and focus on what will really make a difference for people’s lives.”
My applogies in advance for this, but what is up with America? As an Australian, I know my Australian Government introduced a type of private mandate some years ago, which said if you earned over a certain amount and didn't buy private health insurance the Federal Government would slug you will an extra levy on your tax bill. Do you think this was introduced by some sort of socialist – no – it was introduced by our conservative stalwart Prime Minister, John Howard. It boggles my mind that this is such a partisan issue in the US.
That said, I do understand the US is very different from almost every other Western nation, where the notion of a public healthcare safety net has long been recognized as a basic human right. I also understand the Australian law was designed to take pressure off our overworked mass public health care system, something the US doesn't really have.
It has always really surprised me that Americans see 'freedom' as the quintessential 'Christian' virtue – even if that is a right of the poor, homeless, the aged, the infirmed and the innocent to die for lack of basic standards found even in the Developing World. When I read the Gospel I don't get that same impression, and it would appear to me that Jesus' principal mission was to help these oft neglected people. All I can say is thank God for Adventists, who I believe have the second largest private health and education system in the US and around the world.
Stephen, here is where I have a problem with healthcare being a human "right." We conservative Americans believe that "rights" are bestowed upon us by God and cannot be taken away by man. If our federal government creates a "right" (such as free basic healthcare) it can also, at some point, take away that right….which to me really isn't a "right." It's frustrating to me that so many believe the only solution to many of today's challenges can only be solved by the federal government. In my opinion, most of the healthcare challenges we face in America today stem from federal intrusion into healthcare several decades ago. The more the federal government tries to fix the mess it's made, the worse it gets. The solutions can be found in state and private sector initiatives.
In my opinion, many, if not most, of the health problems in the US are preventable. While some "conservative" Americans believe as Ed has indicated, those beliefs are not universal among those who consider themselves conservative–let alone, those who are more comfortable with labels like "moderate," "constructive," "progressive," or "liberal."
I'm also a little dubious about claiming things as fundamental "rights" for ourselves or others, when it seems to me that ensuring healthcare for all who need it is simple decency. Why would not Christians and adventists be at the front of the line seeking to make sure all receive due consideration and care?
Australia does not have quite the same problem regarding "states rights" versus the federal government that exists in the US. In the US we have 50 distinct states. In Oz there are just NSW, Queensland, NT, Western Australia, South Australia, Victoria, Tasmania, and the federal district. This makes the situation in the US quite redundant (in the worst sense of the term) and, I think, inefficient. Having fewer "states" to deal with in Australia is a blessing, and it is quite interesting to hear a perspective from another country. In my opinion, the US should pay more attention to what works or doesn't elsewhere.
This issue is much more complicated than would be evident from the reports by the media. In the State in which I live, there are only a couple of options for health insurance. It's nearly a monopoly, and for that reason is prohibitively expensive. My family cannot afford it. By contrast there are numerous auto insurance companies from which to choose, and the rates are reasonable. If there were more options; more insurance companies competing for your business, the rates would come down. Then there is the issue of how the feds figure the "adjusted gross income" of those who are self-employed. We have a lot of "phantom income," which we never see (except as it passes through our hands on the way to cover expenses which are not deductible), but on which we are taxed as if we took it home. That puts us in a higher income bracket, which excludes many of us from any subsidies available to those who can't afford health insurance. Our solution so far has been to stay healthy. 🙂 In two years we will be forced to pay the tax (the penalty that our fearless leader insisted was not a tax)–and still not have health insurance–unless more options for health insurance become available by allowing more insurance companies to operate in our State.
As a self-employed person who worked for many years in a small business, let me respectfully suggest, Jean, that you seriously consider how you calculate you taxable income. You really should be able to find a way around paying tax on what you refer to as "phantom income." The costs of doing business are, in principle, deductable, including costs associated with employing people. The owners of many small businesses put themselves on the payroll, thus separating their own tax liabilities from those of the business. And, in many cases, people do this so the business pays for benefits like health insurance in the same way as it does for the other employees. One might also wish to check into "self insurance" programs to see whether or not these qualify. The health care law is not as good as it could have been. A very good case has been made for the relative efficiency of a "single-payer" system. Part of the point of trying to expand coverage is so we are not paying the hidden costs of expensive treatment of the uninsured in emergency rooms rather than lower cost clinics. In what universe is it not Christian to try to address everyone's health needs?
Joe, I agree with your statement, "In what universe is it not Christian to try to address everyone's health needs?" As Christians, it is our duty to bring comfort and healing to all who are afflicted. We should be — and in many cases are — doing this voluntarily through individual and corporate (Christian hospitals) efforts. The "rub" is when we assume that as Christians we should "force" everyone to be taxed (with the threat of jail if you don't comply) to create federal governmental programs to do this instead. The societal/governmental goal of meeting everyone's health needs is laudable but the method by which it is achieved is not, unless it is done so through individual and charitable organization efforts (or in the U.S. through constitutionally acceptable state government initiatives).
Thanks for the advice, Joe, but so far I haven't found a way, in spite of talking to other small business owners who are in the same boat, as well as my very efficient accountant. Having kids in college helps with deductions now–but it still doesn't make health insurance affordable. Many of my self-employed customers have no health insurance for the same reasons. The per capita income in our area is not very high. Taxes are.
There is a tax penalty that would be paid by those who refuse to participate, while there are tax incentives for those who join in and participate. The number of people unwilling to participate will be a very small number, smaller, I'd guess, than if there were no penalty.
Now, it seems to me that healthy living is its own reward, at least in part. I understand why those who are committed to "social Darwinism" might be unwilling to support caring for others, if they see the world as a place where they are competing for survival, but why would adventists be so reluctant to participate?
I think some rationing is essential. I certainly do not need any organ transplants, although I am willing to donate my organs. Universal and equal access to transplants, regardless of age or financial status, seems excessive to me. I would be more supportive of a system that incentivized health and healthy living and was less designed to serve the providers of insurance and health care businesses. We are waaaaaaaay over medicated at present, but that is currently where the incentives lie. Basic healthcare for the neediest certainly does not need to be the "Cadillac" style, but poverty should not be a death sentence, either.
I really enjoy all the comments. It certainly is a totally different way of thinking from Australia, and as I understand it, the rest of the Developed World.
Can I ask a simple question? Do you think you really have the best type of political system and political philosophy where you pay the most per captia for healthcare and yet you only have the 37th best healthcare in terms of quality in the world:
http://en.wikipedia.org/wiki/World_Health_Organization_ranking_of_health_systems
Could adventists develop a qualifying insurance system that would only be open to themselves or healthy-living people that would be self-supporting and affordable?
I do not see many things as black-and-white. I'm confident that there are better options than the bill that was passed. It was passed because it could be. Apparently, Congress would not have passed something better–and why is that? Were there too many special interests that were not congruent with the interests of the citizens?
We can and should be able to do better than we are doing….
Universal Healthcare for Adventists (UHA).
Insuring everyone in the church and making the adventist healthcare system available to them would incentivize membership too, although, some could say for the wrong reasons, but wouldn't it all be consistent with the health message? Maybe in some special ways that would provide appropriate legal bases.
I was delivered by an adventist country doctor who was a family friend. We visited each others homes, and his kids were friends with my sibs and me. I imagine he charged my family fairly. I never heard any complaints. Later, family friend physicians provided us with health care either gratis or at affordable rates, largely as a benefit because Mom taught in SDA schools. How well I recall while I was teaching in a one-room SDA school, we were practicing our male quartet repertoire one Sabbath afternoon, when I had an aching tooth. We were at the home of an adventist dentist. After sundown, he took me down to his office and painlessly extracted an impacted wisdom tooth–and would accept no payment. Health care doesn't resemble that much anymore–at least most places.
It will be different for Florida Hospitals as the governor has decided not to adopt the Medicaid assistance provisions which will mean the hospitals will continue to
be forced to care for all the indigent payments with no government payments via Medicaid. How could it not be a bad decision for them that Scott Brown chose?
With everyone enrolled in the health insurance the costs will be much more evenly distributed, exactly how life insurance is calculated: the very young and healthy and the old and sick all in one pool results in fair costs to everyone.
It is most amusing that this health plan brings up talk of "socialism" and "socialized medicine" yet everyone alive is either benefiting, or hopes to benefit from "Social Security" which began in 1933; and Medicare in 1965. Is there anyone alive who refuses to participate or receive benefits from those plans?
