patrick.net

But seriously Ellie when push comes to shove, all you have left to do is attack personal character. Ad Hominem is the style around here.

AdHominem says

Would you start with something like this?
“Hi, I don’t know you but I just wanted to see how Medicare is working for you. You see I am a socialist and I find it hard to believe that you are not happy with your “coverage”. Some guy is claiming that you have been forced to find a new doctor 25 miles away, and a new pharmacy as well. Can this be true?” And if so, isn’t it better to be like all the other people who are forced to change the way they get their care? Isn’t it better that we all suffer the same rather than some people getting better care than others? I mean this is America right? Land of the free and home of the bureaucracy! With wiretaps and bailouts for all.”

No, probably wouldn't be much like that. How about this--you give me her number and I'll conference you in the call as well. You can listen to exactly what we talk about.

No? OK, how about you at least share where she lives? That can't be protected by HIPPA, right? This town that's 25 miles away from a pharmacy that accepts Medicare.

AdHominem says

Ad Hominem is the style around here.

At least someone thinks you're cool. Personally, I'll choose substance over style every time.

I do wonder why it is that when someone agrees with you, they're perceptive - yet when someone (many, many on this board) disagrees with you and points out your inconsistencies, they're attacking you personally?

tatupu70 says

That can’t be protected by HIPPA, right? This town that’s 25 miles away from a pharmacy that accepts Medicare.

...and, once again I must say that Medicare isn't a payment source for medications. It's private companies who are providers within the Medicare program. Having already pointed out that this person could receive meds from a mail order pharmacy for one co-payment per 90 day supply, delivered right to her home - and also that she chose the drug plan that doesn't serve her local pharmacy yet chooses to blame Medicare for her poor choices, I'll move on to the HIPPA reference.

HIPPA applies to providers & patients - certainly not to people who post anecdotal stories on the internet about people who may, or may not, actually exist. It does sound intellectual, to toss out acronyms such as HIPPA - but as previously mentioned I prefer substance over style.

elliemae says

At least someone thinks you’re cool. Personally, I’ll choose substance over style every time.

Mee two.

elliemae says

I do wonder why it is that when someone agrees with you, they’re perceptive

Funny, I never said that. It is great so many people want to speak for me.

elliemae says

yet when someone (many, many on this board)

Really, like how many. A few socialists. A bunch of socialists? What's to worry about that? Are you trying to make it sound like I'm in the minority, or just make me feel bad? Well, even if I am in the minority I am OK with that. All the cool kids can drink the koolade.

elliemae says

I don’t know you - but do believe I could spot you in a crowd. Your tinfoil hat and pocket protector would rat you out.

Calling someone a paranoid nerd (by implication), that is not a personal attack? YOU have no substance, just Ad Hominem. But again, since that is all you have left, I am sure we can expect MORE PERSONAL ATTACKS.

But if you are willing to behave a little less juvenile, Why don't we get back to the facts? Medicare is bankrupting us. It is riddled with fraud, waste and abuse. And yet people are calling for expansion of Medicare or a Medicare like system for everyone. It is like fighting a fire with a blowtorch. Doing the same thing over and over again and expecting different results.

We need to end fraud waste and abuse that is inherent in the third party payer systems.

AdHominem says

"With wiretaps and bailouts for all.”

Brought to you by your friendly local conservative true american patriot George Bush.

bob2356 says

AdHominem says

“With wiretaps and bailouts for all.”

Brought to you by your friendly local conservative true american patriot George Bush.

True. As is: the peace president is escalating our involvement in Afghanistan. Bait and switch, the foundation of American politics since FDR.

AdHominem says

True. As is: the peace president is escalating our involvement in Afghanistan. Bait and switch, the foundation of American politics since FDR

How is it a bait and switch? One of his big promises was to focus our attention on Al Quieda instead of being distracted in Iraq. He's simply following through on that promise... As he should

I am glad that there are less Americans and Iraqis dying in Iraq. But we are still there. Now we are sending more troops to Afghanistan to "finish the job." Whatever that means. Al Quaeda is a "network of Terrorists." It cannot be defeated with force because it is based on an ideology and all attacks just make it grow stronger and more violent, and it certainly cannot be defeated by focusing on Afghanistan.

If we want to defeat this ideology we must get our own ideology in line.

But good luck with that. Hope it works better for Obama than it did for the Soviets. 15,000 soldiers died on their side before they realized their mistake.

@Ad--

But we're not trying to occupy their country. Th

100,000 foreign troops plus hired mercenaries (sorry, CONTRACTORS) is not occupying their country? What planet are you looking at?

bob2356 says

AdHominem says

“With wiretaps and bailouts for all.”

