# Health Care Article...



## Chuck Smith (Feb 22, 2005)

Attached is a good article on what all the purposed health care legislation (House and Senate versions) compare to Obama care...

http://www.msn.com/en-us/news/politics/ ... id=DELLDHP



> WASHINGTON - The Senate Republican health care bill would guarantee immediate assistance for insurance markets that are struggling in many states. Yet overall it would do the same thing as its House counterpart: less federal money for health insurance and a greater likelihood that more Americans will be uninsured.
> 
> The bill's impact on personal health care costs would be uneven: Premiums would likely go down for younger people, but older people would pay more. Out-of-pocket costs to cover insurance deductibles and co-payments would go up.
> 
> ...


Peoples thoughts??


----------



## Chuck Smith (Feb 22, 2005)

I think so far it is a good start but needs tweaking (and it is missing lots of cost factors IMHO)....

Anyway here is my thoughts broken down.

1. *Medicad:* Obamacare put too much burden on the Federal government with the 90% thing. (even though it is an average of 57% now) it could be increased. I think is should be a 50/50 between the states and fed. So I like the House version better. I do like how the Senate bill exempts people with special needs. One thing with this shows you that when people scream they are cutting Medicad... they really are not (as of now). Because it is reducing the match... and this article didn't say what that match is. So if it is 50%... well that is about what it is right now under Obamacare. But Obamacare has a ceiling of 90%... which would bankrupt our country if every state enrolled would get 90% paid by the federal government.

2. *Pre-existing conditions:* I like that Obamacare had this provision. I just think that pre-existing people should pay more. I think is should be along the lines of the elderly provision of Obamacare (up to 3 times more). Lets put it this way... if you have two 25 year old males who buy the exact same car. One of the drivers has 3 tickets, 2 at fault accidents, and two deer/car claims (4 claims total)... and all happened with in 3 years. Then the other driver has a clean record. WHO SHOULD PAY MORE?? Goes along the same lines. (BTW I have high blood pressure so I know I would be paying more in my scenario)

3. *Subsidies*: Well this is one that I didn't like in Obamacare. But I understand the need for it. Out of the three I like the Senate version which lower subsides to the "bronze" style plans. Which means if you want to up grade... it is on you. But... I like the house it is keyed on AGE not INCOME. Because that way you are not penalized if you make money. It is because anyone who pays taxes a portion of that money goes towards this. Just like Social Security. So why shouldn't u get some benefits from the money you pay in. Just my thought. Will make the bite of paying high taxes a little less if you know u get some benefits back.

4. *Age factor: * Again... I like the Obamacare version. Because someone using the system more should pay in more. Just my thoughts. That is how insurance works...ie: more claims the more you pay. Older people tend to be on medications, go in for more doctor visits (check ups), etc. So they are using the system. So they should pay a little more. Before people go nuts on me... this is what I am saying for Private Insurance. But remember many people get off private insurance and go onto Medicare when they hit 65. They just need to buy the supliments.

5. *Mandate*.... I say get rid of it.

6. *Standard Benefits:* I like the idea that was placed with Obamacare.... it gave a good starting point for this. But with the "birth control" aspect. If a man and woman pay the same amount. Then a vasectomy needs to be covered. Just saying...right now that is considered an "elective" type surgery on some insurance policies which means not covered! Isn't a vasectomy a form of birth control???

6. *Opiod epidemic*: Well again I like the idea in Obamacare... bot yet I think it needs to be capped at the federal contribution level. So I lean with the Senates version.

7. *Taxes:* Now this is a hard one. Because we need to pay for this some how. But to only tax certain demographics is wrong. Maybe add a 0.05% sales tax to help pay. Yes that is 1/20 of 1%.... so on a $100 purchase it would be 5 cents tax. Then lower the tax burdens on income. Also lower the taxes on health care companies... because all they are doing is passing the buck on when they sell their goods. Look at Epi Pens and that fiasco.

8. *Abortion: * Well I like the idea in Obamacare. That if someone wants Abortion coverage they have to pay in more. Now I am not for abortion. But I am not 100% against it either. So this if someone wants to pay extra for that coverage.... then I can't be against it. But that extra is paid by the person not the state or fed. So it is an individual choice.