This, hopefully, will make single-payer health insurance more attractive: no more searching through thousands of insurance programs via the internet to find the one that best meets your needs. This is the way Mediare functions: everyone pays pays in, at 65 they can begin using it, choose their own doctor, and when it's accompanied by a Medicare "Gap" plan, there are only $100 copays for the first charges of the year. Physicians agree to accept what Medicare pays and their bills are NOT what they receive. Most physicians (except pediatricians) agree to accept Medicare patients (after all, the geriatric population is the largest user of medical services) and would lose most patients if they did not participate.
Yes, costs are going up, but the most efficient method is now being used by Mayo and Cleveland Clinic (?) which has a set payment for hundreds of conditions and procedures. This eliminates the vast difference between payments for the same identical procedure, even in a state. There is no need for an MRI brain scan for a headache, or a chest x-ray which was done two months ago; often caused by physicians who do not have available the results from other recent blood tests, etc. This computerized system tracks every patient within their entire network facilities and keeps costs much lower than other hospitals.
The fee-for-service must be eliminated if costs are to be contained. With preventive care covered under the new Health Plan, patients who formerly waited until a condition was serious and much more costly, such conditions can be diagnosed and treated at a much earlier stage and medically treated at that time. The Taxpayers are presently paying for the much more costly indigent ER admissions, so covering preventive care for these patients results in less taxes. It is the sensible way to provide health care.
Yes, the other first world countries shake their head at the U.S. which has, by far, the largest healthcare expenditure yet with much worse results. That's crazy-making. To claim that the U.S. has the best healthcare system in the world is to be ignorant of how it is apportioned.
The US also seems to have a very socialised army and police service, but I guess it isn't socialism when they are carrying guns. And to be fair, you also have plenty of private citizens with guns, which of course results in you having about the highest homicide rate per capita in the Western world as well.
Re the individual mandate, to echo Elaine, in Austraila the conservative government (yes again the conservative government) introduced its new law to ensure that young and healthy people buy health insurance and not just wait until they are old, otherwise, it puts an unfair burden on society and drives up insurance premiums. If I only take our health insurance after 30, I get slugged with a higher premium, which is fair in my book.
These are issues that I would have thought can and should be addressed by government, because as Elaine says taxpayers ultimately bare the burden in lost productivity, costs for ER admissions etc etc.
"Most" Adventist hospitals does not include Florida Hospital where the governor of Florida has refused the Medicaid system. This is a remarks from a Florida Hospital CEO in today's WaPo:
" Hospital associations agreed to help fund the law by accepting various cuts to their reimbursement rates with the expectation that they would be more than compensated by money from patients newly insured through Medicaid.
Now they worry that they will be stuck with only the downside of that bargain, said Bruce Rueben, president of the Florida Hospital Association.
“If you’re dealing with a high number of uninsured people and your payments from other sources go down, you have no way to cover that unmet cost,” he said.
Whether this Affordability is seen as good depends entirely on the states. Those who have refused the Medicare provisions which came with Federal aid, are the governors of a number of states, many where there are a majority of poor who have depended on the ER for care. Now, in those states, the hospitals will have to eat the costs, and the federal law prevents them from denying treatment. Taxpayers should fight their governors' decisions.
I also find it interesting comparing the different cultural mindset between Americans and Australia.
America was founded by very idealistic people, who were fleeing religious and political persecution, and who had to 'pull themselves up by the boot strings' to make their own life. You seem to all living under this illusion of the 'American dream', that anyone can be President if they just work hard enough. You also seem to be very wary of government – probably because your colonies (as precursors to your States) fought a bloody revolution against your Sovereign King, and were thus sceptical of the Federal Government that replaced it (probably evident in the Civil War that followed on the same issue).
The product of this appears to be an American philosophy that says if you are poor and can't afford health insurance it is your own fault – if people want to give you charity then fine, but no one should be obliged to do so – certainly not the government.
In Australia, by contrast, we were founded as a penal colony – largely because after the American Revolution there was nowhere to send Britains growing and overpopulated underclass. Our founders were little better than indebted white slaves (actually similar to the NT model, not the racial kind), who were often sent as convicts for petty crimes on account of their economic poverty in Britain (e.g. if you remember the Artful Dodger character in Dicken's Oliver). Our founders were not idealistic people, nor were they under any illusions that life was unfair and that they could succeed in life simply on account of working hard. As such, a key Australian value appears to be social justice and the notion of a 'fair go'.
We are also not as anti-government as you. As noted above, we have fewer States (only 6). Moreover, our Federation was formed by a vote, not a bloody armed struggle (we did once have a protest called the Eureka stockade, where some 15 people were killed – but that is akin to a Brazillian soccer match). Even in my State Western Australia, where there is still a bit of a successionist movement, there is a bit of a realisation that on the whole the Federal Government has been a source of greater good, not evil (e.g. Aboriginal rights).
The end result appears to be that Americans really do appear to value equality of opportunity (i.e. classical liberalism), although I would probably argue that is all an illusion (because obviously rich people ensure their kids get the sorts of education and opportunities poor people can't afford). Even your so-called conservatives are only really neo-conservatives, embracing conservative social issues, but I would argue you are not traditional conservatives at all but classical liberals. It is even funny that in the US 'liberal' means 'left-wing' whereas in the rest of the world it can mean economically right-wing (e.g. our conservative party is called the Liberal Party).
By contrast, Australians appear to value equality of outcome, realising our ancestors literally were all in the same convict boat. This is both a socialist (if you are left-wing) and a conservative (recognising that traditional conservatism founded by Burke, Disraeli and others value social cohesion and noblis oblige) value.
Anyway, I am not saying which system is better. To you Americans your system probably makes perfect sense – to me it is a little bonkers. However, I do really struggle to see how you can claim your philosophy can be called 'Christian', especially in light of Jesus teaching about the Good Samaritan, or the example of the early Church in Acts 2? Perhaps someone can explain it to me?
Sorry another and related question. SDAs typically view the 'Lamb-like Beast' in Revelation as representing the United States. I would be interested to know from people:
– What aspects in current and future America do you see as particularly 'lamb-like'?
– What aspects in current and future America do you see as particularly 'dragon-like'?
P.S. Those who don't believe the prophecy need not reply, because I hardly want a debate on whether the prophecy itself is correct. I am more interested to see if people may in fact have very different ideas on the 'lmab-like' vs 'dragon-like' qualities of the USA.
Lamb-like: the USA still has a constitutional democracy; still allows religious liberty (protests by some evangelicals notwithstanding); and for the most part it still adheres to the principle of separation of church and state.
Dragon-like: there is a growing chorus of voices against the principle of church/state separation (especially within the Republican Party), and it appears that to some degree the Constitution is being creatively interpreted to allow things that I'm not sure the founding fathers had in mind–such as a recent ruling on Eminent Domain (I believe it was Kelo v. City of New London), and the ruling that corporations are people and therefore can spend as much as they want on political campaigns. While the latter two may not have a direct bearing on the suppresion of religious liberty, it does indicate that the Constitution can be interpreted in ways that suppress freedom.
Great Jean – yes that was the sort of thing I was very interesting in hearing about – much thanks. Yes, all the talk about America being a 'Christian country' seems to really mean 'our version of Evangelical Christianity'. As much as many Americans, including many SDAs, hate hippie-loving athiest homosexuals, these people are hardly going to be the ones introducing Sunday law – it will be our fellow conservative Christians.
It is also interesting to see in the person of someone like Santorum, a Roman Catholic, has become somewhat of a darling of Evangelicals. Is this a move towards the fulfillment of Ellen White's quote about the hand of the Papacy reaching across to grasp the hand of Protestantism in America?
Do you also see the growing use of Executive Powers by the President, of both parties and partly because Congress has become disfunctional? For example, Bush was much criticised for Executive actions, but Obama has also used it on several occassions for drone strikes (including to kill US citizens), unauthorised war against Libya and Dream Amnesty. Even if these things are comendable, it does make one worry if these ends are justified by the means?
One would hope that the abuse of executive orders would be checked by either Congress or the Supreme Court. But in the current polarized climate of Washington, I'm not sure how much faith we should have in the checks and balances that exist–especially if one party manages to get control of the presidency and both houses of Congress.
