Would you support mandatory, tax-free HSA contributions?

[pricejj]

Yes or no, and if not why?

[tnedator]

Yes or no, and if not why?

I assume you are referring to a health savings account, or cafeteria style plan.

If so, it's Kind of a broad and undefined question. How much would the contributions be? Would unused funds roll over to the next year if they weren't all used or would they be lost?

A person with cancer, MS or fibromyalgia, not to mention a special needs child, could easily spend $5,000 to $10,000 on non-covered medical expenses, where a healthy person/family might spend a few hundred or thousand or two.

So, like I say, it's a pretty undefined question. Assuming you are asking what i think you are asking.

Those things aside, why should it be mandatory? If it was mandatory, how would you determine the amount each person had to contribute?

[DenverBrit]

Yes or no, and if not why?

HSA accounts already exist making them compulsory won't lower healthcare costs.

Without major cost cutting, we will accomplish nothing worthwhile.

[pricejj]

I assume you are referring to a health savings account, or cafeteria style plan.

If so, it's Kind of a broad and undefined question. How much would the contributions be? Would unused funds roll over to the next year if they weren't all used or would they be lost?

A person with cancer, MS or fibromyalgia, not to mention a special needs child, could easily spend $5,000 to $10,000 on non-covered medical expenses, where a healthy person/family might spend a few hundred or thousand or two.

So, like I say, it's a pretty undefined question. Assuming you are asking what i think you are asking.

Those things aside, why should it be mandatory? If it was mandatory, how would you determine the amount each person had to contribute?

Yes, all funds would be rolled over from year to year, and could be used by anyone in your family. The contributions would be tax free, and you would be able to pay for health insurance premiums with your HSA dollars. I am thinking mandatory contributions would be somewhere in the 3.5% range. This policy would be an an alternative to Obamacare's mandatory tax (which gives no benefit to the person paying the tax).

[pricejj]

HSA accounts already exist making them compulsory won't lower healthcare costs.

Without major cost cutting, we will accomplish nothing worthwhile.

That is false. Giving everyone control over their own healthcare spending, and contributing to their own healthcare spending has been proven to lower healthcare costs. Rather than current U.S. policy in which patients are, for the most part, completely separated from knowledge of actual costs for services, therefore enabling costs to be non-competitive.

[pricejj]

What (if any) cost cutting measures does Obamacare have which lead to you believe that healthcare costs will go to lower than 16% of GDP?

I just don't see any, and I believe that more reforms will be necessary. What do you think?

[DenverBrit]

That is false. Giving everyone control over their own healthcare spending, and contributing to their own healthcare spending has been proven to lower healthcare costs. Rather than current U.S. policy in which patients are, for the most part, completely separated from knowledge of actual costs for services, therefore enabling costs to be non-competitive.

As HSA accounts already exist, how exactly does making them 'compulsory' lower healthcare costs by at least 50%?

At present, HSA's allow around $3100 a year. Enough to cover 'high deductible' policies in many cases, but nothing else. As these have been available for nearly a decade and costs have rocketed during that period, obviously HSA's are not the answer.

If you think its as simple as 'giving people control of their healthcare spending' then you'll have to spell that out. Not in unsupported theories, but with some numbers and details as to what the new healthcare system would entail and how it would function.

All Romney and now Obama have come up with is the current version of healthcare reform.

[DenverBrit]

What (if any) cost cutting measures does Obamacare have which lead to you believe that healthcare costs will go to lower than 16% of GDP?

I just don't see any, and I believe that more reforms will be necessary. What do you think?

I think we are in desperate need of a system that first cuts costs, do that and all options are open. Without a plan to do so, we are just moving money around.

[pricejj]

I think we are in desperate need of a system that first cuts costs, do that and all options are open. Without a plan to do so, we are just moving money around.

I am trying to figure out the next likely cost-cutting step in our 4-payer system. I also don't see the Obamacare punitive tax (without coverage) tax, standing the test of time. There is nowhere in the world where anybody is taxed to pay for healthcare without being able to benefit from their contribution. That is why I see mandatory HSA's as a likely alternative.

As to your other point regarding voluntary HSA's. Voluntary HSA's (with unlimited government spending) would never affect healthcare prices, it only serves as a tax savings for the individuals that have HSA's. As long as government is setting the prices with unlimited reimbursement, healthcare prices won't drop.

Medicare reform that would limit taxpayer liability (for Medicare/Medicaid/Tricare) is the single most cost reducing factor that federal government could implement. Until that happens, healthcare costs will continue to skyrocket.

[peacepipe]

until medicare is opened for all, prices won't drop. there is no competition as it stands now.

[pricejj]

Viewing the poll results has made me curious...it appears that all the "no" votes have come from liberals.

So let me get this straight...

1. You mandate that taxpayers to be forced to pay for universal coverage or pay a 2.5% tax.
2. You refuse to make non-taxpayers liable for any healthcare costs at all.
3. You refuse to limit prices that taxpayers are paying for the world's most expensive healthcare.

Thanks, your agenda is becoming quite clear.

[pricejj]

until medicare is opened for all, prices won't drop. there is no competition as it stands now.

I disagree. You do realize that Medicare is the primary reason that the U.S. has the most expensive healthcare system in the world right? "Medicare for all" certainly would not create any competition. In fact, it would eliminate all competition.

[peacepipe]

I disagree. You do realize that Medicare is the primary reason that the U.S. has the most expensive healthcare system in the world right?that's BS and you know it.

