US POLITICAL DISCUSSION+++KEEP IT HERE

Those are all things to consider, certainly.

One of my good friend's boyfriend is a personal trainer. Crazy amazing bod, but who knows what's really going on on the inside. She says that nearly every night he eats a pint+ of ice cream and a roll of chocolate chip cookie dough. Sure he spends hours each day working out, so it doesn't show. But what about the health of his insides? He's clearly only concerned with the outward beauty. She's tried to change the way he eats, but to no avail.


The elderly (age 65 and over) made up around 13 percent of the U.S. population in 2002, but they consumed 36 percent of total U.S. personal health care expenses. The average health care expense in 2002 was $11,089 per year for elderly people but only $3,352 per year for working-age people (ages 19-64). Similar differences among age groups are reflected in the data on the top 5 percent of health care spenders. People 65-79 (9 percent of the total population) represented 29 percent of the top 5 percent of spenders. Similarly, people 80 years and older (about 3 percent of the population) accounted for 14 percent of the top 5 percent of spenders (Chart 2, 40 KB). However, within age groups, spending is less concentrated among those age 65 and over than for the under-65 population. The top 5 percent of elderly spenders accounted for 34 percent of all expenses by the elderly in 2002, while the top 5 percent of non-elderly spenders accounted for 49 percent of expenses by the non-elderly.

A principal reason why health care spending is spread out more evenly among the elderly is that a much higher proportion of the elderly than the non-elderly have expensive chronic conditions.

What is it exactly that people don't like about the Republican plan?? Other than it comes from the Republicans.


It falls in line with a lot of the reform measures I would like to see, some of the baby steps/low hanging fruit that would actually save money. As far as I can see, the only thing it doesn't do is insure as many currently uninsured, though it insures a good bit more. And from what I can tell, the uninsured number is a moving target with a huge percentage of them able but unwilling to get insurance -- so I don't think the problem is nearly as huge as we were initially made to believe. And if the government doesn't use the right numbers in the calculations, how can they possibly make the right decisions?

Problem: Millions of Americans are without health insurance. The number of uninsured is estimated to be approaching 50 million.

Solution: "Various reform plans aim to extend coverage to most, if not all, of the uninsured."

Hilarious. And sad. Both

From the same article:

Conclusion

Analyses of health care spending patterns shed important light on how best to focus efforts to help restrain rising health care costs. Recognition that a relatively small group of individuals account for a large fraction of spending in Medicare, Medicaid, private plans, and the population as a whole serves to inform more focused cost-containment strategies. The concentration of health care expenses also has implications for the effective design of consumer directed health plans.


Research also continues to raise awareness of the importance of chronic conditions in overall spending and as a major driver of cost increases, leading to disease management programs and other efforts to both improve quality and reduce the costs of conditions such as diabetes, asthma, hypertension, heart disease, and obesity.

------


! Frances, did you write this article?

No, just years of financial risk management employment and you pick up a tidbit or two.

Yes,

Republicans, though, have pointed out that millions without health insurance are eligible for government programs yet are not enrolled, and that millions more are in households with incomes of $75,000 or more. Many uninsured are also illegal immigrants, Sen. Orrin Hatch. R-Utah, said recently.

Remember, however that "you lose your coverage when you lose your job." And not many of us can afford COBRA or to pay out-of-pocket for our own private plan. That happened to me after I lost my dot-com job. My salary was halved and my new employer didn't offer a company health plan. I'm such a hypochondriac, the idea of having no health insurance coverage really freaks me out. So I paid out-of-pocket for my own medical and dental insurance. Christ was it ever expensive. Especially on my lacking salary, at the time. It was really a challenge. In choosing to insure myself, I was unable to afford other things. Like saving for retirement. Luckily my company had a profit-sharing plan where a small amount of money was put into a company Keogh that I rolled over into an IRA when I left. Otherwise though, I saved nothing in cold hard cash or toward retirement in the 7 years at my post dot-com job. I just couldn't afford to. I suppose I could have foregone vacations, but I hated my job so much that (I was sick all the time and) vacations were all that pulled me through each abysmal day. I lived for those few weeks off each year. For years.