It is not known enemies which we need to fear, but those "friends" who can become virulent enemies overnight. Remember, it is not the secular liberals and atheists who Adventists fear of enacting a Sunday law. Secularists are unconcerned about religion and have distinct dislike for the fundamentalist, even ranting homophobic and anti-abortion elements of a small, but very vocal segment of Christianity. What have Adventists done to counter these groups, some within their own midst?
Yes an interesting quirk from the history of my own country Australia is that when our colonies decided to Federate at the end of the 19th Century, it was our fellow Christian countrymen who wanted to enshrine in our Commonwealth Constitution the notion of Australia being a Christian country, including the importance of Sunday. It was actually the very small Seventh-day Adventist Church, working in a very unusual alliance with the main secularists and athiests of the day, who helped insert a separate of church and state clause (section 116) into out constitution.
I guess there is a very big danger in trying to find acceptance within the wider Christian community (which liberals routinely do embracing ecumenicalism) and conservatives do (who despite disliking ecumenicalism routinely join forces over many socially conservative issues such as gay marriage etc).
Question #1 – I don't care what individual political opinions are, but on the whole, who would most Adventists in the US vote for – Republicans or Democrats?
Question #2 – Who is more likely to introduce Sunday law – Republicans or Democrats?
Question 1–40 years ago I would have answered "Republican." Now I'm not so sure. Although Republicans are usually seen as being more Christian oriented; more conservative, and Democrats are seen as being more immoral and anti-religion, when all the dust settles I don't see much difference in the 2 parties. Many foolish policies (such as the Cuba policy) remain entrenched, no matter who is in control of the government; and all presidents claim to be Christians. Mitt Romney (a Republican) is Mormon; so is Democrat Darth Vader; oops, I mean Harry Reid. And yet in theory they are at opposite ends of the political spectrum.
Question 2–I don't think it matters. If things transpire as outlined in Great Controversy (and I believe they will) it won't matter which party is in control. It will be the people who demand a Sunday law, and the powers that be, whether Republican or Democrat, will acquiesce to their demands. Most politicians seem to be committed to expediency over principle.
"…Democrats are seen as being more immoral and anti-religion…." By whom? Republicans?
"Immoral" in the sense of not favoring government intrusion into matters of personal behavior (like libertarians)?
"Anti-religion" in the sense of not allowing any particular religion to impose its tenets or values as law?
So, we have had plenty of politicians of both parties who have exhibited what most of us would identify as "immoral" behavior. Neither party has a corner on moral behavior. But which one is more likely to try to impose a narrowly held or religiously based moral standard onto everyone?
All political operatives from both major parties (and other parties) bear careful watching.
My own perspective? Nearly independent (soon to be reflected in a registration change). I was first registered as a Republican, but I changed parties to vote for Eugene McCarthy (no, not Joe McCarthy or Charlie McCarthy), who was campaigning to end the Vietnam war.
The current gridlock is an abomination, in my opinion, with Democrats too diverse and disorganized to accomplish anything, and Republicans too cohesive and ambitious to support constructive bipartisan action. What we need is a commitment by those of all parties to collaborate and cooperate to achieve constructive progress. I'd like to see an emphasis on policies that serve the middle 80% well, while preserving the rights and well-being of the outliers. Even policies serving the middle 60% would be a great improvement.
Many of the impoverished citizens who live in states where the governors have turned down Medicaid will discover very shortly that they are in even worse conditions regarding their health than before ACA. Taxpayers will also continue to bear the burden of ER rather than preventive care that the Medicaid provision provides–for those states that will enact it.
"The societal/governmental goal of meeting everyone's health needs is laudable but the method by which it is achieved is not, unless it is done so through individual and charitable organization efforts (or in the U.S. through constitutionally acceptable state government initiatives)."
Very good point.
If individual and charitable initiatives were adequate, governmental action would not be needed; but,
is that the case? No.
So, why is the responsibility entirely at the state government level? Why should it not be both state
and federal?
It is, or should be, but the states can refuse to adopt the Medicare provisions.
I believe you mean Medicaid. My understanding is that many states are refusing to participate because of the onerous cost to the state after the initial Federal funds go away.
It will be interesting to look back a few years from now to look at the real costs of this boondogle as compared to the smoke and mirrors we have been fed to date.
Correct. I meant Medicaid; Medi-Cal in California.
Preventive medicine and health education would seem to be a priority in any kind of system. But when we don't have the big food businesses supporting us, it seems hopeless. Maybe if they were regulated in some way, we would be better off. If I have a hard time not eating sugery sweets, I can imagine those who haven't had the same circumstances for learning that I have and will never be able to make good choices as long as there is a fast food chain around the corner.
We would almost have to make "bad" foods and drink inaccessible or at least unpopular (like cigarettes have become).
Adventist health care executives have to say they are happy with Obama Care. Woe be to those who are subject to the long arm of the government through regulatory scrutiny and financial dependence if they oppose the policies of this administration. Why do you think so many of the President's bundlers and so much of his political donations come from big business and Wall Street, whom he villifies? Why do you think the health insurance industry supported Obama Care? If it is such a good thing, why has the Obama administration had to grant thousands of waivers to politically favored businesses?
In reality, Adventist medical care leaders, as well as other medical care leaders are quietly very worried about Obama Care. 1) It theoretically puts 30 million more people in the medical care system without any additional human or financial resources being added to meet the increased demand for health care services; 2) It will drive private insurance out of business, which is the end goal of most who favor Obama Care. For most people – especially seniors such as myself – the tax for not buying private medical insurance is far less than the premiums I now pay. I will drop private insurance for myself and my employees, knowing that when we need expensive medical care, we can't be refused coverage. Why wouldn't everyone do this? This reality will lead to the collapse of the private insurance sector and give rise to a national single-payer system where Adventist hospitals -whose mission is overtly religious – cannot survive the Constitution's anti-establishment ax.
There are many good things about a single-payer system. There is almost nothing good about Obama Care, which is the unworkable product of lies, politically corrupt compromises and under-the-table trade-offs. The problem with either form of universal medical care is that it imposes enormous constraints on freedom of choice, and turns the most intimate, personal details of our lives over to prying eyes and relentless grip of civil service protected bureaucrats and regulators rather than accountable democratically elected representatives.
Some might note that in the preceding post, I used the term "medical care" rather than "health care." Health care involves much more than medical care. Only by rhetorically labelling the problem as "health care" can central planners pretend that demographic health factors and lifestyle health issues, which their system oriented medical care delivery "solutions" do not address, are issues within their power to affect. By so doing, they distort the medical care problem in order to justify massive interventions.
Good health care is best promoted by freedom and personal responsibility. The best health care system in my life was my mother, who inculcated the habits of good health – commitment to God and Church, a positive mental attitude, gratitude, happiness, delayed gratification, good nutritional choices, self-sufficiency, industry, and personal responsibility. The most dramatic increases in life expectancy and health in the history of mankind were achieved without massive governmental intervention. The dramatic increases in the cost of medical care have paralleled the shifting of responsibility for medical care costs to employers and the government, with a concommitant sense of dependency and entitlement on the part of those who consume medical resources.
What do you think would happen to the price of food if a similar process had occurred, where third parties were responsible for feeding you and your family, and you could obtain, through your employer provided insurance or the government, the highest quality food in the world? That's right! The system would collapse under the weight of uncontrollable costs and insatiable demand. Pretty soon we would have food utopia -equal access for all, "cheap" food, and long lines. No one would starve – unless of course an unfortunate Holodomor or two – perhaps a general strike – intervened… But no need to worry about that – not in a wealthy country like ours where the rich can be made to pay for the "generosity" of central planners and the "charitable" sentiments of the intellectual elites. Why…we could have the best soup kitchens in the world.
Many of the metrics used to evaluate the U.S. health care "system" include things like auto accidents, murders, teen pregnancies, which increase the risk of infant mortality, and other life style choices that are the negative by-products of a free, highly diverse society, not our medical care delivery system. When you look strictly at what happens to people when they actually need medical care for conditions like cancer, diabetes, heart disease, joint problems, our medical care is by far the best in the world. Is it sustainable at present levels? Absolutely not! Does it need to be reformed? Most definitely! But throwing around platitudes, slogans, and corrupted studies with an 80% uncertainty factor (The WHO Report) as foundations for radical solutions that will increase government control, without addressing fundamental problems that create demand for medical care and indifference towards health care, is not an approach for responsible adults.
