Stephen Hawking Has Not Yet Been Murdered by the NHS

ndm

-- Could it be run more efficiently and cheaply? Almost certainly.

I suspect most of the people mocking IBD would not agree with the "cheaply." It is pretty much a given in the US that the NHS is underfunded. This, of course, may no longer be true. Things may have changed but it used to be true that the NHS consumed a smaller percentage of GDP to cover the entire British population than Medicare consumed to cover only the over-65s. I believe Medicare remains the largest socialized Medicare system in the World - although the way things are going the VA system will probably be giving it a run for its money soon. (FY2010 budget - $453 billion for Medicare and $112 billion for VA)

-- In Britain you worry what will happen when you fall ill; many Americans worry about what will happen if you fall ill. Will your insurance cover you? Often, yes it will and the best American care probably is better than the best British care, but there's a greater psychological security to the British system.

Actually, oftentimes insurance will not cover you. I use a high-deductible plan costing $678 per month. In all the years of having this plan I have never met the deductible which means I have paid for all care. The only benefit I received from the plan - other than (possible) lack of worry in the case of a catastrophe - is that I get a negotiated rate rather than the billed rate. For those not familiar with an American bill the difference between billed and negotiated rates is rather like the (phony) discounts offered by chain bookstores on new hardback books.

I recently had a surgical procedure done. In the two months between the time I saw the surgeon and the date of the procedure I had calls from the anesthesiologist, the surgeon and the day-surgery clinic all concerned about my high deductible and inquiring whether I might bring some form of payment on the day of the surgery. One of them even demanded a hefty deposit right then and there on the phone. The outcome of all this is that this year I may punch through my deductible although - but I am still worried about precisely what the insurance will pay for. At the end of the day I know the insurance company is uninterested in satisfying my healthcare needs, it is interested only in minimizing its outlays.

During one of these phone calls I asked for a ball park estimate of what the procedure would cost. The person couldn't answer the question because she only dealt with one of the three bills(*) I would receive. She ventured that the total bill would be north of $5000. I did not have a life-threatening condition so to some extent this was a quality-of-life procedure performed half-a-million times a year in the US. There are many people in the US who would struggle to come up with $5000 to pay for this procedure - and they are often the kind of people who do not get a good employer-provided healthplan. I guess, as too many American libertarians would have it, there is always charity (and Medicaid).

(*) If I'm lucky.

David

And yet, as Jon Stewart proved in his interview with Bill Kristol, all these people claiming Obama is a Nazi/Marxist (have they not decided yet?) are perfectly happy with a completely government run system for the Armed Forces.

THX1138

This all goes back to the wingnuts & Lady GaGa twittering on about "Death Panels" and a bunch of socialist libruls Death Czar's deciding who lives and die.

If you really want to know who brought in real “Death Panels” it was Bush as Governor of Texas who signed into law the:

Texas Futile Care Law

http://en.wikipedia.org/wiki/Advance_Directives_Act

“Section 166.046, Subsection (e),[1] which allows a health care facility to discontinue life-sustaining treatment against the wishes of the patient or guardian ten days after giving written notice if the continuation of life-sustaining treatment is considered medically inappropriate by the treating medical team. ”

Sounds Like a “Death Panel” to me and funnily enough we haven't heard much about this from the fringe right at the Town Hall meetings that Glen Beck at Fox has been encouraging them to attend and disrupt.

Even Lady GaGa herself has been saying turn it down, which is a bit rich after saying that The President could kill her son Trig and the “Death Panel” BS.

http://www.politico.com/blogs/bensmith/0809/Palin_urges_restraint_at_town_halls.html

Does Palin have no shame?

Rhoda Klapp

Most Americans don't know much about the NHS, their sources are all tainted, both pro and anti.