Indeed,

The troubling decline in employment-based health coverage has continued. The 2008 report showed job-based coverage dropped for the eighth year in a row -- from 59.3% of Americans in 2007 to 58.5%.

"Smaller firms will find it increasingly difficult to maintain or afford coverage," says Peter Cunningham, a senior fellow at the Center for Studying Health System Change. "It's likely we'll see an even bigger drop (in job-based coverage) next year. It will reflect the higher unemployment rate in 2009."

And about that 20%:

The Census report shows about 20% of the uninsured are in households making $75,000 or more.

"Some of these individuals have health conditions that may mean insurers won't cover them," Custer says. "Some may work for small firms or be self-employed.’" And some, he added, simply may choose not to obtain coverage.

Another 20% of uninsured are not citizens, the report states, though there is no breakdown on whether they are legal or illegal immigrants.

Cunningham says the health insurance problem won't get better on its own, even when the economy improves.

The cost of health insurance and the cost of medical care, he says, are driving the increase in the uninsured.

Lastly - and ZOMG - only in America:

Authorities say a severely overweight South Carolina man stayed in his recliner without moving for eight months until shortly before his death.

Firefighters had to cut Tillmon Webb from the chair after his mother called paramedics because he was in pain. Greenwood County deputies say the 33-year-old weighed about 800 pounds when he died Wednesday at a hospital.

Webb's wife, Ada, says he died of a heart attack. She says the former preacher injured his knee in March and then stayed in his power recliner at home 70 miles west of Columbia. She says she cleaned the chair daily.

Deputies say Webb had sores on his body and a "very bad odor."

Webb's wife says he didn't want help because he was ready to go to heaven and see Jesus. She says he weighed closer to 500 pounds.

(Edited on 2009-11-19 14:42:55 by risamay)

It started with slightly different words. Not a big difference, but then, neither is it a big change to say that Palin claimed tohave international relations experience because she can see russia from her house, or that the tea party crowd wanted to tea-bag the white house.
Apparantly some of the public still hasn't figured it out. We pay the medical costs for the high righ population either way, but if we don't insure them, they get no preventative care, no maintence care, and we get huge ER bills. We save $100 on a visit to the doctors office, and pay $10,000 for an ER visit instead. Good thing we saved the $100.





No one is complaining about what you describe, but what you describe has nothing to do with the way healthcare works, or what the insurance industry works. I've never had a health assessment for my insurance coverage, everyone in my office pays the same rate for the same plan. We could try to weight the cost based on risk, but then what's the point of insurance? The whole point of insurance is that we spread the cost out over a large group and over a long time. One member of the group gets hit with a million dollar expense and that cost is spread out over the group. That's what insurance is for. Maybe you are the million dollar health bill person, or maybe you are the zero bill person who pays for that persons cost.
People with pre-existing conditions are not billed more, they are denied coverage, for expenses related to the condition. Known or not, once the bill gets above a certain level, the insurance company investigates to see if they can find an indictation that the condition is "pre-existing", and if they do, they don't pay the bill and the customer goes bankrupt. They don't stop billing the customer for insurance, they just don't pay any claims for that problem. Coverage denied, your bill is your problem, your health provider is going to cut off treatment until you establish a payment plan and bring your bill up to date, and by the way, here's next months bill for your insurance coverage.
You can "know about" the condition, and it doesn't matter. Overweight, out of breath, every listed symptom for diabetes and heart disease? No problem. If you are in good health, butgo to the urgent care center and pay cash to treat a broken leg because you don't have insurance, and they note on your record "shortness of breath" then get insurance at a later date, that notation of "shortness of breath" will be reason to deny coverage if you have a heart attack5 years later.




