Impeding changes to our Health Care system

Originally Posted by TheMercenary

Sure. You go on believing that Redux. The majority of the public can see through any empty promise this Congress makes.

In fact, once the lies and fear-mongerng that the industry and conservatives jointly and collaboratively perpetuated throughout most of the "debate" (including the town hall meetings) have been debunked, the majority of the public are supportive of the general concepts behind the Democratic bills, including a public option.

[TheMercenary]

Originally Posted by Redux

In fact, once the lies and fear-mongerng that the industry and conservatives jointly and collaboratively perpetuated throughout most of the "debate" (including the town hall meetings) have been debunked, the majority of the public are supportive of the general concepts behind the Democratic bills, including a public option.

So basically what you are saying is that it is a big lie and the insurance companies are not going to pass the costs on to the rest of us as they promised. Right? That really it is just "lies and fear-mongerng that the industry and conservatives jointly and collaboratively perpetuated throughout most of the "debate"". Right?

So since you brought it up, please "debunk" that the insurance companies are NOT going to pass costs on to the rest of us if the bill is passed in its current form.

Originally Posted by TheMercenary

So since you brought it up, please "debunk" that the insurance companies are NOT going to pass costs on to the rest of us if the bill is passed in its current form.

Read up on the proposed insurance exchange (in all different versions of bills) and you might understand how the process will work with regulations to provide greater competition (thous more competitive premium pricing) as well as regulations to limit pass throughs.

[TheMercenary]

CBO is not infalible. That is a fact you want to ignore. There are plenty of examples where it fails.

Originally Posted by TheMercenary

CBO is not infalible. That is a fact you want to ignore. There are plenty of examples where it fails.

But of course, the industry reports and the conservative/libertarian op-eds, all with an agenda to see the proposals fail, but that you cite as evidence of screwing the people ARE infallible, eh?

Keep posting more, if thats the best you got, and hey, you might really convince a few folks.

[TheMercenary]

Originally Posted by Redux

But of course, the industry reports and the conservative/libertarian op-eds, all with an agenda to see the proposals fail, but that you cite as factual, ARE infallible, eh?....so keep posting more and you might really convince a few folks.

Ok, please show me the track record of the CBO and how everything they have estimated has been true and really did not cost us more in the long run.

[TheMercenary]

CBO Failures

Congress’s Health Care Numbers Don’t Add Up

FOR competence and integrity, few organizations command more respect in Washington than the nonpartisan Congressional Budget Office. As health care reform makes its way through Congress, the budget office’s assessment of how much various elements might cost may determine the details of legislation, and whether it ultimately passes. But when it comes to forecasting the costs of reform, the budget office’s record is suspect. In each of the past three decades, when assessing major changes in Medicare, it has substantially underestimated the savings the changes would bring.

In the early 1980s, Congress changed the way Medicare paid hospitals so that payments would no longer be based on costs incurred. Instead, hospitals would receive a predetermined amount per admission, based on the patient’s primary medical problem. This encouraged shorter stays, led to fewer diagnostic services and reduced administrative costs. The Congressional Budget Office predicted that, from 1983 to 1986, this change would slow Medicare hospital spending (which had been rising much faster than the rate of inflation) by $10 billion, and that by 1986 total spending would be $60 billion. Actual spending in 1986 was $49 billion. The savings in 1986 alone were as much as three years of estimated savings.

Why was the budget office so far off? It had projected that the new payment strategy would increase hospital admissions, because hospitals would maximize their payments by admitting patients who were less severely ill and discharging them quickly. In short, they would make up money with faster turnover. But in the first year of the new payment system, admissions, which had been increasing, actually declined by 3.5 percent. By the third year, they had declined by 15.9 percent. It may be that the declining admissions resulted from a new and stronger program for reviewing admissions.

But the Congressional Budget Office was correct in assuming that hospital stays would grow shorter. In the first three years of the payment system, the length of Medicare patients’ hospital stays, which had been decreasing by 1 percent to 2 percent a year, fell by 17 percent. The new system also led hospitals, for the first time in decades, to cut their work forces — by 2.3 percent in the first year alone.

In the 1990s, the biggest change in Medicare came with the Balanced Budget Act of 1997, a compromise between a Republican-controlled Congress and a Democratic administration. At the time, the Congressional Budget Office forecast that, from 1998 to 2002, the act would reduce Medicare spending by $112 billion — a 9.1 percent reduction. Part of that — $36 billion worth — would come from paying skilled nursing facilities and home health care services a set fee per patient. But only a tiny fraction of the savings, about $100 million, would come from better monitoring of fraud and abuse on the part of health care providers, according to budget office projections.

