With the passage of the new health care legislation - I can't help but to wonder what will happen to hip resurfacing.
I know this will end up in many disagreements and opinons, but I can't help thinking about it. Will we all be flying overseas for hip resurfacings in the future? It is a very expensive surgery and costs more than an old fashioned THR. Will we just be offered old fashioned THRs now to help cut costs?
I know that no one can answer this question, but as Surface Hippies I would think it is on many people's minds. With all the changes in Medicare and Medicaid, doctors are just not going to get paid to perform cutting edge technology. Even before this legislation passed, most surgeons would not accept Medicare for resurfacing since it is so expensive.
I can see older people not being offered hip resurfacing since it is so expensive. Maybe not even MOM THRs. We have come so far with hip resurfacing, I hope this new legislation does not remove it as an option for the common person. Are we all going to have to fly to India for resurfacing? I hope not. I have no way of knowing, just thinking about it.
Now the discussion can begin. Let's just be kind and not attack each other - just present our thoughts.
Pat
Hi Pat,
Since hip resurfacing is FDA approved you should see no change. It's important for people to realize that the plan is not a government takeover of health care like in Canada or Britain. The government will not take over hospitals or other privately run health care businesses. Doctors will not become government employees, like in Britain. And the U.S. government intends to help people buy insurance from private insurance companies, not pay all the bills like the single-payer system in Canada.
I see no reason why, as the process improves and becomes more popular, that resurfacing costs come down and be equal to the cost of THR. Dr. Gross did my operation in less than two hours. A total hip would have been longer to do and more expensive as I would have required a custom stem. So for me the resurface was less expensive.
With all the new insured people there will be an expanded need for joint replacement. More customers. This should stimulate innovation. However, as I understand the process, hip resurfacing is not for older people anyway. Doctors will recommend THR for older patients just as they do now.
The bright side is there are limping people in pain that will now be able to buy insurance and get the same care that you and I have been fortunate enough to recieve. I wish them well.
Hi Don
I understand it is not a national health system, but I think we will all be amazed how much influence the government will have in placing guidlines to doctors and insurance companies in what should and should not be done. Especially in efforts to save money and keep insurance rates down. We are now in untested territory. Only my opinon.
About a year ago, I asked many people on the site to express their opinons to medicare about hip resurfacing. As far as I know, it was not accepted for older people. I was told insurance companies follow what medicare does. Since I work closely with doctors, I see a different side of health care than a normal patient. I was contacted by several medical companies and doctors to try to get opinions posted for the medicare decision.
I just know if you were 65, Dr. Gross would not have done your hip resurfacing since you would be on medicare. He does not accept medicare for any surgeries. There are more and more doctors deciding to do that instead of losing money. So there are many things happening that we as patients don't normally see.
One point I have to disagree with you is - hip resurfacing is not for older people. I was 61 when I had mine done 4 years ago. If I need my other hip done, I will want a resurfacing if possible. I know quite a few older people that have had hip resurfacing since they were good candidates. See how many people were 60+ in must my little survey http://www.surfacehippy.info/agesurvey.php (http://www.surfacehippy.info/agesurvey.php)
Again, resurfaicng is for the young, the old, the males and females if they are good candidates. There is no generalization it is not good for old people or women. It is for you if you are a good candidate. That is a myth that I keep trying to correct. THere are even posted results that large boned women have the same outcome in resurfacing as men.
Thanks for your thoughts.
Pat
Pat,
The bill that was passed only sets up new rules for health care companies and brings in money for those without health care, now bear in mind, this is just the first step in bringing in a single payer or government like health care system.
If the second step happens all bets are off the table as then you would have a monopoly within a bureaucratic nightmare.
I do not fear the bill that was passed, I do fear the govt being in charge of my health care as nothing the govt runs is efficient or cost effective. You do not have to go far to see examples, SS is one.
Chuck
Pat,
Hip resurfacing may have cheaper life cycle costs since the device may last a lifetime.
