Obamacare hiccup

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Henry Vilas
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Re: Obamacare hiccup

Postby Henry Vilas » Fri Jul 05, 2013 5:31 pm

What is especially ironic is that Sandi avails herself to the VA health system (which I don't begrudge her, I am a veteran myself). That system is government run and paid for and is a perfect example of a single payer plan.

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Re: Obamacare hiccup

Postby Huckleby » Fri Jul 05, 2013 5:37 pm

In some senses, Sandi is correct. Rich people come to the U.S. because we are extremely effective at treating certain diseases, especially cancer.

Our advanced medicine is probably the best in the world.

But that is far from saying we have the best health care in the world.

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Re: Obamacare hiccup

Postby HawkHead » Fri Jul 05, 2013 6:34 pm

Except my rich clients who fly to Thailand for cosmetic surgeries.

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Re: Obamacare hiccup

Postby HawkHead » Fri Jul 05, 2013 6:36 pm

I thought Medicare had a better rate than private insurance in cost effectiveness.

Henry Vilas
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Re: Obamacare hiccup

Postby Henry Vilas » Fri Jul 05, 2013 6:46 pm

Huckleby wrote:In some senses, Sandi is correct. Rich people come to the U.S. because we are extremely effective at treating certain diseases, especially cancer.

Rich people in the U.S. also take advantage of that fact. But for the average American, not so much. Our survival rate for cancer is only middling when compared to the rest of the world. Of course environmental factors, including diet, affect those outcomes.

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Re: Obamacare hiccup

Postby Zoti Bemba » Fri Jul 05, 2013 6:49 pm

Henry Vilas wrote:Of course environmental factors, including diet, affect those outcomes.

Not to mention early detection. Or lack of same.

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Re: Obamacare hiccup

Postby Henry Vilas » Fri Jul 05, 2013 6:55 pm

Zoti Bemba wrote:
Henry Vilas wrote:Of course environmental factors, including diet, affect those outcomes.

Not to mention early detection. Or lack of same.

Thanks for bring that up. The poor get little or no preventative care. The ER is their last resort. That not only drives up health care costs, but it also shortens lives.

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Re: Obamacare hiccup

Postby Sandi » Fri Jul 05, 2013 10:39 pm

Huckleby wrote:This is a very odd statement. You realize that the pre-Obamacare U.S. has 55 million uninsured people. How does this look like Switzerland, which has universal health care?


Apparently you have a reading comprehension problem. The difference as I noted is that the Swiss subsidize the poor, where as we don't.

Sandi wrote:In other words, the Swiss healthcare is more like the US before Obamacare but with subsidies for about twenty percent that can't buy their own.

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Re: Obamacare hiccup

Postby bdog » Fri Jul 05, 2013 10:54 pm

Henry Vilas wrote:...the VA health system...is government run and paid for and is a perfect example of a single payer plan.

Are you sure you want to go there Hank? Seems to me the VA system is widely reviled. What is your experience?

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Re: Obamacare hiccup

Postby Henry Vilas » Sat Jul 06, 2013 7:14 am

bdog wrote:
Henry Vilas wrote:...the VA health system...is government run and paid for and is a perfect example of a single payer plan.

Are you sure you want to go there Hank? Seems to me the VA system is widely reviled. What is your experience?

Who said (besides you) that VA medical care is "widely reviled"? One of my brothers is a disabled vet (I am his legal guardian) and he has lived at the VA Medical Center in Tomah for over 30 years. He gets excellent care. Recently he came down to Madison's VA hospital for aneurysm surgery. Again, he got excellent care. And the VA is a single payer for all prescriptions, which keeps the cost very low.

Ask Sandi what she thinks about the VA health system.

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Re: Obamacare hiccup

Postby bdog » Sat Jul 06, 2013 7:58 am

Henry Vilas wrote:Who said (besides you) that VA medical care is "widely reviled"?


https://www.google.com/search?q=va+health+system+sucks&ie=UTF-8&oe=UTF-8&hl=en&client=safari

It is good to hear your brother had a good outcome though.

You seem to think Sandi using the VA system is some kind of endorsement. It may be her only option.

Are you going to bhaktifest?

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Re: Obamacare hiccup

Postby Sandi » Sat Jul 06, 2013 9:41 am

Henry Vilas wrote:What is especially ironic is that Sandi avails herself to the VA health system (which I don't begrudge her, I am a veteran myself). That system is government run and paid for and is a perfect example of a single payer plan.


Yes I use VA medical, but what is so ironic about that. It IS the best medical care available in the US, and that isn't just my opinion. A study by the Rand Corp shows that it is far better. A single payer is the most cost effective.

The VA used to be a horror story, but that was turned around in the mid-1990s when Dr. Kenneth W. Kizer transformed it from an unaccountable bureaucracy to a system that beat private sector hospitals hands down. If Obamacare was patterned after VA healthcare, I would have voted for Obama in his second term for that alone.

This is from an article that I bookmarked back in 2006 when some people were telling me how bad the VA health system is. It got such a (deserved) bad name before Dr Kizer that it is hard to get the bad image out of peoples mind.