Brought to you by your friendly local conservative true american patriot George Bush.

Also, to be fair we must give “credit” to a whole bunch of Democrats and Republicans in Congress (most of whom are still in office!)

AdHominem, if I have this correct, you, as a Libertarian, are an advocate for charity care for the Medicare/Medicaid group. At least this is what I'm reading in Ron Paul's Revolution book and from some of your comments.

Here are a few questions: looking at our health care expenditures, how much is consumed by the Medicare group?

Why are companies quick to get rid of promised health care bennies for retirees forcing them onto Medicare and why is the gov paying these companies to keep these retirees on their health insurance plans?

What would health care look like for this population is charity was their main source of care? Just like in the olden days before Medicare/Medicaid existed. How would charities prioritize, for example.

And given that such a huge amount of health care $ is this population, what happens to all the doctors, nurses, etc.

Help me grasp this. I know Medicare can't go on as is but I'm having a hard time seeing solutions without restricting care, denying coverage, requiring much more out of pocket, etc.

Give me some details. Thanks. Leigh

Leigh says

Help me grasp this. I know Medicare can’t go on as is but I’m having a hard time seeing solutions without restricting care, denying coverage, requiring much more out of pocket, etc.

There needs to be a free market in health care in order for proper allocation of resources. We can't have government intervention setting prices, restricting access, misallocating resources etc... That is what we have now. More of the same is going to give us even more of the same.

In order to make health care affordable and accessible we need:

1. Tax free medical savings accounts.
2. Tax free insurance purchase (not just for employers but for everyone)
3. End license requirements for providers which restricts supply of providers, drastically reduces competition, drives up cost of education and creates a powerful monopoly for the few who do obtain a license. (the marketplace will demand competency, and punish incompetency better than any bureaucracy could)
4. A marketplace and information exchange like a priceline.com for health care (shop around, check the ratings, competitive bidding, find what works for you)
5. Freedom to purchase health insurance without regulations. Many doctors would like to be your insurance company. They would be happy to charge your family lets say $120 a month in exchange for unlimited access. Sort of like a cell phone plan. Current laws make this onerous or illegal for them to do so. But that would be a great way to cut out the middle man and the waste associated with it.

These ideas are just a start. I am sure the free market (if there was one) would come up with many new, innovative and cost effective ways to deliver care.

AdHominem says

Many doctors would like to be your insurance company. They would be happy to charge your family lets say $120 a month in exchange for unlimited access.

There are doctors that do this (concierge medicine). It's fine, as long as one doesn't need any labs, tests, procedures at hospitals, etc.

elliemae says

AdHominem says

Many doctors would like to be your insurance company. They would be happy to charge your family lets say $120 a month in exchange for unlimited access.

There are doctors that do this (concierge medicine). It’s fine, as long as one doesn’t need any labs, tests, procedures at hospitals, etc.

I'm sure the market will meet this need if government didn't encourage most people to get health insurance from the mega-insurers through their employer because of unfair tax laws.

Leigh says

Give me some details. Thanks. Leigh

AH never does details, only platitudes. The devil's in the details and he never provides any details of how or why his idea's would work. I have pointed out huge gaping holes in his ideas's several times on this post. Surely there must be a real life example of the type of health care he advocates being used somewhere in the world that we could look at to see the validity of his plans in a real world environment but I can't think of where. Perhaps AH would like to provide the examples of health care systems around the world that show his idea's at work for everyone to examine?

bob2356 says

Leigh says

Give me some details. Thanks. Leigh

AH never does details, only platitudes. The devil’s in the details and he never provides any details of how or why his idea’s would work. I have pointed out huge gaping holes in his ideas’s several times on this post. Surely there must be a real life example of the type of health care he advocates being used somewhere in the world that we could look at to see the validity of his plans in a real world environment but I can’t think of where. Perhaps AH would like to provide the examples of health care systems around the world that show his idea’s at work for everyone to examine?

Here bob,
http://www.healthnewsdigest.com/news/Guest_Columnist_710/What_America_s_Healthcare_Delivery_System_Can_Learn_from_India.shtml

from an earlier post...
In order to make health care affordable and accessible we need:

1. Tax free medical savings accounts.
2. Tax free insurance purchase (not just for employers but for everyone)
3. End license requirements for providers which restricts supply of providers, drastically reduces competition, drives up cost of education and creates a powerful monopoly for the few who do obtain a license. (the marketplace will demand competency, and punish incompetency better than any bureaucracy could)
4. A marketplace and information exchange like a priceline.com for health care (shop around, check the ratings, competitive bidding, find what works for you)
5. Freedom to purchase health insurance without regulations. Many doctors would like to be your insurance company. They would be happy to charge your family lets say $120 a month in exchange for unlimited access. Sort of like a cell phone plan. Current laws make this onerous or illegal for them to do so. But that would be a great way to cut out the middle man and the waste associated with it.
*a new addition* 6. Private an public insurance needs to be banned from price setting, which stiffles innovation, competition etc... and promotes the status quo/and or large corporations who know how to game the system.