The actual savings turned out to be 50 percent greater in 1998 and 113 percent greater in 1999 than the budget office forecast. Overall spending increased just 1.2 percent from 1998 to 2000, rather than 5.6 percent, as was projected. With increased monitoring for fraud and abuse, hospitals billed less aggressively. Spending for skilled nursing facilities, which had increased by 38 percent per year from 1988 to 1997, did not increase at all in 1998 and 1999. At the same time, spending for home health care services, which had been rising at the rate of 25 percent a year, fell by 52 percent. In fact, Medicare spending fell so much that Congress increased payment levels to hospitals and other providers in 1999 and 2000.

In the current decade, the major legislative change to the system was the Medicare Modernization Act of 2003, which added a prescription drug benefit. In assessing how much this new program would cost, the Congressional Budget Office assumed that prices would rise as patients demanded more drugs, and estimated that spending on the drug benefit would be $206 billion.

Actual spending was nearly 40 percent less than that. Spending on drugs declined from fiscal year 2007 to 2008. Seniors proved more willing to buy lower-cost generic drugs than expected, fewer people participated in the program than expected, and competition held premiums down. Few new blockbuster drugs came on the market, so overall drug prices remained relatively constant, rather than accelerating as predicted.

The Congressional Budget Office’s consistent forecasting errors arose not from any partisan bias, but from its methods of projection. In analyzing initiatives meant to save money, it helps to be able to refer to similar initiatives in the past that saved money. When there aren’t enough good historical examples to go by, the estimated savings based on past experience is essentially considered to be unknown. Too often, “unknown” becomes zero — even though zero is not a logical estimate.

The budget office has particular difficulty estimating savings when it considers more than one change at once. For example, last December the office reported that it found no consistent evidence that changes in medical malpractice laws would have a measurable effect on health care spending. It also reported that increased spending on studies comparing the effectiveness of different drugs and medical treatments would yield no net savings for 10 years. Yet if both malpractice reform and comparative effectiveness studies were instituted simultaneously, they might work together to yield substantial savings; doctors would gain more confidence in the effectiveness of less aggressive treatments and, at the same time, could use those treatments with less to fear from lawsuits.

The budget office’s cautious methods may have unintended consequences in the current health care reform effort. By underestimating the savings that can come from improved Medicare payment procedures and other cost-control initiatives, the budget office leads Congress to think that politically unpopular cost-cutting initiatives will have, at best, only modest effects. This, in turn, forces Congress to believe it can pay for reform only by raising taxes, which then makes reform legislation more difficult to pass.

The Congressional Budget Office’s integrity is beyond questioning. But the record shows that it has substantially overestimated the cost of health care reform three times out of three. As Congress now works on its greatest push for reform in generations, the budget office needs to revise the methods it uses to make predictions about costs.

Jon R. Gabel is a senior fellow at the National Opinion Research Center of the University of Chicago.

http://www.nytimes.com/2009/08/26/op...fice%22&st=cse

Look, you can scream "screwing the people" all you want if that works for you. You can cite the CBO when you like it. as you have in the past, and criticize it when you dont and you can post your editorials and industry reports that have a bias than any objective observer would recognize.

I think the bills have taken an approach that I generally support...there are no guarantees, but IMO, they represent the best way forward.

Time will tell.

[TheMercenary]

Originally Posted by Redux

Look, you can scream "screwing the people" all you want if that works for you.

I think the bills have promise...there are no guarantees, but IMO, they represent the best way forward.

Time will tell.

Now you are avoiding the questions and are unable to support your positions. Can you prove the insurance companies are actually just using "lies and fear-mongering that the industry and conservatives jointly and collaboratively perpetuated throughout most of the "debate"' and they really are not going to pass along the costs to all the rest of us that have insurance.

People like you are why the Demoncrats are beginning to fail in such a big way and they are now turning on each other. The majority don't really agree with the majority of anything. They are just a loose organization of vaguely interested parties all fighting for a piece of the power pie. And now that they have beaten the Republikins they are starting to turn on each other. Senate says no public option. Pelosi says no bill without it. So which is it. Who are you guys going to screw next? Really you are just going to start to screw each other because you can't get it together enough to pass something that addresses the root problems in the industry, you have made back door deals with Big Pharm and the Insurance Industry and now they are starting to turn on you. And yet your attitude is, "Eh, whatever, something is better than nothing." What BS. Grow some nads. Do the right thing and tell the insurance companies to fuck off and get them under control. This goes right back to what Henry said. You are just going to let them pass the bills off that screw other people as long as you can shift blame.

And now we actually have the insurance companies TELLING Us they are going to make everyone else pay for their increased costs and risk. And you guys pretend like there is nothing there. Pass it off and some conspiracy. "It's not true", "There really not going to do that, they just want to scare you."

I don't buy your bullshit and most of the American public does not either.