And while studies show that 3% to 8% of the nation's prescriptions are filled erroneously, the VA's prescription accuracy rate is greater than 99.997%, a level most hospitals only dream about. That's largely because the VA has by far the most advanced computerized medical-records system in the U.S. And for the past six years the VA has outranked private-sector hospitals on patient satisfaction in an annual consumer survey conducted by the National Quality Research Center at the University of Michigan. This keeps happening despite the fact that the VA spends an average of $5,000 per patient, vs. the national average of $6,300.

....

The biggest lesson? A nationwide health-care network that gets its funding from a single payer can institute mighty changes. Proponents of national health-care reform extrapolate even further. "The VA proves that you can get better results with an integrated, organized, national health-care system," says Dr. Lucian Leape, a professor at the Harvard School of Public Health and a leading expert on hospital safety. "We will not achieve even close to the level of quality and safety we need [in the U.S.] as long as we have individual practitioners and hospitals doing individual things."

The VA is, in many ways, the exact opposite of America's fragmented private-sector system, where doctors work for hospitals as independent contractors, and third-party insurers pay the bills as they see fit. By far the largest health-care network in the U.S., the VA serves 5.4 million patients -- double the number it treated 10 years ago. Most veterans are eligible for free or low-cost care, paid for out of the federal budget. The 2006 allocation comes to $35 billion.

Not having to rely on piecemeal insurance payments means the VA can finance large-scale improvements such as the electronic medical-records system, up and running in all of its facilities since 2000. In contrast, only some 20% of civilian hospitals have computerized their patient records. Because the VA is a nationwide health-care system, its electronic network is national, which means all of its facilities can share data. When hospitals were evacuated from New Orleans during Hurricane Katrina, the VA's patients were the only ones whose medical records could be accessed immediately anywhere in the country.


Congress ousted Dr Kizer in 1999 after he closed hospitals in key districts. So far his architecture has been kept in place, but I worry, because Congress can change that at any time.

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Re: Obamacare hiccup

Postby Huckleby » Sat Jul 06, 2013 12:15 pm

Sandi wrote: Apparently you have a reading comprehension problem. The difference as I noted is that the Swiss subsidize the poor, where as we don't.

OK, perhaps you used a big word that confounded me.

You mention that the Swiss only offer subsidies to 20% of their population. I imagine that is because they have less income inequality in Switzerland than here, plus it is a very rich country.

The fact that you as a conservative find the Swiss system attractive should give you pause. Obamacare was designed by conservatives. It is designed to leverage as much private competition as possible. It's a long story, but Obamacare might very well evolve to the Swiss system.

Now, by 2013 Tea Party standards, Obamacare is no longer "conservative." The new conservatives believe that government needs to get out of health care, and let a relatively unregulated consumer market work its magic. Get all insurance out of the picture other than a catastrophic umbrella. I actually would be willing to meet the new conservatives half way, add considerable subsidies to the model, give her a try. But this would be a truly gigantic, revolutionary change, if you stop and think about it. 85% of Americans have health insurance, half of it government provided; we are no where close to a free market where savvy consumers go shopping for bargains.

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Re: Obamacare hiccup

Postby Huckleby » Sun Jul 07, 2013 7:47 am

If anybody is interested in what's going on with OBamacare and the employer mandate, you need to read Ross Douthat's column, he nails it.

But you won't, you don't care. You can't handle the truth.

http://www.nytimes.com/2013/07/07/opini ... -care.html

The politicians’ consensus is that health care reform shouldn’t alter or disrupt the way the majority of Americans get their insurance today. This is President Obama’s official position on the issue....The policy consensus, though, is that the status quo is actually the problem, and that it deserves to be threatened, undermined and replaced as expeditiously as possible. Wonks of the left and right are united in regarding employer-provided coverage as an unsustainable relic.....the mandate is mostly just a political device designed to hide the full cost of the bill and discourage employers from eliminating employee coverage too quickly once Obamacare’s new exchanges are up and running....Right now, both parties are still pretending that H.R. departments will go on doubling as welfare states forever. If it dropped the employer mandate, the Obama White House would be fully committed to a more disruptive future, in which exchanges and subsidies gradually replaced the employer-based system.

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Re: Obamacare hiccup

Postby snoqueen » Sun Jul 07, 2013 1:51 pm

Don't be cynical. I read that column this morning, long before I saw your link for it. Douthat is the kind of conservative worth reading and his ideas are worth discussing, a lot of the time. The world he wants isn't the world I necessarily want, but it's a reasonable world and if we're ever to crawl back to a reasonable two-party system, we need to listen to this kind of viewpoint.

And just about everybody agrees we need to get the employer out of the healthcare-provision racket. The employers believe it -- that's the most important part. Obama listened and did them a favor. Everybody who has healthcare will still have it when this is done, and in most states (not here, naturally) a few who did not have it previously will have it too.

What's becoming apparent is the places in the healthcare bill where they had to cobble together workarounds to satisfy various special interests are the clumsy spots where difficult conditions will manifest. The employer thing is one of these. Because we can see that other countries have succeeded in providing healthcare, we know these problems can be alleviated.


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