These ideas are just a start. I am sure the free market (if there was one) would come up with many new, innovative and cost effective ways to deliver care.

bob2356 says

Leigh says

Give me some details. Thanks. Leigh

AH never does details, only platitudes. The devil’s in the details and he never provides any details of how or why his idea’s would work. I have pointed out huge gaping holes in his ideas’s several times on this post. Surely there must be a real life example of the type of health care he advocates being used somewhere in the world that we could look at to see the validity of his plans in a real world environment but I can’t think of where. Perhaps AH would like to provide the examples of health care systems around the world that show his idea’s at work for everyone to examine?

wow ... how odd it is for a liberal minded lefty to attack on the personal level. It's as rare as sand on a beech.

Bap33 says

bob2356 says
Leigh says

Give me some details. Thanks. Leigh

AH never does details, only platitudes. The devil’s in the details and he never provides any details of how or why his idea’s would work. I have pointed out huge gaping holes in his ideas’s several times on this post. Surely there must be a real life example of the type of health care he advocates being used somewhere in the world that we could look at to see the validity of his plans in a real world environment but I can’t think of where. Perhaps AH would like to provide the examples of health care systems around the world that show his idea’s at work for everyone to examine?
wow … how odd it is for a liberal minded lefty to attack on the personal level. It’s as rare as sand on a beech.

That's a personal attack?? You conservatives are awfully sensitive, aren't you?

Thank you, tatupu70, with my mommy fog I often question my thinking and I was thinking this exact same thing...a personal attack? Seriously?

what is the definition of is?

Leigh says

Thank you, tatupu70, with my mommy fog I often question my thinking and I was thinking this exact same thing…a personal attack? Seriously?

Tatu says: "AH never does details, only platitudes. The devil’s in the details and he never provides any details of how or why his idea’s would work."

That IS a personal attack in my book. But at least he didn't call me a paranoid nerd. He just made false accusations.

from an earlier post...
In order to make health care affordable and accessible we need:

1. Tax free medical savings accounts.
2. Tax free insurance purchase (not just for employers but for everyone)
3. End license requirements for providers which restricts supply of providers, drastically reduces competition, drives up cost of education and creates a powerful monopoly for the few who do obtain a license. (the marketplace will demand competency, and punish incompetency better than any bureaucracy could)
4. A marketplace and information exchange like a priceline.com for health care (shop around, check the ratings, competitive bidding, find what works for you)
5. Freedom to purchase health insurance without regulations. Many doctors would like to be your insurance company. They would be happy to charge your family lets say $120 a month in exchange for unlimited access. Sort of like a cell phone plan. Current laws make this onerous or illegal for them to do so. But that would be a great way to cut out the middle man and the waste associated with it.
*a new addition* 6. Private an public insurance needs to be banned from price setting, which stiffles innovation, competition etc… and promotes the status quo/and or large corporations who know how to game the system.

These ideas are just a start. I am sure the free market (if there was one) would come up with many new, innovative and cost effective ways to deliver care.

But, details are probably not good enough for you so it really doesn't matter what I say does it? Some people will never believe a truly free market is the most efficient way to allocate resources. They think that we need a big brother with a big stick making sure everyone stays in line and gets the same portion of rice and broth.

AdHominem says

Tatu says: “AH never does details, only platitudes. The devil’s in the details and he never provides any details of how or why his idea’s would work.”
That IS a personal attack in my book. But at least he didn’t call me a paranoid nerd. He just made false accusations

Thanks, but I didn't actually say that. Calling that a personal attack was a personal attack on me!

Thanks Thunderlips11, and from what I am reading is parts of this new bill or should I say one of a few bills, it will require name brand drugs to be the ones covered, not generics! And they are extending the patents by three years to prevent generics from hitting the market earlier. Grrrrr.

I said it. It's hardly a personal attack. It's an observation. A personal attack would be saying something like Ah is a stupid jerk and his ideas are just rushbot fodder (for the people who can't tell the difference the previous sentence was an EXAMPLE). There's a big, big difference. Anyway, Ah keeps putting up the same list of feel good items but they don't wash. Some are at best a start, but hardly a cure all.