I've been under the NHS most of my life, but I can't decide whether it is good or bad. Soemtimes it can be stupid and unresponsive, sometimes it's wonderful. The difference can be as little as who is in charge on the ward or in the outpatients department. There are things about its approach in areas of management which seem to me to be slack. I leave it there. OTOH my american relatives can get bad service too, and live in fear of running out of what their plan covers, or what will happen if he loses his job and his pre-existing conditions aren't accepted by any new employer's plan, or any private one.

At the same time their son, my nephew, is in the US Army and is not getting what he needs from the VA and Army care, which service has been under some strain recently. I know Americans believe in it, but it ain't all that great for everyone.

The Obama plan is half-baked. It's not just what's in it, which most don't know, but what is not in it at all, or not clearly explained. It's a bad bill, and rushing it through won't make it better. I say this though I mock conservative America's paranoid fear of 'socialized medicine' as much as I sneer at the worst excesses of the NHS.

There's a need for a post on the town hall meetings here or on Americano. I see Obama has backed off from the Pelosi conspiracy theory. Pelosi is far more deserving of the term Lady Gaga than that private citizen to whom THX gives the prize.

David

"but I can't decide whether it is good or bad. "

Perhaps it is neither. It doesn't have to be black and white you know.

But the problem with the US system is that they spend far more money for less in terms of outcome. If the NHS had the same spending ratio, the right on here would be screaming blue murder.Yet somehow it's not doing so in the case of the US, and is almost doing the opposite, decrying any attempt to move to a more efficient system simply because it's based on the European system where there is greater state involvement. It's an ideological stance that has no bearing on pragmatic reality and outcomes.

Dirty Euro

American right wingers just say the first thing that comes into their head on these issues that is why they win the argument they are just prats and liars. Most of what they say is utter rubbish.

Rhoda Klapp

"""but I can't decide whether it is good or bad. "

Perhaps it is neither. It doesn't have to be black and white you know. ""

Well, if the bad bit kills you or delays your treatment it doesn't matter how good the other bits are. The NHS has real problems with delayed diagnosis and referral, but that is partly down to 'targets' and the poor management practices imposed by the governemnt. There is nothing that makes the government good at managing health care. The NHS probably isn't the best way to do things. But neither is the US way, even the Medicare and the VA.

This is not a place for ideology. This is the time to find out who does it best, and copy them. Whoever it is.

THX1138

Rhoda Good posts I always enjoy your contribution.

I think Palin has courted too much of the right wing fringe of the party because she loves the adulation but then has to row back from explosive comments like The President would likley kill my son with his Death Panels because thy will look extreme & nuts in a 30 sec attack ad if she wants to run for higher office.

N

Alex,

Your argument has one flaw: Stephen Hawking. Stephen Hawking is more or less a celebrity, celebrities get special treatment. Do you honestly think that someone as famous (and awesome) as Stephen Hawking would get "bumped off by some heartless NHS bureaucrat"? Hawking has power and outlets in which he could destroy the reputation of the hospital were he passed over. If the patient were someone not famous whose to say they wouldn't be "bumped off by some heartless NHS bureaucrat"?

David S.

"N" says: "Stephen Hawking is more or less a celebrity, celebrities get special treatment."

I must disagree with you, N. Hawking is NOW a celebrity, but he wasn't when he was first diagnosed with his condition back in the late 60s. His celebrity dates to the early 90s, by which time he was already in his wheelchair, and the NHS had already spend hundreds of thousands of pounds on his treatment.

israel

This has not been a great week for the right wing American rent-a-mobs against healthcare reform.

First they have this piece of idiocy floating around the web being laughed at around the world and then the man who they were touting as the example of left wing thuggery turns out to be an uninsured, unemployed grifter looking for a handout:

http://www.conservativecabbie.com/american-politics/kenneth-gladley-liar/

Looks like they have to try again next week.

Dan

Neither system is perfect but for the spending levels actually spent in the US the NHS would be able to provide much more responsive and consumer friendly service.

