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Archive for Sunday, August 5, 2012

Fact-based

August 5, 2012

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I would like to encourage everyone to read Insurance Commissioner Sandy Praeger’s answers to questions regarding health reform on page 6A of the Aug. 2 Journal-World. After reading her responses to questions, it is difficult for me to understand how people can be against the Affordable Care Act (derogatorily named Obamacare by its opponents). In my opinion, negative comments about the Affordable Care Act are based on politics and not what is positive for our citizens.

Finally, I would like to commend Commissioner Praeger for basing her beliefs about the Affordable Care Act on thorough study and responding in an unbiased way. I realize her responses may not be favorable to many conservatives in her political party, but thanks, commissioner, for having the courage to express what you know to be the truth.

Comments

George Lippencott 1 year, 8 months ago

One more time. Your entire premise is based on a massive savings in health care cost from adding twelve million more insured, providing all sports of new services and establishing a massive entitlement program. In your world all of that is costless because we become more efficient. 1. I am going to pay for 12 million new “insured” through the overall healthcare system. That amounts to about $90 billion in costs to be paid by somebody. Some of that has already been found its way into our private insurance. Despite the comment about no contribution our carrier, a public entity, has acknowledged an almost 10% add for Obama care requirements last year. That of course goes on forever. 2. That 7% escalation quoted amounts to about $500 Billion per year. That is where I allocate all potential savings from Obama Care. These savings do not cover the basic 7.6 trillion costs of health care– they do help reduce cost growth - the part of Obama Care we support.. 3. A new entitlement is added that subsidies medical insurance for those making up to $88K per year. The cost of that entitlement – which is the majority of my estimates, must be paid by someone. Mr. Obama initially estimated that at essential a trillion over ten years To get that to zero he used a $500 billion cut in Medicare (if real somebody loses something). He also used the savings you reflected earlier to offset part of the rest and assumed that better care would eliminate costs for the rest. Being the Luddite that I am, I do not accept the “savings” and get my low estimate of $100 billion per year directly from Mr. Obama. Of course those estimates did not address individual cost, state costs and the doc fix, to mention a few. Some groups (not your friends) have estimated these costs at as much as 2.5 trillion for ten years. There is my range of costs. I will bet you dollars to donuts if we were discussing a “fighter plane” estimated to cost 2 Billion you would be disputing that number and suggesting something close to 4 billion. It never ceases to amaze me that some people will accept anything that supports what they want but are highly skeptical of things they do not want. Perhaps you can find one major program that has managed to come in on budget. Why do you believe this one is different – because you want it? Your entire argument has evolved to I am not going to pay more. Fine, I will make a deal with you. We put your money where your mouth is and you get to pay for all the increases in our health care over the next ten years (that includes costs to maintain current coverage). Would you still argue that nobody will pay more if you had to pay??

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Richard Heckler 1 year, 8 months ago

How much is the sick U.S. health care system costing you? By Joel A. Harrison

Paying through the Taxman

The U.S. health insurance system is typically characterized as a largely private-sector system, so it may come as a surprise that more than 60% of the $2 trillion annual U.S. health care bill is paid through taxes, according to a 2002 analysis published in Health Affairs by Harvard Medical School associate professors Steffie Woolhandler and David Himmelstein.

Tax dollars pay for Medicare and Medicaid, for the Veterans Administration and the Indian Health Service. Tax dollars pay for health coverage for federal, state, and municipal government employees and their families, as well as for many employees of private companies working on government contracts.

Less visible but no less important, the tax deduction for employer-paid health insurance, along with other health care-related tax deductions, also represents a form of government spending on health care.

It makes little difference whether the government gives taxpayers (or their employers) a deduction for their health care spending, on the one hand, or collects their taxes then pays for their health care, either directly or via a voucher, on the other.

Moreover, tax dollars also pay for critical elements of the health care system apart from direct care—Medicare funds much of the expensive equipment hospitals use, for instance, along with all medical residencies.

All told, then, tax dollars already pay for at least $1.2 trillion in annual U.S. health care expenses. Since federal, state, and local governments collected approximately $3.5 trillion in taxes of all kinds—income, sales, property, corporate—in 2006, that means that more than one third of the aggregate tax revenues collected in the United States that year went to pay for health care.

Recognizing these hidden costs that U.S. households pay for health care today makes it far easier to see how a universal single-payer system—with all of its obvious advantages—can cost most Americans less than the one we have today.

Medicare must exist in the fragmented world that is American health care—but no matter how creative the opponents of single-payer get, there is no way they can show convincingly how the administrative costs of a single-payer system could come close to the current level.

