Sept. 7, 2009 issue
Health care debate
By Carl Hege Aberdeen, IdahoI hope Helen Nachtigal’s stomachache has abated, even without Obamacare. She deplores “rude” behavior at town-hall meetings. These citizens are expressing legitimate concerns about what is not being explained. At least they are not resorting to the vitriol, thuggery and violence that seem to delight some liberals. How dare anyone question this ambiguous plan of government takeover! It was Hillary Clinton who said dissent was the highest form of patriotism. I guess freedom of speech applies only to certain people.
Of course, the words “death panel” will not appear in the bills, though bureaucrats will make life-and-death decisions for us.
No one really knows what is in these bills, including members of Congress who defend them. Yet some of the uninformed insist they know how rosy this will all come down. There are other ideas to help the 46 million uninsured. These ideas are ignored, because their advocates didn’t win the last election. As for Medicare, it is already going broke. Spending is out of control, and we’ll soon have to pay the piper.
Whoever compared President Obama to Hitler is pathetic, but liberal blogs and other media that called for President Bush’s assassination and other forms of hatred toward him are reprehensible. This is not about Obama, but about the direction our country is going. I hope we can communicate in a more Christ-centered way in the future.
Comments
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Thank you Carl for your brief, but very informative message.
The ignorance of proposed health care supporters is sad. As I have ststed in the past, this is not about true health care but rather an attempt for additional government intrusion into our personal lives. It is another entitlement program and the government has an extremely poor management record in other progams.
Improvements in existing health care practices would be to promote medical savings accounts, tort reform and competition among insurance companies across state lines in states that may be restrictive. In addition, get government out of current health care programs.
Tort reform is not even covered in current legislative proposals. The trial lawyers and their many and extremely high dollar lawsuits is another way for Democrats to spread the wealth. These costs find their way to our personal budgets in the form of high doctor and hospital charges.
Furthermore, MC USA should not be asking the government to extend taxpayer paid health care to everybody when MC USA does not, and never has, extended paid health care to men, women and children in MC USA.
Do we really want to trust those in govenment who openly have a low regard for the sanctity of life? I am thankful for the truth that is emerging on this issue.
If you think healthcare costs are high now, wait till it is free.
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Why are people talking about Medicare going broke when it is not projected until over 25 years from now? How long has the federal government been broke? I assume the writer defines "broke" as no longer having a balance in the trust fund. Reagan/Bush quadrupled the deficit by cutting taxes and increasing military spending. The most recent Bush doubled the deficit. (Check the facts. They are true.) Why did not their supporters complain? It is only when the deficit continues to increase, started with the $787 billion for the bank bailouts under President Bush that we hear many complaints.
You can donate your medicare payments back to the government if you want the government "out of current health care programs". But my mother (deceased)would not have voted for the end of Medicare. My wife, my siblings and spouses, and I will not vote for that. That would be more health rationing than we already have.
My wife and I have filled 4 prescriptions this year. Three of them were not paid for by our health insurance or any other insurance. That is rationing of health care. We pay for the coverage, but they do not cover them. -
Dale, you are surprisingly quick to label others with whom you disagree ignorant, especially when your arguments are based off of so much disinformation and bias. Your arguments consistently fall under their own weight.
Current health care reform proposals do not include new entitlements. The public option is something Americans must buy into. Its primary goal is to keep the private insurance monopolies honest through market competition.
Our current health care situation puts the free market to shame. Why? Because they function as a monopoly. Consumers must pay increasing amounts into insurance for years, and the system functions well. That is, until the consumer becomes ill. First, the insurance company fights paying its obligations, denying coverage. Sometimes the time runs out on the coverage battle and the patient dies. (The "death panel" has struck!)
Next, the insurance company grudgingly agrees to pay treatment, but looks for the earliest opportunity to drop the patient. The patient is left in the lurch, and is unlikely to get coverage through another insurance company, since no one is interested in a "pre-existing condition." Consumer, who has done everything he could to be responsible, goes bankrupt or dies of a curable ailment.
All of this works in the "free market" because insurance companies have the market for a necessary commodity cornered. Thus, insurance companies are free to take their clients' monthly payments while not providing the coverage agreed upon. Stock holders are happy. CEOs are happy, since they can take home their multiple millions, but the consumers are cheated. Nevertheless, they come back because going without health insurance is even worse.
Dale, I must ask you, since you are so set in your defense of the status quo, and even though I know better than to expect an answer from you: Is such a system just? Is such a system sustainable? Does such a system place greater sanctity on life or profit? Finally, I must ask. Why do you dedicate such energy to defending a system that will just as soon swindle you as anyone else?