The targets distorting care is partly true but they did improve care as well, the worst of the problems were a combination of politicians and the Media trying to generate a story were there was none.

i.e. 4 hour wait in AE was a response to patients lying on trolleys unsupervised for 48-72 hours at the worst point 10 years ago. When it was first measured it was only measured once a year on one day, so all the media complained that does not count you are only measuring one day, so it moved to once a quarter and eventually every case via AE and reported every month. We still got a media that said if 98% in 4 hours was the target moving from 10% to 97% was not good it was a FAILURE to meet the target so politicians over-react so manegers fiddle the results so we get everyone meets 98% in 4 hours but patient persception is worse because they do not know about the fiddles.

Overall NHS spending has gone up significantly in 10 years but is still amongst the lowest in Western Europe even if much closer to the average than it was, a lot of the increase went on things such as overdue maintenance on buildings or equipment which once done will not need to be done again for some time but will not have been obvious to the public. Too much went on pay increases in the early years but that has been clawed back somewhat since 2006.

Bottom line the cheapest insurance pool is the biggest insurance pool and has to include those least likly to have ilness now, and prevention requires long term thinking, of that insurance pool. In the UK all of that can be done as the pool is everyone via the state. In the US it is in the intrests of the multiple insurance pools to try and exclude those who need care and it is also in the intrests at any one time of a large group of well people to do that but those same people will become ill later and ironically will then be covered by the state via Medicaid.

Matthew Kalash

Ability to pay does NOT equal rationing. A writer should always understand when he is speaking in figurative terms. When he does not, he becomes quasi-literate -- which sin is every bit as egregious as that committed by IBD.

Maxwell Jump

David, you said

"perfectly happy with a completely government run system for the Armed Forces."

Yes, this is true, mainly because it is one of the few powers the federal government is given by the constitution. When you look at the leviathan the government has become, compare it to what the founders, well, founded, then you can do nothing but weep and fear for liberty.

ndm

[via Matthew Yglesias]

The Obama Administration has published a list of some of the benefits Americans could get from the health insurance reform it is seeking. Far from the horrors proclaimed by the crazy coots causing trouble at the town-hall meetings they are responsible reforms which would benefit all Americans. Those unfamiliar with American healthcare may wish to ponder why such reforms might be necessary. Here is the entire list:

No Discrimination for Pre-Existing Conditions
Insurance companies will be prohibited from refusing you coverage because of your medical history.

No Exorbitant Out-of-Pocket Expenses, Deductibles or Co-Pays
Insurance companies will have to abide by yearly caps on how much they can charge for out-of-pocket expenses.

No Cost-Sharing for Preventive Care
Insurance companies must fully cover, without charge, regular checkups and tests that help you prevent illness, such as mammograms or eye and foot exams for diabetics.

No Dropping of Coverage for Seriously Ill
Insurance companies will be prohibited from dropping or watering down insurance coverage for those who become seriously ill.

No Gender Discrimination
Insurance companies will be prohibited from charging you more because of your gender.

No Annual or Lifetime Caps on Coverage
Insurance companies will be prevented from placing annual or lifetime caps on the coverage you receive.

Extended Coverage for Young Adults
Children would continue to be eligible for family coverage through the age of 26.

Guaranteed Insurance Renewal
Insurance companies will be required to renew any policy as long as the policyholder pays their premium in full. Insurance companies won't be allowed to refuse renewal because someone became sick.

brian

@ndm -

Well, there's really only two possible meanings to your list:

1) A massive increase in our already too-high taxes

2) the list is a complete fabrication and none of what it says will come to pass because there won't be enough money to pay for that level of care.

Supporters of this plan seem to think that there's some magical money pit where everything can be paid for if only we let government handle it. But nothing the government does ever gets done well.

There is only one purpose to this entire proposal, and that is to lead to the nanny-state that Britain is now becoming. After all, if your behavior increases healthcare costs, then the government has a vested interest in controlling your behavior.

And control is the only thing that politicians really want anyhow.

ndm

Maxwell Jump writes:

-- When you look at the leviathan the government has become, compare it to what the founders, well, founded, then you can do nothing but weep and fear for liberty.

