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Health Care Debate

Health Care 2004

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#1 Kevin Street

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Posted 19 May 2004 - 03:13 AM

Let's talk about something new in OT. As I understand it, health care in the United States is paid for almost exclusively by private insurance companies. (Except for the poor, who can qualify for a government program called Medicaid.) Most people don't pay for this insurance directly, but instead receive it as a benefit provided by their employer. However, there are apparently forty-two million Americans who have no health care insurance at all - they have to pay their doctor or hospital directly, or more likely, simply go without medical care until an emergency makes hospital treatment unavoidable.

Both John Kerry and George Bush have proposed solutions to solve this problem and provide some kind of medical coverage for the missing forty-two million, but the two proposals differ radically in both philosophy and scope. Here's an excellent webpage (imo) that compares the two plans in a nonpartisan way:

Candidates Offer Very Different Health Care Plans

And here are some quotes (but you really should read the whole article to get a sense of the big picture):

Quote

Bush Favors HSAs and Tax Credits

In the past four years, spending on prescription drugs has tripled and the cost of health care premiums has spiked 40 percent. In response to these changes, Bush recently held several televised meetings in which he promoted Health Savings Accounts that are already available to voters.

Bush's Health Savings Accounts allow policyholders to pay for medical expenses directly and save any money they don't use in a tax-free account earmarked for healthcare costs in the future. The accounts resemble Individual Retirement Accounts in that they allow people to plan for the future at no tax penalty today. Available since January 2004, Health Savings Accounts are now taxed when they are purchased. To make these plans more affordable, Bush proposes removing these taxes and making premiums paid through the accounts tax-deductible. The accounts can serve as primary health coverage, or help people fill gaps in their employer-sponsored coverage. If an individual does not have insurance through a job--or if an employer's plan doesn't pay for expenses such as out-of-network doctors or diagnostic tests--the accounts can be used to help cover costs.

Bush also proposes a tax credit that would help uninsured Americans purchase private health insurance. Under Bush's plan, individuals earning $30,000 or less would get $1,000 back in taxes every year and be able to use this money to buy insurance. Families earning $60,000 or less would get $3,000 back in taxes and use this money for family coverage.

In addition, Bush proposes expanding prescription drug coverage offered by Medicare (55 percent of those covered by this federal health program for the elderly are female) and creating 1,200 new public health centers.

Quote

Kerry Would Boost Government Programs

Kerry proposes expanding both Medicaid (a federal program that insures low-income Americans--) and SCHIPs (state children's health insurance programs). By bolstering these programs with more tax dollars, Kerry hopes to cover all uninsured children in households earning up to $55,000 and all parents in households earning up to $37,000.

Currently, 9 percent of Americans (50 million people) are insured through Medicaid or SCHIP programs. Of the adults covered by Medicaid, 70 percent are female. An additional 14 million qualify but have not yet enrolled. Kerry hopes to register them by automatically enrolling children when they enter public school or when they visit public health clinics.

To help more Americans gain coverage, Kerry would allow individuals to buy into federal employee health benefits. During his recent health care tour, he pledged to cut insurance costs by 10 percent for both individuals and families.

Kerry also hopes to make health coverage more affordable for businesses to provide to employees. According to a 2003 survey by The Kaiser Family Foundation, rising medical costs are forcing many employers to cut back on the coverage they offer. Under Kerry's plan, the government would help employers by absorbing most of employees' catastrophic health care costs. Small employers would receive a tax credit of up to 50 percent of the cost of health premiums for low to middle-income workers. Small businesses would also be able to participate in the insurance program now offered to members of Congress.

Quote

For more information:

Kaiser Family Foundation--
"Side-by-Side Summary of Presidential Candidates' Proposals for Expanding Health Insurance Coverage" (Adobe PDF format):
http://www.kff.org/u...ad/29348_1.pdf

John Kerry for President--
"Affordable Health Care for Every American":
http://www.johnkerry...ues/healthcare

George Bush for President--
"Health Care: Issue Brief":
http://www.georgebus...care/brief.aspx

So what do you think?
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#2 Kevin Street

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Posted 01 August 2004 - 06:46 PM

This thread died on the vine a while back, but I'm hoping that there might be some interest in it now so I'm giving it a bump.

What do you think about health care?

#3 Rommie's Ronin

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Posted 01 August 2004 - 07:53 PM

Glad you bumped this, since I missed it the first time.

If you look at the two, Bush's plan essentially says (as I read it) "let the public create their own health insurance through an organized effort."  Kerry is saying (same caveat) "Let's expand the government's role in health care."

I have to run with Bush on this one.  Kerry's plan means more taxes...period.  God Almighty knows, we've had enough of the government dictating our health through impersonal plans and whatnot...and we don't need more taxes. Bush is trying to cut the taxes and stimulate the economy that was wrecked by Clinton's administration (and he inherited and is getting blamed for) and shift health care to the individual.
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#4 Shalamar

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Posted 01 August 2004 - 08:15 PM

Medicaid is fine for children and the very poor, but for those of us caught in the middle it is not helpfull at all.

I favor Bush's over Kery's - in his the money will have to come from taxes - so those will either be raised or other programs raided for the funds to expand medicaid.

I'm against bloating the goverment even more, raising taxes even more.

And cutting insurance costs? How by odrering ( via some sort of law setting limits on how much an insurer can charge?) the insurance companies to reduce rates....I can't see them bowing down to this.