You reference a number of facts and statistics but I don't see a single cite to your authority. On a daily basis millions rely on government programs: fire department, public schools, police departments, public utilities, state universities, public parks (state and federal), transportation, etc. These systems haven't collapsed. Why is healthcare or "medical care" as you refer to it any different? Are you suggesting we do away with public education simply because you feel your mother was the best school teacher?
Would it not be absurd to argue that since you've never had a house fire or needed the fire department, you should be exempt from paying to support that public service? What if a fire broke out in your home and the fire department refused to put out the fire until you verified that you'd paid into a private fire protection fund?
There's nothing "radical" about these systems. Nor is it radical to have government funded health care. Indeed, this system has been in place in first world countries for decades. A form of it has been in place in this country since the enactment of medicare. If seniors are entitled to government funded health care, why should the rest of us be deprived simply on the basis that some don't want or need health care? Under that rational hotels in the South could continue discriminating against minorities; farmers in the Midwest could grow and sell as much corn as they wished, impacting the national price of corn; vendors in the northeast could sell milk as cheaply as they wished without regard for the effect on the national price of milk.
While I agree the government shouldn’t have unfettered right to control the people and their way of life, in instances where there’s a significant impact on people of this country, the government has a responsibility to ensure those in need are cared for.
Thank you for articulating your points so well, Cid. I could not have done it better. Really appreciated your comments.
For the millions formerly uninsured and using the ER, the availability of seeing a physician or PA for preventive care could offer savings in millions and most physicians are happily promoting this as much less expensive than the ER which is presently used by these patients.
Most all of the first world countries, none of which is richer than the U.S., provides healthcare for all its citizens. Did your mother's health system prevent need for any medical care? I have been a life-long vegetarian, never smoke or drank, yet I have had three joint replacements. Currently, there is no medical recommendation to avoid depletion of cartilage. Nor auto-immune disease, which was recently diagnosed. Many such conditions come with the longevity being seen in the population.
Medicare is a government-run program, and administrative costs are far less than private insurance. After all, there is only one reason health insurers are in business: profits. If they cannot show a profit, they stop operation.
Yes, the present ACA may lead legislators to recognize that a single-payer system is far more equitable and efficient. Why not a government single-payer healthcare system? The insurance companies are now deciding whether to pay, will the government be worse?
How many are ready to repeal these features: all children under 26 covered by parents? No refusal of pre-existing conditions? Just those two are changing health insurance, and offer lower rates when everyone is covered.
Elaine, WE CAN"T AFFORD IT! FIRST WORLD COUNTRIES CAN"T AFFORD IT! They are spinning out of control economically. Even with queueing up for medical appointments and elective sugery, the increasing costs of medical care in 1st World countries, now being imposed on shrinking generations of young people, are unsustainable. The First World countries that you admire are trying to move away from nanny state policies that are bankrupting them to find free market solutions that will increase personal responsibility and incentivize cost-efficient choices. There are two ways to lower health and medical care costs. 1)Competitive, free medical markets, or 2) rationing and price controls. Only the former has the potential for maintaining or improving quality in the process. As long as we refuse to accept the unequal prosperity which is the byproduct of free markets, we are doomed to the equal poverty which is the byproduct of command and control, centralized government.
Would you go out and buy a car that you couldn't drive until you had been making payments on it for four years, knowing that even when you could use it, you would still be going further into debt every year? Would it matter to you if the salesman convinced you that it was a better car than you presently have? Of course not. You wouldn't buy it unless you could afford it. This country is going into debt at the rate of 1 trillion dollars a year. Exactly how is that Christian or Biblical, much less rational, and how can any Christian justify imposing such staggering debt on our children and grandchildren in the name of justice and equality? Iraq and Afghanistan cost us what – a trillion dollars over ten years? We're now increasing our debt by that much every year with less military spending. Greed and envy have produced a numbing insanity that makes us think we can escape the economic abyss by stepping on the accelerator as we approach it.
Adults have to look at causes; children seek quick fixes. We are a nation of greedy children and resentful adolescents. It doesn't bode well for our spiritual or material future as a people.
From today's WaPo:
"Texas Hospital Association President and CEO Dan Stultz said hospitals agree with (Gov) Perry that the Medicaid program is “severely flawed,” but he added that “without the Medicaid expansion, many will remain uninsured, seeking care in emergency rooms, shifting costs to the privately insured and increasing uncompensated care to health care providers."
But there is always money for defense. This makes a world of difference: The U.S. spends more on defense than all the first world nations combined.
Yes, there are numerous problems and financial is the main one. But I haven't heard a solution, other than to let "nature take its course" where people die for lack of care and only the well will survive. Darwin's solution: "Survival of the Fittest"?
One suggestion: eliminate fee-for-service and list fees for hundreds of conditions and procedures. Eliminate costly tests; eliminate malpractice and negligent suits by having panels of peers approve only those that have real credit. Today, millions are paid to settle without going to court, a very costly choice, and games insurance companies' lawyers play–all driving up physician's insurance. Salaries for physicians. These are already being used in many large recognized medical centers.
Remove competitive health insurance. Competition is fine for selling cars and houses but medical needs are entirely different, and everyone, at some time or another will need medical care; not everyone must buy a car or house, and negotiation is part of the game in buying those products. Congress has long denied volume pricing and negotiation for phamaceuticals, which the V.A. does and Canada's prices are far less because they negotiate for drug prices. Why do you think that is? It's because the pharmaceutical lobby is one of the largest in D.C. and they have essentially written any bills affecting them.
Just a few suggestions.
"One suggestion: eliminate fee-for-service and list fees for hundreds of conditions and procedures" That sounds a lot like managed care or the fee schedules used by all insurance companies for decades.
If you recall the pharmaceutical industry became a big booster of Obamacare as soon as they took the Candadian option off the table. The trial attorney lobby made sure tort reform never saw the light of day. There are plenty more examples of sell outs to industry special interests to garner their support of the legislation.
When the process is as flawed and corrupt as this legislation became we shouldn't be surprised at the outcome.
If there were no for-profit health insurance companies there would be no fights over fees. This is the way Medicaire works: except for certain locational differences, rates and procedures are set and there are no middle-men like insurance companies who must make a profit. The government doesn't operate like a business (in spite of what Romney seems to think); Medicaire is not competitive and there is no profit to be made. Physicians MUST accept what Medicaire pays and cannot bill additionally.
There are few physicians who do not accept Medicaire but as the largest and sickest are the elderly, it would be almost impossible to practice without accepting Medicaire–unless one wishes boutique medicine. Medicaid patients have a much harder time as their fee schedules are so low that fewer physicians accept Medicaid patients.
Long before Obama became president, the pharmaceutical lobby worked to keep their drugs from being negotiated, as in Canada, and therefore, Americans pay more for the same drugs while the VA negotiates and gets much better prices.The lobbyists are spending large sums to prevent this from happening. Pharmaceutical companies have some of the largest profits of any single segment of the economy. Their CEO's income reflects this: healthcare, which should be a non-profit industry is one of the most profitable.
Oddly, the physicians who have long been opposed to single-payer universal health care have now rallied behind this. Billing so many separate insurance companies takes exorbitant time and money that could much better be spent caring for patients. One single payer would eliminate the many choices now: choices that most people are unable to evaluate. With everyone covered, or pay penalties, the costs would be evenly shared, unlike the present system.
It is hard to understand why everyone cannot be enrolled in a plan like Medicaire. Everyone has paid into the program, just as SS and once you beging using it, there are regular monthly premiums, plus most take out additional "Medi-gap" plans to augment costs and rarely have out-of-pocket costs.
Nathan, of course we can afford it. Have you seen what taxpayers contribute–I mean middle class and working class who bear the brunt of it all?
You appear so worried for our country's budget and purse-strings now that regular Americans might receive a break. How did you feel about the wars and Halliburton and our country going from the biggest lender in the world to the biggest borrower during the Bush years and taxpayor funded rebates going to corporations who moved manufacturing out of this country and , and, and…?
As someone who owns a clinic with my physician husband, I can tell you that big business and a financially broke government (Wars are expensive!) have contributed to this mess. That 40+ million working Americans don't have health coverage in this nation should be considered a SIN. Period. Single-Payer should have happened years ago, when we had a surplus. I visited Europe recently and those people don't accept the propanda as easily as we do when it comes to their health care. Greece has a national health plan even in their financial mess. And it's not because of their health plan that their country has problems. I understand we implemented a Nat'l Healthcare plan for Iraq soon after our invasion. So why not U.S. citizens? I think it's because we can be propagandized and polarized so easily.
