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Old 09-06-2009, 08:11 PM
 
20,187 posts, read 23,751,044 times
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Quote:
Originally Posted by anifani821 View Post
I am hearing all sorts of misinformation about a "public option" in the discussion on healthcare reform.

What do you define as a "public option?" I want to know what folks actually think that public option represents.

I have heard some people refer to it as "free healthcare."

I have heard others say it would mean a type of insurance issued by the government which would have low cost premiums.

I have heard others say it would mean that any of us could participate in the Medicaid program, if our employer didn't provide insurance, and would have a low monthly premium cost.

So what are you all thinking this means: "public option?"
For me, a public option is a "program that cannot be allowed to fail" and supported "mainly" by taxation... if it tries to fail, taxes go up and prevent it from failing, even though it is a complete failure... that is what a public option is to me... be it in healthcare, manufacturing, farming, or whatever... we already had what we called businesses "too big to fail"... I rather NOT create another one...
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Old 09-06-2009, 09:06 PM
 
3,599 posts, read 6,761,018 times
Reputation: 1461
Quote:
Originally Posted by PurpleLove08 View Post
Mandatory public option?

What part of, "If you like the coverage you have now, you don't have to change" is so hard to comprehend?
There's a big problem with when Obama says, "If you like the coverage you have now, you don't have to change."

Notice that he didn't say he's mandating your employers maintains your current healthcare.

Many small business healthcare employers are "switching" over to less expensive HSA plans with very high deductibles....like $5000 for a family. So a family of four essentially pays $600 a month out of pocket in premiums (compared to $1000 a month in premiums in a non-HSA plan with a more lower deductible).

Employers will try to save as much money as possible...making private healthcare insurance almost unaffordable to their employees. Than what happens, many employees with just flock to "the public option". The public option is just a stop gap to an eventual single payer (ie govt run healthcare system)

I am a healthcare provider. I say lets go for the single payer system. But there needs to be wholesale changes.

1. Insurance reform (eliminate pre existing conditions). But insurance companies in return demand that people lose weight, stop smoking, in essence, people need to get healthier. I wonder how ultra liberals such as the ACLU would respond.

2. Reduce physician salaries. Yeah, I am a doctor and I don't mind my salary being reduce. But in return, the government needs to heavily subsidize medical education. Many of my European counter parts graduate with almost zero debt. Most US med students graduate with around 150K debt (for public med schools) and 250K for private med schools. Almost most physicians in the US work on average 55-60 hours a week. I work 50 hours on a good week and 75 hours on a bad week because of call. Most European docs work 35-40 weeks with 8-10 weeks of vacation. So I will gladly take a 50% paycut if my work hours are reduced and my vacation times are increased just like my fellow docs in European countries. US physicians, especially specialist do make much more than than European counterparts. But when you factor in med school debt, hours work, years of training, they are appropriately paid. My lawyer friends who are just now becoming full partners at law firms earn between 300-500K and remember law school is 3 year. Med school is 4 years plus 3-7 years of residency where you get paid around 40K a year for 80 hours a week of work.

3. Go to a "loser pays malpractice system" This will still keep the lawyers happy since they still have the opportunity for "hitting the malpractice jackpot" But only the strongest cases will proceed. So those patients seriously injured by medical malpractice will still have their day in court and be properly compensated.
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Old 09-06-2009, 09:16 PM
 
Location: Chicago, IL
8,998 posts, read 14,739,674 times
Reputation: 3545
Quote:
Originally Posted by aneftp View Post
There's a big problem with when Obama says, "If you like the coverage you have now, you don't have to change."

Notice that he didn't say he's mandating your employers maintains your current healthcare.

Many small business healthcare employers are "switching" over to less expensive HSA plans with very high deductibles....like $5000 for a family. So a family of four essentially pays $600 a month out of pocket in premiums (compared to $1000 a month in premiums in a non-HSA plan with a more lower deductible).

Employers will try to save as much money as possible...making private healthcare insurance almost unaffordable to their employees. Than what happens, many employees with just flock to "the public option". The public option is just a stop gap to an eventual single payer (ie govt run healthcare system)

I am a healthcare provider. I say lets go for the single payer system. But there needs to be wholesale changes.

1. Insurance reform (eliminate pre existing conditions). But insurance companies in return demand that people lose weight, stop smoking, in essence, people need to get healthier. I wonder how ultra liberals such as the ACLU would respond.

