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PostPosted: 23 Apr 2010, 09:42 
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http://news.yahoo.com/s/ap/20100423/ap_ ... _law_costs

y RICARDO ALONSO-ZALDIVAR, Associated Press Writer – Fri Apr 23, 5:58 am ET

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WASHINGTON – President Barack Obama's health care overhaul law is getting a mixed verdict in the first comprehensive look by neutral experts: More Americans will be covered, but costs are also going up.

Economic experts at the Health and Human Services Department concluded in a report issued Thursday that the health care remake will achieve Obama's aim of expanding health insurance — adding 34 million to the coverage rolls.

But the analysis also found that the law falls short of the president's twin goal of controlling runaway costs, raising projected spending by about 1 percent over 10 years. That increase could get bigger, since Medicare cuts in the law may be unrealistic and unsustainable, the report warned.

It's a worrisome assessment for Democrats.

In particular, concerns about Medicare could become a major political liability in the midterm elections. The report projected that Medicare cuts could drive about 15 percent of hospitals and other institutional providers into the red, "possibly jeopardizing access" to care for seniors.


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PostPosted: 23 Apr 2010, 09:48 
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Claiming that health care reform would save money might have been a good tactic for Democrats trying to get support for the bill, but it may backfire in the intermediate term. I suppose we live at a place and time where no one can be honest about taxes and spending without fear of being bounced in the next election. Everybody wants to take advantage of government programs, but nobody wants to pay for it. Thus the pressure on the legislature to borrow more and more.

It would be refreshing if someone were to stand up and say, "yes, health care reform is going to cost money. We're going to need to pay for the services that we want. Extending coverage to everyone is going to cost more. Our aim is to provide the widest coverage and the best value for the dollars we spend on health care."


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PostPosted: 24 Apr 2010, 09:46 
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Zebulon wrote:
Claiming that health care reform would save money might have been a good tactic for Democrats trying to get support for the bill, but it may backfire in the intermediate term. I suppose we live at a place and time where no one can be honest about taxes and spending without fear of being bounced in the next election. Everybody wants to take advantage of government programs, but nobody wants to pay for it. Thus the pressure on the legislature to borrow more and more.

It would be refreshing if someone were to stand up and say, "yes, health care reform is going to cost money. We're going to need to pay for the services that we want. Extending coverage to everyone is going to cost more. Our aim is to provide the widest coverage and the best value for the dollars we spend on health care."


Shame the idea is sound, but as I said before on a related thread, the implementation isn't. the top 30 rated health services world wide are all either fully nationalised, mostly nationalised, or a combination of both private and public as in the UK. Healthcare is not best run as a business solely, and the statistics speak for themselves; there is a different ethos in health care from the profit orientated business world, and it runs very ineffeiciently when purely privatised to the tune of 16% GDP at the last count, 4 times the US's military budget. Much of which comes from litigation and bureaucracy the system promotes. You'll find that centralising bureaucracy is a better idea in small countries and compartmentalising it is a better idea in larger countries. Talking to US DRs generally in poles, they are in favour of this because of the sheer amount of time it can take when patient treatment is tied up in red tape, in companies where it is in their best interested to pay out as little as they can ethically do. At last count 75% of psychiatrists were in favour of public health care and about 2/3rds of other Drs. They should I think know what would serve them best.

Our NHS runs at 7% GDP, and at a loss of 1% per year. Which for a "business" of its size, the largest employer in Europe is remarkable. Our system isn't perfect by any stretch of the imagination, and it was hamstrung by criminally bad policies of underfunding by previous Conservative governments and has never really recovered. But it is at least practical. I am in favour of giving the people the right to chose private or public healthcare, according to their means and needs. Expecting people to pay for something they might not need is rather nonsensical, people don't often think ahead, hence you have 1 in 6 uncovered people in the US about 48 million uncovered citizens, probably a small deal less if you take out some groups. It's not even the poorest that suffer as they qualify for free health care, it is the lower income middle classes.

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PostPosted: 26 Apr 2010, 08:54 
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there is a different ethos in health care from the profit orientated business world, and it runs very ineffeiciently when purely privatised to the tune of 16% GDP at the last count, 4 times the US's military budget. Much of which comes from litigation and bureaucracy the system promotes.

Exactly. You're talking about people's health and lives, not what to buy for dinner or what kind of car to drive. When insurance companies are in the health care business to make a profit, their aim is to collect premiums, not to pay claims. The well-being of their customers comes second to showing good quarterly financial figures (a short-sighted fixation that is another, separate problem with publicly traded companies in this country).

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It's not even the poorest that suffer as they qualify for free health care, it is the lower income middle classes.

Yep. Insurance premiums keep going up and up. The rate of price increase is unsustainable, and the pressure is mostly on those in the lower middle. The poor already qualify for public assistance for health care, and the well-to-do can better afford to pay the higher premiums.

I think that in general people have unrealistic expectations about the level of medical care they should be provided. Maybe it has something to do with the fact that the actual costs have been hidden due to insurance and employer-subsidized coverage. The reality is that resources are finite, and someone has to make decisions about what is going to be covered. If it isn't the individual making individual choices about how to spend his own money, it will be an insurance company or government agency. Everybody wants the latest medical technology, even when it is unnecessary or (as has been proven to be the case for some pharmaceuticals) older, cheaper treatments are more effective and have fewer side effects. Does it really make sense to spend a disproportionate amount of money on end-of-life care to extend life a few weeks in a state of chronic impairment and pain, when those resources could be spent on childhood vaccinations and other preventive measures that would provide better quality of life for more people over a longer period of time?


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PostPosted: 27 Apr 2010, 02:36 
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The drug companies aren't blameless, Avastin for example was used as treatment for macular degeneration in the eyes, each treatment was a very reasonable £10. It was then discovered that it also had the ability to treat certain kinds of cancers, and was being used on patients for this; so it was withdrawn for testing, all very well so far, unfortunately though instead of asking those using it in the field about it they accrued a great deal of expense from subsequent retesting and rebranding. Of course they then charged £1000 per treatment, far more than it cost them to retest and rebrand it, that is quite morally moribund. Now no one in the NHS is given this treatment unless they pay for it themselves it is simply too expensive to justify the costs, even though it is a somewhat better treatment than those already available. Here the decision is do they treat 1 patient with an effective treatment or 10 or a 100 for the same price with somewhat less effective ones. Which of course is a no brainer. Companies in general are pretty much about the money thing, of course, but that's why they don't gel with a service that isn't about money only about its efficient usage.

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May the road rise up
To meet you
May the wind be always
At your back
May the sun shine warm
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May the rain fall soft
upon your field,
And until we meet again.
May God hold you in the palm of his hand.


"I apologise... For nothing!"


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