nitza19 - 02/25/10 11:54 AM Gotta go out and spend today, I forgot that one of my teacher's anniversary days was coming up (when I could have combined it with another spend day) so I will have to go and do that today. Also need to drink a lot of caffeine and get on the phone and schmooze people for a few hours. Not my kinda thing, but in an economy like this, gotta do it. Speaking of, I'm so tired of hearing about health care. I know it is a big problem and all, but I am 100% more concerned about creating jobs than I am about health care. I am tired of hearing them argue about it, I am tired of having it be the seemingly most important part of the agenda, and I am sick of reading the non-headlines. Sure, my BFF would like health insurance. But what she would like more is A JOB. Then she could be paying for her prescriptions and able to see the doc in an emergency while the politicians yammer and bicker and debate and maybe in two years get SOMETHING done.
SingleMom - Ky - 02/25/10 05:04 PM
nitza – Not to start a politically debate as I completely understand your view but my congressman recently had a different perspective on it when he was at my firm for a meet & greet. He said when people ask him about why congress is not focusing on jobs he tells them that health care has more affect on jobs than the govt creating jobs. He gave an example of a company here in Louisville - the place employees 110 people. Last year 2 of those people had some pretty major issues so when the renewal came due the premiums had raised 83%. The company was finally able to negotiate an increase of 37% but that also meant less coverage, higher deductibles and the employees paying a share of the increase. He said that means that because of 2 people, 108 others have their lifestyle changed.
He said it just doesn't make sense and more people need to realize that companies cannot continue to pay for their employees coverage 100% (when the premiums keep increasing at such rates) b/c that causes a loss in their cash flow which eventually could shut down the company. He said Congress needs to focus on getting a package passed so that there can be some stabilization instead of spiraling out of control.
Red2Black2011 - 02/25/10 12:39 PM
Nitza: I'm with you 100%. I'm so tired of the insurance debate which at this point is a farce. However, The Jobs Bill passed the House and going to the Senate for the President to sign by next week. Which entails employees get a major tax cut for hiring people and creating new jobs. Hope your BFF benefits from the bill.
Sharing the Simple Lifestyle - 02/25/10 08:04 PM smokey[/b], Never one to miss a good debate, I've come around completely to your point of view. I just don't think any more that the USA can afford universal coverage. Your example is excellent. For one thing, you get better care, many more tests, etc. Your pharma costs are way higher. The minute a company of 110 people, to use your example, has two employees who require very expensive drugs, the shared funds quickly empty. We have bare bones service and inexpensive drugs. Doctors are equally well-trained, but all medical is terribly short-staffed and wait time is long. In fact, many with $$ will go have procedures done in Cuba, India, etc. Many in Toronto go around the lake to Buffalo and pay out of pocket. Buffalo has become a very important medical center for southern Ontario for years and this is growing dramatically. Rochester, too, of course.
wvugurl26 - 02/25/10 08:42 PM Health debate I really don't think a socialized policy is the answer. I just don't think it will work here. I agree we have many problems with the current system and its expensive but I just don't think we can afford it. We've spent our way into billions of dollars of debt with no plan for getting out and this would just add to the massive debt load. Let me say I don't currently have insurance through my employer bc I am a temp and my dad does not at this point either bc he was laid off. I worry about something happening to either one of us but both of our budgets are stretched to the max. I know a trip to the hospital would be devastating to me financially between the bills and theoretical lost wages. However, the cold reality is I can't pay my bills as it is and I'm missing what I can cut to come up with the money to meet all of my obligations and pay for insurance that would pay for anything.
Pharma costs can be astronomical but in some cases you can use a generic. Many stores are offering a $4 generic program. My dad's doctor has him on 2 different blood pressure medicines right now and has found ones on the $4 list for him. He also got a discount for the office visit for paying in cash which made it semi affordable fo him. Perhaps I should add a disclaimer that I currently work for a drug manufacturer. Many of them have assistance programs though for drugs with no generic equivalent. The FDA is also considering different possibilities under which the approval process would be speeded up and generics would hit the market sooner.