More on this matter: http://www.dollarsandsense.org/archives/2008/0508harrison.html

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Richard Heckler 1 year, 8 months ago

Medicare Single Payer Can Save $400 billion Annually http://www.pnhp.org/facts/single-payer-resources Physicians for a National Health Program

IMPROVED Medicare Single Payer Insurance for ALL would cover every person for all necessary medical care 24/7 to include:

Wellness /prescription drugs / hospital / surgical / outpatient services / primary and preventive care / emergency services / dental / mental health / home health / physical therapy / rehabilitation (including for substance abuse) / vision care / hearing services including hearing aids / chiropractic / medical equipment / palliative care / long term care

No deductibles / No Co-pays

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tbaker 1 year, 8 months ago

There are a lot of things that could have been done to increase the number of people with access to healthcare, maintain and/or improve its quality, and reduce healthcare costs (the stated goals of the President and Democratic Congress) that all cost the tax payer absolutely nothing. None of them were tried. Creating massive new government bureaucracies and imposing huge new tax increases have a long history of total failure. Common sense says we try these other approaches first. We can’t afford the failed government we have, let alone a much larger one.

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Agnostick 1 year, 8 months ago

Moderate wrote, 1 day, 3 hours ago:

"So when you ask your question as to who can be against it the answer is the 50% of the citizenry who will have to pay a substantial sum for it with little improvement in their own medial services."


I think you're being generous with that 50% notion.... very generous.

If population growth continues in roughly the same direction, there are going to be a lot fewer people... paying for a lot more benefits.

Second verse, same as the first:

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jayhawklawrence 1 year, 8 months ago

You could not have come up with a better title for this letter.

It really does seem to come down to Fact based vs. Faith based logic.

When facts and logic threaten deeply held beliefs, people become very defensive and close their minds. I think for these kind of people they need to believe in a Satan called "Liberals".

It explains for them where evil comes from.

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George Lippencott 1 year, 8 months ago

Well enlightenment,

It is clear that we do not share a common notion of what constitutes sufficient justification for one to accept a proposition. I demand independent sources and am quite capable of adding numbers I believe are reasonable estimates. That is what I have done. You have refuted none of my numbers – as broad as they are - with anything other than generalities and emotion.

Now you have resorted in the past two posts to attacking me as ignorant and juvenile because I disagree with you. That is a standard liberal tactic when they can not support with detail the numbers they throw about.

Now from my intuiting of the emotion in your posts, you are a true believer and want desperately the AFCA to solve all medical problems. I would be a fool if I did not want the same outcome. Unfortunately for me the numbers do not add and the wished for outcome remains elusive. There are elements of the AFCA that I like and want preserved and there are elements I want terminated. There is no legitimate reason we can not do that.

More importantly, my family, who worked hard for 40 years to acquire medical insurance, will now suffer significant cost increases if not serious reductions in medical services. This on top of large social costs for climate issues, poverty issues, employment issues and the like. Now, I too am willing to see my taxes/social costs go up a few hundred dollars a year for the benefit of all. Unfortunately, I see them going up more than an order of magnitude greater each year to pay for the AFCA, the traditional entitlements and the near trillion dollars Mr. Obama has added to our annual deficit.

We will be losers – not little losers - big losers. Just about anybody that has worked a lifetime in a professional capacity will be badly gored by the Democratic Party Platform as currently pronounced. So we are talking enlightened self interest motivating my concerns. But enlightened self interest is more than a sufficient and appropriate reason to oppose something.

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George Lippencott 1 year, 8 months ago

Enlightenment

Sorry numbers seem to hurt you so much. I agree that we need to reduce annual cost increases in health care to close to normal inflation. Dictating cost reduction is not the way to do that. Almost every time we have tried that approach we end up with a shortage of whatever we constrain (like corn right now). It will be medical services in the future if we are not careful.

There are all sorts of proposals to reduce medical costs some of which are in the AFCA. I SUPPORT MOST OF THOSE as I said in the opening of my post. Automatic records, best practices and the like are good starts. Tort reform would sure help. Both sides of the aisle have good ideas. Loyalty to constituents should not limit our ability to compromise.

That said, I totally reject your inference we need all of the AFCA in order to control costs. The entitlement for example does little of that and what it might do is overwhelmed by the costs to all of us. You are simply arguing that a massive income transfer program reduces cost. It certainly will for some at the expense of most of the rest of us.

If you are a loser it is not surprising that you oppose the program. Why not a win-win?

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Flap Doodle 1 year, 8 months ago

In breaking news, HR 676 is still dead like fried chicken.