2. Reduce physician salaries. Yeah, I am a doctor and I don't mind my salary being reduce. But in return, the government needs to heavily subsidize medical education. Many of my European counter parts graduate with almost zero debt. Most US med students graduate with around 150K debt (for public med schools) and 250K for private med schools. Almost most physicians in the US work on average 55-60 hours a week. I work 50 hours on a good week and 75 hours on a bad week because of call. Most European docs work 35-40 weeks with 8-10 weeks of vacation. So I will gladly take a 50% paycut if my work hours are reduced and my vacation times are increased just like my fellow docs in European countries. US physicians, especially specialist do make much more than than European counterparts. But when you factor in med school debt, hours work, years of training, they are appropriately paid. My lawyer friends who are just now becoming full partners at law firms earn between 300-500K and remember law school is 3 year. Med school is 4 years plus 3-7 years of residency where you get paid around 40K a year for 80 hours a week of work.

3. Go to a "loser pays malpractice system" This will still keep the lawyers happy since they still have the opportunity for "hitting the malpractice jackpot" But only the strongest cases will proceed. So those patients seriously injured by medical malpractice will still have their day in court and be properly compensated.

I'm on board but I'm not 100% sure salaries of doctors need to be reduced. I would just like for us to get away from the fee for service system. Some doctors will abuse that.
It would be nice if doctors were paid a salary and they get paid more if their patients are healthier. At the same time, patients are held accountable.

There was a discussion on another board about increasing the # of federally subsidized doctors or something along those lines. It's on the sticky for the health care debate. It should be on the last or next to last page.

Here ya go: http://www.city-data.com/forum/10632121-post395.html

A quote from the article:
Quote:
4. Reform efforts don't address our critical shortage of health-care workers.
Many people believe that the fix for our physician deficit is simple: expand class sizes at existing medical schools and create new ones. Sorry, it's not that easy. There is a cap on the number of federally funded training positions for newly minted M.D.s. It hasn't changed since 1996. If the number of graduates of U.S. medical schools increases but the number of post-graduate training positions remains the same, we won't have fixed the problem -- we'll have created a different one. Training programs will simply take more U.S. graduates and fewer foreign ones, and the total number of physicians trained each year will remain the same -- too low. And foreign medical school graduates tend to practice in rural and underserved urban areas, the very places that need the most help.
Source: http://www.washingtonpost.com/wp-dyn...T2009090403390
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Old 09-06-2009, 09:26 PM
 
Location: Foot of the Rockies
90,316 posts, read 120,209,612 times
Reputation: 35920
Quote:
Originally Posted by GOPATTA2D View Post
Then you have not read the Bill. If you are currently uninsured, you will be required to get insurance. Again, who do you think is going to pay for it?
What frickin' bill are you talking about?

I believe the general goal is mandatory insurance for everyone. This means if your employer offers insurance, you need to take it (unless you can prove you are somehow covered elsewhere). Employers who don't offer insurance will have to pay into a fund, presumably for the public option. That is the general understanding I have of the overall goal for health care reform.
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Old 09-06-2009, 09:54 PM
 
Location: State of Being
35,879 posts, read 77,117,408 times
Reputation: 22750
Quote:
Originally Posted by Katiana View Post
What frickin' bill are you talking about?

I believe the general goal is mandatory insurance for everyone. This means if your employer offers insurance, you need to take it (unless you can prove you are somehow covered elsewhere). Employers who don't offer insurance will have to pay into a fund, presumably for the public option. That is the general understanding I have of the overall goal for health care reform.
HR 3200 - this is the bill Congress is going to be sending to the floor - and then will be sent to the Senate.

The last I had read (and of course, we don't know what will be marked up) - everyone will be required to have healthcare coverage. There has been a lot of discussion about how this will be monitored, and that was spelled out in the legislation, as well (employers have to report annually to the IRS the SS #, addresses and tel # of each person who is employed, along with info about their insurance coverage).

There has been a lot of discussion about whether or not employers will be fined if they don't provide insurance (few seemed to like that provision, for obvious reasons) and there was also discussion about taxing whatever insurance benefits employers are paying on the behalf of employees (that provision will most likely remain).

The version of the bill I read did not include a fund that employers paid into to create insurance - but as I said - I read the Kennedy/Dodd bill in June and HR 3200 in July, if I remember correctly, and a lot has evidently been discussed/possibly changed since then.

I just can't figure out what the public option is, as both the Kennedy/Dodd bill and HR3200 raised the qualifying limits on Medicaid to around $80,000, I believe, which would make Medicaid available to folks who didn't have employer insurance.
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Old 09-06-2009, 09:58 PM
 
Location: Chicago, IL
8,998 posts, read 14,739,674 times
Reputation: 3545
Quote:
Originally Posted by anifani821 View Post
HR 3200 - this is the bill Congress is going to be sending to the floor - and then will be sent to the Senate.