Regarding all the comments about malpractice claims, etc., I can tell you that Tort Reform protects insurance companies, not patients who have received horrific medical care. Thank God most states don't inhibit a medical malpractice lawsuit! Truthfully, litigation is the only thing that barely keeps a check on inferior hospitals and lousy doctors. Take away this right or limit it, and we as Americans will get Third World care. In fact, our system is so broken, many Americans don't even realize how far good health care has dropped. I'm not talking about a missed ear infection, but life and death situations on a scale most of you would be shocked by. As it stands now HMO's are immune from serious claims and get away with murder. Truthfully, it is more cost effective to settle a few lawsuit claims (usually deaths) than spend the money on CT Scans, MRI's, non-generic medication, etc. etc. for thousands of their members.
So Nancy, help me understand how owning a clinic with your physician husband qualifies you to opine about the causes of our country's economic woes. I own a law firm. So what! And just because you strongly disagree with someone on an issue like this doesn't mean they have succumbed to propaganda. I may be wrong, but I am highly informed. Our differences have more to do with values and how we prioritize them than they do with information.
Moral hyperbole does not advance adult thinking. If 40 million uninsured working Americans is a SIN, then how can you morally reconcile your own standard of living with the far more significant deprivations experienced by 90% of the world's population? By those standards, the 40+ million uninsured in America live in luxury.
You say tort reform just protects insurance companies. So tell me, are medical care liability insurers more profitable in California? I don't think so. They just charge lower premiums. In free markets, lowered costs are passed on to consumers.Your hypothesis – that litigation is the only thing that keeps a check on inferior hospitals and lousy doctors – would suggest that California, with it's medical tort reform, has poorer quality medical care than other states without tort reform. And what about countries with single payer systems, where there are litigation constraints in place that make U.S. tort reform proposals seem like a litigator's paradise?
So who's being propagandized? I have been working exclusively as a medical malpractice litigation attorney for the past 22 years. You are just flat out wrong. Most med mal claims are NOT deaths, and I have never heard of an injury resulting from lack of access to imaging equipment. Compared with other countries, the U.S. has a glut of high tech medical equipment. It is never more cost-effective in the long run to settle cases that do not have merit than to defend them. In my experience, such cases represent about 50% of the claims that are brought by attorneys.
Nathan, surely you can give me some credit (expertise, as you would call it) for seeing firsthand thousands of insured and uninsured patients and the complications to their medical care they must endure because of this broken system. You seem to be well-read but you don't appear to really understand what the average American is going through. Reading about how it's not that bad does not qualify you as an expert. Neither does your law degree, frankly.
Furthermore, you are wrong about people dying from lack of proper studies that insurance companies don't want to pay for or a physician doesn't see as necessary. Happens all the time, sir.
I'm assuming you represent clients who are large institutions and medical malpractice defendents. It's very clear to me you don't understand the lack of recourse grieving family members have when they have to go up against HMO's and institutions you probably represent.
Furthermore, your statement, "By those standards, the 40+ million uninsured in America live in luxury", is just plain goofy reasoning. Human death through medical neglect is death no matter if you're in India or Indiana. You are committing the forbidden fallacies all over the place. Think back to college and remember the difference between a Valid arguement and a Sound one…
Nancy, since you insist on countering arguments I haven't made, arguing with you is pretty pointless. Where did I say medical mistakes don't cause death? I said you were wrong in asserting that most medical malpractice lawsuits have to do with death. In fact, only a tiny fraction have to do with death.
I never said you don't have an experiential understanding of health care. Rather I dismissed your suggestion that owning a clinic qualifies you to opine regarding the reasons for the nation's economic woes.
I can tell you with great confidence that reluctance to order studies, for financial reasons or otherwise,is almost never the cause of malpractice lawsuits. Rather it is the failure to properly interpret and act on evidence, because the medical care provider is not focused on what should receive attention. You may be an expert in delivering medical care. But I am confident that you have no working knowledge – at least I hope you don't – of what types of medical mistakes most commonly result in injuries and lawsuits.
Finally, did I say that human death through medical neglect is insignificant? Why don't you read what I said rather than reaching goofy conclusions that have nothing to do with what I actually said???
Just what college did you go to? I only went to U.C.L.A. Law School – I'm sure you had a much better education in logic and reasoning – but I confess that I never really grasped the difference between a "valid argument and a sound one." Perhaps you could enlighten me…? If you see a distinction, I feel greatly relieved that you see my reasoning as goofy.
Mr. Schilt,
With due respect, if as a mal practice attorney you are seriously contending that med mal tort reform does not just protect insurance companies you have either been lied to by your clients or are the most biased defense attorney I've ever encountered. There is no question tort deform was put in place to protect the bottom line of insurance companies – period. This is not even debated among those who are objective members of the bar across this country (at least those who know what they're talking about). I would be interested to hear who else you believe benefit from tort reform and damage caps?
I suggest you read the many studies done in Texas following the recent enactment of med mal caps and the quality of medical care. As an attorney, surely you know that exposure of liability (real liability as opposed to pocket change liability) is a significant driving force behind products being made safer (automobile seat belts, less famable clothing, safety features on home applicances). As an attorney, risk of a legal malpractice suit is a reason for your attention to detail, compliance with SOL deadlines, settlement releases and the like. If legal malpractice caps were passed, would you seriously contend that the quality of legal services would improve as opposed to decline?
Caps are not the answer to better healthcare. That notion is just as silly as one that legal services will improve by enacting legal mal practice caps. Divesting the people of a constitutional right to protect a company's bottom line is not only injustice but flies in the face of one of the basic principles this country was founded on – a country for the people by the people.
All you have done, Cid, is to offer a bunch of opinions. Stating your opinions dogmatically and forcefully doesn't make them facts. Have you read the legislative history of MICRA in California? Are you really seriously arguing that MICRA did not have an impact on rising insurance costs in California? The legislative justification had nothing to do with making insurance companies more profitable. You've offered no data, and quite frankly, I don't think a reliable study could be done to evaluate the impact of caps on quality of care. If it could, surely California, which has had caps in place since 1975, would be a good place to start. Perhaps you could cite me some of those "reliable" studies that have been done in Texas.
What you seem to be saying is that doctors and nurses are more cavalier about medical mistakes when they know that their patients can only recover $250,000 for general damages, even if the patient can still recover millions for economic and special damages (There are no caps for economic damages). They would take much better care of patients if they knew that a medical mistake might cost their insurance company a million dollars instead of $250,000, right? You can't be serious!
Your argument would support a public policy preventing health care professionals from purchasing any liability insurance, so that fear of personal liability for their mistakes will make them even more vigilant. Not such a good idea? I didn't think so. You're not really so concerned about avoiding medical mistakes as you are about making sure that the tort system keeps the wallets of trial lawyers fat through windfall recoveries for plaintiffs.
I did not argue that caps on recovery improve the quality of medical care. What I said is that they reduce the cost of malpractice insurance. For you to set up a straw man argument and then call it silly seems monumentally dishonest, but not atypical of the Left. As for legal malpractice, the fear of a lawsuit has never driven the quality of my work. I am a professional and I take pride in my work. I am also a human being, and know that I am capable of making mistakes and getting sued by unhappy clients even if I made no mistake. If there were caps on legal malpractice claims, I assure you it would not diminish the quality of legal services. Surely you do not believe that people would be worse drivers if there were say a $250,000 limit on recovery for pain and suffering in an auto accident? That is preposterous! You can argue that justice is thwarted when limits on recovery are imposed. But I don't see how any rational person who understands how caps on pain and suffering damages work could argue that such caps adversely impact quality of care.
And where is your authority that caps reduce the cost of liability insurance? I used texas as an example because the premiums did not decrease but increased and it is easier to measure given the recent enactment of reform. Doctors were flat out lied to and they are realizing it now in Texas.You admit to making mistakes so why should a client be prevented from being made whole when you mess up? Are your mistakes less critical than a mistake by say a department store that is negligent to a customer? That is what we said with med mal caps: the healthcare system is exempt from making an injured person whole (or as you incorrectly refer to it as a "windfall") because…well…because what they do is more important than what others to or what the injured person's quality of life was. Clearly there is no convincing you on this message board. You have been indoctrinated over your 22 years of insurance defense work and nothing I say or do here will ever change that. It is clear where your loyalty lies and that you are a "true believer".