Now what was missed or not in any of the bills: Again... I will say it. They need to do something about pricing of medical procedures. They need to make it so people don't get gouged. Like I have stated... call and ask what an MRI will cost at 3 different hospitals. You will get 3 different prices.... then call a Chiropracter who has an MRI machine or an MRI service..... You will be amazed!! They also need to discuss tort reform... Which is malpractice stuff and also how long it takes for a drug comes to market and patent type stuff. But I have gone over this a million times. So I wont here.

But I think we are moving in a better direction but still needs tweaking.


----------



## north1 (Nov 9, 2010)

Thank you for taking the time to break it all down and provide the link. After reviewing it all, the only thing I have developed is a massive migraine. The easy answer is that government involvement in anything always leads to higher costs, picking winners and losers and degraded results. We are too far down the road; however, to turn back. One area I do not understand is the opiod epidemic. How many epidemics can we afford? Alcohol, tobacco, marijuana(believe me when I say this, it is coming!!), meth, and I could go on and on. There is always another one the horizon. I know one immutable fact, government should not legislate or mandate behavior. Individual states have to become more involved in these these areas including healthcare and the federal government needs to get off their backs regarding legislation. If states fail to properly address issues then citizens can vote with their feet. I agree that healthcare costs never seem to be addressed. Medical procedure,supply costs and results should be required to be made public. Consumer could then shop around like getting a water pump replaced on your vehicle. Never happen though because pharmaceutical and healthcare companies have seats at the legislative table not citizens. Long answer made short, with increased government involvement=:-(


----------



## north1 (Nov 9, 2010)

Relating to the opioid epidemic, I would like to add that it should be considered criminal to add acetaminophen to opioids. Far too easy to overdose and destroy your liver. In fact a large majority of deaths relating to opioids are classified as overdoses, when individuals have actually died of liver failure. I was prescribed opioids when taking cancer treatments to deal with pain. Luckily I was having my organ functions checked regularly so if there were to be a problem they could have lowered doseage or prescribed something else. I specifically asked for morphine instead of OxyContin but was told it couldn't be prescribed for my instance. Wonder if it was because of higher kickbacks by pharmaceutical company to hospital? In any case, I was able to ween myself off of them after my treatments, but it was not easy.


----------



## indsport (Aug 29, 2003)

Just some food for thought. In Minnesota, over half of nursing home residents are relying on Medicaid for all or part of the cost (North Dakota not as much but substantial). Considering the proposed cuts to Medicaid, what would be the result? Also think about the 10,000 baby boomers reaching age 65 every day.


----------



## dakotashooter2 (Oct 31, 2003)

It would be nice to see an investigation into the actual cost and source of money for drug development. The drug companies claim the prices are high because they have to recoup their costs, but think. How many millions of dollars are donated by the public for medical research which trickles down to drug development. Essentially we pay for a lot of the research/drug development then they turn around and overcharge us for that kindness.


----------



## Chuck Smith (Feb 22, 2005)

indsport....

A few things about Medicad.... Well the bill isn't really cutting any funding as of now... but it is cutting "potential" funding. It is making the states more responsible than the federal government. You bring up MN... well we have a huge surplus in tax money... HMMMMM... there could be our portion of the medicad. It is shifting responsibility to the states not the fed. Which was the first thing they said about the ACA but it really didn't. So actual cutting isn't happening. Because right now the average is 57% is picked up by the FED.... I say that is a decent range or 50/50. But the ceiling for the Fed in the ACA is 90%... so any state that is opted into the Medicad expansion could get 90% from the FED if they want too. So future of Medicad spending could skyrocket. Just like you mentioned with the baby boomers... it is going to Skyrocket. So this bill will reel in the Fed spending. Along that note... the one purposal wont cut the limits now on medicad for people with special needs. So lets say a family who has a child with a disability... that funding stays at 90% and doesn't get cut. So again lots of the stuff the Dem's are screaming about isn't 100% true. They are making it all doom and gloom when it really isn't.