A traditional THR (small femoral head and plastic liner) may wear out and require a revision, so the life cycle costs will be higher.
Since the first modern BHR's were first installed in 1997 (13 years ago), we will need to monitor the performance history.
I suppose insurance companies will need performance data before accepting the cheaper life cycle cost advantage.
My understanding is the older you get the better your chances of femural head fracture due to lowered bone density. This is especially true for women. However, if someone who is active and has good bone density then age does not matter. Test conclude that the ideal patient is 55 or younger.
Another thought to consider is the 2 year prospective study done on the BHR. It said the following... The combined superior regions of the neck showed a statistically significant decrease in bone density at 6 weeks and 3 months. This returned to preoperative levels at 1 year and was maintained at 2 years. Anyone slightly low in bone density could be at risk for failure and the majority over 65 fit this description. There are a few exceptions.
Rush medical Study: Nov. 3, 2008
"The ideal patients for hip resurfacing are males under the age of 55. They have the fewest, and the least serious, complications," said Dr. Craig Della Valle, lead author and a specialist in joint reconstruction at Rush University Medical Center. "Patients may be eager to take advantage of technological innovations, but for older individuals, a conventional hip replacement is generally more appropriate."
Dr. Gross transcript on Feb, 2009
TAYLOR_ED] 7:39 pm: What is the average age of your resurfacing males? When is a replacement better than resurfacing?
[Dr. Gross] 7:42 pm: Taylor_Ed: The average age of my patients is 48. My opinion is after approximately 65 years of age. Diagnosis, bone quality and bone defects are also important factors to consider.
Quote from: obxpelican on March 22, 2010, 02:55:48 PM
Pat,
The bill that was passed only sets up new rules for health care companies and brings in money for those without health care, now bear in mind, this is just the first step in bringing in a single payer or government like health care system.
If the second step happens all bets are off the table as then you would have a monopoly within a bureaucratic nightmare.
I do not fear the bill that was passed, I do fear the govt being in charge of my health care as nothing the govt runs is efficient or cost effective. You do not have to go far to see examples, SS is one.
Chuck
There is some straight up BS in this plan, I really can't believe people think this is a good idea.
Salary caps. Wheres the motivation for someone to become a heart specialist or brain surgeon, (or hip resurfacing guru) when the govt says you can only make X amount know matter how gifted you are or how hard you've worked. How about that fact that employers will be required to provide health insurance to PART TIME employees, AND THEIR FAMILIES, think thats gonna drive up the price of EVERYTHING ?? It will put me out of business quite honestly. (Or force me to pay guys cash under the table) How about having the gov't decide who gets what treatment and when are you "just too old" to justify a needed procedure ? They couldn't deal with getting the country a flu vaccine for crissake, now they want to eventually run healthcare altogether ? God help us.
Here is one effect that is factual: Any surgery requiring medical devices will cost more.
The healthcare reform legislation imposes a 2.3 percent excise tax on sales of most medical devices. (ie hip resurfacing devices)
The medical device excise tax would apply to products ranging from surgical instruments to bedpans starting in 2013, according to news reports. The provision is expected to raise $20 billion over 10 years to help pay for healthcare reform.
Reaction from the industry was mixed, at best. Tom Sommer, president of the Massachusetts Medical Device Industry Council, blasted the tax, saying it would stifle growth and put innovation in peril.
"You're certainly going to see an impact on growth and expansion by medical device companies in this country that are going to be faced by a higher tax bill. In addition to job cuts and rollbacks on expansion plans, you're going to see a reduction in R&D spending. Innovation in this industry is definitely in jeopardy, which is shameful," Sommer told MassDevice. "Obviously we're disappointed in the final outcome. The device tax does not take effect until 2013 and we're hopeful that between now and the implementation date we'll be able to scale back, and certainly we'll be supportive of any effort to remove that tax from the law."
There has been a lot of "noise" and disinformation about this health care bill. I am very suspicious about the numerous dire consequences that some have warned of.