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George Lippencott 1 year, 8 months ago

Enlightenment Wow, I wish I could buy a new Prius and declare the savings in gas sufficient to eliminate the cost of the car. 1. Any savings that result from the AFCA will be used to address (as we must) the annual escalations in health care costs not the basic cost of services. Only a naïve person would believe you can add 12 million people to the health care equation for nothing. Just take the annual cost per person of health care in the US and multiply by 12 million and then explain why all these people are free? 2. 2. You are correct that in the long haul preventive services may reduce costs. They may also increase costs as people live longer and require care longer. The bottom line is that a heavy slug of medical cost comes from treatment of the illness that eventually kills us. We are still going to die from something and that costs will still be there however long the preventive services might prolong life 3. You listed savings in the amount of $100 Billion or so. According to the web those are 10 year savings (CBO estimate). So by my reckoning that would be $10 Billion a year. A nice down payment on the annual costs of the program but certainly way too little to appreciably offset the costs to the consumer/taxpayer.

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George_Braziller 1 year, 8 months ago

ACA resulted in me getting a rebate on the health insurance premiums I paid in. The act requires that insurance companies spend 80% of total premiums on health care services and keep no more than 20% for administrative costs and profit. My insurance company only spent 74% on health services so I received a rebate for 6% of what I paid in last year. It was a nice sized check.

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Dan Eyler 1 year, 8 months ago

Regardless of what our insurance commissioner has to say real life changes being imposed on the healthcare industry will be nothing short of disastrous. The cuts being imposed on healthcare and hospitals will easily reach 20 to 25 percent in the next 5 years. Imagine the business you work for announces a 20% cut to the bottom line. A perfect example was the leaked email from St. Lukes Hospital in Kansas City just a couple of weeks ago. A prestigious hospital in our area. They are cutting 100 million dollars from their budget and it must be completed by the end of 2012. Just the tip of the iceberg. Imagine every hospital in the nation having to reduce overhead by 20%. Nurses being changed out for aids with as much as a 1 nurse to 5 aids. Access to doctors will decrease dramatically. Reduced staff causing lack of access to services. Layoff for healthcare workers is coming. So may of you are so fixated on pretending there will be better healthcare for all when in all reality we are in the early stages of the end to quality healthcare as we know it. Unlike our insurance commissioner, those in healthcare such as myself are witnessing the decline first hand.

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voevoda 1 year, 8 months ago

Mitt Romney has praised the Israeli system. Obama's ACA shares some characteristics with it, and maybe with the Republicans' help (led by Romney, of course), the current law can be revised along the lines of the Israeli system. A bi-partisan plan.

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George Lippencott 1 year, 8 months ago

Of course the Affordable Care Act (Obama Care) is a desirable initiative. Who can fault making medical care available to all our citizens? The law has already broadened available services by addressing the most egregious abuses under our present medical insurance system. In the future it will make sure basic medical insurance is available to many who do not have access to it today. Additionally it will establish another substantial entitlement through subsidies for families with insurance making upwards of $88K per year (about 80% of us.)

Like all good things, the AFCA will cost money. Those costs will appear in our monthly payments for our insurance, in the costs of goods purchased from businesses that provide health insurance, increases in taxes for existing federal medical programs to fund the new services and a substantial cost for the subsidies for medical insurance. When you strip away the gimmicky in the CBO estimates for the program and add in the costs to the states and individuals we are looking at an annual bill between 100 and 300 billion dollars. In short a middle income citizen will need to contribute something between $500 and $5,000 a year through the various components mentioned above to fund the new law.

So when you ask your question as to who can be against it the answer is the 50% of the citizenry who will have to pay a substantial sum for it with little improvement in their own medial services

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FalseHopeNoChange 1 year, 8 months ago

At press time, a bipartisan blue-ribbon panel called the State Budget Crisis Task Force issued a sobering report. We made our acquaintance with two of the 11 panelists during the filming of I.O.U.S.A: former Federal Reserve chief Paul Volcker co-chaired the group. Clinton budget chief Alice Rivlin was on the advisory board.

The panel spelled out six major problems facing state governments. No. 1 was spending on health care for the poor: “Medicaid spending growth is crowding out other needs.”

No lie: Medicaid takes up 24% of a typical state’s budget, the biggest single line item, now eclipsing education. Even before the 2007–09 recession put a hurt on state revenues, Medicaid spending was growing faster than those revenues.

“Medicaid is now such a large part of state spending,” says the task force report, “that the imbalance… can no longer be absorbed without significant cuts to other essential state programs like education or unpopular tax increases or both.”

http://addisonwigginsapogeeadvisory.agorafinancial.com/2012/08/03/the-end-of-the-world-as-we-know-it-just-not-yet/

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Liberty_One 1 year, 8 months ago

Sigh. The problem is that this bill cannot overturn economic realities with high hopes and big wishes. Saying what the bill hopes to achieve while ignoring the negative consequences is to put our heads in the sand.

The bill does nothing to increase the supply of doctors, hospitals, clinics, medical staff, pharmaceuticals, medical devices or anything else related to health care, but it does aim to increase the demand for these products and services by increasing the number of people with third-party payment. The laws of economics tell us that this can only mean one thing: price increases.