Now with the talk about nursing care.... well to be honest that should be some planning by the individual. Like purchasing long term care insurance. I am 40 and am purchasing it right now because I don't want to burden my family. I got coverage that is $5000 per month if I go into a home with a 10% inflation guard per year... but is capped at $10,000 in my lifetime. So you see... medicad wont need to pay for me in a nursing home. It just takes planning.... I am just saying we need person responsibility out there... not a hand out to the government. :bop: If people like to point to Europe and all that for medical... Look at the culture. Many families in Europe take care of their elderly parents. They move into the home with them. In the USA (as of now) u don't see that. there is a trend starting lately... but not so much. Just google "granny pods".... you will see what lots of people are doing or thinking.

Dakota.... On the drugs. I have friends that work in Pharma.... at one time I know they said it takes likes 10 million or so to bring a drug to market. This was about 15 years ago... so who knows now what it costs. But think about that... it takes over 10 million investment to get a drug on the counter. Now I don't agree with price gouging... but then they have a 10 year window to recoup the money. They also said that the FDA wont let people "piggy back" on research. Like lets say if a certain pill in development at one point shows signs of doing two things... like a fork in the road... either we go left and cure one thing or go right and cure another... Just depends on which way the recipe goes could do a totally different thing. The FDA wont let the company or other companys (after patient is up) use the research to that point and then start from there. The FDA makes them start from scratch... so all new testing, trials, etc. I am not sure if that changed but is a big thing. Because that is more money needed. So instead of 1/2 the investment they have to go back to square 1.

Here is an article I read on Pharma... and the issues with it and hospitals.... This goes along with my spending stuff!!!!
https://www.theatlantic.com/health/arch ... source=msn

Basicly it talks about how two over the counter stuff is now condensed into 1 pill for simplicity....and how the doctor is prescribing it with out letting the patient know. So the doctor/hospital is prescribing a pill that gets billed to insurance for $3000 when you could have bought the over the counter stuff and take two pills for $40.



> You can walk into your local drugstore and buy a month's supply of Aleve and Nexium for about $40. For Vimovo, the pharmacy billed my insurance company $3,252.


You see this is my Insurance is so expensive!!!!! So don't blame the insurance company 100%... they just pay the bills..... it is the people who are billing them that need to be looked at. *Which none of the legislation out there is doing!!!*

I forgot to add in comments about North1...

North.... I agree we need to put a cap on all of the "epidemic" stuff. Now my heart goes out to people... but when you are passing the buck on to insurance or the state to pay for things of your personal choice (yes to use drugs/alcohol/tobacco is your personal choice) we are going down a slippery slope. Because soon Stupidity will be an epidemic.

I know that addiction is hard and some cant get over it with out help or with out government assistance. That is why I say there needs to be a cap on it. I also agree that marijuana will soon be one. I know people don't think it is a problem... but it will be like alcohol... so just wait and see.

I also agree that more government isn't the answer. That is what I think this bill is trying to do... a little... very little.


----------



## dakotashooter2 (Oct 31, 2003)

> They also said that the FDA wont let people "piggy back" on research. Like lets say if a certain pill in development at one point shows signs of doing two things... like a fork in the road... either we go left and cure one thing or go right and cure another... Just depends on which way the recipe goes could do a totally different thing. The FDA wont let the company or other companys (after patient is up) use the research to that point and then start from there. The FDA makes them start from scratch... so all new testing, trials, etc. I am not sure if that changed but is a big thing.


So how did Viagra get on the market as a boner pill so fast then? That was not its developed purpose. LOL


----------



## Chuck Smith (Feb 22, 2005)

Dakota.... like I said... you develop a pill.... and you come to T in the road... right you try to cure cancer... left is a boner pill. They decided which direction to go.... LOL But you see just like anything with development... when the FDA makes them start over from point 1 and not the T in the road.... you don't have all the trial and error... you know the steps you need to take to get to the T in the road... so the process is a little quicker the second time around.