Remember that the BHR was developed and initially marketed in England, which has actual socialized medicine. The last I heard, you can still get your hip resurfaced in England and in Canada.
If it's any indication, Smith and Nephew stock has been steadily rising:
http://bigcharts.marketwatch.com/quickchart/quickchart.asp?symb=UK:SN&sid=206109&time=
So has Johnson and Johnson (owner of Depuy):
http://bigcharts.marketwatch.com/quickchart/quickchart.asp?symb=jnj&sid=0&o_symb=jnj&x=0&y=0
Biomet is a private company since 2007, so no stock price data is available.
Of course, the insurance companies can always downgrade service in an effort to improve their profit margins. So maybe the fact that they can't dump people from their roles any more for being sick will cause them to tighten their wallets and refuse more expensive orthopedic solutions.
But I doubt it. THe profit motive has always been king at those companies. If they could have saved a nickel by refusing resurfacing and gotten away with it, they would have done it by now.
Bionic -
Well said. I agree. There is a danger that too many additional excise fees [taxes] may ultimately stiffle innovation, but we are not even close to that level. Now, if the US starts to resemble the Japanese market where the nationally set price for implants has eroded some 25+% over the past 3 years then yes. Try to make a list of industries that have gross profit margins in the range of the medical device or pharma. I will give you one to start your list - Tobacco.
The sky was falling when Medicare was enacted, the sky was falling when Social Security was enacted, the sky seems to keep falling each time the minimum wage is increased... on and on. Fatalistic views never materialized. Our current financial situation has nothing to do with the above.
In my opinion, Medicare and Social Security are two solid ideas for a society. There are very few extremely wealthy individuals / families in the US who could afford to opt out [if possible]. The problem is that these programs can no longer be as generous as in the past. Perhaps there is a party that can bring fiscal responsibility to these programs.
Enjoy the day all... I hope that you are all recovering...
I disagree with SS and Medicare being something good for us, we cannot continue down the same path, medicare is set to be insolvent in 2020, yeah, that's 10 years. SS is supposed to last till 2041, then what? We'll dump more money into it.
Our government has never introduced a social program that is actually efficient and cost effective. Had we all invested our SS money into CDs we would have been far better than what we're going to end up with.
Whatever socialized medicine our country ends up with it will be a catastrophe, it will be a bloated bureaucracy just like every other program our politicians have come up with.
Socialized medicine works somewhat well in other countries, it even works for the politicians like Newfoundland Premier Danny Williams, he came here from Canada for his heart surgery, or I could give you the email of my sister in-law who came to America to treat her ovarian cancer.... she was going to have to wait 6 weeks for treatment, she would have died for sure.
My Nephew has autism, they get checks every month, which they blow on everything but for learning aids for him, now their other Son has trouble with math, now they are seeking out a doctor who will label him learning disabled, guess why? Great use of our SS money.
Someone name me one government program that is efficient and cost effective here in America, our military, maybe but they are not cost effective, remember the $600 toilet seat, how about the $400 hammer? Maybe NASA, but then they have lots of cost overruns.
Sorry folks, I desipise all politicians, it does not matter which party either, they are all thieves.
Now off of my soap box.
I feel better now.
Chuck
SS and Medicare are certainly good things for my retired parents, and for most people who are able to collect benefits. The fact that these programs are not currently sustainable doesn't make them complete failures--lots of people benefit. It just means they need to be upgraded to better reflect economic realities.
In my opinion, entitlements are generally a good thing but they need to be coupled with real economic development. Like a company, the US can't provide benefits unless it's making money, or rather its people are. A sustainable tech revolution would be mighty welcome right about now. I'm putting my money on clean energy and bio-tech.
Bionic, yes, SS is great for our parents, most people on SS right now are taking more out than they put in, maybe not your parents, but mine for sure, my Dad always laughed about it too.
Our age group will fair much worse, we will receive far far less than what we put into it, the main reason? Politicians re-defining who can and do receive benefits, like my in-laws for example.
SS is nothing but a ponsy scheme, all you can hope for is that you get money out before it all folds.