SES_Books - 02/25/10 10:01 PM I don't know exactly where I come down in the health care debate. I truly believe that basic and preventative health care should be available to all. Pre-existing conditions should absolutely not affect insurance coverage. I'm not sure where I stand with some of the extensive treatments that cost so very much. Perhaps that is where the "cadillac" insurance plans could come in being. I do not believe in being allowed to opt out because you are young--eventually you will be old. There should be extensive good health centers/fitness centers, in your face nutritional info for all foods in fast food places and maybe all public dining places. Not on wall posters, when you are handed or served your food. Start teaching our kids to be healthy as well as smart.
Sharing the Simple Lifestyle - 02/25/10 10:25 PM SES_, [/b]Good point about good nutrition and life-style choices. I've heard it said that life-style accounts for up to seventy percent of good health/poor health.
wvugurl, It's the debt load, isn't it? In many ways, the last, best time to get universal health care through was possibly the Clinton years. The generics are indispensable for low costs and hats off to $4 fill fees, too. Still, universal coverage seems like mission impossible. That deficit is terrifying.
wvugurl26 - 02/25/10 10:48 PM
SES I agree that many could do more for preventative care. My mother is a prime example of this and even though she is my mother she should be smacked for how she has handled her health. And she most definitely was aware of the consequences of her actions as she is a nurse. One with a strong family history of Type 2 diabetes should not lead a sedentary lifestyle with poor food choices and allow their weight to get out of control. It was completely preventable and that is what irks me about it. Ok enough of that rant.
Toasty I think the debt is weighing heavily on the minds of many. We have increased our deficit at a record rate and I'm not sure what we have to show for it or what plan we have chipping away at that mind boggling deficit. I also think and doubt I am in the minority when I say I do not like the idea of being indebted to nations such as China. I also think as the current administration has attempted to sprawl and expand powers (bank/auto bailouts) many have become disenchanted with the idea of further government control.
I think
SES is correct with her emphasis on preventative care starting young. I was looking for information to prove an argument the other day and was shocked when I found the recommendations were for ppl in their 20s to have a physical every 5 yrs! Surprised By the time you are 30 you may have already done irreversible damage. So many things are treatable/preventable if caught early and I don't see how an exam every 5 years is going to catch squat early! This is an extreme example and most 20 somethings do not get cancer but if one were only to visit a doctor every 5 years they could very well be in an advanced, untreatable stage if they are suffering from one of the types with few obvious symptoms until it is too late. I think a regular exam along with a good diet and exercise could cut down on many of the ever increasing healthcare costs. I'm not saying this will fix everything and I'm talking in terms of the general public as a whole not individuals but if more ppl were willing to take responsibility for their health now instead of in their 40s and 50s when they are overweight and suffering from a host of related problems costs overall and to insurance pools may decrease.
nitza19 - 02/25/10 11:16 PM Smokey [/b]- I *think* I understand your post about the 2 people and the 108 people etc., but even 108 people who have jobs but pay more for insurance seems better than 10% of the city without work. My company also pays exactly 0% for health care and I have always had to pay for it on my own. Sure I'd love to see that situation fixed, but I'd like to see the 10% situation fixed more. It's not that I don't think something's wrong with health care, I do. But I don't think it's the biggest problem at the moment and it annoys me that it seems like the politicians think so.
preventative care - yes, but man oh man am I sick of being responsible for teaching kids (young and old) about the food pyramid and exercise. And manners. Maybe it's because it also reduces the time I have to teach them friendship skills, and perseverance, and believing in themselves, and anti-bullying, and sharing, and healthy financial habits, and human *ahem* biology, and Chlamydia, and internet safety, and when not to swear, and where not to spit, and how to talk to a boss (or how not to), and how to pronounce "nuclear," and how not to look at porn and download a virus that will disable our school's entire printer system for a day Angry Oh right and math. Shoot, with all that other stuff, I almost forgot math! *RME* Lol, sorry, I'll get off my own soapbox now
It's been a lonnnng day at school.
Red2Black2011 - 02/26/10 12:15 AM Nitza:[/b] The politicians are talking about Health Care instead of jobs because it makes a better sound bite. For the midterm elections its easier to use as a speaking point. Lack of jobs is a loose loose sound bite and no political points can be made.
Nitza, SES, WVU: Get back on the soapboxes. Maybe the government will start actually hear what people are actually saying and worrying about.