The number one problem with our health care system is not quality but price. A bill that increases our number one problem is a disaster.

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autie 1 year, 8 months ago

In fact, Romney is running around bitching about people having to pay the penalty if they don't get in a plan. Estimates are that less than 1.7% will be affected. I say screw those lazy bums because when they don't pay the cost shifts to dummies like me that pay thousands a year in premiums. And the AHA is better than sticking you head in the sand and hoping it goes away....especially those dolts in Congress with their cadillac taypayer funded plans.

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autie 1 year, 8 months ago

I still am amazeded at how many people still believe that crap about death panels and illegals getting care blah blah blah. And they talk about the 'new' taxes and how much it will cost. Why can't the Republicans listen to sources paid to be non partisan for accurate information. The Congressional Budget Office and GAO both tell different stories on cost than the shill the right dumps out.

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Richard Heckler 1 year, 8 months ago

Let's Compare:

Single-Payer (HR 676 and S 703) Expanded Medicare for All Vs. Proposed Healthcare “Private insurance with Public Option”

http://www.healthcare-now.org/docs/spreport.pdf

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Richard Heckler 1 year, 8 months ago

Obamacare will save $84 billion over the next 10 years. Why the opposition?

Medicare Single Payer Insurance for ALL would save $350-$400 billion annually. No Co-pays and No deductible. Why the opposition? http://www.pnhp.org/facts/single-payer-resources Physicians for a National Health Program

Republicans favor a return to the worst case scenario which means large increases will still carry on. And insurance providers would be able to cut off clients at their will = dumb coverage.

50% of bankruptcies are due to medical bills in which victims had medical insurance. Are you still under insured?

Insurance providers are the "middle men" which adds big time NOT necessary expenses to health care. Why do we need "middle men"? The "middle men" do not provide health care.

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Steven Gaudreau 1 year, 8 months ago

Why not just have state hospitals and private hospitals. If you do not have insurance, go to the state hospital, if you have insurance, go to the private. I would assume care would be better at a private hospital just as education at a private school is usually superior to a public education but you get what you pay for.

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msezdsit 1 year, 8 months ago

The billions spent on lying about the bill are bets that the bad information will help repeal the affordable care act before people actually realize the truth about the bill and it's benefits to them. Its literally a race. The politicians who are campaigning on repealing ACA are campaigning on the lies about the ACA and that their base believes them without questioning them. Their risk is that if Obama wins the election ACA will survive and the people that have been lied to will finally figure it out. All the politicians that are campaigning on the lies won't be able to buy a vote and finally will be run out of Dodge. Until then gridlock will continue. The clock will have run out on all the viral fanatical right wing nut cases before any civility can return to the political process. Until then expect the wackos like brownback to continue to systematically dismantle and destroy the society americans are so proud of and have worked for so long to build.

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jayhawklawrence 1 year, 8 months ago

Sandy Praeger gave me some hope that intelligent, caring and qualified people actually exist in politics.

She makes going to the voting booth something I look forward to and this time around I really need that.

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Abdu Omar 1 year, 8 months ago

The ACA was enacted and we are the benefactors of such a bill. So, Republicans, if you are opposed to it, where is your plan? What do you have to say to the rising cost of health care? All you do is sit in congress and say "NO". What good is that? Do something!! Say "this isn't right so we must do this:". What is "this"?

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Les Blevins 1 year, 8 months ago

Another big problem in this country is the way the super rich evade paying anything like a fair share of their taxes. Romney campaign spokeswoman Andrea Saul stated last week that “there has been no year in which Romney paid zero taxes”. In 2008, this was true. He earned $23,425,316 and paid $412.18 in federal income taxes. This calculates to a federal tax rate of 0.0018%. How did Romney get his tax burden so low? According to his return, he had approximately $23,407,000 in itemized deductions. These deductions ranged from $78,923 for “Toupee Creators Unlimited” and $41,826 for “Spray-on tan services” to a $3.8 million dollar write-off for a trip to Las Vegas with potential campaign donors. The Romney family also paid salaries to their numerous employees including, two yacht captains, three pilots for their private jets, two professional dog walkers, one toupee stylist and a “live-in contortionist”. What someone does with a live-in contortionist, one can only speculate. However, the $891,064 Romney spent on an “EWS Donor Party at the Pennsylvania Mansion” might give us a clue. While the return does not indicate what “EWS” stands for, given that the deducted supplies for the party included “Venetian masks, alcohol, lubricant and various Egyptian leather accessories” it was most likely an “Eyes Wide Shut” party.

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jafs 1 year, 8 months ago

There are certainly some positive aspects to the ACA.

But, it's overly long and complicated, and structured so that we won't really be able to evaluate the consequences of it's full implementation for some time.

Even Ms. Praeger agreed that rising health care costs are a big problem, and one that's not sufficiently addressed by the bill.

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