[peacepipe]

medicare for all is where we are headed.it is not a matter of if,but when.

[pricejj]

that's BS and you know it.

No it's not BS at all. Medicare doesn's negotiate any prices. Not only that, but their is no limit to services, creating a pricetag to taxpayers of 7.5% of GDP.

What you have created is the most unfair, most expensive healthcare system in the world.

Even in single-payer Europe, all wage-earners (even the "poor") are required to pay much more than the U.S. 1.45% Medicare tax.

[peacepipe]

No it's not BS at all. Medicare doesn's negotiate any prices. Not only that, but their is no limit to services, creating a pricetag to taxpayers of 7.5% of GDP.

What you have created is the most unfair, most expensive healthcare system in the world.

Even in single-payer Europe, all wage-earners (even the "poor") are required to pay much more than the U.S. 1.45% Medicare tax.

it's also not for profit.

[pricejj]

it's also not for profit.

Medicare/Medicaid/Tricare (taxpayers) pay about half of U.S. healthcare costs which account for 7.5% of GDP (about twice the amount of Singapore's total healthcare costs as a % of GDP). Doesn't sound very cost effective to me.

[DenverBrit]

Viewing the poll results has made me curious...it appears that all the "no" votes have come from liberals.

So let me get this straight...

1. You mandate that taxpayers to be forced to pay for universal coverage or pay a 2.5% tax.
2. You refuse to make non-taxpayers liable for any healthcare costs at all.
3. You refuse to limit prices that taxpayers are paying for the world's most expensive healthcare.

Thanks, your agenda is becoming quite clear.

As long as you try and frame reform into a 'lefty' 'righty' discussion, it's you that has the agenda.

And the points you make, have nothing to do with HSA accounts, limiting costs or mandatory participation and fines.

Again, HSA accounts, compulsory or not, will not bring down costs without drastic cuts in healthcare charges.
Peacepipe is on track with medicare....it's one logical answer. Though probably on a State level.....as State high risk pools already exist.
It would further bring down Medicare costs and the healthcare industry would no longer be of hiking costs in the private sector to make up lost profits.

These charts illustrate why using a single payer system would bring down per capita costs.
Looking at Medicare, it's not difficult to see what the costs might be if a huge pool of healthy adults were to pay into the system, instead of just the elderly.

Hey, Medicare scans are a bargain!
http://voices.washingtonpost.com/ezra-klein/assets_c/2009/11/ctprices-thumb-454x324.jpeg

http://voices.washingtonpost.com/ezra-klein/assets_c/2009/11/doctorvisit-thumb-454x317.jpeg

[DenverBrit]

No it's not BS at all. Medicare doesn's negotiate any prices. Not only that, but their is no limit to services, creating a pricetag to taxpayers of 7.5% of GDP.

What you have created is the most unfair, most expensive healthcare system in the world.

Even in single-payer Europe, all wage-earners (even the "poor") are required to pay much more than the U.S. 1.45% Medicare tax.

If you really believe that, you should stop talking about Healthcare costs and their containment.

Why Our Health Care Costs Are Running Wild
While a for-profit health care industry has absolutely led to out-of-control prices, Maggie points out that “In the U.S., the government (i.e. taxpayers) picks up more than half of our national healthcare tab by paying for Medicare, Medicaid, care for government employees, the Veterans administration and other government health programs. As a purchaser, the government does have the size and the clout needed to insist on discounts. The problem is that Congress does not have the spine to stand up to the lobbyists and let Medicare begin negotiating for lower prices.“ But I would contend that in the realm of Medicare, the government has negotiated much lower prices. Kidney dialysis is one area that I’m fairly well-educated about, as my father has been on dialysis for several years. He lives in Colorado, but over the years, he’s been treated at various hospitals and dialysis centers across the US. The monthly bill for his dialysis treatment (standard fare, regardless of where it is done) has ranged from $2,800 to $18,000. And yet Medicare pays $2,800/month for dialysis, regardless of what the facility bills (the rest is written off, and cannot be billed to the patient). This is just one example – Medicare has negotiated rates that are far lower than private health insurance reimbursement amounts on just about every treatment imaginable. The problem is that these rates haven’t carried over into the rest of the health insurance world.

http://www.healthinsurancecolorado.net/blog1/2008/10/27/why-our-health-care-costs-are-running-wild/

[tnedator]

As long as you try and frame reform into a 'lefty' 'righty' discussion, it's you that has the agenda.

And the points you make, have nothing to do with HSA accounts, limiting costs or mandatory participation and fines.

Again, HSA accounts, compulsory or not, will not bring down costs without drastic cuts in healthcare charges.
Peacepipe is on track with medicare....it's one logical answer. Though probably on a State level.....as State high risk pools already exist.
It would further bring down Medicare costs and the healthcare industry would no longer be of hiking costs in the private sector to make up lost profits.

These charts illustrate why using a single payer system would bring down per capita costs.
Looking at Medicare, it's not difficult to see what the costs might be if a huge pool of healthy adults were to pay into the system, instead of just the elderly.

Hey, Medicare scans are a bargain!
http://voices.washingtonpost.com/ezra-klein/assets_c/2009/11/ctprices-thumb-454x324.jpeg

http://voices.washingtonpost.com/ezra-klein/assets_c/2009/11/doctorvisit-thumb-454x317.jpeg

This is a simplistic view of things.

There are multiple reasons why health care costs so much more in the US than other countries. Not only do we have a large percentage of uninsured/indigent (some legal, some note) that get treatment, but don't pay for it, but there are other factors as well.