Sharing the Simple Lifestyle - 02/26/10 05:23 AM
nitza, R2B2, That's a really good point, both of you. Health care just doesn't strike me as the biggest problem right now. Jobs, Jobs, Jobs. And speaking of which...
nitza, right now Steve Jobs says they need all forty billion of their cash (!!!) for research. Won't split and won't pay a dividend. Frankly, at this point, I wish he'd take a leaf from Bill and Melinda Gate's page and put some of that back into the community. How about summer camps with cool tech experiences for disadvantaged kids?
nitza, It sure is a good idea! DS contributes heavily to Dress for Success and has for a good decade. I hear you on the social neediness of kids. It's crazy. Here in Ontario, there's a movement to make teachers responsible for kids' obesity. What the !!! Are you kidding me!
wvugurl26 - 02/26/10 08:32 AM Toast[/b]y are you kidding me?!? $40 billion for R&D?? I'm sorry I work for a drug manufacturer and we do not spend $40 billion on R&D and we are the #3 or #4 drug company in the world! Yeah tech gadgets are nice but a gadget with all the bells & whistles will not help someone who has chronic pain, a bacterial infection, etc. And while their gadget just has to do what they say it will, our drugs have to be safe and meet regulatory approval. Geesh! And yes, this is America and they are a private company (well publicly held but not a govt entity) but I can't begin to imagine where they need $40 billion for R&D. And now I am back on the soapbox. And while $40 billion didn't accumulate overnight you would think at some point it would have been better tax wise to give money to camps for kids and other similar charities. It just boggles my mind that for $40 billion you couldn't find some worthy cause to give even a million or two as support.
nitza in no way should it be your responsibility to teach all of that. And in a sad commentary on our priorities in this country, recess time/health classes/gym classes are being cut or eliminated. Along with arts and music but still what message are we sending to these kids? And again thank you for caring about your kids. Perhaps one day it might sink in to their thick heads. My brothers and I still remember the teachers who truly cared about the kids and it impacts us as we make our way through our 20s and becoming adults with jobs, etc. I can see why the burnout rate is so high for those who do care about their kids and what happens to them.
azmomx3 - 02/26/10 10:49 AM Nitza: [/b]Please do stay on your soap box and let me just say again and again THANK YOU THANK YOU. I agree that teachers should not be the ones responsible for teaching the kids all of the things you mentioned BUT unfortunately they are not being taught at home and they and society are blessed to have teachers such as yourself and others on this thread who are willing to spend the time to teach it. It still amazes me how much is expected out of teachers but they are not valued in ways that reflect their responsibility and compassion. As a parent, I do not in any way think I have it all together when it comes to raising kids and I appreciate and respect all the different parenting styles BUT I do think that respect and discipline should be a major factor in raising kids, no matter how you chose to teach it and enforce it. IMHO it is the foundation for all things that life brings (eating well, physical activity, finances, relationships, ect) Okay, I'm off my own soap box now.
shanendoah - 02/26/10 11:22 AM
Healthcare / jobs - I have worked in healthcare for 8 years- 3 of them as a medical receptionist when the medicare advantage plans first came out, and the last 5 in a major managed care organization that has been held up by some as an example of the direction the country should go. Luckily for us, that meant that when DH lost his job last May, I was able to instantly and inexpensively add him to my coverage.
To me, these issues are different sides of the same coin, work on either will help the other. Personally, I come down on the side of working on healthcare. For jobs, there is only so much the government can do. Markets will eventually self correct. It takes time and it sucks to be caught in it, but that is one of the downsides for living in a (mostly) free market society. The New Deal did not get us out of the Great Depression, WWII did. (Not that I am encouraging any more wars/fighting, just saying that eventually, the world will change in such a fashion as to bring jobs back.)
Government can, however, have a real effect on healthcare in this country. Hawaii has had state run health care for ~20 years. Massachusettes recently passed their own universal coverage law. (I prefer the HI system to the MA system.) But one of the biggest reasons people fear losing their jobs is healthcare expenses - what happens if they, or one of their kids get sick when they don't have coverage? Medical bankruptcy is huge.
I believe in a public option for those who are self employed or whose jobs don't/can't afford to pay for health insurance. The federal governement is already in the business of providing healthcare through medicare, tricare, and congressional health plans. (Federal employee plans normally contract with a local insurer.) States other than MA and HI are also in the business of providing healthcare through Medicaid programs. So this isn't something that is actually new/outside of their ability - it is just upping the scope.