Merc...what you characterize as "turning on each other" I would characterize as a diversity of opinion, with a shared foundation. That is why the Democrats have become the "big tent" party and the Republicans are mired in a rigid and narrow ideology. With that big tent comes challenges as well as opportunities.

IMO, that always provides a better and more comprehensive review and discussion of policy options than a party that is so ideologically driven that expressing a diverging opinion makes you an outcast in your own party.

I think the American people will benefit from the outcome of the Democratic proposals, even if what results is not a perfect bill and from what I have been reading lately (as opposed to earlier in the national debate), more and more Americans agree.

As I said, in the end, time will tell....but debating it with you is a waste of time.

But I will continue to point out when you post one of your partisan editorials as "evidence" of anything

[TheMercenary]

Bottom line is that you can't answer the questions I have posed to you. The Congress will not solve the insurance crisis in this country with this bill. But they will have given the insurance companies a HUGE increase in income paid for on the backs of taxpayers with no caps for what can be passed on to the consumers. The American public is about to be stuck with a huge ass bill that does not address many of the problems in this industry.

The most partisan person in this debate on this forum is you Redux as you defend only one parties plan for change in healthcare reform.

Originally Posted by TheMercenary

Bottom line is that you can't answer the questions I have posed to you. The Congress will not solve the insurance crisis in this country with this bill. But they will have given the insurance companies a HUGE increase in income paid for on the backs of taxpayers with no caps for what can be passed on to the consumers. The American public is about to be stuck with a huge ass bill that does not address many of the problems in this industry.

The most partisan person in this debate on this forum is you Redux as you defend only one parties plan for change in healthcare reform.

Merc.....I'm sorry you are not willing to take the time to read more about the proposed insurance exchange (on the state level in the Baucus bill) and regional/national level in the other bills...and how the exchange will encourge competition and set standards for pricing and benefit levels (through regulation, not legislation) in order for an insurance company to be included in the exchange.

I haver never shied away from my partisanship and I still firmly believe the Democratic bills are the best and most realistic way forward.

On the other hand, you have demostrated in numerous threads that you are just as partisan as anyone here. You have already judged Obama to be a failure (after only 9 months) ...you think Pelosi is a Nazi.... and you flood the site with the most partisan links of any poster here. So lets not pretend that you are somehow above partisanship.

But, I suspect the other members here are tired of reading our exchanges.

So, I encourage them to read the summaries of the bills and a variety of reports on the propsoed legislation fromi across the political spectrum..and judge for themselves.

[TheMercenary]

Originally Posted by Redux

Merc.....I'm sorry you are not willing to take the time to read more about the proposed insurance exchange (on the state level in the Baucus bill) and regional/national level in the other bills...and how the exchange will encourge competition and set standards for pricing and benefit levels (through regulation, not legislation) in order for an insurance company to be included in the exchange.

I will take the time to address this fantasy of the "insurance exchange" in another post. Anyone who has done their research will understand that it is nothing more than a pie in the sky guess that they would function as proposed.

I haver never shied away from my partisanship and I still firmly believe the Democratic bills are the best and most realistic way forward.

But yet you claim you want everyone to read the information out there "read the summaries of the bills and a variety of reports on the propsoed legislation fromi across the political spectrum..and judge for themselves". So as long as their conclusions are the same as yours you are ok, but if anyone disagrees with the Demoncratic proposals you are insensed. What a line of bull shit. You can't want it both ways and think it is going to come out as you plan.

On the other hand, you have demostrated in numerous threads that you are just as partisan as anyone here.

Partisan for the consumers who are going to foot the bill for anything your guys are trying to pass, sure. For any political party, no. Absolutely not.

You have already judged Obama to be a failure (after only 9 months)

Failed on his promises?, yes, a failure overall?, way to early to tell... I don't hope he fails. But I know Congress will fail him.

...you think Pelosi is a Nazi....

Absolutely, I can't stand the bitch.

and you flood the site with the most partisan links of any poster here.

Bull shit. Just because they are not views you share you, and others claim they are partisan. They may be opposing views but they are not the views of one party, even if there is overlap.

So lets not pretend that you are somehow above partisanship.

Partisan in the sense that they disagree with your views, sure, see above response.

So, I encourage them to read the summaries of the bills and a variety of reports on the propsoed legislation fromi across the political spectrum..and judge for themselves.

If you cared if anyone read things from "across the political spectrum" you would not be making claims of "partisan" views that I or anyone else posted. You would let them stand on their own merits. But instead you attack them as some right-wing conspiracy.

[Clodfobble]

That's what the Mexicans are for, duh. Don't have to insure them either.

[Spexxvet]

Originally Posted by Clodfobble

That's what the Mexicans are for, duh. Don't have to insure them either.

The Mexicans are way too busy working the lawn care industry. Might need to smuggle in some azerbaijanians for the fast food chains.