"Weep and fear for liberty" may be a pretty phrase but it is meaningless in the context of healthcare reform. The (white) seniors who appear to form the bulk of the protestors at the town-hall meetings already experience socialized medicine in the form of Medicare. I don't hear too many of them weeping and fearing for liberty even as they benefit from the taxes paid by American workers by getting the best healthcare a leviathin Government can buy. What I see is a mob desperate to stop American workers sharing their good fortune.

porkbelly

ndm - simply repeating Obama's empty promises will not make them real. Americans just don't trust their government to control their healthcare - Europeans, with their vestigial serf mentality, have a much higher tolerance for doing as they are told and thus state-run health systems are tolerated or even welcomed. It is indicative of the deep cultural differences between Europe and the U.S. and to expect either to change into the other is a social engineering bridge too far.

Furthermore, as the Congressional Budget Office has made clear, the costs of the Obamacare plan will be astronomical - the citizenry is naturally wondering where the money is going to come from (as if we don't know!).

The plain fact, little understood in these comments, is that 85% of Americans have health insurance and 85% of them are satisfied with the insurance they have. No wonder so many of them are concerned that under Obamacare they will be forced to switch to a government-run plan that no-one knows anything about.

Add this to the growing apprehension at the massive, unprecedented encroachment of Washington's control over huge swaths of the American economy and you have the current popular uprising that has so shocked Obama and his minions.

The real question is: will he pull back and regroup as more of a moderate, or will the boot come down?

Dennis Shaper

Many here seem to say Americans don't know jack about the UK system, then proceed to tell Americans all about America.
That's what I'd call rubbish.

Edward McLaughlin

ndm

"Things may have changed but it used to be true that the NHS consumed a smaller percentage of GDP to cover the entire British population than Medicare consumed to cover only the over-65s."

Things have indeed changed: the remit of the NHS has now been widened. It's responsibility now is to provide care for a much 'enhanced' client base, plus anyone in the world who can afford a plane ticket to Heathrow.

ndm

porkbelly writes:

-- Europeans, with their vestigial serf mentality, have a much higher tolerance for doing as they are told and thus state-run health systems are tolerated or even welcomed.

As I pointed out earlier, Medicare is the largest socialized medical system in the World with a FY2010 budget of 410 billion dollars which is more than twice the 2007-2008 NHS budget of 104 billion pounds. Clearly, there are many Americans who are more than happy with their vestigial serf mentality.

porkbelly continues:

-- the costs of the Obamacare plan will be astronomical - the citizenry is naturally wondering where the money is going to come from

The costs of Obamacare may well be astronomical but they will certainly be dwarfed by the cost of doing nothing. The cost of individual health insurance in the United States is currently out of control with Americans facing unsustainable increases every year. I believe the CBO talked of healthcare costs perhaps increasing as much as 8% a year under some form of Obamacare. I would take an increase of 8% a year any day because my private health insurance is increasing at a far faster rate. Here are the insurance rates (not inflation adjusted) for my high-deductible family plan for the last five years:

2004 - 308
2005 - 378
2006 - 415
2007 - 442
2008 - 509
2009 - 678

That represents an absolute increase of 120%, an annualized increase of 17%, and includes two years with increases of about 20% and with this year an increase of 30%. These kinds of price rises are utterly unsustainable. How many 17% annual increases can the average American family afford?

The reality is that the health insurance sector, like the car and financial services sector before it, has become a leviathon that has grown out of touch with the needs of the American people it supposedly serves. The greatest threat to the financial and physicial health of the American people is not Obamacare but a health insurance industry seemingly intent on bleeding the American people dry with its rapacious greed. The problem is not so much that a "citizenry is naturally wondering where the money is going to come from" rather the citizenry knows where the money is going to - a self-serving and rapaciously greedy insurance sector.

porkbelly ends:

-- The plain fact, little understood in these comments, is that 85% of Americans have health insurance and 85% of them are satisfied with the insurance they have.