But I also believe that there are simpler steps that could be made to bring healthcare costs down. However, it requires a re-evaluation of what we find the most important in this country - healthcare or $$. Right now, if an unisured person goes to the ER, their bill will be ~125-150% higher than what it would be if they were insured. Since it is the overwhelming size of the bills that cause people to not pay/declare medical bankruptcy, hospitals would actually make more money if they lowered their costs to uninsured people, making it easier for them to see a way to pay. It took us 3+ years to pay off DH's kidney stone when he had just started a new job so didn't have insurance yet, and we weren't married. (He became DF during that ER visit.) And we only paid because we remained proactive. They lost our contact information at one point and just wrote us off until we contacted them to find out what was going on.
Additionally. the federal government could save money on healthcare by modifying the Medicare Part D regulations. Right now, they are not allowed to negotiate prices with drug companies at all because their buying power is considered an unfair advantage. So they pay full retail cost for all drugs. No insurance company pays full retail. (This is one of the reasons Medicare Advantage plans save the gov't money.) Medicare does not have to be allowed to negotiate based on its own buying power to save the gov't money - they could simply say that the drug companies have to give them the best negotiated price. So Medicare pays the same price for a drug as the Blues, or whichever local insurance company has negotiated the best price.
That's my soapbox - I want universal coverage/a public option, but I am willing to wait for those, allowing that they will take time. But there are other, smaller steps that could be taken now to start helping those who need it most and to change the cost of healthcare in this country.
Honeylioness - 02/26/10 11:51 AM Healthcare -[/b] I am hesitant to jump into this discussion until I can get my thoughts in better order because my spontaneous response when this subject comes up is probably not the most politically correct or constructive one.
I will say though that as a resident of Massachusetts I have not seen any real benefit to anyone I know from the "reform" the state passed a couple of years ago. In fact it has some, what to me, are rather moronic clauses - such as, if you cannot afford to pay for the state offered medical care because you make too much to qualify for Medicare but too little to be able to eat and have insurance, then you are penalized hundreds of dollars on your taxes. If you cannot afford to feed your kids and pay the high insurance premiums (and yes, the rates have little to no discount off the rate any single insurer would pay) then how do they suppose you will have $400-$500 "extra" dollars for pay this fine? Many people, especially in the area I live in, have no chance at all of coming of with $300 a month to pay for the barest bones catastrophic insurance available.
I also think a part of lowering the costs should come from a complete overhaul of the malpractice laws and insurance policies. I am sick and tired of people not being able to either A) Accept responsibility for their own actions and B) Feeling that everyone else owes them when anything goes wrong.
Is it a tragedy when a kidney transplant patient dies on the table? Yes, for the family. Are they owed millions in malpractice? Depends. If, like a recent case I heard of (can't remember now where) the patient while on the waiting list insisted on smoking, neglecting his cholesterol medications, and showed no sign of stopping his high level of alcohol consumption - then I say he was a bad candidate for the operation to begin with, how did he even stay on the list and finally - he chose to be an A$$ then he has to deal with the consequences - as does his family.
In the case of the idiot surgeon in Boston who left a patient on the table for over an hour so he could run to the bank - YES, that is malpractice and he is lucky the patient did not die.
But come on people, shite happens. Genetics is a carp-shoot, not all babies will be born "perfect", the courts need to get a 2x4 upside the head and stop allowing these ridiculous lawsuits to clog up our judicial system, the insurance companies need to rewarding some of this stupid behavior, and the country needs to find it's moral center and common sense again. I am not advocating going back to the days of viewing medical staff as god like and unable to make mistakes - but this cycle of CYA and victimization of everyone needs to stop and NOW.
Oh, and by the way, if you develop lung cancer from smoking three packs a day for over 40 years and you die - your family should not be able to sue, and win against, the tobacco company - and especially not to the tune of $81 Million. I don't for one minute believe that he "...didn't realize how dangerous cigarettes really were...She said her husband told her that Philip Morris wouldn't sell unsafe products."