Chuck
Chuck
Hold on a minute. I know that the Ben Roethlisberger thing has got you all fired-up! We all agree about the politicians but... why does everyone keep sending their congressman back to Wahsington? Back to the issue.
Could you as an individual afford to fund your own health insurance? Buffett, Gates, and alike. That's it.
SS, I generally agree, but not for an entire country as diverse as ours. Many like you and I would like to sign out of the SS program and keep our own money, making our own investment decisions. I bought Ford at $3.33. Most US citizens could not do this. I love my mom but she has no clue about investments, and I don't want her calling me every market swing. 10 yr bonds yielding 3.68%.
I guess I better get back to work..
GO EAGLES!
LOL--- yes, Ben, he's been a disapointment for sure.
I for one have no problem passing laws that made health insurance a bit more fair, for instance I have no issue with passing laws against pre-existing conditions, not a problem. Some of what was passed is good.
I do have problems with the fact that the current bill is nothing but a pathway to socialized medicine, the politicians have said it all along that the first bill would be just the beginning of socialized medicine.
I fear a government that cannot even keep solvent the social programs they have currently, let alone something that is going to affect our families health for years to come.
BTW-- close to 4% is still better than the negative number I'll receive from SS.
Chuck
Bionic
QuoteBut I doubt it. THe profit motive has always been king at those companies. If they could have saved a nickel by refusing resurfacing and gotten away with it, they would have done it by now.
I take it you have not been reading on this site and the Yahoo Health Group surfacehippy to read story after story of people trying to appeal their insurance decisions to get a resurfacing. They are still fighting with their insurance companies. I could go thru my emails and send many who ask my advice.
Hip Resurfacing is definitely not an accepted standard for hip replacement or all hospitals or all doctors would be performing it. Any old orthopedic surgeon will give you a THR - the gold standard. Don't take it for granted that hip resurfacing is well accepted by insurance companies or the medical community. It is not. It is my feeling that it may not be offered as freely in the future as it is now. That's not saying much since only a very few surgeons in the US even do resurfacing now. Resurfacing is a more expensive surgery and a more expensive device than a THR, that is why most surgeons will not accept Medicare for resurfacing, they don't want to lose money.
We are on the slippery slope of sliding down into a socialistic country. People in many other countries don't even have many surgeons doing resurfacing in their countries. These people write to me asking who does resurfacing in their countries like Ireland, Greece, Peru, Africa, Holland, etc, etc. The purpose of socialized medicine is to provide some care for everyone without busting the monetary system and that's probably a positive statement about socialized medicine. Everything has to be paid for somehow. When the middle class has dissapeared, where is the money going to come from.
I receive emails from all over the world, with many from Canada and the UK. It is an eye opener about what these people can and can't have - how long they have to wait for what they get. This is not where we want our country's healthcare system to end up.
Right now not much is going to happen in healthcare, but just give them time. This is but the first step to "take care of us."
My opinion only. I sit at home working on the computer all day and listen to Fox News to pass the time. If only 1/2 or even 1/3 of the information they provide is true - we are all in for a bumpy ride.
A very interesting discussion with many diverse opinions. The only thing for sure is that we all love our hip resurfacings and if or when we need another one - we want that option open to us without having to fly to India.
Pat
Pat,
I hope you're not right when it comes to the health care next step. It's a shame people are still being turned down.
The problem with you is that you're right so many more times than your wrong. Of course I'm always right, right? ;D
Chuck
Quote from: Pat Walter
Right now not much is going to happen in healthcare, but just give them time. This is but the first step to "take care of us." My opinion only. I sit at home working on the computer all day and listen to Fox News to pass the time. If only 1/2 or even 1/3 of the information they provide is true - we are all in for a bumpy ride.
Try listening to MSNBC for a while. It'll make you feel better. :)
It's important to remember that people had trouble getting insurance to pay for resurfs under the pre-reform system; it's not reform's fault.