Again I know the FDA is doing its job so there isn't people dying and getting sick/hurt. But let companies sell that branch in the road at that point to someone else... let them go back to that exact point and start the research over there... not from the beginning. Would save the companies money and time... which hopefully would mean a cheaper pill. Or let the company sell off that research to another company. That way they can make some money back plus saves the new company time and money as well. Again hopefully lowering the cost of medicine.

But another problem is that doctors just prescribe pills... it is easier now. Just look at the way Ritalin is handed out like candy to kids... or was there for about 10 years!


----------



## indsport (Aug 29, 2003)

One followup piece of data. Across the country, about 60% of all elderly in nursing homes currently rely on Medicaid. Those of us over 65 who have long term care insurance and/or sufficient resources don't have the problem but what about my neighbors who don't have either the assets or the time to save for those expenses? As I noted, that is the issue and it is just going to get worse. What do we do with them?


----------



## north1 (Nov 9, 2010)

The problem is we have developed a system where they deemed it unnecessary to properly plan and save money for their retirement and healthcare needs. Once that was put in place (FDR and new deal) we started sliding down the slippery slope and we are nearing the cliff edge. Only choice is to ween off, cut off(never happen) or hope the cliff edge is not too steep. There is no easy answer that can be solved by politicians or Obamacare, Obamacare lite , Trumpcare or whatever moniker they label it. The US is too broke to buy are way out of this one.


----------



## dakotashooter2 (Oct 31, 2003)

When you look at how many drugs are currently subject to lawsuits, one really has to question the validity of the testing and of the FDA. Which I'm sure also drives up the cost...... 
I truly believe if you use any drug long enough there WILL be some detrimental effect on your body/health. It's pretty much comes down to which is the lesser evil the disease or the drug. Which is why I really try to avoid drugs when possible or get off them as fast as I can.


----------



## Chuck Smith (Feb 22, 2005)

Indsport.....

You are missing the whole thing. These two proposals are doing nothing to cut what medicad is paying right now. All it is doing is lowering the possible burden in the future. If people are happy and everything can stay status quo right now.... it will stay the same. but if states start needing 90% of medicad to be paid for by the Fed's... that is what it is cutting. Right now the fed is paying on average 57% of medicad.... with the ACA it says the feds can pay up to 90%.... which will bankrupt our government even more. Think about it roughly a 33% increase in spending!!! What the proposals are doing is capping that. Both are around that 50% mark for the federal kick back. Then the states or the insured needs to make up the rest. This is all for the elderly. If handicap they will still pay up to 90% (one of the bills had that provision in it).

So again... these proposals are not cutting Medicad right now... but are cutting back the possible future burden! That is where the media and the Dems are trying to confuse. It is a "cut" per say... but how big of a cut is it when we don't know what the future is. It is not cutting anything as of right now. They will still pay the same amount. So people screaming that they will lose coverage ASAP... is totally false. They say they will lose future coverage... that isn't 100% accurate either. Because they don't know what they will need in the future. They might be better off... nobody knows. That is the problem with the CBO... those are all projections. Which could be true or false. We don't know. I will talk about the CBO and how you cant believe it 100% either.

Now like I stated earlier.... look at the USA compared to other countries when it comes to caring for the elderly generations. Other countries the elderly come back and live with the family most of the time. Here not so much. But that attitude is starting to shift. Like I mentioned.... Look at "granny pods".... look that up on google. :beer: But again... that is something people need to look into if they don't have the means like you are worried about.

North1.... You are 100% correct on your last post. And sometime the thinking needs to shift or we are doomed as a society.

Dakota.... Now with many of the "lawsuits" out there are Class Action ones... where the only people getting money will be the lawyers and the people who got hurt will be getting pennies compared to them. With the lawsuits that are going on about many of the medications are with the "side effects".... in the earlier years with PHARMA and the PILL CRAZE as I call it....Just give them a pill it will fix everything... Is that many of the side effects were not published or explained to patients. So now Lawyers found that loophole and are going after it. Now that is why you see the small writing at the bottom of TV commercials... the small print on brochures.... the long list of side effect that get rattled off during the TV commercials... etc. So this way it helps to "cover" the drug companies. Were as before they didn't put out what the side effects are or were. Plus some of the medical law suits are things would say they would last forever... and are starting to fall apart 10 years later. Just like with anything mechanical... you have break downs and inferior products. They past testing... but you cant test "a lifetime". Because "a lifetime" is different for each and every person.