Can we all just make up figures? The fact of the matter is that every American below the age of 65 is worried about the cost of health care. They are all worried, especially in these days while unemployment approaches 10%, that their access to insurance-based care is more and more at the whim of their employer. The health-insurance sector is killing off entrepeneurship in America because small businesses are unable to provide affordable healthcare for their employees. Many people remain in their jobs solely because of the healthcare benefit. Are they happy with their health insurance?

Republicans need to realise that healthcare in America is completely broken TODAY. They can either work with Democrats to get a decent bill through Congress or they can once again side with a broken and decrepit business and force Americans to face disaster alone. The one certainty is that if it doesn't get fixed this time, the Republican Party will not like the consequences of facing an American people demanding a more robust solution next time.

AtheistConservative

"all these people claiming Obama is a Nazi/Marxist (have they not decided yet?) are perfectly happy with a completely government run system for the Armed Forces"

About the level of intelligence one expects from a Jon Stewart viewer.

"All these people" are not "perfectly happy" with the VA. I defy you to show me a poll that proves anything close to that. Throughout the various past administrations, one of the common threads has been that the VA treats its patients horribly. It does not do so because it is evil; it does so because it has a heavy burden for ongoing care for those most likely to be put in harm's way.

The VA is not a model of efficiency, and laughably it manages to be such a bad example even with full knowledge of each of its clients, completely privately-owned staff and resources, the ability to command specialization in needed fields, and the fact that people coming into the system are, by necessity, amongst the healthiest and most fit in the nation.

What makes your point the most laughable, however, is that for the past 5 years we have been hearing about how the crazy scary Bushitler didn't care about the soldiers because of horror stories from the VA. Do you take all your inspiration from Barack "Two Faces in a Speech" Obama?

Stewart's point on this was no more cogent or forceful than his asinine statement that Truman was a war criminal. Stewart should do himself a favor and not debate his intellectual superiors, like Kristol and May, or do as he did with Goldberg and chop the interview down so Stewart doesn't look quite so foolish.

AtheistConservative

The whole "the US spends more money" canard is also particularly galling.

We spend more money for three major reasons:

1. Government involvement driving up prices. Every year the government has gotten more involved "for the people" prices have gone up, because government is only able to keep the programs running by underpaying for services, requiring non-entitlement citizens to pick up the difference.
2. The cost of innovation. The US leads the world in medical innovation precisely because of the limited free market we have left. We subsidize the distribution of drugs, technology, and procedures to other states, who then turn around and laugh at us for picking up part of their bill.
3. Better health care. Because despite the nonsense you hear, we receive better health care than those with socialized medicine. Google "Ten Surprising Facts About American Health Care" to see some of the examples.

If the US goes the socialized medicine route, who will pick up the slack we leave behind? We'll all be standing in line to be bled with leeches.

Grim

Word.

ndm

Atul Gawande, in a recent magisterial article in The New Yorker, puts the lie to Athiest Conservative's assertion about the causes of out-of-control healthcare costs in America. Gawande writes of McAllen, Texas in Hidalgo County, which has the lowest household income in the country:

-- McAllen has another distinction, too: it is one of the most expensive health-care markets in the country. Only Miami - which has much higher labor and living costs - spends more per person on health care. In 2006, Medicare spent fifteen thousand dollars per enrollee here, almost twice the national average. The income per capita is twelve thousand dollars. In other words, Medicare spends three thousand dollars more per person here than the average person earns.