We have astronomical law suit awards which impact costs in multiple ways (cost of bringing new devices to market, cost of product liability insurance on said devices, cost of medical malpractice insurance, extra tests run to make sure nothing is missed that would lead to a malpractice suit). The liberals say that tort reform is a tiny piece of the pie, but that's because they don't look at all the "trickle down" costs of lawsuits. It is huge.

The US subsidizes the R&D for medical devices and drugs worldwide. Yes, it's cheaper to buy prescriptions in Canada, because the Canadian medical agencies negotiate low rates that they will pay or not buy the drug. Same with UK and elsewhere. Their leverage against the drug companies is that they will use the old treatment method, rather than the hot new drug, unless the drug company hits a certain price.

However, if every country did that, then it would greatly curtail the amount of money put into R&D, because now they know they can have 50 failed projects costing millions or billions, but if only one is a success, they will pay for it all and more just on US sales, and the rest of the countries they sell to at cheaper prices are gravy.

If they US was just another UK or Canada, then there would be a major hit to the R&D of pharmaceutical companies.

The same is true of medical devices, whether its imaging scanners like MRI's and CAT scans or stenting equipment or about anything else you can think of.

Good or bad, right now we subsidize the rest of the world's medical advances.

[DenverBrit]

This is a simplistic view of things.

There are multiple reasons why health care costs so much more in the US than other countries. Not only do we have a large percentage of uninsured/indigent (some legal, some note) that get treatment, but don't pay for it, but there are other factors as well.

We have astronomical law suit awards which impact costs in multiple ways (cost of bringing new devices to market, cost of product liability insurance on said devices, cost of medical malpractice insurance, extra tests run to make sure nothing is missed that would lead to a malpractice suit). The liberals say that tort reform is a tiny piece of the pie, but that's because they don't look at all the "trickle down" costs of lawsuits. It is huge.

The US subsidizes the R&D for medical devices and drugs worldwide. Yes, it's cheaper to buy prescriptions in Canada, because the Canadian medical agencies negotiate low rates that they will pay or not buy the drug. Same with UK and elsewhere. Their leverage against the drug companies is that they will use the old treatment method, rather than the hot new drug, unless the drug company hits a certain price.

However, if every country did that, then it would greatly curtail the amount of money put into R&D, because now they know they can have 50 failed projects costing millions or billions, but if only one is a success, they will pay for it all and more just on US sales, and the rest of the countries they sell to at cheaper prices are gravy.

If they US was just another UK or Canada, then there would be a major hit to the R&D of pharmaceutical companies.

The same is true of medical devices, whether its imaging scanners like MRI's and CAT scans or stenting equipment or about anything else you can think of.

Good or bad, right now we subsidize the rest of the world's medical advances.

I know this is often cited as a major problem, but it represents 2.4% of healthcare costs. It includes:

payments made to malpractice plaintiffs; defensive medicine costs; administrative costs, such as lawyer fees; and the costs of lost clinician work time.
Medical Liability Costs in U.S. Pegged at 2.4 Percent of Annual Health Care Spending
“Medical liability costs have been in the bull’s-eye of efforts to bend the health care cost curve down,” said lead author Michelle Mello, professor of law and public health at HSPH. “But we can’t have a meaningful debate about the potential effects of liability reform without solid cost estimates. At nearly $56 billion per year, the medical liability system carries heavy costs, and there are good reasons to want to improve it. But we should be realistic about what liability reform can achieve in terms of health care cost control.”

According to Mello and her co-authors, other reforms, such as changing the fee-for-service reimbursement system that gives providers incentives to overuse services, probably hold more promise for reducing health care costs. Proponents of liability reform argue that it will address two drivers of health care costs: providers offsetting rising malpractice insurance premiums by charging higher prices and “defensive medicine,” in which liability concerns lead doctors to order more tests, procedures, and other services than are medically necessary.
http://www.hsph.harvard.edu/news/press-releases/2010-releases/medical-liability-costs-us.html

Your point about subsidizing the "world's medical advances" is on the money.
The US should be negotiating costs comparable to those of other countries.

[tnedator]

I know this is often cited as a major problem, but it represents 2.4% of healthcare costs. It includes:


Medical Liability Costs in U.S. Pegged at 2.4 Percent of Annual Health Care Spending

http://www.hsph.harvard.edu/news/press-releases/2010-releases/medical-liability-costs-us.html

Your point about subsidizing the "world's medical advances" is on the money.
The US should be negotiating costs comparable to those of other countries.

Yes, but the second part of my point is that if we do, it is very likely that we will see a BIG slow down in medical advancements, OR the rest of the world will have to chip in to cover the reduction in what the US pays.

It's a very simplistic view to think it's just because we don't have Medicare administrators negotiating contracts for all US health care. It's only looking at one side of the equation.

Speaking of one side of the equation, in anticipation of you posting that 2.4% stat, I already addressed a number of aspects that weren't in your quote. The trickle down impact of the lawsuits is FAR greater than just the cost of the malpractice suits.

The "payments made to malpractice plaintiffs; defensive medicine costs; administrative costs, such as lawyer fees; and the costs of lost clinician work time" addressed in that quote could best be described as the part of the iceberg you see above water, with the vast majority out of site.

As I said, every chain of the drug, medical device, hospital, patient care supply chain is impacted by the fear of lawsuits and the resulting HIGH insurance costs.