In my previous job I had great insurance...and I paid for it. The company I worked for paid the bulk, and more was deducted from my paycheck to cover the options that I 'bought'.  I've been without insurance since that job ended, somewhat over a year a go. I went with out medical care during that time.  I have no benefits with this new job and so I will continue to go with out as I can't afford to by private health insurance.... Neither of their plans will do much to help me so it's pretty much a theoretical discussion for me.
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#5 DWF

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Posted 01 August 2004 - 08:29 PM

I'm not sure how cutting taxes will help matters, I don't think it'll change the insurance rates. But I do think there should some change in the allowable malpratice suits, it's those suits that are raising the insurance rates.

And I think both of those plans will change over time, if Kerry becomes President, or if Bush stays in office, their plans will change.
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#6 Ogami

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Posted 01 August 2004 - 10:45 PM

The "forty-two million without health care" is just a political ploy.

Many of those are young people, for example, who don't want any health insurance. They're not weeping in the gutter or the alleyway, hoping some bureaucrat will come by to save them.

Like prescription drugs, a federal program will be set up so that everyone pays for it, whether they want to partake of it personally or not.

(NOTE: The above comment is not intended to disparage any particular poster, group of posters, political party, political affiliation, philosophical discipline, or body of people anytime or anywhere, pursuant to advanced moderation guidelines)

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#7 Shalamar

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Posted 01 August 2004 - 11:37 PM

Actually Ogami that number comes from census data,

Quote

The ranks of those without health insurance grew from 41.2 million in 2001 to 43.6 million in 2002, according to new data the Census Bureau has just released. The percentage who lack insurance rose from 14.6 percent in 2001 to 15.2 percent in 2002.

from the Center on Budget and Policy Priorties
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#8 Shalamar

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Posted 01 August 2004 - 11:45 PM

and it's just as possible for a young person to have a catastrophic health problem as it is for an older person.  They are just as much at risk, if not more so - they may not have the savings, home equity built up etc to be able to weather the costs of major medical care.

An emergency room vist cost about $175, an ambulance ride about $125.  For a 20 something that could be quite a bite out of their funds.  You don't want to think about what an MRI costs.  They (young people ) may not want it or think they need it, but it's a smart thing to have.
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#9 Ogami

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Posted 02 August 2004 - 07:28 AM

I get that it's from census data, but the point being that those people who don't have health insurance haven't gone out of their way to get it. Why must the government provide everything? We have to pay for it in the end. The idea that the government can provide all this "free" stuff comes out in the goods you buy, the other taxes you pay, anyway.

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#10 Shalamar

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Posted 02 August 2004 - 08:57 AM

Well, it's not that they don't want it, it's that they can't afford it.

Both plans have the goverment providing some help with this but to me Bush's plan looks like less goverment bloat, and increased taxes.  I don't think we can stop the goverment from shoving it's nose in, so I think we should go for the plan that keeps the goverment out the most.

I really think the public as a whole needs to get together and  talk about /work out a solution curtailing the factors that are making medical cost go up so much.

The cost of a doctors malpractise insurance is one big factor. And that cost has been driven up so much by what I consider frivolous lawsuits.

It's been reported (and sorry I don't remember the article ) that OB-GYN's are giving up their OB portions of their practise in droves because of the cost of the insurance.  That hurts us all.

Hospitals too have to cover the costs of paying for lawsuits, and thus raise their rates.
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#11 Drew

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Posted 02 August 2004 - 09:03 AM

Quote

I get that it's from census data, but the point being that those people who don't have health insurance haven't gone out of their way to get it.

When I was in my twenties and working for a company that did not provide health insurance, I got my own through a major insurance provider, and because I was a single, healthy twenty-something, it was pretty cheap. I suspect that a lot of twenty-somethings that aren't covered haven't really considered that for them, assuming there are no existing health issues, it's not expensive at all. If you do have an existing condition, it may pose some financial problems, but otherwise, I wonder if many uninsured young people are uninsured just because they don't see a need for it.

Here in Wisconsin (as in many other places, I'm sure) farmers are one group that typically goes uninsured, because getting insurance for a large family is a lot more expensive than for a single twenty-something. The state is planning to implement a program by which farmers and other self-employed people can cooperatively get in on group health insurance, which makes a lot of sense. I think a big problem is that insurance offered at a group rate is so much cheaper than insurance offered individually. Are we to believe that the "group" has fewer medical problems than the individual?

Anyway, should this program work out, and I am completely (rather than partially) self-employed, we'll definitely be looking into it.

Now about rising health care costs due to frivolous malpractice suits, I wonder if John Edwards will admit to his part in that?
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#12 Anna

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Posted 02 August 2004 - 09:21 AM

Drew, on Aug 2 2004, 08:01 AM, said:

Here in Wisconsin (as in many other places, I'm sure) farmers are one group that typically goes uninsured, because getting insurance for a large family is a lot more expensive than for a single twenty-something. The state is planning to implement a program by which farmers and other self-employed people can cooperatively get in on group health insurance, which makes a lot of sense. I think a big problem is that insurance offered at a group rate is so much cheaper than insurance offered individually. Are we to believe that the "group" has fewer medical problems than the individual?
See, this is an example why I get so sick of federal bureaucratic BS. I'm absolutely positive that states can implement things faster, cheaper and better than the feds. And there's likely a lot less overhead than a federal program.

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#13 Drew

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Posted 02 August 2004 - 09:46 AM

Shalamar, on Aug 2 2004, 08:55 AM, said:

It's been reported (and sorry I don't remember the article ) that OB-GYN's are giving up their OB portions of their practise in droves because of the cost of the insurance.
Particularly in North Carolina.  :suspect:
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