Imagine that the US Government provides socialized healthcare to recipients which costs $3,000 more than the average income in the county! And the reason for that is the most expensive item in American healthcare - the pen used by physicians to order tests and treatments. Guwande compares McAllen to another border town in Texas with similar demographics - El Paso:

-- The Medicare payment data provided the most detail. Between 2001 and 2005, critically ill Medicare patients received almost fifty per cent more specialist visits in McAllen than in El Paso, and were two-thirds more likely to see ten or more specialists in a six-month period. In 2005 and 2006, patients in McAllen received twenty per cent more abdominal ultrasounds, thirty per cent more bone-density studies, sixty per cent more stress tests with echocardiography, two hundred per cent more nerve-conduction studies to diagnose carpal-tunnel syndrome, and five hundred and fifty per cent more urine-flow studies to diagnose prostate troubles. They received one-fifth to two-thirds more gallbladder operations, knee replacements, breast biopsies, and bladder scopes. They also received two to three times as many pacemakers, implantable defibrillators, cardiac-bypass operations, carotid endarterectomies, and coronary-artery stents. And Medicare paid for five times as many home-nurse visits. The primary cause of McAllen's extreme costs was, very simply, the across-the-board overuse of medicine.

And there we have the reason. Not runaway Government involvement, not the cost of innovation, and certainly not better healthcare. No, the reason is "across-the-board overuse of medicine."

vanderleun

"That's a psychological burden people in this country (and many others), don't have to worry about."

And there are so many more "psychological burders" that have been so kindly taken off the minds of the Brits by their elected government. So many in fact that Brits seem now not to be burden of a mind at all.

Nice island. I really liked it during the four years I worked there. Too bad you've done yourselves in in your quest for the unbearable sunshine of a burdenless mind.

Michael B

Following are some (given space limitations, this is a drastically foreshortened list) of the valid concerns and more substantial problems people have with the U.S. House proposal (HR 3200). It is vast, sweeping, and does in fact seek to overtake 15% to 20% of the economy, and that speaks only to the pure economic scope, without addressing the personal freedom/choice and other issues:

Sec. 113, Pg. 21-22 of the Health Care (HC) Bill MANDATES a government audit of the books of ALL EMPLOYERS that self-insure in order to “ensure that the law does not provide incentives for small and mid-size employers to self-insure”.

Sec. 122, Pg. 29, Lines 4-16 YOUR HEALTH CARE WILL BE RATIONED.

Sec. 123, Pg. 30 THERE WILL BE A GOVERNMENT COMMITTEE deciding what treatments and benefits you get.

Sec. 142, Pg. 42 The Health Choices Commissioner will choose your benefits for you. You have no choice.

Sec. 152, Pg. 50-51 HC will be provided to ALL NON-US citizens.

Sec. 163, Pg. 58-59 beginning at line 5 Government will have real-time access to individual’s finances & a National ID health care card will be issued.

Sec. 163, Pg. 59, Lines 21-24 Government will have direct access to your bank accounts for electronic funds transfer.

Sec. 164, Pg. 65 is a payoff subsidized plan for retirees and their families in unions & community organizations (ACORN).

Sec. 201, Pg. 72, Lines 8-14 Government is creating an HC Exchange to bring private plans under government control.

Sec. 203, Pg. 84 Government mandates ALL benefit packages for private Health Care plans in the exchange.

Sec. 203, Pg. 85, Line 7 Specifications of benefit levels for plans means that the government will define your HC plan and has the ability to ration your health care.

Sec. 205, Pg. 95, Lines 8-18 The government will use groups (i.e., ACORN & AmeriCorps) to “inform and educate” (sign up) individuals for government plan.

Sec. 2201, Pg. 864 The government will MANDATE the establishment of a National Health Service Corps.

Sec. 2212, Pg. 875-891 The government takes over the education of Medical students and Doctors through education and loans.

Rhoda Klapp

The bill isn't bad because it proposes to reform US Healthcare. There is a great need for reform. The bill is bad because it is too big for anybody to understand, it contains many many unresolved issues and most of all because it is being rushed through.

Both sides have some good arguments and some rotten ones. It's all mixed up. Time to step back and do it right.

ally

Hmmm. It seems to me that the "protests" are about something rather simpler.