The ranks of the uninsured today are equal to the combined populations of Oklahoma, Connecticut, Iowa, Mississippi, Kansas, Kentucky, Arkansas, Utah, Oregon, Nevada, New Mexico, West Virginia, Nebraska, Idaho, Maine, New Hampshire, Hawaii, Rhode Island, Montana, Delaware, North Dakota, South Dakota, Alaska, Vermont and Wyoming."
The states with the people most lacking in Medicaire have refused to accept the Medicaid program now offered. Where is their healthcare to be found? Who do you think will be paying for their only medical care that is given in the ER?
Typo: Second paragraph should read: "people most lacking in Medicaid…"
"The states with the people most lacking in Medicaire have refused to accept the Medicaid program now offered. Where is their healthcare to be found? Who do you think will be paying for their only medical care that is given in the ER?"
Elaine, I believe it will be the same people that pay for it now. Half the population that still pays taxes.
Yes, we taxpayers will continue to pay, but at much higher costs that the ER charges. Some are free riders, those who are well able to pay but choose not to.
This is where the penalty kicks in, as it should.
I wonder if it might be helpful to look at just who those 46 million uninsured are. A look at Census Bureau statistics shows that 9.7 million of them are not U.S. citizens. 17.6 million of them had incomes of more than $50,000 in 2007, and 9.1 million had incomes in excess of $75,000. In fact, Sally Pipes notes in Top Ten Myths of American Health Care: A Citizen's Guide, that those making more than $75,000 per year are the fastest growing segment of the uninsured population. 18.3 million were under 34. The HHS department estimated that 6.4 million of the allegedly uninsured actually are on Medicaid or S-CHIP but mistakenly tell the government they are not insured. Another 4.3 million are eligible for Medicaid or S-CHIP, but have simply not signed up because they haven't needed health care. When you subtract non-citizens, Medicaid/S-CHIP undercount, Medicaid/S-CHIP eligible, those who make over 300% of the poverty level, and childless adults between 18 and 34, there are about 10.6 million uninsured Americans left.
It kind of helps to put things in perspective, though I'm sure it won't change anyone's opinion. But isn't it interesting to see that if we focused on truly uninsured at-risk citizens who make too much to be eligible for Medicaid, but perhaps not enough to pay for medical insurance, we could address that problem without a government takeover of medical care. Of course, other reforms would still be warranted. But we could at least begin to talk as adults about reality instead of indulging in sententious pieties and pithy political slogans.
"those making more than $75,000 per year are the fastest growing segment of the uninsured population. 18.3 million were under 34."
Are you content with such free riders who are able to pay for insurance? This is where the penalty for not getting insurance is appropriate. Those on Medicaid are S-CHIP must qualify by low income. No longer will people be able to "wait" until they need healthcare and then let others pick up the tab. The former uninsured will now no longer be able to be uninsured. If they cannot afford it, the government will subsidize the cost of insurance; which, BTW, is much less than ER care. Makes economic sense to insure BEFORE the house burns down; or before your car is involved in an accident. If only sick pay for insurance, it's like only those who have been involved in accidents then are convinced to buy insurance at much higher rates.
Reality check, Elaine. Back in your day 75,000 smackers was almost like being a millionaire today. We've reached a time when some universities are offering full scholarships to students whose parents earn less than $100,000 a year. That gives us some idea of how far a dollar goes these days.
If I were prone to being offended I would take offense at your remark about "free riders." I haven't had medical insurance for more than 20 years. How does that make me a "free rider?" I've never benefited from not having insurance. No one had to pick up the tab for any of my medical bills. Just for the record, I've had only 2 visits to the emergency room (one of which was a waste of time and money)–both of which I paid for myself. And I pay out of pocket for a rediculously overpriced epipen every year. Now, how am I a "free rider?"
Jean,
Thanks for the lecture on economics. The U.S. sets the official poverty level which is a guide for subsidization for health insurance or Medicaid. Anyone today who is making $75K/yr is making more than the average U.S. citizen. It really makes no difference in comparing salaries yesterday with today because other commodities were similarly priced. Do you know what health insurace, if was available, would have cost then? You would be a "free-rider" unless you had a very large bank account or had other resources or choose not to age 😉
You are still only one serious illness or accident away from a major financial surprise. Do you also not carry car or home insurance?
The problem here, as with so many government-run programs, is that there is, to a great extent, a "one-size-fits-all" mentality. It doesn't work. Car insurance is required in our State, and it is reasonably priced–unless you're a really lousy driver. Home insurance also very reasonable. Not so with medical insurance. We've explored it. Can't afford it. Will pay penalty (excuse me–TAX) in 2 years. Then go on medicare the next year.
It would be wonderful if Obama Care only sought to treat the the problems which concern the public – pre-existing illness, transferability, rising costs, waste. But the real goal is not fixing problems (85% of Americans are happy with their medical care coverage, and 85% of the uninsured report that they are in good health), and most of the problems that exist have been created by counterproductive governmental interference in markets.
The immediate goal of the Left is to bring medical care delivery under the control of the federal government, disingenuously using the poor, who are already insured or insurable, as mascots to manipulate public sentiment. And the long term goal is to bring the entire economy under the control of centralized government.
As Jean points out, auto insurance and home owners' insurance are competitive enterprises where I can decide what type of coverage I want. I can choose to go without comprehensive coverage; I don't have to buy extended warranties or coverage for routine maintenance. Under Obama Care, I can't choose a plan that will only pay when I need major medical coverage, allowing me high deductibles or the ability to purchase routine care in an open market. I will have to purchase a Cadillac plan that covers drug counseling and lots of other things that I would never purchase on my own. I can't get discounts because I don't drink, smoke or sky dive. I can't start my own medical insurance company selling policies that people actually want. Obama Care rigs the system to keep start-ups out of the market, and to prevent them from offering coverage that people actually want if it does not fit within federal mandates. In fact, that's one of the major problems with even the pre-Obama Care system – lack of free choice.
If Obama Care is so great, why exempt Congress from its coverage and mandates? Why the need to grant thousands of waivers to politically favored businesses? Why cook the numbers to distort true costs by spreading those costs over a ten year time period, the first four years of which will be revenue collection without benefit payments? Why count cuts to Medicare as Obama Care savings when you just reinstate those cuts via a back door after Obama Care is passed?
Believe me, Elaine, I will indeed be able to wait until I need health care, and let others pick up the tab, because the 2.5% tax I will have to pay for not having coverage is about a third of what I currently pay for health insurance. Under Obama Care, when I have a "major financial surprise" I can simply apply for insurance at the going rate, and I can't be turned down… Except for one teensy-weensy problem: the insurance companies will be going bankrupt right and left, because everyone who is healthy – most working Americans – will choose, like me, to pay the penalty until they need major coverage. Insurance companies only stay in business because healthy folks like me buy insurance. Since I have less than 50 employees, I'll drop their medical insurance as well, and just pay the uninsured tax penalty for them. It will be much cheaper than what I am paying now for their medical insurance.
Under Obama Care, there will be far more free riders on the freight train named "Surprise" headed toward the Orwellian labeled abyss – Affordable Health Care.
Nathan,
Don't you know that the ACA covers pre-existing conditions? This was a major problem with most insurance, and "pre-existing" was defined by the insurance companies and few people after 30 don't have what the insurance companies claim is a "pre-existing condition." Do you think that Americans, now being covered who previously were not able, will be happy to surrender that benefit? Or be happy that their children to 26 will no longer be covered?
Will people vote for those to be repealed? You heard the NAACP give Romney a sustained 15-sec. "booing" when he said he would repeal the ACA?
For those who are presently insured, there should be no changes, whatsoever. It is for those who are uninsured, or have not been able to afford it who were the targets of this act.
Do you prefer the private, for-profit insurance companies to government run?
Medicare needs make no profit and their administrative costs are far less than insurance companies; and I would much rather the government decide what should be paid than insurance companies who profit by refusing payment. Medicare Advantage, an alternative to Medicare, was a disaster and people returned back to Medicaire.
Claiming that Obama "rigs the system" is unsubstantiated. Congress has their own generous government plan that makes them immune from understanding their constitutents needs when they have such excellent health and retirement.
Where do you get your figures for "free riders" when there are millions now who are the "free riders" that you and I pay for, but only at much higher costs in the ER.?
If this is headed toward disaster, medical care was headed toward disaster before the ACA. Your employees will be able to get their own insurance, Just as everyone not covered at work. With everyone covered, just as in those horrible "socialist nations" there will be no need for employers to offer health insurance.