Will reform make it better or worse? At the moment, it looks like reform will benefit the insurance companies by making enrollment mandatory and therefore increasing their numbers of customers.
How that change will filter down to the patients is anybody's guess. Health insurance companies have been posting record profits. I'm sure they'll try to expand and extend their profits as much/long as possible, and this will mean paying for less and less while collecting more premiums. That's just their business model (and also a good reason for offering a public option).
I think Chuck wrote above that resurfacing may be a better surgery in the long run for purely economic reasons. That's a good argument, and insurance companies would do well to listen to it. Although resurfs may be more costly than THRs, you usually need just one. Of course, if resurfs start failing at the same rate as THRs (or if THRs get so good they fail as infrequently as resurfs), then resurfs may be on their way out. But it seems that would only happen if the market viewed them as roughly equivalent in terms of revision rate.
I see your point, however. Will the good (reform) be the enemy of the great (resurfacing)? I think it will depend on a lot of other factors besides reform itself.
Quote from: obxpelican on March 23, 2010, 05:39:56 PM
LOL--- yes, Ben, he's been a disapointment for sure.
I for one have no problem passing laws that made health insurance a bit more fair, for instance I have no issue with passing laws against pre-existing conditions, not a problem. Some of what was passed is good.
I do have problems with the fact that the current bill is nothing but a pathway to socialized medicine, the politicians have said it all along that the first bill would be just the beginning of socialized medicine.
I fear a government that cannot even keep solvent the social programs they have currently, let alone something that is going to affect our families health for years to come.
BTW-- close to 4% is still better than the negative number I'll receive from SS.
Chuck
I'm with you Chuck, we have got to do something but turning health care over to the govt is a scary thought. I don't know everything that is in this bill (who does, isn't it 2700 pages or something ?) But I do know that you can't pick up a turd by the clean end...
Most of the latter arguments against health reform are pure crap. I suppose you'll next say that national health care is socialistic and communist. I congratulate President Obama and the Democratic party for passing national health care. Better to spend dollars on our health than pork-barrel defense or paying severance bonuses to the private sector executive frauds at failied wall street firms. Everybody deserves health care. Let the rich with incomes over $200 k/yr help fund it through tax increases. If you go to India or elsewhere overseas, try winning a malpractice suit in a foreign court if your Dr. or hospital screws up!
First, I would never have a procedure done in any of those countries - India, Greece, Russia, Peru... Please! UK, Canada, and US - fine. I have seen cases presented from all these countries, and they "are not so experienced." Edited in case the kids find this site!
It is amazing that no one has issues with our military spending, except Steve. Any ever read about the Osprey helicopter! The fact is we spent money beyond our national means - both democrats and republicans - and now we have to pay for it. CAGR of healthcare dollars cannot be sustained.
Steve, they are socking it to the rich! A new tax of 3.8% on long-term investments including dividends.
Someone else on the site said it best, we have great surgeons, great technology & innovation.... with an inefficient delivery system. Just becasue you get a knee resurfaced on a few days notice does not mean anything. Go to the right suregon and it will take longer ,but what does it matter. Red herring.
The site below is awesome for information about healthcare expenduress for those interested. The link is to a fact sheet by the US Health & Human Services Sept:
http://www.cms.hhs.gov/NationalHealthExpendData/25_NHE_Fact_Sheet.asp#TopOfPage
Good to see reasonale conversation by all. Have a healthy and great day....
Steve,
Nobody said that some changes to healthcare, for instance pre-existing conditions is not a good thing, it should be changed.
What many of us fear is OUR government running OUR healthcare that affects OUR lives. Like I asked before, show me a US govt social program that is efficient and cost effective, you cannot find it and we all know that Obama and his gang are using this current healthcare bill as a pathway to socialist healthcare.
Many people come to America for our healthcare because it's great, just ask the Newfoundland Premier, Danny Williams.
Obama does not even have support of the majority of this country for what he just signed.
Chuck
"I sit at home working on the computer all day and listen to Fox News to pass the time."
Pat, over and over again you advise people on this forum to seek second opinions.
