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  #261  
Old September 29th, 2009, 3:15 pm
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Re: Health Care Politics: V.2

I'm just gonna second what Chris said. I've been sitting here with my nose out of joint at some of what I've read. Too hacked-off to ignore it, exactly, but not wanting to start an all-out brawl either. We've just gone through a decade of income redistribution and just about all of it went to the top tier of earners. The Associated Press has a story today called: "Income gap widens as poor take hit in recession." Yet we're fighting over a slight tax increase for the richest Americans, who are faced with having their maximum tax rate rise to 39.6%. It was 50% under Reagan, for God's sake!

Changing the subject before I blow a gasket here, Kevin Drum has an excellent analysis of the Medicare Advantage rip-off. For every dollar spent on Medicare Advantage, an insurance-company add-on to Medicare for which the program pays a premium over regular Medicare rates, the consumer gets a whopping 14 cents’ worth of benefit. The rest goes to pad the insurance companies' bottom line.


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  #262  
Old September 29th, 2009, 4:18 pm
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Re: Health Care Politics: V.2

Quote:
Originally Posted by Chris View Post
You keep saying this like we shouldn't listen to or count the votes of or value that 50%. Do you advocate disenfranchising these people? Are their opinions less valuable? Do senior citizens who have paid taxes their entire life all of a sudden not matter, once they retire and stop paying taxes? Do students, who are the future backbone of the economy, not matter? Are their opinions moot because they don't pay income taxes now? Should we just do this health care debate with only income-tax-paying citizens?
No one is saying to disregard anyone's opinions. What is being asserted is to be sure to look at the net effects overall and the perspective of those who don't pay taxes to finance a program like this. I think the people financing the programs should have a pretty big impact on this type of policy.

If I remember correctly we have personal freedom and personal wealth and personal responsibilities in this country. We do care for one another and we are singularly the most individually charitable country in the history of the planet. This isn't a matter of not wanting people provided for, but a matter of whether or not our ability to support is consistent with the provisions being presented. In that, there is the economic component that is easily treated more cavileerly by those who percieve to have no burden from it.

I am completely disquited by the percieved right and ability to pilfer private wealth by the government and the people as if it were a public holding. That is niether moral nor selfless on anyone's part. Of course, expecting selflessness from others is much easier than displaying it ones self, isn't it?


Quote:
Originally Posted by Chris View Post
This severely bugs me, since I think that I have good things to contribute, and I pay taxes in many other ways, but for the moment my income tax liability is zero. And, trust me, I am working hard to get to the point where I have enough income to have to pay taxes. And I think that in this debate over health care, the voices of those who don't pay those income taxes - some of whom are the uninsured that we are trying to get covered - matter, and they should have a say, and they should have advocates in Congress and the White House who care about what they say, instead of just paying attention to the campaign contributers and the income tax payers.
All voices should be heard, but good intentions don't make good policy. Sole focus on an intended outcome is a bad way to evaluate anything. Hope is fine, but not when it concerns the entire economy of the largest economic nation on Earth. At that point, the good intentions need to be tempered with sound logic and reasoning and realistic expectations have to be used in place of hopeful wishes.

In the end, there has to be reasoned consideration to the point that the bill will need to be paid for and the burden carried. When one group sees only the advatage personally and don't have a percieved burden, it makes convincing them pretty easy, doesn't it? Who wouldn't want some nameless, faceless entity called "the rich" paying for them? It is a pretty attractive offer. The problem is, as I see it, too many are seeing it for that and that alone and aren't critically evaluating the actual outcome in total. The price, in every respect isn't now, nor could it ever be, solely paid by "the rich".

To the point that so many who won't actually pay are willing to say they have no problem paying for such a plan, of what difference is such an empty assertion? If it costs them nothing, I don't see why they would have any trouble financing it with other people's money, of course they have no problem with it. Ironicly, or probably not so ironicly, the greatest concern seems to be with those who actually will be flitting the bill. Wonder if it has anything to do with their hard earned dollars being the ones actually spent? Maybe they have a right to expect some bang for their bucks? If not, why not?