The artificial hip costs what it does, in large part, because if there is a problem, you will see commercials broadcasting nationwide asking you to join a class action suit. That means that they need to have a reserve to cover these lawsuits. The product liability insurance is through the roof to cover potential lawsuits. Their is defensive/cover your ass actions taken every step of the way.

The 2.4% number simply looks at the tip of the iceberg. While that number "might" be accurate for just the costs of the tip, it in NO WAY covers the cost impact of the whole iceberg.

[tnedator]

Here's another, more accurate, view of the costs associated with medical malpractice, taking stats from the JAMA, along with PWC.

The president said he doesn't "believe malpractice reform is a silver bullet." He claims he has talked to enough doctors to know that defensive medicine "may" be contributing to costs. "May" be contributing? The Journal of the American Medical Association found that 93 percent of doctors admit practicing defensive medicine. A new study by the Pacific Research Institute estimates that such practices cost $191 billion a year, while a separate study by PricewaterhouseCoopers puts the number even higher -- $239 billion.

Medical-malpractice premiums have risen by more than 80 percent each year in some parts of the country and can cost almost half a million dollars a year in some specialties. The direct costs of medical-malpractice tort claims range from $16 billion according to the Pacific Research Institute to more than $30 billion according to Tillinghast-Towers Perrin. A CBO report requested by Sen. Orrin Hatch admitted that medical-malpractice reform could save $54 billion for the U.S. government alone.

http://www.heritage.org/research/commentary/2009/10/the-power-of-the-plaintiffs-bar-why-democrats-are-avoiding-medical-malpractice-reform-at-all-costs

And this is only research done on the direct costs of malpractice suits, premiums and defensive medicine. That's still only part of the iceberg, because it doesn't account for the costs of product liability insurance and other costs at the drug/device manufacturing level.

The fact is that you guys have been sold a bill of goods because the plaintiffs bar is a HUGE, supporter of the Democratic party, so therefore any kind of tort reform is strictly off limits.

[DenverBrit]

Here's another, more accurate, view of the costs associated with medical malpractice, taking stats from the JAMA, along with PWC.



http://www.heritage.org/research/commentary/2009/10/the-power-of-the-plaintiffs-bar-why-democrats-are-avoiding-medical-malpractice-reform-at-all-costs

And this is only research done on the direct costs of malpractice suits, premiums and defensive medicine. That's still only part of the iceberg, because it doesn't account for the costs of product liability insurance and other costs at the drug/device manufacturing level.

The fact is that you guys have been sold a bill of goods because the plaintiffs bar is a HUGE, supporter of the Democratic party, so therefore any kind of tort reform is strictly off limits.

Really??

From the Harvard School of Public Health study, another 'first'. Someone is mistaken. You or Harvard. :P

In an effort to separate fact from fiction—and to provide the first academic study of medical liability system costs-- a comprehensive analysis from Harvard School of Public Health (HSPH) researchers found that medical liability costs totaled about 2.4% of annual health care spending in the United States, or $55.6 billion per year in 2008.
http://www.hsph.harvard.edu/news/press-releases/2010-releases/medical-liability-costs-us.html

....and which guys have been "sold a bill of goods"??

[barryr]

It is pretty amazing in today's world, where so many are out of homes and jobs when 56 billion dollars can be considered a small amount. With over 13,000 pages of Obamacare, rather foolish to believe anyone can really figure out how much anything is going to cost and in reality and history as a guide, it will cost more than estimated. A lot more. With the IRS involved in this, it will all be as clear as the tax codes.

[tnedator]

Really??

From the Harvard School of Public Health study, another 'first'. Someone is mistaken. You or Harvard. :P

http://www.hsph.harvard.edu/news/press-releases/2010-releases/medical-liability-costs-us.html

....and which guys have been "sold a bill of goods"??

First, we will assume that Professor Mello's motives are pure, even though she was an adviser to President Obama during the creation of the Health Care Bill (now law).

With that out of the way, let's focus on you. You're good at copy and paste, now maybe you should expand your skill to actually reading posts and articles/studies you link to.

As I already stated, what Professor Mello looked at was the tip of the iceberg, the part above water. The smallest part of the whole kit and kaboodle. She focused on the direct costs of litigation, which makes sense because she has been an outspoken proponent of an alternative to traditional malpractice suits where there is a special malpractice court making it easier for patients to bring a claim and get paid then it happens now. She claims that only two out of ever hundred patients injured by malpractice get paid, and she hopes to create a new system that would make it easier for patients to file claims and get paid by doctors/hospitals for their malpractice.

She did estimate the cost of defensive medicine, which is part of the big picture, but still not all of it. Her number was significantly below what PCW came up with, and we would have to see the actual methodology used by each of them to draw a valid conclusion as to which is more accurate, but there is no reason to believe that Professor Mello's is correct and should be gospel.

Again, even with the defensive medicine, that's still not the whole equation, because you also have the cost of bringing drugs and medical devices to market in this hostile environment, which includes, but isn't limited to, extremely high product liability premiums.

So, rather than just copy and paste and parrot ****, take a moment and think about the subject and be open enough to have a real dialog about it.

[spdirty]

I don't support anything that's mandatory.

[pricejj]

I don't support anything that's mandatory.

Fair enough...but the Democrats keep ragging on the so-called "free-riders". A group, they say, is predominantly responsible for the U.S. enormous health care costs.