Maybe you should too.
Quote from: stevel on March 24, 2010, 03:11:00 AM
Most of the latter arguments against health reform are pure crap. I suppose you'll next say that national health care is socialistic and communist. I congratulate President Obama and the Democratic party for passing national health care. Better to spend dollars on our health than pork-barrel defense or paying severance bonuses to the private sector executive frauds at failied wall street firms. Everybody deserves health care. Let the rich with incomes over $200 k/yr help fund it through tax increases. If you go to India or elsewhere overseas, try winning a malpractice suit in a foreign court if your Dr. or hospital screws up!
whoa - maybe not socialistic/communistic in their strict definition, but it's definitively redistribution of wealth - which has both communistic and socialistic ideals.
The "everybody deserves" argument is an entitlement argument. I do agree no one should be turned away from necessary medical care, I don't want the government to decide who gets what though.
The first step should have been abolishing the anti-trust exemption for the insurance companies â€" allowing national pools and competition. This would lower rates.
What does malpractice have to do with anything in the reform? Tort reform is something totally different (I would suggest that the Canadian model for tort is pretty good)
I'm changing my mind on this and am going to be more positive.
I think it's awesome that the govt wants me to work harder and pay more taxes so those that aren't as driven to succeed can have the same health care as me and I don't mind helping them pay for it. I guess I was greedy before thinking that all the money I make should go to me and my family, not sure what I was thinking.
I see now how wrong I was and that yes, we should punish those people who have worked hard to become "Rich", they should absolutely pay a higher percentage to help carry the lazy. Just because someone is not motivated to work hard and better themselves they should not be punished with sub standard insurance.
I see now that while the concept of "Freedom" means you have the oppurtunity to do anything you want with your life, it also means that some will not succeed and won't be able to afford good health care or own a home etc. Thats not fair is it ?
I realize now that the governments real job is to make sure everyone who steps foot in this country legally or not should get the finest health care available, regardless of who pays for it, I need to start thinking more about my fellow man and stop being so self centered.
What a jerk I have been. Well I won't bore you anymore I have to get to work, I see Juan and Juanita are expecting again....
Thank you B.I.L.L. I have now seen the light! Even though I'm far from rich, I can see how paying additional taxes will help!
As an aside - I'm all for opening up competition and putting some specific regulations in place. But, in reality, when everything kicks in, there's nothing stopping health insurers from jacking up rates.
And, what is stopping someone from getting insurance only for a major medical issue, then dropping the insurance right after said procedure? Shoot, my hip cost about 50 grand. I could have had no insurance, bought insurance right before the operation, had them pay their part (about 80%), and then I could have just dropped it with the new regs.
The easiest way to control people is to make them afraid. Fear is running rampant on the airwaves. Fox news has people on the edge of their seats. After listening to Glen Beck for an hour I have to peak through my blinds to see if there are Nazis marching in the streets and terrorists behind every tree. Fear sells and the pundits are making millions.
All this talk of Socialism and there is little or no discussion of what socialism entails. The mere use of the word is enough said. If it's socialistic, it must be bad.
There comes a point where the government has to step in and say…â€we are going to tax people in order to provide this serviceâ€. This ‘stepping in’ is what most people now define as socialism.
The military is the largest social program we have. We support over 2000 military bases worldwide. Talk about excessive government spending. There are many other socialist programs currently in America … public schools, police department, social security, fire department or medicare/medicaid or the fee for 911 on your phone bill.
The NFL is a fantastically successful experiment in corporate socialism. The league’s business practices contradict the tenets of a free market. With its salary cap and salary floor that oblige all 32 franchises to spend the same amount on players each year, the NFL effectively prohibits any team from gaining an investment advantage over its competitors.
I hear no one screaming socialism towards these programs. I know, technically these government programs are called ‘Public Goods’ but lets face it… it runs just like a socialist program. We all pay for it and the government decides, usually without the consent of the taxpayer, what munitions will be manufactured where troops will be sent, and what operations will be carried out on his/her dollar. Not only that, but our troops receive all kinds of benefits we would deem “socialist†if they were provided to the population at large: medical care, housing, childcare, education assistance, pensions etc.