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Oh. Lest the second paragraph above be confused. Americans must buy into the public option if they choose it. They will still be free to buy private insurance. My point is that it will not be an entitlement or give away.
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In paragraph 1, I complimented Carl on his letter to MWR.
I find it interesting that in letters from Jim and Les, directed to me, they really do not address the issues I raised in my other paragraphs. Further, some of their statements are vague, such as Jim's first paragaph that I am unable to address.
One more thing, social security and medicare are not in any trust fund. The government is not legally obligated to pay taxpayers one thin dime, that is why they can make reduction in benefits at their discretion. Both are funded by taxes that go into the US general fund.
On the other hand, corporations who have pension plans for their employees are required by accounting rules to fully fund their pensions plans in a separate fund managed, I believe, by an investment firm. Not so the government.
If Medicare and Social Security were accounted for in separate trust funds, there would be no cash on hand, only IOU's, therefore I don't know how Les can state that Medicare is solvent for another 25 years. Further, current unemployment is in double digits, businesses are going bankrupt, therefore social security and medicare taxes from employees and employers will be significantly less, yet benefits to taxpayers will increase. Go figure.
Jim, if you read my comments carefully, I am not satisifed with the status quo as you indicate as I made several suggestions for cost reductions.
When each and every issue in my paragraphs are addressed, then I will address specific, not vague, issues from anyone, but not until then.
One more question for Jim and Les, do you believe government health care legislation currently in congress, without tort reform, will provide quality health care for every one at lower cost and not violate the physican's hippocratic oath? If yes, tell me how.
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Dale, it is hard to dialogue with a person who does not accept facts. Check on the Social Security Trust Fund website and you will see that there is listed more than one trust fund, it statesL "each trust fund". The money may go into the general fund, just as no one has an account at the bank that is kept separate in their name. It goes all into similar funds. But each one gets the interest according to the contract.
Second, the unemployment rate in some areas is in double digits. Nationally, it was reported last week to have gone up to 9.7%. That is not a double digit unless you remove the decimal point. Third, your complaint that the Mennonite Church does not provide free health care to all its member families and children (and attenders and illegal immigrants nearby as you once wanted) can't be done without costs. You refused to say if your were willing to pay your share. (Please don't blame others for not answering your questions, when you do not answer ours.) We have tried to answer your questions, but you come up with others that even you can't answer and you know are not reasonable questions.
There may be false terms used. There will be no free health care for everyone. Many do not pay their bills now, so they get "free health care". Talk to any authority at any hospital and probably doctor's office. Those insured pay for the care of the nonpayers' care. As was explained before, the Mennonite Church does not have enough money to give "free health care" to those you claim we should. Third, what health care legislation in Congress are you talking about? There are several bills. I believe what Obama proposes can be paid for. If we can spend $1 trillion on war in less than 10 years, we can spare $1 trillion in 10 years on health care. (Every dime we have we have gotten from someone else. So why should the billionaires say it is their money? They got it from us!) I need to believe my President until proven unbelievable. Some people claim he has lied, but I have not heard of any specific lie stated. He has a tremendous job and he does not know everything. As he learns, as have all previous Presidents, he has had to tweak his plans and proposals. Please accept facts and be reasonable. "each and every issue addressed".? Do unto others as you want them to do unto you. Set an example and we will follow. -
Dale, it is possible. Canada, Great Britain, France, Sweden, and a whole host of industrialized countries are able to keep costs down while extending treatment to all. None of their doctors are forced into violation of their Hippocratic oaths. Are their governments really better than ours? This would seem to be your argument.
I might add that many of our doctors are presently forced to set aside their Hippocratic oaths when dealing with insurance adjusters. That is sort of the whole point of my last posting, that the present system favors profits, not patients.
Concretely, here is what the proposed bill before congress would do.
It would outlaw discrimination against sick people.
1) Exclusion of patients from coverage due to "pre-existing conditions" would be outlawed.
2) Dropping a patient's coverage or capping off a patient's care due to serious illness would similarly be outlawed.
3) With the use of a public option--I reiterate, option is precisely what it means, although those who chose it would have to buy in--the government would guarantee health insurance coverage to all at an affordable price.
The public option would provide market competition against what has so long been a virtual health care monopoly. Insurance companies would be forced to turn profits based on their ability to attract and retain clients. As a result, they would be forced to put patients first, while cutting down on overhead costs.