1. Tax free medical savings accounts.
A very good idea that exists already. Many, many companies have tax fee medical savings accounts. Did you mean personal medical savings accounts?? You first proposed this idea as allowing deductions for medical expenses. Which you can if expenses are over 7.5% of agi. I agree it should all be deductible. Either way it only matters to people who itemize their taxes, less than a third. Once more into the breach dear friend, what about everyone else????????? Or is part of your free market/ less government solution to force everyone to itemize taxes and force all companies to offer MSA's? You can't have it both ways.
2. Tax free insurance purchase (not just for employers but for everyone)
I was not aware there was sales tax on health insurance. How much is it, what percentage of total health care spending does this represent??????? What will our savings be?????? How much will other taxes have to be raised to make up for the loss of revenue??????? Or are you talking about corporate taxes paid by health insurers on their profits?? Sure make health insurers profits tax free, why not? I'm positive the savings will be passed on to the consumer, not used for executive bonuses. I also believe in the Easter bunny.
3. End license requirements for providers which restricts supply of providers, drastically reduces competition, drives up cost of education and creates a powerful monopoly for the few who do obtain a license. (the marketplace will demand competency, and punish incompetency better than any bureaucracy could)
This is just silly. The market will punish incompetency?????? You go first, you, your wife and children can be the wind dummies. By definition incompetency would have to be proven by people getting hurt or dying. Great. I will go with licensed doctor's thank you.
4. A marketplace and information exchange like a priceline.com for health care (shop around, check the ratings, competitive bidding, find what works for you)
That's probably workable for people getting a boob job, but hardly applicable when you are dealing with sick children in the middle of the night, or get chest pains and can't take a breath. I don't know anyone who doctor shops on price, even if they are paying out of pocket. People go with who they know or who friends recommend. It's just human nature.
5. Freedom to purchase health insurance without regulations. Many doctors would like to be your insurance company. They would be happy to charge your family lets say $120 a month in exchange for unlimited access. Sort of like a cell phone plan. Current laws make this onerous or illegal for them to do so. But that would be a great way to cut out the middle man and the waste associated with it.
Really? All the doctors I know, and I know a bunch since I used to do medical billing, want to do a LOT less business management and paperwork. Running a faux insurance company on top of everything else involved with running a practice isn't going to be a wildly popular idea. Please cite the laws involved (just the statute # and title will be fine) that prohibit a doctor from doing capitation on their own. I have never heard of this. It didn't exist 10 years ago. Boutique medical practices use this model, are they breaking the law??? It's a nice model by the way, but boutique practices are almost always in area's of high income, which usually means better health. Aka, they cherry pick.
6. Private an public insurance needs to be banned from price setting, which stiffles innovation, competition etc… and promotes the status quo/and or large corporations who know how to game the system.
This doesn't really make sense to me. Public health care rates are set by politicians. Private health care providers, which are the ones you support set their own rates by the free market. What is the point??? How is anyone banned from price setting? Somehow, someway, sometime the price has to be determined by somebody. Do you mean price fixing? Who is doing price fixing?? Where, how?

Maybe you just don't understand what people mean by details. Asking for details is not an attack on your idea's, just a request that you support them. When you say "CURRENT LAWS" do whatever (a favorite phrase) it's really meaningless. What is the law, where is the cost analysis, how much would a change to the law affect the costs, why would people change their behaviour if the law were changed, etc.? Without providing those kinds of things then just saying eliminate the law the free market will provide is most certainly a platitude.

Maybe the best place to start on healthcare reform, which almost everyone agrees is needed, is to see what works first. How can places like the Cleveland clinic and the Mayo clinic provide high quality health care at very reasonable rates? Maybe whatever they are doing right can be applied across the board. Saving 30% across the board would be a really big number. Maybe other countries have lessons we could apply. They are getting better results for half the cost.

That kind of research along, with the concurrent recommendations, would take several years to do. Simply not going to happen with the get something done now political climate we are in. The current plans in congress are most certainly no more than political theater combined with vote buying for the next election cycle. Which means that whatever gets passed will probably not work very well. I am not surprised, Obama was never more than a mark 1 mod 0 basic issue politician. Very smart, probably a better choice than McCain, but not anything special.

tatupu70 says

AdHominem says

Tatu says: “AH never does details, only platitudes. The devil’s in the details and he never provides any details of how or why his idea’s would work.”

That IS a personal attack in my book. But at least he didn’t call me a paranoid nerd. He just made false accusations

Thanks, but I didn’t actually say that. Calling that a personal attack was a personal attack on me!

