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Cherie Kail
Posts:41
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| 08/14/2008 2:34 PM |
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Health Care is the topic.
Dr. Lilly gave a FABULOUS outline of the current health care system and opened the floor for questions. John, if you read this, is there a way you can post your type-written doc to the forum? It provided a GREAT wealth of information! Thank you :)
A fact to note, step aside from this, but it ties back to health care: by 2042 only 50 percent of Americans will be native white American citizens. The rest will be foreign-born immigrants. That is also allowing for population growth to nearly 500 million, though we have just crested 350 million. The bulk of the growth will be due to immigration (legal or otherwise) and the high birth rates among those certain demographic groups. Very few will be educated, native citizens of this country. Beware the Newspeak!
Back to health care: private insurance follows rates set by preset Medicare multiples. If there were greater transparency in health care and government, how many patients would be truly cared for? How would that affect the government mandates where there is a tracking system for transplants and what about government regulations on reporting, what would the follow-up standards be? Should incentives be offered for preventive care? Subsidizing a servie (i.e. health care) merely means that those who do not use it provide for those who DO. In essence, the Rich pay for the Poor. Consider this: With Universal Health care comes higher tax rates on federally mandated services. Because taxes are passed on through sale of goods and services, this becomes evidenced in the relative cost. Disproportionate taxation affects most strongly the poor!
We need a case and need to bring home the fact that $2.2 trillion is spent in the U.S. on health care. Less than 5 percent of that is truly for medications (Rx) but a cornerstone of Conservative beliefs is that it is not just "in our hands" We need a comprehensive medical plan that will allow us all to take individual control and we need a strong Conservative response to that statement.
People who support Universal Health Care should take a moment to realize how ineffective and inefficient it is. We don't have a health care crisis as much as we have a health care financing crisis. Why is the health care system set up for referrals? With the ability to put more power into the peoples' hands, it effects competition. Doctors make a little less money but can attract the strongest attention by the best level of care offered.
What a doctor gets paid for is what a doctor will do more of. Fewer customers=higher costs=incredible service.
With union negotiations, health care is a huge negotiation factor. Health care is the way most companies strive to keep their employees happy in America. If we went to a user-pay catastrophic health insurance and followed criteria for a better premium plan and had this choice, wouldn't that be a better base to build on?
Base rates exist from state mandates and is nationwide as a collection pool, so we can afford better health care insurance.
Some health conditions can cause others--just knowing people, how do terminal illnesses and genetics factor into this type of reform? Would it make sense if all health care costs were decreased in monthly premiums, could we afford them so that we'd have fewer people just needing a safety net?
Check this out: http://medi-share.org/what_is_medishare.aspx
With a free market, part of society that wants to be told and let the Nanny State handle their affairs just clings to that. We cannot lead by pandering, so we have to stand up and take control to clear up the mess we have created. We only have to win over thirty percent of Americans to conquer the Conservatism and win over the real moral values.
The AMA proposal would eliminate billions in tax dollars and subsidies to give to medicaid to help pay for those who have not and this can replace the losses. Health care is not currently competitive but if it were, we could stretch it much farther. We also have to realize the insuance industry is backed by reinsurance companies and the money has to come from somewhere so our rates will inevitably increase. Furthermore, health care is not a RIGHT. It is a privelege, something that must be worked for or paid for. We need to educate people, change the underlying principle of that philosophy that it is owed to us! |
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John Lilly
Posts:15
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| 08/22/2008 8:41 PM |
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Here is my talking points from the August 12th meeting. John Lilly
Health Care Summary
1. Health care is not a right.
2. Employer paid health insurance started due to wage and price controls during World War II.
3. When Medicare was started, health care was very simple. Since that time, medical procedures have become more complicated and expensive, and individuals are living longer.
4. Private insurance rates follow Medicare rates. They are a percentage of Medicare rates, i.e. 120%, 130%, etc. Whatever Medicare pay for a specific visit or procedure, the private insurance will pay 120% of the rate. By law, private insurance rates cannot be less than Medicare rates.