Today, billions in health care expenditures disappear into the insurance companies' overhead long before the patient comes into question.
In answer to your question of cutting costs, here is a major cost cutting opportunity that goes unrealized today precisely because insurance companies are beholden to their investors and not to patients. Thus, insurance companies have an incentive to inflate overhead, because any income that does not go to helping patients can be counted as profit. It does not seem likely that eliminating state restrictions will do away with this problem.
Removing government from the equation entirely would not be advisable. Who else would offer seniors health insurance? They are, by definition, a higher-risk group for health insurance.
Finally as to tort reform. I agree that sometimes these lawsuits range into the ridiculous. However, there are quite a few that are legitimate. I think tort reform ought to be discussed, but on the other side of the present proposed reforms, since the problem with lawsuits is more a symptom of the greater health care crisis than its cause. Moreover, so long that health care is treated as an item to be dictated by the market, and so long that so many people go bankrupt due to illness, consumers should have every right to recover their money, plus damages, should something go wrong.
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Dale, sorry, I had an appointment and did not finish my note. You could get some of your answers from the internet. I mean the reliable sources, not the prejudiced sources. I have always heard "Social Security Trust Fund". Some times our reasoning is faulty, so let's stick to the facts. The government debt is in bonds, call them IOUs if you want (that is what they are), but China and other countries have a sizable amount invested in our debt. Check the reliable internet, or your public library. The library staff here has been very helpful.
The Bush administration in several departments have said that Medicare is solvent until 2037. Some say benefits may be reduced before then. But no one knows that far ahead. Former President Bush, soon after he attacked Afghanistan on World-wide Communion Sunday, said (I heard him.) that we had plenty of money to fight the war and meet our domestic needs. Several times he said in his second term that we were on target to balance the budget in 2012. Ah?? I don't say he lied. It is obvious that he did not know the future and he was not good in math.
The recent statement from Social Security is that there will be no benefit increases in 2009 and probably not 2010. But Medicare premiums will go up, so the Social Security recipients will actually get a cut in benefits.
According to the time posted, Jim was writing the same time I was.
I will not go back over all your writings, but is there anything we have evaded in your last posting?
Someone suggested that you read two books before more posting on health care. Did you read them? Or are you the only one that is allowed to make suggesting or demands?
I suggest that you watch President Obama tomorrow night and that will tell you how the health care plan will be paid for. President Obama said the plan would not increase the deficit. He may be as right as President Bush. But I am willing to give him a chance. And if he is wrong, he should not be criticized, or called a liar, any more than President Bush
It is strange that some people want us to have the ability to choose our Dr. etc. The public option would give us another choice. I favor that. Currently in my insurance I have to clear my Dr. and all of my prescriptions with my insurance company before they will cover the bills. Therefore, I have rationing and do not have much choice. The last three prescriptions we had filled were not covered by our insurance. We paid the full bill, and we are supposed to have insurance.
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I find a few things in this debate amazing. The first is that much of this fear mongering--lack of choice, rationed coverage, death panels, etc.--has originated with health insurance companies, their paid employees, or their bought elected officials.
The second point of fascination is that the insurance companies restrict choice of doctor and medication, ration coverage, and effectively hold death panels when they frequently deny coverage for life-saving operations. They are in effect projecting their own ills onto the reform.
The third area of interest is that some are unable to see past their fear to see who its primary beneficiaries--the insurance companies--are, and that their fears are, in fact, a reality under the present system.
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According to the CBO, large savings in malpractice premiums would not cut health care costs very much. The cost of malpractice suits amounts to less than 2% of our health care costs. It seems that the insurance companies are the benefits of malpractice insurance because the premiums are rising twice as fast as health care costs. Source: Congretional Budget office when you search malpractice insurance costs on the internet.
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A note of interest: In reading the arguments above (and hearing them in the media) everybody fails to mention that Canada, France, Britian, Sweden etc. have population sizes far smaller then the U.S. In fact, those four combined have a total population of 169.1 million people.....half the U.S population. The U.S has more uninsured then Canada has citizens! Can you imagine a single-payer system functioning efficiently in this context when even those countries experience distinct challenges? We are fulling ourselves into believing a canard.
Also of interest, when have Mennonites trusted government more then their fellow members or neighbors? If we have problems with effectively implementing mutual aid in healthcare within the church, how will the federal government do a better job and with any resemblance of the stewardship we often claim to stand for? A dollar paid to govt. is a dollar that could have gone to the church or stayed with the person who earned it.......we seem to forget all those dollars leaving daily and discreetly and treat them differently. The govt. is the worst steward of our/God's resources we could imagine and blanket support of it......in any instance (war or otherwise).......has never been Mennonite.