My apologies tatu. It was bob making the false accusations.

bob2356 says

I don’t know anyone who doctor shops on price, even if they are paying out of pocket.

Exactly and that is fueling the health care bubble. We need a paradigm change.

bob2356 says

This doesn’t really make sense to me. Public health care rates are set by politicians.

No, they are set by bureaucrats and lobbyists.

AdHominem says

The current plans in congress are most certainly no more than political theater combined with vote buying for the next election cycle.

At least we agree on that.

@Ad
You would seriously pick a doctor based on price? And without any licensing?

Any product, market, or service is self regulating based on the wishes of consumers. Its only when governmnet interferes that the efficiency of free will becomes negated, efficiency lost, costs go up, jobs get 'out-sourced,' taxes go up, peoples standards of living go down. Many might argue "but its for the common good" - right on Comrade!

Consumers always know whats best for themselves.

@Honest

That's only true if information is readily available and accessible. Which isn't the case for Drs.

I'm glad you addressed all my points ah. Good job bolstering your position

Honest Abe says

Any product, market, or service is self regulating based on the wishes of consumers. Its only when governmnet interferes that the efficiency of free will becomes negated, efficiency lost, costs go up, jobs get ‘out-sourced,’ taxes go up, peoples standards of living go down.

So that would make somolia and nigeria the most efficient places on earth with the highest standard of living? There are no scams, hustlers, or con artists in your perfect world?

tatupu70 says

@Honest
That’s only true if information is readily available and accessible. Which isn’t the case for Drs.

Or almost any business or government agency you care to name. Why bother to call for less regulation when the regulators we have are simply handmaidens of the industries they regulate? Madoff, medicare, housing, banking whatever. There were plenty of regulations on the books that could have prevented disaster in each case that no one bothered to enforce. Bush (actually probably Rove and Cheney) was very smart about that. Instead of getting into a political battle about regulations he didn't like he just eliminated enforcement.

AdHominem says

bob2356 says

This doesn’t really make sense to me. Public health care rates are set by politicians.

No, they are set by bureaucrats and lobbyists.

Freshman government 101. Bureaucrats administer the laws passed by politicians. Whats your point with this hair splitting?

Based on the wishes of CONSUMERS. No, its not a perfect world, but CONSUMERS make choices based on their own best interest. That dynamic has nothing to do with scams, hustlers or con-artists. Hustlers and con-artists are criminals, if they are breaking the law. Again, that has nothing to do with consumers making free choices.

Free choices by consumers reward the efficient produces and punish the inefficient. Its self cleansing...all based on consumers "voting" with their dollars.

Our government, on the other hand, has rewarded the inefficient companies, with taxpayer dollars. That kinda sucks, doesn't it ??? My wife is going to try the government method, she's going to spend us out of debt.

Lew Rockwell.com

Honest Abe says

Free choices by consumers reward the efficient produces and punish the inefficient. Its self cleansing…all based on consumers “voting” with their dollars.

OK--but how do I make an efficient choice about my doctor then? If I pick a bad one and he kills me, I certainly won't choose him again, but I'm thinking it's probably too late at that point....

I agree with tatupu70. The free market does not work for essential medical care.

Are you going to go to "Budget Surgeon" because it's a good value, half the price but 20% more fatalities from complications? I think not.

For small or elective medical treatment, the market works.

For big or essential medical treatment, the market fails completely. They charge whatever they want, and you have to pay or die. (That's also known as "robbery" if you want the legal term.)

The insurance market is even worse. Competition could work there, but they have corrupted Congress, so anti-trust laws are not enforced against them and there are only a couple of insurers in each state, each one offering the same BAD deal. Take your pick of bad deals.

Tatupu - you'd make a decision about a doctor the same way you do now.

Patrick - Why would you assume "For big or essential medical treatment, the market fails completly". According to who? The "market" is the collective free choice of millions of people...free choice can never be "wrong".

And its not "you have to pay or die". Treatment is given before payment...or else my nephew would have died a week ago.

For small or elective medical treatment, the market works.

Good So lets start there. restore a free market in small and elective medical treatment. And allow people to buy insurance just for catastrophe.

AdHominem says

For small or elective medical treatment, the market works.

Good So lets start there. restore a free market in small and elective medical treatment. And allow people to buy insurance just for catastrophe.

People are perfectly free to buy catastrophic coverage now. No one is stopping them. The only thing stopping them is that most people, for whatever reason, prefer comprehensive coverage. What is your point?

bob2356 says

What is your point?

Conservatives: Good. Liberals are the root cause of all evil and have victimized him.

That's his point.