5. Insurance reimbursement is based on encounters and procedures performed, not on maintaining health. In a fee for service arrangement the more a physician does, the more a physician earns. In a capitated health-maintenance system the less a physician does, the more a physician earns.
6. The current health care system is not a market based competitive system. An example of a competitive system is the cellular phone industry. An example of market based competition in the health care system is LASIK eye surgery and cosmetic plastic surgery, because the individual consumer pays the entire price.
7. National health expenditure reached $1.9 trillion in 2004, accounting for 16% of GDP, or $6,280 per person. Overall, sources of funding are 55% private ($1,030 billion) and 45% public ($847 billion), with 71% of public spending by the federal government. More than a third of all expenditures ($659 billion) were made by private insurers, with Medicare and Medicaid each accounting for about 16% ($309 billion and $293 billion), and patient out-of-pocket expenditures 13% ($236 billion). (AMA Reports of Council on Medical Service, June 2006. Original source: Adapted from NHE data reported by Smith et al., Health Affairs v.25 no.1, January/February 2006. Primary data from Centers for Medicare and Medicaid Services, Office of the Actuary, National Health Statistics Group; U.S. Department of Commerce, Bureau of Economic Analysis; and U.S. Bureau of the Census.)
8. Employer provided health insurance is a $246 billion tax subsidy given to employers. Health Insurance Experiment was a RAND Corporation study in the 1970s. It enrolled 7,700 adults and assigned them to one of five groups: participants in group 1 were offered free care, those in three were offered varying levels of cost sharing (25%, 50%, or 95%) up to a maximum expenditure, and those in the last were enrolled in a nonprofit health maintenance organization. Patients with 25% coinsurance spent 20% less than those with free care, and those with 95% coinsurance spent approximately 30% less. Savings resulted in using fewer services rather than from finding clinicians or health centers with lower prices. There were no differences in the health outcomes of the five groups. Cost sharing reduced overall use of medical care, but there was no difference in change of use between effective and ineffective care. In addition, differences in inappropriate hospital admissions between cost sharing plans were not statistically significant. (What Is Different About the Market for Health Care? JAMA Dec 19, 2007).
9. Health information technology (IT) offers tremendous opportunities to make care safer and more effective and efficient. As more and more physicians, multispecialty group practices, hospitals, and health systems make sizable investments in health IT, the benefits in terms of quality of care have become clear and compelling. Overall, IT adoption continues to be slow, with 4 percent of physicians having access to fully functional electronic health records (EHRs) and 14 percent using EHRs with minimal capabilities. Three of every four physicians are in small practices (1–4 physicians). They, in particular, face major economic, cultural, and technical challenges to implementing health IT. For the most part, large group practices have successfully transitioned to EHRs. Continued efforts to promote health IT adoption at all levels of the delivery system are crucial to achieving system transformation. (Crossroads in Quality, Heath Affairs, May/June 2008)
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John Lilly
Posts:15
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| 08/22/2008 8:45 PM |
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I also have a summary of an excellent book on health care, Redefining Health Care: creating value-based competition on results - Michael E. Porter and Elizabeth Olmsted Teisberg (Harvard Business School Press 2006)
I can e-mail a copy to you if you send me an e-mail requesting it:
jlillydo@sbcglobal.net. |
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John Lilly
Posts:15
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| 08/22/2008 8:48 PM |
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Here are some ideas for the next meeting on August 26th
Health Care Summary
1. Transparency in pricing
2. Eliminate state mandates
3. Eliminate federal subsidies
4. Promote nationwide plans
5. Promote electronic medical records
6. Promote measurement and reporting of results
7. Promote new payment models
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John Lilly
Posts:15
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| 08/24/2008 9:19 AM |
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| Ther are good resources on health care policy at the American Enterprise Institute web site, www.aei.org. Click on Health Policy in the left hand column and download How to Fix Medicare. It's a long paper, but worthwhile. |
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