If so many are that concerned, they are at liberty to give more money to the federal government than they owe at any time they like. They already make an interest free loan every payday, but anyone can contribute freely if they see the government as a worthy source of charity or donation. As that doesn't happen, I can only assume the convinced aren't as sure as they let on. Nor would it seem are they as willing to finance government spending as they let on.


Even the government is riddled with people who pay as little as they can get away with, yet somehow we are supposed to buy in that it is "patriotic" to pay our taxes?


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  #263  
Old September 29th, 2009, 4:23 pm
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Re: Health Care Politics: V.2

Quote:
Originally Posted by purplehawk View Post
Changing the subject before I blow a gasket here, Kevin Drum has an excellent analysis of the Medicare Advantage rip-off. For every dollar spent on Medicare Advantage, an insurance-company add-on to Medicare for which the program pays a premium over regular Medicare rates, the consumer gets a whopping 14 cents’ worth of benefit. The rest goes to pad the insurance companies' bottom line.
I'm not an expert on Medicare Advantage, but it's very existence brings to light the inherent problem with Medicare as a model for a national health system. Medicare Advantage fills a very expensive gap that seniors have to pay under the traditional Medicare infrastructure, so if we eliminate Medicare Advantage, how will that gap be filled?

Like I said, I'm not an expert on the program, but I do look at what the plan users say:

Quote:
Although Medicare was originally conceived as a program that would relieve older persons of the burden of paying for health care, Medicare beneficiaries now pay a greater percentage of their incomes for out-of-pocket health care expenses than they did before Medicare was enacted in 1965. In addition to paying a monthly premium, Medicare recipients are often required to pay a portion of the cost of the services they receive in the form of a deductible or co-insurance amounts. Deductibles, co-insurance amounts and premiums increase each January. In addition, there are many services and items, such as long-term nursing home or in-home care that Medicare does not cover. To help with this cost-sharing and the items that Medicare does not cover, Medicare beneficiaries often purchase private insurance policies called "Medigap" policies.

For the most part, Medicare pays only for "acute" care -- care that the program&#39s administrators view as reasonable and necessary to diagnose or treat an illness or injury. In other words, the program does not pay for most preventive or chronic health care.
Source: Elder Law Answers

Medicare costs do not even include so-called indirect or Administrative costs, according to the AMA.

Quote:
Such uncounted administrative
costs are especially evident in the Medicare program
and include:
• Tax collection to fund Medicare—this is analogous to
premium collection by private insurers, but whereas
premium collection expenses of private insurers are rightly
counted as administrative costs, tax collection expenses
incurred by employers and the Internal Revenue Service
do not appear in the official Medicare or NHE accounting
systems, and so are usually overlooked
• Medicare program marketing, outreach and education
• Medicare program customer service
• Medicare program auditing by the Office of the
Inspector General
• Medicare program contract negotiation
• Building costs of the Centers for Medicare & Medicaid
Services (CMS) dedicated to the Medicare program
• Staff salaries for CMS personnel with Medicare
program responsibilities
• Congressional resources exhausted each year on setting
Medicare payment rates for services
Source: AMA Position Paper on Reform

I agree that there is some overpayment in Medicare Advantage programs, however, the private nature of these options still bear some advantages:

Quote:
The profit motive behind Medicare Advantage assures that there is some scrutiny in the payment of claims and some care coordination/management for the very sick to help them manage their disease. In absense of a private insurance option, Medicare could become a “claims paying machine” with little incentive to control claims costs. Ironically, the more claims which Medicare pays, the better the administrative cost ratio appears (admin cost ratio = admin costs/claims, so increasing claims payments will lower the admin cost ratop). Alternatively, by scrutinizing claims, you would, theoretically, increase admin costs and reduce claims which would increase the admin cost ratio in 2 ways, but that would, ultimately, reduce the overall cost to the taxpayer. Essentially, some administrative costs are “good”!
Source: Is Medicare Advantage Good?