I would rather take mandatory HSA payments (where EVERYONE would be responsible for their own health care costs), than the Democrat Socialist vision of exempting those making less than $33,000 per year from ALL health care costs, and separating the U.S. 4-payer system (which Singapore has managed into the least expensive health care system in the world) to a European-style single-payer system with non-sustainable costs.

Give me a mandatory HSA contribution over a 2.5% Obamacare tax anyday...





So Brit, what's it going to be? You claim "free-riders" are a huge problem that grow health care costs, but you are against mandatory HSA contributions because you claim "mandatory HSA's don't cut costs"? One or both of your statements are wrong.

[pricejj]

As long as you try and frame reform into a 'lefty' 'righty' discussion, it's you that has the agenda.


Yes, I do have an agenda. My agenda is to cut U.S. health care costs to a sustainable level. The best way to do that is by putting all health care dollars into individual HSA's, and limiting taxpayer (and private insurance) liability on subsidized services.

You promote the European Socialist single-payer model, which is unsustainable and still spends 10%-12% of GDP on healthcare, and don't believe that competition lowers health care costs, even though there is evidence from the beginning of time, showing that it does.

I promote the best, cheapest healthcare system money can buy. This is a system which limits taxpayer liability, and puts control of health care dollars back into the hands of individuals (systems like this have proven to limit health care spending to 4% of GDP)

[W*GS]

There's a lot more to Singapore's health care system than mandatory HSA-like accounts, pricejj.

That alone will not create a replica of their system here.

You're forgetting the price controls and regulations they have in place, which is very unlikely to be duplicated here.

[tnedator]

There's a lot more to Singapore's health care system than mandatory HSA-like accounts, pricejj.

That alone will not create a replica of their system here.

You're forgetting the price controls and regulations they have in place, which is very unlikely to be duplicated here.

What's the income/cost of living like there? I had a cousin that spent a number of years there for work. I remember him saying that the apartment he had was something like either $3000 or $5000 a month.

[W*GS]

What's the income/cost of living like there? I had a cousin that spent a number of years there for work. I remember him saying that the apartment he had was something like either $3000 or $5000 a month.

It's not cheap. A dinner I had with a pizza and a couple of beers was over $50.

[DenverBrit]

First, we will assume that Professor Mello's motives are pure, even though she was an adviser to President Obama during the creation of the Health Care Bill (now law).

With that out of the way, let's focus on you. You're good at copy and paste, now maybe you should expand your skill to actually reading posts and articles/studies you link to.

As I already stated, what Professor Mello looked at was the tip of the iceberg, the part above water. The smallest part of the whole kit and kaboodle. She focused on the direct costs of litigation, which makes sense because she has been an outspoken proponent of an alternative to traditional malpractice suits where there is a special malpractice court making it easier for patients to bring a claim and get paid then it happens now. She claims that only two out of ever hundred patients injured by malpractice get paid, and she hopes to create a new system that would make it easier for patients to file claims and get paid by doctors/hospitals for their malpractice.

She did estimate the cost of defensive medicine, which is part of the big picture, but still not all of it. Her number was significantly below what PCW came up with, and we would have to see the actual methodology used by each of them to draw a valid conclusion as to which is more accurate, but there is no reason to believe that Professor Mello's is correct and should be gospel.

Again, even with the defensive medicine, that's still not the whole equation, because you also have the cost of bringing drugs and medical devices to market in this hostile environment, which includes, but isn't limited to, extremely high product liability premiums.

So, rather than just copy and paste and parrot ****, take a moment and think about the subject and be open enough to have a real dialog about it.

You're a little late to the party. This is the 3rd or 4th thread related to this topic in the last couple of days.

As for not reading what I paste or link, what brings you to that conclusion?

What was the source of your claim that you posted the "only research done on the direct costs of malpractice suits, premiums and defensive medicine"?

Or is that something you concocted?

You prefer to post lengthy claims without sources, I prefer to keep opinion brief and post facts.
If I see material that has some relevance and credibility....like Harvard, I'll post it, but I won't make false claims about it to pump up my credibility.

Feel free to keep going.

[DenverBrit]

There's a lot more to Singapore's health care system than mandatory HSA-like accounts, pricejj.

That alone will not create a replica of their system here.

You're forgetting the price controls and regulations they have in place, which is very unlikely to be duplicated here.

He's not forgetting, he's denying.

[pricejj]

There's a lot more to Singapore's health care system than mandatory HSA-like accounts, pricejj.

That alone will not create a replica of their system here.

You're forgetting the price controls and regulations they have in place, which is very unlikely to be duplicated here.

Yeah W*GS, I know price controls and regulations are just as important (if not more) than self-payment...REAL, SUSTAINABLE health care reform, is a combination of many factors.

It's pretty obvious, that to be cost-effective, the non-private, subsidized sector of U.S. healthcare will have to have a significant amount of regulation and price controls implemented, in order to lesson the burden of health care on taxpayers. Medicare is the single, largest, unfunded taxpayer liability in the history of the world.

The good news is, something will have to be done sometime within the next few years.

The trick is electing a President, and a Congress that can do it. It is possible to have a largely free-market health care system, with all of the benefits that a free-market brings...like quality, price competition, innovation, and increasing technological advances...which mankind depends on.
...alongside of a public, subsidized health care system that exists for catastrophic, or end-of-life care, which no one would be able to afford without subsidization...along with providing services for those who don't work, and can't afford to pay.

Is America up to the task? That remains to be seen. It is the single largest issue affecting the solvency of our great country.