The last I had read (and of course, we don't know what will be marked up) - everyone will be required to have healthcare coverage. There has been a lot of discussion about how this will be monitored, and that was spelled out in the legislation, as well (employers have to report annually to the IRS the SS #, addresses and tel # of each person who is employed, along with info about their insurance coverage).

There has been a lot of discussion about whether or not employers will be fined if they don't provide insurance (few seemed to like that provision, for obvious reasons) and there was also discussion about taxing whatever insurance benefits employers are paying on the behalf of employees (that provision will most likely remain).

The version of the bill I read did not include a fund that employers paid into to create insurance - but as I said - I read the Kennedy/Dodd bill in June and HR 3200 in July, if I remember correctly, and a lot has evidently been discussed/possibly changed since then.

I just can't figure out what the public option is, as both the Kennedy/Dodd bill and HR3200 raised the qualifying limits on Medicaid to around $80,000, I believe, which would make Medicaid available to folks who didn't have employer insurance.
As far as taxing insurance benefits employees receive, the plan is/was to tax Cadillac plans, not the every day run of the mill health care coverage.
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Old 09-06-2009, 10:16 PM
 
Location: State of Being
35,879 posts, read 77,117,408 times
Reputation: 22750
Quote:
Originally Posted by PurpleLove08 View Post
As far as taxing insurance benefits employees receive, the plan is/was to tax Cadillac plans, not the every day run of the mill health care coverage.
Actually, the legislation (when I read the version I saw) made it very plain that any insurance benefits an employer paid would be recognized as income to the employee. It even had an amendment to the IRS Tax Code in it re: same.

Now - I am not trying to present myself as an "expert" on this subject b/c what I read has been discussed in committee and Congressmen have stated that things are being changed from that original bill.

I am truly confused about what is being proposed at this point as a "public option" - especially since the qualifying rates for Medicaid have been changed to include folks making around $80,000.

I have no idea if it is a great idea, a lousy idea - I am just wondering if anyone else out there has a real grip on what this public option really is.
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Old 09-06-2009, 10:18 PM
 
Location: Chicago, IL
8,998 posts, read 14,739,674 times
Reputation: 3545
Quote:
Originally Posted by anifani821 View Post
Actually, the legislation (when I read the version I saw) made it very plain that any insurance benefits an employer paid would be recognized as income to the employee. It even had an amendment to the IRS Tax Code in it re: same.

Now - I am not trying to present myself as an "expert" on this subject b/c what I read has been discussed in committee and Congressmen have stated that things are being changed from that original bill.

I am truly confused about what is being proposed at this point as a "public option" - especially since the qualifying rates for Medicaid have been changed to include folks making around $80,000.

I have no idea if it is a great idea, a lousy idea - I am just wondering if anyone else out there has a real grip on what this public option really is.
Last I heard of any talk about taxing benefits, it was about taxing generous health care plans.
They have since backed off that and are considering taxing the insurance companies that provide such plans....
It makes sense to some degree.

If you're far removed from the cost of the health care, you're very likely to use more health care services than someone that say has a high deductible or high co-pays.
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Old 09-07-2009, 07:30 AM
 
Location: Central Maine
4,697 posts, read 6,421,837 times
Reputation: 5046
About what is and what is not a "public option" .... FiveThirtyEight has an interesting article about this.

FiveThirtyEight: Politics Done Right: Poll: Most Don't Know What "Public Option" Is -- Including Pollsters
A new survey by Penn, Schoen and Berland Associates for the AARP reveals widespread uncertainty about the nature of the "public option" -- a government-run health insurance policy that would be offered along with private policies in the newly-created health insurance exchanges.
The three very different definitions of "public option" given in the poll:

  • Creating a government-funded insurance company that competes with existing private insurers to offer health coverage at market rates
  • Creating a national healthcare system like they have in Great Britain
  • Creating a network of healthcare cooperatives

If you knew that the first definition is correct, congratulations - only 37% of people taking the poll knew the answer. 26% thought it was a national healthcare system, and 13% thought it meant healthcare cooperatives. Oh, and 23% were honest enough to say they didn't know.
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Old 09-07-2009, 07:54 AM
 
955 posts, read 2,151,328 times
Reputation: 405
Quote:
Originally Posted by PurpleLove08 View Post
As far as taxing insurance benefits employees receive, the plan is/was to tax Cadillac plans, not the every day run of the mill health care coverage.
What will shock many, many people who have no conception of what health care premiums are for businesses is that what they consider to be a "normal, reasonable" health care plan will be viewed as a "Cadillac" plan. Surprise, surprise.

If anything good comes from this debate, it is that people will begin to realize just how expensive their health care benefit is and how subsidizing others will either affect their coverage or their salary.
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