How can you tell who can and can not control those things? Many health problems are made worse by being overweight, and at the same time, the problem and it's medications cause weight gain. My wife has chronic health problems. When they started, she was a gym rat who did jazzercise every day of the week, but fatigue, shortness of breath, and chronic muscle pain took away her ability to exercise at the same level, and lack of exercise and medication side effects resulted in a substantial weight gain. Now when she describes her problems, doctors blame it on her being overweight.



I agree. But a bad proposal doesn't change the underlying problem. Finding ways to make fun of a phrase that the opposition didn't actually say doesn't help the situation.







AOL has the fundamental problem that they are selling dial up in a broad band world. Their product faded from the market years ago, and they are shrinking with their industry. That's not the economy, they have been shrinking for years. They can blame the economy, but they have failed to advance with their industry. I have a lot of friends who have worked there, and when dial up was king, AOL could do anything it wanted and gain customers (not make money, but who cares? dot com!). Now there are no new dial up customers and AOL is history. They have a lot of management trying to come up with numbers to show otherwise, but it's not working. Which is a shame. If they were a functional company, they have offices close to my house and their day-care runs a bus to my daughters school.

What do you mean no one has been able to articulate the problem?


Our health care costs are higher than any other nation in the world.


Our health care outcomes can not be shown to be in the top ten in most measurable categories and we aren't number one in anything other than cost.


We don't provide any routine care to a sizable portion of our population, when every other industrialized nation in the world has universal coverage.


The cost of practicing medicine pushes doctors to lucrative specialties, resulting in shortages and long waits in some areas of medicine. This problem is become pronounced for the worst possible specialty, the General Practicioner.


We are the only country in the world where medical bills are a major cause of bankruptcy.





Too wordy? Our health care costs too much, does too little, and we are running out of doctors because they are going broke.


I like my doctor, but the billing is insane and when my coverage at work changes in december, he's not on the new plan, so I have to change. I can like my doctor and admit that there are problems, at the same time.

That looks great, but it's a list of goals, not a plan. If you reduce the dem plan to bullet points that they write, it sounds just as rosy.

I always forget that AOL even still exists. It seems such an irrelevant company, today. Unless they can massively restructure their business/mission, they'll eventually go the way of the dodo. It's inevitable.

Your answer is definitely wordier than mine, but it's also more accurate. Hopefully the problem is now crystal clear, for Elaine.

It's definitely a multi-faceted problem, which is why (in part) designing solutions to reform the system is so sticky.

I'm in the "she couldn't get re-elected mayor of Wasilla" camp, myself.

While I see the strategy, I don't agree with it. I mean, she's endlessly (and tragically) entertaining (and I do love a giggle). But ... I wish she'd just go away.

Democratic strategist Garry South says Palin has won the undying support of many of his party's faithful, who are doing all they can to keep her in the spotlight of the national stage.

"I see Democrats at bookstores buying her books by the dozens and trying to keep the book tour going," he said. "She's a magnet for controversy - and that's not what the Republicans need right now."

Even President Obama's adviser David Plouffe told The Chronicle that he hopes Palin will command the airwaves for months to come. "I think she'll be most helpful to the Democratic Party with a high profile," said Plouffe. "I hope her book tour lasts two years."

And while health care costs are skyrocketing, education isn't faring much better. I find this incredible. So screwed up. What are students to do? Bury themselves deeper in student loan debt? Work multiple jobs to make ends meet (as their studies, which should be their primary focus, suffer)? Drop out?

The UC Board of Regents is considering boosting undergraduate fees — the equivalent of tuition — by $2,500 next year. The average annual fee for a full-time undergraduate would jump to about $10,300 — three times the cost only a decade ago.

My mother insisted on paying for my UC education 10+ years ago (because her parents paid for hers). Bet she's glad I'm not a UCLA student now (as am I, because I would have had to take out loans or work a bunch of jobs if I couldn't secure sufficient scholarships).