[DenverBrit]

Yes, I do have an agenda. My agenda is to cut U.S. health care costs to a sustainable level. The best way to do that is by putting all health care dollars into individual HSA's, and limiting taxpayer (and private insurance) liability on subsidized services.

You promote the European Socialist single-payer model, which is unsustainable and still spends 10%-12% of GDP on healthcare, and don't believe that competition lowers health care costs, even though there is evidence from the beginning of time, showing that it does.

I promote the best, cheapest healthcare system money can buy. This is a system which limits taxpayer liability, and puts control of health care dollars back into the hands of individuals (systems like this have proven to limit health care spending to 4% of GDP)

Really? When did that happen?

I simply disagree that Singapore's Healthcare system will work in the US for the reasons I mentioned in other threads. Where did I promote 'European Socialist models'?
I have said several times, reduce US healthcare costs drastically enough and all systems can be considered.

I happen to think that the US will end up with and expanded version of Medicare on a State level.....because it's already in place in many states.

Perhaps if you started with the state you live in, you'll begin to understand why it's feasible. It's called Cover Colorado and it works well, though I have no idea what financial burden Colorado's program imposes.

[Broncosman]

that's BS and you know it.

and that's the reason why we have to pay for more tax

[pricejj]

Really? When did that happen?

I simply disagree that Singapore's Healthcare system will work in the US for the reasons I mentioned in other threads. Where did I promote 'European Socialist models'?
I have said several times, reduce US healthcare costs drastically enough and all systems can be considered.

I happen to think that the US will end up with and expanded version of Medicare on a State level.....because it's already in place in many states.

Perhaps if you started with the state you live in, you'll begin to understand why it's feasible. It's called Cover Colorado and it works well, though I have no idea what financial burden Colorado's program imposes.

Cover Colorado has nothing to do with Medicare, and is not funded by taxpayers. It is strictly a high-risk pool, that gets half of it's funding from high premiums that insureds with pre-existing conditions pay, and half of it's funding from fee's collected (about $3 per month on your typical insurance policy) plus charitable donations, and grants. It is facing serious funding shortfalls, but no matter, guaranteed issue makes Cover Colorado obsolete...shifting the enormous costs of high-risk pool into the general health insurance market, driving costs up for everybody else.

In other words, in 2014, Cover Colorado ceases to exist.

You really have to wonder why the drafters of Obamacare did nothing to address the cost of health care. Much like everything else with this administration, it was a shell game, to garner more votes, and further socialize (which never works) the U.S.

[W*GS]

He's not forgetting, he's denying.

True.

In some ways, what Singapore has done with health care is analogous to how the whole place is run. The fact that it's controlled in order to enforce harmony and "equality" is either something the Right here should oppose, or, reveals that the Right has a hankering for authoritarianism.

[tnedator]

You're a little late to the party. This is the 3rd or 4th thread related to this topic in the last couple of days.

As for not reading what I paste or link, what brings you to that conclusion?

What was the source of your claim that you posted the "only research done on the direct costs of malpractice suits, premiums and defensive medicine"?

Or is that something you concocted?

You prefer to post lengthy claims without sources, I prefer to keep opinion brief and post facts.
If I see material that has some relevance and credibility....like Harvard, I'll post it, but I won't make false claims about it to pump up my credibility.

Feel free to keep going.

Because I actually researched what you posted before responding to it. I know, a novel concept, isn't it.

Professor Mello only focused on the direct costs of malpractice, and then estimated the cost of defensive medicine.

She focused on four areas:


Indemnity Payments (Actual malpractice awards including if attorneys fees were ordered to be paid)
Administrative expenses (including legal expenses)
Other costs (primarily just lost clinical time for people in the lawsuit - depositions and stuff)
Defensive medical costs


Here is just ONE of the things I looked at last night after you posted a very brief summary of her study and did NOTHING to actually understand it:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3048809/

As you can see, the authors of the study themselves state that:


They did not include the cost of hospital and doctors malpractice insurance premiums.
Just as an example of the limitations on their study, they received their data on other administrative expenses from the AM Best Company, which has no data on hospitals or other organizations that are self insured, therefore they just guessed and increased that particular number by 10%.
When it comes to defensive medicine, they referred to the reliability of the data as low, where the other items they actually included were considered moderate or good --- "the quality of evidence supporting our systemwide estimate is best characterized as low."



We have highlighted the many limitations to the data available to support this analysis. Our estimates should be interpreted cautiously, with recognition that some system cost elements were excluded and others—particularly the defensive medicine figures—were estimated based on substantial assumptions and extrapolations.

You might want to actually read studies you reference, rather than grab a couple lines that you think support your position and just copy and paste them.

This is a VERY superficial study that only looked at a tiny part of the full picture, and admits as much in some areas (malpractice premiums as an example), but doesn't address the product liability/medical device/drug costs related to malpractice.

Much of their data was gained by reviewing previous studies, some decades old, which they admits can create problems. Further, most of their cost estimates were made based on guesses as to what was "likely" not based on hard data.

As I said in an early post, in order to try and make an assumption as to which data was correct (Harvard Study, PCW data or the third one whos name is eluding me now), you really need to review the methodology of the research. Instead of simply accepting that and accepting we had three different sources, two putting the number high and one low, you just wen with the....

"yea, but, err, ya know, it's Haaaarvard, so it has to be right!!"

Come on man, up your ****ing game if you want to represent yourself as an expert.

Geez

[barryr]

True.