Thanks for the time.
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Thanks, B. Weaver, for your entry. You bring up some good points. You are right. some issues have not been focused on. I'm not sure that the government plan is a single payer plan. The United States does have many more people. That means we have a larger economy and a larger pool to draw from. The promise is that the cost will not increase the deficit. Is it better for our dollars to go to insurance companies than taxes--a large part of which goes for war? You can go on the Social Security Trust Fund web site and see how much interest is paid per month since Social Security was started. Insurance companies don't pay interest. The overhead for Medicare is 2%. For private insurance companies the overhead is 17-20%. Which is better stewardship? It is a complex issue.
More than all that, I have been a Chaplain in assisted living/nursing homes for over 10 years. I would like for you to hear all the stories I'm told of the medical errors, the dissatisfaction with insurance, etc. of these seniors. It is pathetic. Some have died because of these things. We need a better system from the bottom up or the top down. You have not given us any ideas of how to improve the present system. I watched President Obama last night. He has many good points. I would rather get my information direct rather than have it chewed up and spit out by talk show hosts and the media. The son of a woman (he was present)I visited Sept. 8 said he did not think he would listen. His comments make it clear that he had been listening to those who do not tell the truth. I prefer the truth. At least we need to be civil as we discuss the issue and listen to speakers. Personally, my wife and I have prescription insurance. However, our insurance refused to cover 3 of our last 4 prescriptions. Fortunately 2 of those were not expensive. I have never had problems with medicare. I was sure for months that a male member of our small group had Parkinsons Disease. His Dr. only diagnosed it a couple months ago when his shuffle was very slow with short steps. The symptoms to me were for a long time visible. I have been pastor to a significant number of people with Parkinsons. My father had it.
My plan for improvement is the President's plan.
Then there is the Biblical plan to help the poor. All the money we have, we have gotten from someone else--inheritance, gifts, wages, interest, etc.
Enough written?
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The population size argument does not hold much water. From personal knowledge of the Canadian system, much of the day-to-day medical decision making is left to doctor and patient, while the state primarily serves as single-payer insurer. This allows the state a strong footing in negotiating prices with drug companies, and for medical care in general. This also helps ensure availability of health care in rural areas. The latter is something the United States already does to a certain extent with tax and student-loan incentives. None of this would be difficult to run in the United States. Although the transition could be rough, the results would be more efficient. Each of the countries listed pays less per capita than we do for medical treatment than we do. In other words, even if taxes would increase, one would still be taking home more overall because of savings in private insurance.
Nevertheless, this is not what is on the table in this country. There is no move for a single-payer system, and there is nothing on the table that would limit insurance options. The proposed reforms would make it so that Insurance companies could no longer legally deny coverage for pre-existing conditions, nor could they legally drop coverage in case of illness, or place caps on coverage.
The public option, meanwhile, would be available to all. It would be 20-30% less expensive than current health care coverage, while offering full benefits. The public option would be useful primarily in leveraging insurance costs down through market competition.
Finally, everyone would be required to buy insurance. Tax incentives would be offered based on need to make this affordable to all. With everyone insured, there will no longer be cases of bankruptcy due to medical emergency. Those of us with insurance would no longer be paying extra premiums to cover the costs of those who can't pay, because everyone will be insured. The net result in all of this is more money to take home because of lower insurance costs.
The plan is said to cost 700 billion over ten years, but much of the cost will come in Medicare savings. Medicare costs have gone up with health care costs for the reasons listed above. With the health care costs lowered, Medicare will cost less, too.
As for trusting in government as Mennonites. Again, Mennonites have not shied from working with the government in the past when our interests have coincided.
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A few facts to consider:
Low administrative costs of Medicare are a mirage.....we are being lied to. The claim that Medicare's administrative costs are only 3% is fantasy. If all Medicare costs—such as revenue collection, personnel and enforcement—were accounted for, its administrative expenses would be at least twice as high. And it still wouldn't be providing services private insurers do, such as nurse hotlines, decision-support tools and fraud detection, or paying the income, property and provider taxes that private plans must pay (Note the last - LOST TAX BASE & ADDED TAX BURDEN!)
Medicare IS going bankrupt. The Medicare Trustees estimate that the program will run short of money starting in 2017. Medicare will drown in a sea of red ink, with spending over the next 75 years outpacing dedicated revenues by nearly $38 trillion. Add the 70+ million baby-boomers getting set to retire in the next decades.