True, addressing the symptoms will not cure the disease.


FWIW: Estimated Financial Effects of the “America’s Affordable Health Choices Act of 2009” (H.R. 3962), as Passed by the House on November 7, 2009

The report linked I to above claims that preventative care could save $8 Billion between 2010 and 2019. The problem is: It's not enough. From the same report, the aggregate effect of the legislation is to increase national health expenditures by $289 billion dollars. (To 21.1% of GDP by 2019.)

As for the rest of the savings: "We show a negligible financial impact over the next 10 years..."


ETA I am not saying that people shouldn't have access to health care. I am saying that this solution is not likely to work as advertised. We can do better.

(Edited on 2009-11-19 16:29:33 by RichardUpshur)

Jesse Jackson: "You can't vote against healthcare and call yourself a black man" He should be ripped to shreds for saying that and people barely blinked. I have to give it to Davis, against whom the remark was made. Kudos for the backhanded comeback --"One of the reasons that I like and admire Rev. Jesse Jackson is that 21 years ago he inspired the idea that a black politician would not be judged simply as a black leader,” Davis’s statement said. “The best way to honor Rev. Jackson’s legacy is to decline to engage in an argument with him that begins and ends with race.” Classy.


On the tax front, in addition to the new cigarette tax, we have proposed taxes on healthcare, cap & trade, lifting the payroll tax cap, equity trades (yesterday and most recently (today), the war in Afghanistan. Yep, that's right, a new surtax is on the burner. The TED Caucus must be having a field day! TED stands for 'Tax Everyone to Death'. I assume there is a caucus for that as there is pretty much a caucus for everything else. I think I'll add remove caucuses to my wish list, right up there with remove government unions. It's too clicky for my taste and doesn't seem to serve the voting public very much. Anyone care to guess what new tax they'll propose tomorrow?? Shocking that Politifact rates Obama's tax promise a compromise: "I can make a firm pledge. Under my plan, no family making less than $250,000 a year will see any form of tax increase. Not your income tax, not your payroll tax, not your capital gains taxes, not any of your taxes." And he said it with a straight face. I call it a promise broken.


How many times do these people expect me to alter my budgeted 'obama factor'!!!! Maybe I should just put a line item in for each new tax, rather than one big number. (I like the new emoticon too!)

Then you see good midwestern schools start to flourish. Apparently cost of living is the only area in which we can compete. Out of state tuition at my research 1 university is around 11K.


Not that we don't have our problems: University of Nebraska Weighs Tighter Limits on Stem Cell Research. How counter intuitive. We're going to invest 800 million in a technology park annex for our campus, but we feel it necessary to castrate it by limiting the academic freedoms of the scientists we hope to recruit. In the words of my professor tonight, "If you are interested in making your name in a controversial area, get the f*** out. Nebraska is not the place for you. Harvey Perlman [chancellor] wants this university corporatized, and this kind of bad press is not what he wants. Start looking now." Perlman also cancelled the speech to be given by Bill Ayres last fall -- a speech that was not about politics at all, but rather was about pedagogy and the Chicago school system. Not a fun day on campus overall.

JJ is such a nucking fidiot. Like Sarah Palin, I wish he'd go away (and take Al Sharpton with him). Great reply on Davis' part.

And speaking of Sarah Palin, David Plouffe must be so pleased:

Sarah Palin has suggested Fox News firebrand Glenn Beck could be someone she'd consider as a running mate if she makes a bid for the White House in two years.

"But Glenn Beck I have great respect for. He's a hoot. He gets his message across in such a clever way. And he's so bold - I have to respect that. He calls it like he sees it, and he's very, very, very effective."

The Anti-Defamation League has cited Beck, who also has a syndicated radio show, as the "most important mainstream media figure who has repeatedly helped to stoke the fires of anti-government anger."

Needless to say, it's a potential ticket that has some moderate Republicans squeamish.