In some ways, what Singapore has done with health care is analogous to how the whole place is run. The fact that it's controlled in order to enforce harmony and "equality" is either something the Right here should oppose, or, reveals that the Right has a hankering for authoritarianism.

So it should be your paradise. Glad you can make posts without worrying about someone's rear for a change.

[DenverBrit]

Because I actually researched what you posted before responding to it. I know, a novel concept, isn't it.

Professor Mello only focused on the direct costs of malpractice, and then estimated the cost of defensive medicine.

She focused on four areas:


Indemnity Payments (Actual malpractice awards including if attorneys fees were ordered to be paid)
Administrative expenses (including legal expenses)
Other costs (primarily just lost clinical time for people in the lawsuit - depositions and stuff)
Defensive medical costs


Here is just ONE of the things I looked at last night after you posted a very brief summary of her study and did NOTHING to actually understand it:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3048809/

As you can see, the authors of the study themselves state that:


They did not include the cost of hospital and doctors malpractice insurance premiums.
Just as an example of the limitations on their study, they received their data on other administrative expenses from the AM Best Company, which has no data on hospitals or other organizations that are self insured, therefore they just guessed and increased that particular number by 10%.
When it comes to defensive medicine, they referred to the reliability of the data as low, where the other items they actually included were considered moderate or good --- "the quality of evidence supporting our systemwide estimate is best characterized as low."





You might want to actually read studies you reference, rather than grab a couple lines that you think support your position and just copy and paste them.

This is a VERY superficial study that only looked at a tiny part of the full picture, and admits as much in some areas (malpractice premiums as an example), but doesn't address the product liability/medical device/drug costs related to malpractice.

Much of their data was gained by reviewing previous studies, some decades old, which they admits can create problems. Further, most of their cost estimates were made based on guesses as to what was "likely" not based on hard data.

As I said in an early post, in order to try and make an assumption as to which data was correct (Harvard Study, PCW data or the third one whos name is eluding me now), you really need to review the methodology of the research. Instead of simply accepting that and accepting we had three different sources, two putting the number high and one low, you just wen with the....

"yea, but, err, ya know, it's Haaaarvard, so it has to be right!!"

Come on man, up your ****ing game if you want to represent yourself as an expert.

Geez

Fascinating.

Now back to this one more time.

What was the source of your claim that: "And this is only research done on the direct costs of malpractice suits, premiums and defensive medicine"

[pricejj]

He's not forgetting, he's denying.

Another falsehood. Have you even read my posts?

Something, very obviously, needs to be done to limit taxpayer liability for Medicare subsidization. Why the Obama and the Democrats refused to do that, while crafting their so-called "health care reform", which is strictly a transfer of wealth...is anybodies guess.

[barryr]

Another falsehood. Have you even read my posts?

Something, very obviously, needs to be done to limit taxpayer liability for Medicare subsidization. Why the Obama and the Democrats refused to do that, while crafting their so-called "health care reform", which is strictly a transfer of wealth...is anybodies guess.

No question the DNC and lawyers are in bed, so tort reform is not included for that reason. The only "good" reason they can come up with his their supposed "it's such a small percentage of the problem" but if it's a problem, then why isn't addressed? What difference does it make how big a problem? We can argue numbers all day, but in the end, it's still a problem no matter how you cut it. But they in turn they make a big difference of how many people don't have insurance, which most have made that decision not that they can't, which is a small amount compared to those that do, but that is a problem so important, but not tort reform? It's just all political BS.

[pricejj]

No question the DNC and lawyers are in bed, so tort reform is not included for that reason. The only "good" reason they can come up with his their supposed "it's such a small percentage of the problem" but if it's a problem, then why isn't addressed?

The DNC is in bed with several special interests in an attempt to garner more votes, that's why Obamacare is nothing but a bump in the road, on the way to real health care reform. Limiting taxpayer liability by instituting block grant funding for Medicare patients is the next logical step to decrease health care costs...followed by many more cost-cutting measures (like regulating taxpayer liability on end-of-life care, interstate health insurance purchasing, tort reform, mandatory HSA contributions, fees for Medicaid patients, a removal of government spending in the primary care private health care market, and a repeal of the ridiculous "bronze" plan as a health insurance standard (the lowest tier should be strictly catastrophic).

...we can expect nothing from the divider-in-chief and his cohorts, except to demonize any fair, and useful legislation...I have been sick and tired of it for awhile now, and I bet the rest of Americans are too.

[tnedator]

Fascinating.

Now back to this one more time.

What was the source of your claim that:

Brit, this is really sad. So, you are incapable of clicking a link and reading the actual study that you referenced? Ok, I'll help you out, so here you go:

The major categories of costs are indemnity payments, or the amounts that malpractice defendants, typically through their liability insurers, pay out to patients who file malpractice claims against them; administrative expenses, consisting of attorneys’ fees and other legal expenses for both sides, plus insurer overhead; defensive medicine costs, which are the costs of medical services ordered primarily for the purpose of minimizing the physician’s liability risk; and other costs, some of which are difficult or impossible to quantify in economic terms. All costs are presented in 2008 dollars.

Of course my statement you quoted was wrong, because when I wrote that, I mistakenly thought she had included premiums paid by doctors/hospitals, but that isn't the case. She intentionally excluded those costs, because she says it would be "double counting".

Come on, I'm embarrassed for you right now, that you keep referencing a study that you didn't even take 5 or 10 minutes to read and understand.