Elaine, you offer false choices – the present system or government run health care. I prefer competition to no competition. In general, competition leads to innovation, increased efficiency, higher quality, and lower prices. Think computer technology or groceries. That is why so many socialistic countries are moving toward market oriented reforms while this country is hell-bent on going in the opposite direction. Private insurance companies do not operate in a truly free market because they have government facilitated monopolistic influence over the marketplace.
You should be able to switch insurance companies if they don't provide the product you want at a competitive price. You can't switch governments, and you won't be able to sue the government for bad faith denial of your claim.
I just don't buy your flip suggestion that insurance companies make money by denying claims which they are legally obligated to pay, especially when health is in issue. Insurance companies are subject to punitive damages for bad faith denial of claims, and they are not protected by tort reform caps. If they are not legally obligated by the terms of their contract with you, why would you expect them to pay? Do you think Medicare uncritically approves payment for services?
I completely agree with you that the pre-ACA medical care delivery system was headed toward disaster – not because of private insurance, which suffers from a plethora of anti-competitive anti-choice government mandates – but because Medicare and Medicaid, like government run healthcare in socialist countries, and like all other entitlement and needs based wealth redistribution programs, is unsustainable in its present form. So why do you want to put failure on steroids? Maybe if Medicare and Medicaid spent a bit more on administrative costs, they wouldn't be in such financial trouble.
Nathan,
Do you know why coverage for pre-existing conditions became an issue? Because regulations in many states prohibited it. The rules were written for policital reasons. The "cover me as I am" approach only makes sense to the consumer. Solving that issue by itself would have been far simpler. But it got wrapped-up with all sorts of other things and we will soon all be paying a very big price for it.
Now that we've had some time to compare the promises made to promote Obamacare with the reality that is becoming obvious, we can see the truth in Jesus words when he said the poor would always be with us.
Those are some astounding statistics Nathan. I'm guessing the talking points will continue but thanks for sharing.
Perhaps you could explain, Elaine, just why those states are refusing to accept the Medicaid "offering" that comes with Obamacare – or would the truth ruin things for you? Could it be that they are refusing a Trojan Horse that they cannot afford? Naw, that can't be. Obama would never give a gift with strings attached, now would he? And after all, if you and President Obama are willing to saddle our children and grandchildren with the crushing debt of government mandated Cadillac insurance coverage, administered by the diktats of apparatchiks, why shouldn't the states be willing to ride shotgun into the abyss?
I think it has more to do with the leaders of those states being from the other side of the aisle than fear of "crushing debt". It's no coincidence many of the states that are refusing to implement this healthcare law have republican leaders who would take pleasure in seeing Obama fail even if it's to the detriment of the American people. After all, his opponent started the same healthcare system in MA. Frankly the healthcare plan is a republican baby. It could have been much better but there had to be a compromise with the insurance companies. It remains to be seen if those state leaders will truly not accept the money. If they do, it could spell the end of their political careers.
I find it amusing that suddenly we have these fiscally responsible conservatives after nearly 8 years of reckless spending and unsound budget policies from the republican controlled congress and white house. We wouldn't blind an eye when it came to spending $3B a month in Iraq but scream the sky is falling when the ACA goes into effect to benefit American people and their health IN THIS COUNTRY.
Very true, Cid. Again, propaganda gets people perceiving things a certain way and they will cut off their nose to spite their face, for the cause. Critical thinking skills help, but truthfully big business has so corrupted our government (Think: Supreme Court) and media that I doubt we will ever be the same.
I saw deregulation in action as a stockbroker and subsequently decided it wasn't such a good thing having the fox guarding the henhouse. Unfortunately, both political parties fall prey because of their need for campaign $$. It's too bad the compromise with insurance companies and pharmaceuticals will affect us all.
Newsflash from Nancy: "Big business corrupts government" No kidding. Is this tritely true, but intellectually vacuous, slogan the product of "critical thinking?" This ranks right up there with: "Sex-craved men corrupt the porn industry." Somehow, Nancy, I suspect you haven't read Michelle Malkin's Culture of Corruption, and I won't be holding my breath waiting for you to read it. But the reality is that government, by its very nature, attracts corruption like rotten fruit attracts flies.
There is no bigger business than government. And there is no more corrupt institution in America than government… Okay, I stand corrested; there is big labor. That is why it is vital to limit the power of government – so that special interests cannot benefit by pouring money into politics. Labor unions, public employee unions, trial lawyers, the media are all big business. But they are pikers compared with the federal government, whose metier is corruption. Only the federal government can pass laws of general applicability from which its executives are exempt; only the federal government has the wealth and power to imprison, tax, fine, reward friends, punish enemies, and build political constituencies through class warfare; only government executives (politicians) can amass vast wealth in office on middle class salaries, and position themselves for vast wealth when they leave office, while producing no consumer goods or services.
I have no sympathy for Wall Street, which contributes far more to the regulators than to the deregulators. Wall Street, like Washington, loves money and power more than it loves free markets. If big business is the fox guarding the henhouse, then government is the skunk in the henhouse stealing the eggs and cutting deals with the fox.
It is depressing to realize that intelligent people actually believe in the fantasy of government as Camelot – a mythical, all-powerful, pristine organism which can be entrusted to humans with exceptional intelligence and wisdom (in other words – liberals) who rise to power on the wings of grievance, greed and envy. Power – not freedom – corrupts. You're right, Nancy, "we will never be the 'same'." But the truth is, we have never been "the same." Government has always been, and always will be, no less corrupt, corruptible, and corrupting as the corruptible people we put in positions of power. Patrick Henry said it well: "The Constitution is not an instrument for the government to restrain the people; it is an instrument for the people to restrain the government – lest it come to dominate our lives and interests"
Geez! Nathan, you speak to those who disagree with you in condenscending ways and I notice you're more sarcastic with women. –( Elaine, WE CAN"T AFFORD IT! FIRST WORLD COUNTRIES CAN"T AFFORD IT!) (So Nancy, help me understand how owning a clinic with your physician husband qualifies you to opine about the causes of our country's economic woes. I own a law firm. So what!) and your opening paragraph above is a little juvenile. If I exposed a raw nerve the other day by implying you may have been propagandized I'm sorry. However, you have an inflated view of yourself and your opinions and it's difficult to have exchanges with you. You make me feel defensive even about my education by some of your comments. No matter that I have an economics and finance background. Do I have to send you some credentials or should I change my first name to reflect a different gender? Please, cut me some slack. I may not agree with you and who you represent as an attorney, but I understand that's how you make a living. I have tried to restrain myself from criticizing your superfluous and supercilious language. But truthfully, I'm finding it difficult.
Nathan, such remarks are insulting to women, I agree with Nancy:
"It is depressing to realize that intelligent people actually believe in the fantasy of government as Camelot."
While you speak as a lawyer, Nancy speak as a medical provider and I speak as a medical user–under Medicare for more than 20 years and have worked many years in hospitals and doctor's offices. My roommate for 60 years was a practicing pathologist, so we are not simpletons in regard to medical practice.
I found your remarks terribly condescending and beneath someone who claims to practice law. Law, just as medicine, is very specialized and is not a qualification, EVER, for the attitudes toward women you have repeatedly expressed. Even some of the men conversing here have also found your attitude to be demeaning. This should be a reality check. I hope that if there are any women in your life this is not the attitude they experience.
Okay, let's see…According to you, Nancy, I lack a basic college level understanding of logic; my ideas are the product of propaganda; I don't understand what average Americans are going through; I am guilty of "goofy" reasoning. That's not condescending, right? But when I forcefully point out the fallacy of your appeal to false authority; when I call you out for employing fortune cookie wisdom -"Big business corrupts government" – as self-evident truth, suddenly, I'm being condescending, and my sarcasm is insulting to women, right??? Are you kidding! If you can't stand the heat…uh-oh, hang on a minute… I think I'm about to commit a sexist sin…umm…let me think…umm…Okay, I've got it! If you can't stand the heat, move to Iceland. Whew! Close call.
Seriously, Nancy, what did I say to make you feel defensive about your education, other than that your education and experience, like my education and experience in finance, economics and health care, entitles your opinions no particular weight? Who raised the notion that you or Elaine is a simpleton? It wasn't me. It was Elaine. The fact that I found your arguments simplistic and weak doesn't mean I think you are a simpleton. You may have an I.Q. of 175. That doesn't mean everything you say is meritorious.