If Obama gets this sorted - i.e. to a place where the vast numbers of the currently uninsured Americans get cover and the rest get a better deal because the HMOs won't be running a virtual monopoly any more - the Republicans are finished, House, Senate and White House. That's the electoral mathematics; it's not got very much to do with actual healthcare - there aren't any intellectually supportable arguments for spending 18% of GDP on healthcare and getting statistically identical results to countries which spend half of that. If he fixes that and manages to couple it with something approaching an economic recovery, it's goodnight sweetheart. So, the Republicans have nowhere to go at the moment; the only thing they can do is try to make things up, block any progress on healthcare then announce in 3 years' time that they're going to fix it because the Democrats couldn't.

It certainly makes for an entertaining spectator sport, that's for sure.

Fergus Pickering

vanderleun, you mean it's good and character forming that you worry about your medical insurance and whether the bastards will actually pay up when the crunch comes? Presumably it would be even more character forming to soldier on without those pansy doctors at all. That must account for the mental toughness of the American poor.

ndm

I like the way Michael B manages to copy material without attribution. I guess that's what you do when you live and die with the Freepers. Now this is way deeper than I want to get into the healthcare debate - I don't care what the clowns shouting down the town-hall meetings think I don't want to read the text of bills. Nor do I want elected officials wasting their time reading them either - that is why they have staffers. I understand British politicians think staffers are someone up for a quick shag - spouse or otherwise - but in Congress they have a fair number of substantive tasks. One of them being reading bills and coming up with information or misinformation as needed.

Michael B treated us to much misinformation as even a quick gander at the relevant bill shows - God help us. Here is the text of America's Affordable Health Choices Act of 2009 (H.R. 3200).

Michael B "writes:"

-- Sec. 113, Pg. 21-22 of the Health Care (HC) Bill MANDATES a government audit of the books of ALL EMPLOYERS that self-insure in order to "ensure that the law does not provide incentives for small and mid-size employers to self-insure".

Unsurprisingly, this is NOT true. Sec. 113(b)(1) states:

-- Commissioner, in coordination with the Secretary of Health and Human Services and the Secretary of Labor, shall conduct a study of the large group insured and self-insured employer health care markets.

There is mention of a "study" and absolutely no mention of "a government audit of the books of ALL EMPLOYERS." The motivation for the study is specified in Sec 113(b)(2) which states in its entirety:

-- (2) REPORTS- Not later than 18 months after the date of the enactment of this Act, the Commissioner shall submit to Congress and the applicable agencies a report on the study conducted under paragraph (1). Such report shall include any recommendations the Commissioner deems appropriate to ensure that the law does not provide incentives for small and mid-size employers to self-insure or create adverse selection in the risk pools of large group insurers and self-insured employers. Not later than 18 months after the first day of Y1, the Commissioner shall submit to Congress and the applicable agencies an updated report on such study, including updates on such recommendations.

Michael B's then "writes:"

Sec. 122, Pg. 29, Lines 4-16 YOUR HEALTH CARE WILL BE RATIONED.

Love the scare quotes. I also love the way these Freepers use page and line numbers rather than the more traditional section/paragraph subdivision of the bill to make it harder for anyone to verify their nonsense.

Sec. 122 is titled "ESSENTIAL BENEFITS PACKAGE DEFINED." And just what is an "essential benefits package?"

-- Sec. 122 (a) In General- In this division, the term 'essential benefits package' means health benefits coverage, consistent with standards adopted under section 124 to ensure the provision of quality health care and financial securityessential benefits package' means health benefits coverage, consistent with standards adopted under section 124 to ensure the provision of quality health care and financial security

What's this about rationing in Sec 122.(a)?

-- (3) does not impose any annual or lifetime limit on the coverage of covered health care items and services;

Woohoo, no more $2M lifetime caps for me. I know two people whose healthcare bills exceed $100,000 just so far this year - so this bill gives them some hope of not running out of care. But hold on, what does Sec 122 also give us but a definition of

-- (b) Minimum Services To Be Covered- The items and services described in this subsection are the following:

-- (1) Hospitalization.

-- (7) Mental health and substance use disorder services.

-- (9) Maternity care.