Private payers are bailing out Medicare. According to Milliman, an independent actuarial firm, Medicare — and to an even greater extent Medicaid — underpays doctors and hospitals, shifting costs to private insurers. Milliman estimates that the average family in a private PPO health plan pays an additional $1,788 a year to compensate for underpayments by Medicare and Medicaid, representing a "hidden tax" on commercial payers totaling $89 billion a year.
I agree with B.Weaver. This blanket acceptance of government is both troubling and ill-advised. There are other ways to cover everybody, eliminate medical bankruptcies and provide high quality care that do not involve the takeover of healthcare by government. A more Christian way. There are few medical or business professionals that advocate a government plan because they know the truth......lower payments aren't sufficient to sustain current levels of care and and enforced lack of right to choose (both at a patient level and for businesses - currently businesses can switch plans - could you refuse to pay taxes on a govt. plan and keep your business?)
I suggest we perhaps look at an auto-insurance model for primary coverage and perhaps have expanded medicaid or subsidies/co-ops for those who fall through the cracks. Free the system instead of confine it....allow for better coverage at lower prices. Tort reform........and we should have total Mennonite support here......should also be a primary concern.
The American consumer is not ready, or able, to accept what realities government care will force on them. I hope some compromise is reached before its too late.......
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Joel, you give the wrong impression about Medicare "running short of money in 2017". Read the Medicare Trustees Report on the internet again.
There will be "cash flow deficits beginning in 2016". Reserves will be exhausted in 2037. There is plenty of time to make some adjustments before then.
Medicare Hospital Insurance (HI--one of 4 trust funds) reserves will be exhausted in 2017, but they will still pay 81% of HI costs. (Medicare website)
Medicare Hospital Insurance is only part of Medicare, not Medicare.
Private payers are paying now for uninsured patients and for those who do not pay their bills. --Reports from hospitals.
The CBO estimate is that only 5-10 million would sign up for the government option should one be offered. If that is true, there is a big fuss over less than 3% of our population.
6% overhead is still far below the 17-20% private insurers overhead. Usually overhead does not include profit. We provide for their profits.
It is true that there are many problems with Medicare and private insurers. I'm glad that we have a President that is persistent to work at it. His plan is not perfect. But we can improve on it in the years ahead--that is, if people will be honest and civil. We can all help with the civility and honesty. We cannot start over as someone said we should do. The atmosphere is so poisoned that some do not believe the truth.
Most of the rest of your article is too technical for me.
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Kudos to Welty and Weaver!! We need some rational debate instead of naive and blind loyalty to a cause that sounds good and makes us feel good. I still don't understand how people who know virtually nothing about the bill insist they understand it completely. Logic will tell us that it just doesn't add up. It seems partisanship plays a major role. I am tired of people telling me how Mennonites should vote and what to think. God gave us all a brain and we should use it, not be a bu;nch of sheep herded down the trail.
Henry
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There is no THE bill. So no one has read THE bill nor understands THE bill completely. There are several bills to be finally worked out in committee between the House versions and the Senate versions. That is why I liked President Obama's first hand explanation. He is now giving leadership to the debate. I believe facts and experiences trump opinions, including those that tend to criticize instead of improve and encourage. What can you add to improve the atmosphere and attitudes as well as the content of the final decisions?
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Henry. I must say I agree with some of your arguments. It is ridiculous to tell me how a Mennonite should vote and how a Mennonite should think. It is a crime when people who know absolutely nothing about the present health care proposals pretend that they do. It is ridiculous that so many are led about like sheep rather than using their God-given brains.
I am Mennonite, versed in scripture, and I will thank the right wingers among us to stop telling me how un-Mennonite it is to support the proposed health care reform. I support it because of my Christian, Mennonite faith, which calls me to compassion for the ill.
I also do not understand how people who know virtually nothing about the bill can insist that it contains all manner of evil. Obama clearly outlined the goals of the legislation, and the health care reform proposals have been made clear from the beginning. Why do so many right-wingers see fit to make up lies about death panels, socialism, and government takeover? If one says he knows nothing about the bill, then that is where it should stop.
Finally, why do so many right wingers see fit to be led about like sheep by the interests of the health insurance industry? Or by the likes of Rush Limbaugh, Glen Beck, and company? None of these have your interests at heart. All of these will abandon you when you are sick and no longer profitable. There are plenty of other people to make money off of.
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