The jury is still out on whether there is better care using MA vs. straight Medicare. Politifact states:

P
Quote:
resident Obama said, "Medicare does just as good, if not better, at keeping people healthy" as Medicare Advantage. We found little statistical evidence that would definitively confirm or refute this. MedPAC, the independent agency that reports to Congress, said it had no reason to think that Medicare Advantage overall was superior to regular Medicare. Nevertheless, there is uncertainty that merits further study. We rate Obama's statement Half True
.

Source: Politifact

Now, that's not saying that the President is wrong, it's simply saying that no one knows because it hasn't been studied by MedPAC, the Congressional advisory organization on Medicare. Why not study MA and fix it, or fix Medicare to eliminate the Gaps?

Politically, it's problematic:

Quote:
For Obama to suggest eliminating Medicare Advantage outright, however, is extraordinary.

First, it would go back on a campaign promise that he would let Americans keep their current health insurance. Eliminating Medicare Advantage would force 10 million seniors out of their current health plans and into traditional Medicare, according to Congressional Budget Office estimates.

Second, it’s surprising he would begin a health care reform effort with a proposal to take something away from seniors, America’s largest and most politically active voting bloc.

Source: Michael Cannon - Cato and Heartland

Lastly, the plan members LIKE their MA plans:

Quote:
Members also view their Medicare Advantage plan as a good value for the services provided. Nearly seven-in-ten (69%) evaluate low monthly premiums and their prescription drug coverage as “excellent” or good” when assessing the performance of their Medicare Advantage benefits. In a separate question, an overwhelming majority (65%) rate their Medicare Advantage plan as “excellent” or “good” when asked to assess its value, taking premiums into consideration.
Quote:
An overwhelming majority (71%) of members view their Medicare Advantage coverage as being “much better” or “somewhat better” than traditional Medicare coverage. Only 16% of those surveyed believe it to be the same or worse. Medicare Advantage even appears to outperform Medicare+Choice plans from a 2002 survey conducted on behalf of Blue Cross/Blue Shield Association. This earlier poll shows only 64% of participants rating their plan better than traditional Medicare coverage. Not surprisingly, three-quarters (75%) of Medicare Advantage members would recommend their health care plan to a friend or relative.
Source: The Mellman Group

I won't pretend to know what course of action should be taken around MA, but it seems to me that it fills a pretty large gap, has very strong support by it's membership who are elderly and still does not address the waste in Medicare itself, I don't know how it can be eliminated and still keep seniors confident in the system.


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  #264  
Old September 29th, 2009, 4:33 pm
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Re: Health Care Politics: V.2

Quote:
Originally Posted by purplehawk View Post
I'm just gonna second what Chris said. I've been sitting here with my nose out of joint at some of what I've read. Too hacked-off to ignore it, exactly, but not wanting to start an all-out brawl either. We've just gone through a decade of income redistribution and just about all of it went to the top tier of earners. The Associated Press has a story today called: "Income gap widens as poor take hit in recession." Yet we're fighting over a slight tax increase for the richest Americans, who are faced with having their maximum tax rate rise to 39.6%. It was 50% under Reagan, for God's sake!
So the contention is that the people who make the most, and in turn pay th most, do the hiring and employing and pay for expansion and industry need to pay more taxes because people have been loosing their jobs? So instead of financing industrial expansion we should finance more social programs? What was the old addage about give a man a fish?


Quote:
Originally Posted by purplehawk View Post
Changing the subject before I blow a gasket here, Kevin Drum has an excellent analysis of the Medicare Advantage rip-off. For every dollar spent on Medicare Advantage, an insurance-company add-on to Medicare for which the program pays a premium over regular Medicare rates, the consumer gets a whopping 14 cents’ worth of benefit. The rest goes to pad the insurance companies' bottom line.
With a bottom line of 4.2%? If that is padded, there must be no money to be made in insurance.