**** now I am not trying to stick up for big Pharma but just stating facts out there *****

But I will keep saying this until my last breathe.... (and I have sent letters, emails, and called to my elected officials...and it always falls on deaf ears) Nothing any side comes up with will do anything to lower costs of insurance companies, medicare, medicad, etc... UNTIL THEY DO SOMETHING TO LOWER THE COSTS OF DOING MEDICINE! Which means come up with a universal pricing on medicine, procedures, hospital visits, check ups, rehabs, MRI's, Exams, etc. Until they reel in those costs insurance, medicare and medicad all that spending and costs will keep rising as well. :bop:

Now onto the CBO:

1. Has their projections been 100% correct?? I think not. Remember they came out and said that the ACA would be a huge success... Well it isn't sustaining itself, private insurance companies in the individual markets are pulling out of states at a rapid rate, Insurance premiums are still sky rocketing, etc. So those projections back in 2010 (I cant remember) are totally false. Remember the CBO didn't have an accurate account of how many uninsured people were out there back then. Remember we heard numbers from 60,000 citizens to 20,000. So again numbers are all over the board.

Little something I found on Wiki....From the projections of the uninsured.



> Illegal immigrants, estimated at around 8 million-or roughly a third of the 23 million projection-are ineligible for insurance subsidies and Medicaid.[25][26] They remain eligible for emergency services.


https://en.wikipedia.org/wiki/Patient_P ... e_Care_Act

***** Above link is a pretty good read. Shows you what is good and bad with the ACA ....IMHO
****** It also shows how it cant stay funded as well and how it is imploding... IMHO

Now again they don't get or receive subsidies or can be on medicad (unless they break another law with forged documents, etc). But they are in the number of "uninsured" people are throwing out as people losing or not having insurance. So 1/3 of the number the MEDIA and others are using are illegal immigrants. So again... take that into consideration when talking about uninsured numbers. So again the numbers are not 100% accurate on how it will hurt citizens.

2. CBO and the "uninsured"... Those numbers are not 100% correct. because the people that were forced to go onto the ACA or forced out of the coverages they had (I was one of them). People can go back into the market. Some insurance companies which pulled out of states might get back in that market with different plans. Also with the CBO analysis they are going on the "silver" plan. Who says people want the silver plan... They might want the bare bones policy. So out of those millions who "might" lose coverage with the repeal. they might get a "bronze" plan instead. Because that is what they want or what they had previously. ALSO SEE ABOVE

3. Then what I stated with Medicad. They don't know what the future will bring. They can accurately guess the number of people that will be available (census data with age) to use or sign up for Medicad in those years. But like Indsport stated some people have planned and wont need it where others might.

I know many boomers who planned and used the Stock market who are sitting good and wont need medicad. Which if any boomer who planned and played with 401K's, investments, etc and had an asset manager worth a grain of salt made money. Now people will go off on how the crash killed them. yes some people "lost money"... but that loss was what they gained. Example: a portfolio that they invested $100K into and it jumped to $500K before the "crash"... and then went down to $150K. Most never lost what their initial investment that was in the portfolio or the 401K. They just lost lots of the gains. But many are back up in very comfortable standings some are even back up to what it was before the crash. Again these people are ones who had an assent manager who was worth a grain of salt.

Now that is the issue I have with the CBO... it isn't 100% accurate. Should we listen and take that info into account. YES... but that is when you make adjustments. But both sides are sticking to what I call "semi false" data. Because we don't know what the future holds. There projection on this is all the DOOM and GLOOM.... IMHO. they are the "worse case scenario"... which we need to plan for. But it isn't gospel. Like mentioned above. Their projections have been off in the past. Just like with everything people need to listen to all outlets, gather as much info as they can, and make their own decisions. Not just think one source of info is the only correct source.