Get a grip - they're cigarettes people, not carrot sticks.
shanendoah - 02/26/10 01:10 PM Honey [/b]- I agree, I am not really a fan of the MA program, but it exists, it represents the fact that the states recognize something needs to be done, too. However, if there is a public option, I do believe it should have the bargaining power of a "large group" as we call them and not the bargaining power of an individual policy. Again, I think a lot of it has to do with the fact that we have come to see medicine in this country as a highly lucrative professional industry (not just MDs, but hospital administrators, etc.), instead of as a service industry, which is what it really is.
The best way to cut down on medical malpractice suits is to remind MDs that they are not gods, that they are people, just like their patients. There have been some really interesting studies done that show that if an MD talks to his pts like they are equals than they don't sue. Essentially, the study placed recording devices in exam rooms and then fuzzed out all the words so that only tone of voice and length of conversation were the only things that could be gotten. The study was able to predict with ~90% accuracy which MDs would be sued.
I also know from previous experience that this is true. My step-dad died because his pulmonologist (and many, many other "experts") missed something very basic (given his medical history) and missed it for well over a year. His health steadily declined, he and mom went to out of state specialists and nobody found anything until the night he had to be rushed to the ER and then careflighted to a bigger hospital. The ER didn't care about all the previous tests and looked at his basic medical history and found the problem. My step-dad never left the hospital. It never even occurred to my mom, step-aunt, or step-sisters to sue because his pulmonologist apologized and treated them all with dignity and respect. If the mistake had been made by the cardiac surgeon, though...
My company actually has a training video that all employees watch during orientation that compares a traditional doctor visit to a vet visit, and shows how the vet visit is in every way superior. Our point is that our patients should recieve at least the same level of care and respect that their pets get.
Our system could be greatly improved simply by adding an ettiquette class to medical schools, and holding MDs not just to the letter of the Hippocratic oath but also to the spirit.
SES_Books - 02/26/10 01:26 PM We have such SMART ladies on this thread! With all of the problems this country is facing and the way congress is working (or not) you would think someone would listen to us! Honey is right about all the litigation being a large part of the problem . But as long as there are so many attorneys in Congress that will never change. Maybe we do need term limits.
We also need to bring back the notion of personal responsibility, starting in our homes by teaching respect, responsibility and how the real world works. We also need to take responsibility for the elective process and the preciousness of our votes. (Personally, I think we need to take more responsibility in the way TV, movies, games…keep “pushing the envelope” in what is acceptable and what is not. Teach less violence, dependency, and settling for the lowest common denominator and teaching more civility, respect and consideration.)
What Honey mentioned about the affordability of health insurance is so important. I want everyone to have basic and preventative care without giving up food to get it. We don’t need to start at the top of the income range to determine what will be spent. Lets start at the bottom where it is so terribly needed. A certain percentage should be auto deducted from wages (like SSI) up to 200% of the poverty level. A gradual change in the percentage from 200% to 300% of poverty level and above 300% of poverty the individual would be responsible for paying for any insurance above basic and preventative care. With no upper limits like SSI now has. There should be no opting out, and no pre-existing conditions restrictions. Bring back recess and PE as required classes -(including things as yoga and ti chi--not everyone is into traditional sports) Lets include music and art to get the creative juices flowing, too.
Now that we have a start on solving those issues, I want more involvement by parents so Nitza doesn’t have to teach so many things before she gets to math. (Once again Thanks to the parents here who are doing such a fantastic job) Remember “it takes a village to raise a child.”
I love Shanondoah’s idea about Part D being based on rates negotiated by the Blues or insurance groups.
Above all , I want a congress that WORKS!!
This is a big issue with me. I have been hearing so much about Greece and Spain and other Euro nations that I am getting really worried. China is no longer buying our debt, even selling to Japan. I heard Greece described today as “the canary in the coal mine,” an early warning device for the world economy. I have mentioned to Sapphire and Sharing off thread just how concerned I am and how I am trying to develop a basic survival budget. This recession is not over and will not be over for many years to come. I am afraid jobs will never return to the level we want in this country. I fear unemployment will always be in the big picture for many years. We will have to be strong to survive. I hope WWIII does not happen because it will not end a depression just end civilization as we know it.
Now a return to regular programming, thanks for letting me vent.
My IRS Refund!!!! <*Insert happy happy joy joy dance here*> It only took them eight days from the time I filed to deposit the money. Oh joy, I can breathe again now that my savings is healthy once more - AND I have the money for pay for my annual quilt vacation.
It's been a lonnnng day at school.