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  #265  
Old September 29th, 2009, 5:59 pm
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Re: Health Care Politics: V.2

Quote:
Originally Posted by Mundungus Fletc View Post
It's not fair but it is moral. (The problem is solved btw if you have a comprehensive system funded out of taxation since even illegal immigrants can't avoid paying taxes.)
Is it? Moral for you, maybe, but how about everyone else?

Quote:
Originally Posted by Chris View Post
You keep saying this like we shouldn't listen to or count the votes of or value that 50%. Do you advocate disenfranchising these people? Are their opinions less valuable? Do senior citizens who have paid taxes their entire life all of a sudden not matter, once they retire and stop paying taxes?
You're taking this out of context and stretching this way too far. Senior Citizens may not be paying taxes at this very moment, but they have in the past. Illegal aliens, on the other hand, don't pay taxes and haven't in the past.

You may not be currently paying taxes at the moment because your income isn't enough, but you're trying and you're documented. When you make enough you will pay taxes. Compare to the illegal alien who isn't documented and if he makes enough he still won't pay taxes. If you aren't willing to give into the system, why should we allow you to take out?


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Last edited by leah49; September 29th, 2009 at 6:08 pm.
  #266  
Old September 29th, 2009, 6:52 pm
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Re: Health Care Politics: V.2

Quote:
Originally Posted by Old Lupin View Post
I am completely disquited by the percieved right and ability to pilfer private wealth by the government and the people as if it were a public holding. That is niether moral nor selfless on anyone's part. Of course, expecting selflessness from others is much easier than displaying it ones self, isn't it?
ITA.


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  #267  
Old September 29th, 2009, 7:01 pm
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Re: Health Care Politics: V.2

Quote:
Originally Posted by leah49 View Post
You're taking this out of context and stretching this way too far. Senior Citizens may not be paying taxes at this very moment, but they have in the past. Illegal aliens, on the other hand, don't pay taxes and haven't in the past.

You may not be currently paying taxes at the moment because your income isn't enough, but you're trying and you're documented. When you make enough you will pay taxes. Compare to the illegal alien who isn't documented and if he makes enough he still won't pay taxes. If you aren't willing to give into the system, why should we allow you to take out?
The past instances of this statement bugging me were in different context so I stand by my offense at the implications.


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  #268  
Old September 29th, 2009, 7:04 pm
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Re: Health Care Politics: V.2

I'm just being honest that I don't think you should be offended as I don't think it was directed at people like you, but it's your prerogative.


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  #269  
Old September 29th, 2009, 7:13 pm
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Re: Health Care Politics: V.2

Quote:
Originally Posted by Chris View Post
You keep saying this like we shouldn't listen to or count the votes of or value that 50%.
Please don't put words into my mouth, Chris, I have never once said that the50% who pay no taxes don't matter, and I take great offense to you accusing me of implying that.

Dung commented that illegal aliens pay taxes and that that should entitle them to receive taxpayer subsidies to purchase health insurance. I countered, if you read my post, that the majority to the illegal aliens in the US have jobs on the lower end of hte pay scale and pay no taxes as 50% of the population pays no taxes.

Quote:
This severely bugs me, since I think that I have good things to contribute, and I pay taxes in many other ways, but for the moment my income tax liability is zero. And, trust me, I am working hard to get to the point where I have enough income to have to pay taxes. And I think that in this debate over health care, the voices of those who don't pay those income taxes - some of whom are the uninsured that we are trying to get covered - matter, and they should have a say, and they should have advocates in Congress and the White House who care about what they say, instead of just paying attention to the campaign contributers and the income tax payers.
Please provide one shred of evidence to support your accusation that I believe that these people don't matter, or apolo9gize to me. Please show me where I have ever - one single time stated such a thing. I find that accusation highly offensive and flat out incorrect.