I know I went on many tangets. But just trying to get info out there to people and also with a side of my take on things. I predicted much of this back when we debated the ACA bill 7+ years ago. (if you don't believe me go look up past posts) Now like I said previous.. I am not 100% in on either of these proposals. I think they are missing the mark on not lowering costs and try to set a Universal Pricing (but that is against my belief in capitalism)... But that should be step # 1. I do like how they are "trying" to reel in spending and expenses. But I don't think these can sustain funding as well with tax cuts. Also nothing will get done until this Dems vs Rep stops and we start working as a WHOLE. :bop:


----------



## indsport (Aug 29, 2003)

Chuck, you are missing my point. I am talking about the future (which is why I referenced the 10,000 a day that will go on for another decade or more). The last of the baby boomers will be reaching 66 in 2030. I am not talking about current reimbursement rates but those projected over the next 20 year. The problem at its root is the proposed legislation does nothing to stop the ever increasing costs (neither did the ACA). If you cap the reimbursement rate and costs keep rising (and they will), what will happen? The states won't make up the difference and given the current data (and assume the percentage who need medicaid stays the same), the total number of retirees needing medicaid will definitely overwhelm the system.


----------



## Chuck Smith (Feb 22, 2005)

Indsport....

I understand what you just said and were saying. It is exactly what I have been talking about. We need to reel in costs on health care.

But spending more doesn't do a damn thing.

Here is the deal you are talking about..... Lets use the figure of 57% and the average nursing home cost is now $5000 a month. So as of now the FED is picking up $2850 of that monthly bill. Now if costs rise up to the $10,000 per month (like you projected and so are many others).... The FED will pick up $5700 of that bill.

Now lets look at the ACA with this same example. Right now they pick up 57% of that $5000 bill. So that is still $2850 a month. If it jumps to $10,000 a month and the don't move shut down the cap of 90%.... that means the FED will cover $9,000 of that $10,000 bill!! So in the future the states can lower their contributions to less than they are paying right now. 
I hope you see the difference. And why a reduction on the cap on re-imbursement is needed.

I agree that something will need to be done on costs. I also know that costs will keep rising and the $10,000 a month is right on track figure. Will care have to be decreased? Will some of the "extras" that nursing homes provide have to be decreased (movie nights, outtings/adventures, entertainment, cable tv, etc)... Will it be bare bones...ie: You have a bed, you get fed, you get "basic daily functions" taken care of (bathroom, shower, feeding).... Who Knows? Will people have to live with children or family members? I don't know the answers. But Spending isn't one.

Here is my wishful thinking is we start to "cap" the re-imbursements maybe costs will go down. Because places will realize that they cant just charge what ever they want. Again a pipe dream. I mean when someone else is paying the bills why not charge more? Am I correct. Look at all government contracts.... they typically pay way more than what they would be paid in the civilian world. Same goes with the medical field.... and people doing jobs for hospitals....they charge more because they can (government, insurance companies are footing the bills).... :bop: If you don't think people charge more because they know "insurance is paying".... just look at roofers, siders, auto mechanics, AUTO GLASS REPLACEMENT (I capped the last one because just call and ask if you pay cash the price and if you turn into insurance the price!!) But people charge more when insurance companies and government are picking up the tab.

But again the last stuff goes along the lines of "universal pricing system". Which is needed IMHO... that will help clear up lots of the issues I have discussed and stuff Indsport is talking about with rising Nursing home costs.


----------



## carol palmer (Jul 18, 2017)

There is this informative article on helath care in the other thread viewtopic.php?t=173802


----------



## Plainsman (Jul 30, 2003)

The moderstor move tool wasnt we working this morning so I deleted some spam for gay teen dating.


----------



## mmorgan121 (Jan 9, 2020)

Instead of getting any kind of healthcare services from the government or private clinics, I would rather consider for the actual steps and modifications, that you can do in your own house, preventing those diseases, as much as possible. Just take a look here, at Healthy Home Makeovers website, it has plenty of really useful stuff, that can help with maintenance your personal health at the home conditions.


----------



## howardtaylor (Nov 17, 2021)

Thanks!


----------