You offered a nonsensical slogan – "Big business corrupts government" – as a self-evident foundation for some declarations that struck me as preposterous. I admit that I am highly sensitive to, and easily offended by, the sentimental moral presumptions underlying Leftist ideology that were encapsulated in your swipe at "big business." I did not think it was worthy of what I presumed to be your level of intelligence. And I pointed out why.
I am likely to come across as quite condescending to those who offer their political or religious opinions in angry, self-righteous tones, implying that those who have contrarian perspectives are either moral cretins or ignorant fools.
If you are offended that I happen to think the politcal/moral tropes of popular culture and mainstream media, which all educated bien pensants are supposed to accept on faith, are nonsense, that's too bad. But it is really quite contemptible for you and Elaine to flash your gender as kryptonite. Foolish ideas and fallacious appeals to authority are not deserving of kid glove treatment simply because they are offered by women.
Well, Nathan you just keep proving my point. And btw, I like Iceland so it was hard for me to take offense at your swipes. I guess what I can't figure out is how you could come down hard on me about a comment re our economy and assumed I had no credibility and yet you seem to be an expert on everything, unabashedly. What a double standard you portray. See, I consider myself well-read (don't we all?!) but I would never think to boast here and while I read your well-thought out pieces I wonder how a UCLA grad and one who prides himself on that, not the midwest life & education which probably influenced you most, could end up spewing the stuff you generate. I know, I know, you sincerely believe this. So on the one hand you flaunt your liberal left graduate school but are full of animosity if you suspect someone has UCLA-type "leftist" views. And the fact that you didn't end up a "bien pensant" is supposed to make you special? Coulter and Fox do not an intellectual make. Personally, I've thought that your crusading for big business and insurance companies with the animosity you've shown is compensatory behavior. BTW, there are so many examples of you projecting also, as in: "I am likely to come across as quite condescending to those who offer their political or religious opinions in angry, self-righteous tones…" Turn it around. It is you who are self-righteious and angry.
Here's the problem, you probably feel a litte guilt at being a rich republican and believe me, even wealthy demos feel some shame that way, especially with many in the world living in such poverty as you so aptly pointed out to me early on, (as if that was a newsflash). Furthermore, you and I both know the breaks we get in our tax bracket. We have CPA's, trusts, LLC's, tax attorneys and more write-offs than we can count–and all of it is legal. Every investment property is a write-off and I'll bet every vacation you take is written off. We depreciate the heck out of everything and we sure make use of every loophole. We tell our employees that it's been a rough year. My point is you are transparent and no one is passing judgement on you personally, because I certainly wouldn't cast the first stone. See that's where much of the intelligentsia is left in the dark because they assume their lives are not that different than ours. You and I know better. And please don't pontificate about your charitable giving as that is a write-off too. I know, because I sent $35K to India for some churches last month. Again, not accusing you, Nate. Just sharing the fact that you may resent me not so much for what I've said, but for that fact that I'm not that thrilled at supporting the status quo, yours and mine. Incidentally, it's the out-of-sight Uppers who really control things including the news and commentary we buy in to, but you know that. So, if you are content with your political opinions, that's fine. But you need to be willing to take some heat yourself.
Come on Nancy – you know very well why I brought up my UCLA education. I sarcastically offered it when you disparaged my reasoning as goofy, and suggested that my education had not prepared me to recognize fallacies or valid arguments. I am quite anti-elitist. I believe it is the relative convincing force of one's arguments, not their education or life experiences, that validates their values and ideas. But I am also aware of how frustrating it is for liberals to have to deal with conservatives who they cannot dismiss as ignorant rubes. So I love to rub their noses in the reality that a smart, articulate conservative is not oxymoronic.
"Here is the problem…" Huh??? Where did that come from? I have no idea why you want to speculate about my income, my tax breaks or my vacations. I guess it's because psychopunditry is a favorite past time of the Left. But you could hardly be more wrong. For what it's worth, I am not a one-percenter; I am not a Republican; no part of my vacations is tax deductible; no part of my vacation property is a tax write-off; I have never told my employees it's been a rough year, because both I and them are blessed to have steady middle to upper middle income jobs and benefits; I do not take any depreciation allowance; and it is usually a toss-up whether I am better off itemizing my returns or simply paying the alternative minimum tax. Sorry, I do not feel guilty about who I am or what I have been blessed with. Conservatives feel gratitude, not guilt. But most importantly, none of that matters.
The only thing I resent, Nancy, is the clear message I get from folks like you and Elaine that you think you care more, that you are more compassionate, and that you are more moral than I am, because the liberal herd gives you strokes for wanting to empower politicians to create rights that take away my liberty, and to take my income and give it to others. I vigorously attack those arguments and I rain on the parade of those who are cheering Obama Care on as the answer to SIN, without being willing to honestly look at the trade-offs, downsides, and red ink. That doesn't make me self-righteous.
I think you and Elaine are wrong, not evil. You, on the other hand, seem to very much see issues in good vs evil terms. You see private insurance companies as uniquely evil; you believe that because I represent physicians and hospitals, I am morally obtuse. You see me as blinded by ideology, and incapable of seeing moral issues through your enlightened, compassionate vision. If you can identify how I have cast aspersions on your morality or compassion, then perhaps you can accuse me of duplicity.
Nate, I'm completely "aware of the truth" as you claim. It really makes little difference as in the future, all our children and grandchildren will inherit debts that are unpaid. Is there another method?
It's a matter of interpretation: one explanation for refusing Medicaid is that the states will be responsible for continuing it gradually decreasing federal aid. Another explanation: they are content with having millions in their state who are uninsured for healthcare. But, this does not mean that they will not get healthcare, as they will–but at much higher costs at the ER. Make sense?
Elaine,
The Medicaid situation is a bit different than you describe. The mainline media paint the issue in emotional colors without looking below the surface to see what is actually happening. The claim that state officials are uncaring about the poor is a bald-faced lie. I used to be a newspaper reporter so I have a large network of friends and acquaintances who are public officials, including legislators. All of them are caring and willing to help those who cannot provide for themselves.
The bottom-line issue for the states is the bottom line. Obamacare shifts the entire cost for providing increased services under Medicaid to the states. They just can't afford the bill. The estimated increase is s large that in some states (like New York) the Medicaid cost would be larger than the entire current state budget. They can't print money or go into debt, so they can't afford the bill. If you or I had to pay that bill we'd be forced into bankruptcy, but states can't do that. Add that most of the Obamacare rules haven't been written so the states really don't know how big the bill will be. Right now the estimated increase in Medicaid costs in several states exceeds 130% of the entire current budget, including current Medicaid costs. If it follows typical cost patterns for federally-mandated programs the cost will multiply.
The Supreme Court ruled that requiring the states to pay the bill violated the 10th amendment which leaves all matters not specifically addressed in the Constitution to the states. That prevents the federal government from hiding the true cost of Obamacare by shifting costs to the states. Such cost-shifting is repeated many times in the Obamacare legislation and is a major reason why the Congressional Budget Office estimates of the cost have been so low. Prior to the Supreme Court ruling the accounting firm Price-Waterhouse estimated that the total costs of Obamacare in 2014 would increase the deficit by at least $3 billion.
The bottom line: we can't afford it.
Please substantiate your statement that "Obamcare shifts the entire cost for providing increase services under Medicaid to the states."
States have always paid some costs, determined for each state. Cities are declaring bankruptcy, but not because of Medicaid but the unrealistic contract offers given employees when times were flush and now the chickens have come home to roost.
With all the worry and hand-wringing over medical costs, where were these same folk when the two wars were costing billions every month? There is a blind eye to need of its own citizens and much more given to nations half way around the world. Shouldn't our own citizens take first priority? All of the first world nations surely do and are willing to pay for healthcare, while America is far more willing to pay for wars.
Finally, a conservative Supreme Court has seen the light. The power to tax lies with the U.S.
Yes, the states currently pay a portion of the Medicaid cost. If you read the law you will see that it called for the states to pay the entire bill for the expanded portion of Medicaid starting in 2014 and the total cost for medicaid starting in 2016. That is what the Supreme Court said was unconstitutional. It was also one of the factors allowing the CBO to estimate the cost to the federal government going down starting in 2016.
A correction: the projected increase in the federal deficit in 2014 as a direct result of Obamacare costs is a minimum of $3 trillion, not billion. I have not seen an estimate of that expansion after the court ruling.