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  #270  
Old September 29th, 2009, 7:49 pm
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Re: Health Care Politics: V.2

Quote:
Originally Posted by Chris View Post
You keep saying this like we shouldn't listen to or count the votes of or value that 50%. Do you advocate disenfranchising these people? Are their opinions less valuable? Do senior citizens who have paid taxes their entire life all of a sudden not matter, once they retire and stop paying taxes? Do students, who are the future backbone of the economy, not matter? Are their opinions moot because they don't pay income taxes now? Should we just do this health care debate with only income-tax-paying citizens?

This severely bugs me, since I think that I have good things to contribute, and I pay taxes in many other ways, but for the moment my income tax liability is zero. And, trust me, I am working hard to get to the point where I have enough income to have to pay taxes. And I think that in this debate over health care, the voices of those who don't pay those income taxes - some of whom are the uninsured that we are trying to get covered - matter, and they should have a say, and they should have advocates in Congress and the White House who care about what they say, instead of just paying attention to the campaign contributers and the income tax payers.
Mom, I don't think that Chris was implying that you meant to disenfranchise whatever population he's cited and Chris, there is a significant element that sees personal wealth as something to be taken.

The point of this topic, in my opinion, is about Health Care politics and the machinations on both sides to see whatever their agendas passed.

My problem is that there is no such thing as getting something for nothing. There is an inherent cost to providing a SERVICE as Health Care and that cost, nominally, will be born by those who pay taxes, whether now or in the future.

Taxes are collected at the point of a gun and spending such as this is nearly irreversible. If we find out that this is the wrong course, then it will be too late.

Now, those receiving the service should and do have a say in what's written, but so should the people who will and do bear the cost. By no means are either better than the other, but both sides would do well to recognize the very real concerns of the other.

For example, most local school budgets are paid through the collection of municipal property taxes. Raising those taxes usually only affects property owners, yet everyone gets to use the service. Should not property owners have, at least, some say in the way the money being collected from them is spent? At least as much say as those who will not end up paying for the service?

I think we need to concentrate on the details of the plan and see if there is some sort of consensus here. Mom had a great start with her list, but was derailed by certain parties who seem to thrive on putting the other side down. I don't see how that is helpful.


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  #271  
Old September 29th, 2009, 8:17 pm
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Re: Health Care Politics: V.2

RIGHT.

I'm getting involved in this goddamn thread now.

I am sick and tired of reading and re-reading the same old effin B S most of you are spewing out in here. US politics has caused this massive divide amongst you all that has gone completely against the grain of why I created this site in the first place.

I only have to read both private groups to see how much you seem to privately hate one another and it's absolutely wrong. This issue is poisoning the lot of you. You all nit pick at everything. Cite endless sources that no-one ever bothers to accept and all go to great lengths to refute. You accuse your respective political parties of either lying or spreading hate, fear & god knows what else. By extension you are slandering each other and it leads me to realize that you are simply not capable of any kind of common ground here.

It boils down to the Democrats spending eight years watching Bush seemingly do "bad things" to the country and now the flip is made, we have the Republicans labeling in much the same way over different issues. You were unpatriotic if you didn't support Bush and you're racist if you criticize Obama. It comes down to labels and slander. You know for a progresive, plural & tolerant society, you don't have to go far to find intolerant people. Now I cannot cure the ills of an entire nation, but I will not have my forum used as a place to mount these continuous assaults on people, to have you all take umbrage over the smallest of issues. To put words into other peoples mouths and create a headache we staff have to mediate later. I have to believe that you are better people than this.

Warnings, bannings. It's irrelevant. The issue is at the core of who you all are. No-one here is moved or changed by whatever their respective opposites have to say. I've yet to see anyone moved by a convincing counter-argument, merely driven to retaliate by other means.

I've had enough. This thread is closed for a while. I need to talk to the staff here and come up with something. One solution would involve me closing the DoIMC down. That's how much I've grown to loathe this area. It's too divisive for people and it eats too much time into our days. I won't have volunteer helpers stressing out daily about how to manage this place.


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