And so on. I only put in (7) because "mental health and substance use disorder services" would be useful for anyone who believes the nuttery posted by Michael B.

I don't want to take up any more of Alex Massie's blog or my time in trashing the rest of Michael B's post but I think we can all see the direction this is headed. Freeper mendacity masquerading as informed commentary.

ndm

Rhoda Klapp writes:

-- Both sides have some good arguments and some rotten ones. It's all mixed up. Time to step back and do it right

The problem is that the Republican Party has no interest in doing it right.

David

"Government involvement driving up prices"

If this were true, then countries with greater government involvement than the US would be seeing far higher costs. The fact is that they aren't. European healthcare systems manage to combine public and private provision in a way which ensures better outcome for less money than is spent in the US. Very few of those countries are fascist or Marxist dictatorships the last time I looked. I'd have more time for the debate from the Republican core if they stopped with the rhetoric, such as that highlighted by Alex in his post or such as the mis-representation of NICE.

The US system of healthcare is more expensive and less comprehensive than comparable systems in the Western World. By any counts, this situation woudl be regarded as one which needs attending to and fixing, and the empirical evidence from healthcare systems across the world is that there needs to be a better balance between public and private provision.

Failure to reform will simply condemn the US to spiralling costs and an increasing proportion of the population being unable to gain access to proper healthcare. That is not the scenario of a First World country.

David

"compare it to what the founders, well, founded, then you can do nothing but weep and fear for liberty."

Ah, the good old days of slavery and male only sufferage. How much more free we all were.

Rhoda Klapp

"The problem is that the Republican Party has no interest in doing it right"

And the democrats have no idea of stepping back and doing the hard work necessary to get the whole public on board. They need a better plan.

They need to stop calling protesters un-american too. The idea of a town hall meeting with no dissent is preposterous.

Michael B

ndm,

For the sake of time considerations (mine), I'll take these one at a time and selectively (the entire summary contains over one hundred items). Firstly though, the bill, HR3200, can be found in pdf format here. The entire summary of what I provided a mere excerpt from can be found here.

Regarding Sec. 113, Pg. 21-22, your construal is, to be kind, imaginative. The bill, if passed, becomes the law of the land, i.e. a "mandate." The study and corresponding report will be based upon what, if not an audit of employers? Do you imagine it's going to be some type of arcane study, conducted from ivory towers with professors pouring over ancient tomes and abstracts? Good grief. As to the emphasis upon "all" employers, that admittedly could be an exaggeration, but that's entirely dependent upon the discretion of "the Commissioner" and how the study is conducted by. But again, it's the law of the land, and therefore would permit an audit of all employers.

Finally, as your own excerpt from the bill states, one of the primary purposes of the study and report is to "ensure that the law does not provide incentives for small and mid-size employers to self-insure," which in turn was the primary emphasis of the point in question, your own imaginative spin notwithstanding.

ndm

Rhoda Klapp writes:

-- And the democrats have no idea of stepping back and doing the hard work necessary to get the whole public on board.

The Democrats have been working on health-care reform for years - these bills and the ideas in them don't just fall out of the sky.

They are NEVER going to get the whole public on board with anything - NOR should they try. The Democrats will never get Fox News and the hordes of mindless individuals who watch it to agree with them on anything. The system of financing healthcare in the US is broken and we need to start fixing it now before it collapses in precisely the same way the financial services and the auto industry collapsed. We are witnessing the end of times for the unfettered and irresponsible greed of Reaganism.

nina

When a 22 year old is told she cant have treatment for breast cancer (which would give her an 83% chance of still being alive without recurrence in 10 years time [NICE-Cochrane figures]) because a consultant considers it would be 'futile ' and/ or 'too burdensome', and her 'quality of life is low anyway' DESPITE THE FACT she has worked and paid NI and TAX since the age of 16 AND has a fully independent life, you know the dangers of allowing doctors to make 'best interest' judgements.
We've already arrived at this point in the UK