[DenverBrit]

Brit, this is really sad. So, you are incapable of clicking a link and reading the actual study that you referenced? Ok, I'll help you out, so here you go:



Of course my statement you quoted was wrong, because when I wrote that, I mistakenly thought she had included premiums paid by doctors/hospitals, but that isn't the case. She intentionally excluded those costs, because she says it would be "double counting".

Come on, I'm embarrassed for you right now, that you keep referencing a study that you didn't even take 5 or 10 minutes to read and understand.

LOL.

Nice try, but we are talking about the study YOU posted, that's where YOU made the claim that it was the only study.
You were referencing the unbiased Heritage Foundation, not the Harvard study.
You're having difficulty remembering your own BS.....here it is.

http://www.orangemane.com/BB/showpost.php?p=3616955&postcount=23

[DenverBrit]

Another falsehood. Have you even read my posts?

Something, very obviously, needs to be done to limit taxpayer liability for Medicare subsidization. Why the Obama and the Democrats refused to do that, while crafting their so-called "health care reform", which is strictly a transfer of wealth...is anybodies guess.

I was talking about your denial that Singapore's government had controlled healthcare costs. Nothing else.

[tnedator]

LOL.

Nice try, but we are talking about the study YOU posted, that's where YOU made the claim that it was the only study.
You were referencing the unbiased Heritage Foundation, not the Harvard study.
You're having difficulty remembering your own BS.....here it is.

http://www.orangemane.com/BB/showpost.php?p=3616955&postcount=23

That's because you mix you nonsense. You keep repeating, "it's Harvard, it's gotta be right," which would indicate that was what you were talking about.

As to the other, again, click the link and read. It won't kill you. It says it's only the cost of defensive medicine. It doesn't include the other costs.

Just to a little research and you'll be amazed how much you can learn.

[pricejj]

I was talking about your denial that Singapore's government had controlled healthcare costs. Nothing else.

Singapore's government does not control prices in the private sector primary care market.

[DenverBrit]

That's because you mix you nonsense. You keep repeating, "it's Harvard, it's gotta be right," which would indicate that was what you were talking about.

As to the other, again, click the link and read. It won't kill you. It says it's only the cost of defensive medicine. It doesn't include the other costs.

Just to a little research and you'll be amazed how much you can learn.

You know well that I said no such thing. Those are your words, not mine.

Again, nice try but get your stories straight, that hole you're digging is getting deeper.

[tnedator]

You know well that I said no such thing. Those are your words, not mine.

Again, nice try but get your stories straight, that hole you're digging is getting deeper.

I paraphrased: "material that has some relevance and credibility....like Harvard"

At this point this is a circle jerk. Why don't you read the study you referenced, and the PCW survey/data and then let's talk when you actually have something more than hyperbole.

[DenverBrit]

I paraphrased: "material that has some relevance and credibility....like Harvard"

At this point this is a circle jerk. Why don't you read the study you referenced, and the PCW survey/data and then let's talk when you actually have something more than hyperbole.

Nah, you're not paraphrasing, you're bull****ing and throwing hyperbole around like confetti.

[tnedator]

Nah, you're not paraphrasing, you're bull****ing and throwing hyperbole around like confetti.

All of your sidestepping and obfuscation aside, have you even read your girl Mello's study yet? Do you even comprehend what and how she calculated her 2.4% number. Are you able to grasp what isn't included in that number?

Or, do you just prefer to copy and paste without actually reading/understanding/discussing the contents?

Either way is fine, it would just be nice to know what the ground rules are when dealing with the Brit.

[DenverBrit]

All of your sidestepping and obfuscation aside, have you even read your girl Mello's study yet? Do you even comprehend what and how she calculated her 2.4% number. Are you able to grasp what isn't included in that number?

Or, do you just prefer to copy and paste without actually reading/understanding/discussing the contents?

Either way is fine, it would just be nice to know what the ground rules are when dealing with the Brit.

Stop your bull****ing and deflecting would be a good start.

As for reading what I post and link, always.

As it was the first study of its kind, (Harvard's) it was worth posting, if you want to spend your time arguing its methodology, go find someone who cares.

[tnedator]

Stop your bull****ing and deflecting would be a good start.

As for reading what I post and link, always.

As it was the first study of its kind, (Harvard's) it was worth posting, if you want to spend your time arguing its methodology, go find someone who cares.

Yes, a study done by an adviser to President Obama regarding the health care bill. An adviser that wants to come up with a way for more than 2 out of 100 (her numbers) victims of malpractice to get paid.

Yep, not only didn't you read what the study data did or did not include, and which parts she herself labeled as a "low" level of confidence in the data, but you didn't even do any basic due diligence as to the author.

Instead, you just keep hearkening back to Haaaarvaaard.

Come on dude, it will take you less than 10 minutes to actually READ the study you posted about. Not the article you linked to summarizing it, but the actual study, which I posted a link to.

[DenverBrit]

Yes, a study done by an adviser to President Obama regarding the health care bill. An adviser that wants to come up with a way for more than 2 out of 100 (her numbers) victims of malpractice to get paid.

Yep, not only didn't you read what the study data did or did not include, and which parts she herself labeled as a "low" level of confidence in the data, but you didn't even do any basic due diligence as to the author.

Instead, you just keep hearkening back to Haaaarvaaard.

Come on dude, it will take you less than 10 minutes to actually READ the study you posted about. Not the article you linked to summarizing it, but the actual study, which I posted a link to.

Really, is this the BS you want to keep repeating?

Seriously, go find someone who gives a **** about what you think.