Secondly, the benefits that a given person derives from the provision of a ‘Public Good’ do not depend on that individual’s contribution to funding it. Everyone benefits, including those who pay little or no taxes.
Now, you may be quick to point out that maintaining a military is vital to securing the freedom and prosperity of our nation. I agree but that doesn’t negate the fact that the military is far too big and the financial burden is enormous.
No question that 9-11 was horrible terrorist attack that killed over 3000 people but 45,000 people die EACH YEAR due to the lack of health care. I see nothing wrong with health care becoming a ‘Public Good’ just like the military if we redirect funds out of the military and reduce our debt.
Quote from: DonC on March 24, 2010, 03:53:28 PM
The military is the largest social program we have. We support over 2000 military bases worldwide. Talk about excessive government spending. There are many other socialist programs currently in America … public schools, police department, social security, fire department or medicare/medicaid or the fee for 911 on your phone bill.
You're attempting to re-define a social program, I am talking FEDERAL SOCIAL PROGRAMS. But that's ok.
The military is one of the biggest examples of waste, you really don't want to talk about waste and inefficiency in regard to miltary spending now do you? You can call it anything you like, either way the military wastes more money than most of our programs. Schools? Come on, look at our schools, compare us to Japan and look at the results. In my school district I could send my daughter to college on what they pay per student. Give me a break.
Police departments have waste also, keep in mind schools and police departments are run at more of a local level, they are not federal social programs, most of their money is derived from local taxes. The federal government does not RUN our police departments, schools are run by school boards (although don't get me started about them).
Medicaid, medicare, social security, all bloated and great examples of true inefficient, government waste, money is wasted by the billions in those true FEDERAL social programs.
What surprises me are the people who are actually buying into this cradle to grave nonsense that somehow our government is going to be efficient and cost effective with OUR health care.
I'm sorry, be it either George Bush, Vice President Biden, Al Gore or any other government idiot, I do not trust them with my life, you should not either.
Again, please someone, please show me one social program our government runs that is efficient and cost effective.
Chuck
QuoteAgain, please someone, please show me one social program our government runs that is efficient and cost effective.
no one can - because there aren't any. It seems like the government's responsibility (the way it's currently constructed) is to re-distribute wealth - at all levels.
The US Patent & Trademark Office has been operating at a profit. This is despite the fact that neither it, nor any other government agency or program, is designed to operate at a profit. This is where the comparison to private industry falls short.
Private companies must consistently make profits or die. They exist to make profits. Corporations may be in a particular industry, like electronics or insurance, but the only measure of their success is their profits. Corporations have a duty to do what's best for their shareholders--not their customers or their employees--and they have no other duties to anybody else, except to the extent that government regulation (what Republicans call "socialism") requires it by law.
This is why the goal of insurance companies is to collect maximum premiums while paying out as little as possible. With all the talk about how health care reform was going to kill Grandma, nothing pleases insurance companies more than when old people die as soon as possible after becoming sick. Remember the "I'm not dead yet" skit from Monty Python. The insurance company is the guy carrying the old man out to the wagon.
Government programs, on the other hand, are not driven by the profit motive. In fact, they are designed not to operate at a profit, since profit is considered a sign of poor budgeting and a waste. In recent years, the USPTO's profits have been funneled into the military.
Quote from: dw on March 24, 2010, 05:41:45 PM
no one can - because there aren't any. It seems like the government's responsibility (the way it's currently constructed) is to re-distribute wealth - at all levels.
Capitalism is wealth redistribution run amok. Not that I'm complaining. I've benefited and I know it. But I still don't think it's right. I know CEOs work hard and all, but should they really make 300 times what the average employee makes?
Capitalism is always based on exploiting something, whether it be natural resources, workers, or the environment. The whole point of capitalism is to make profit, yet profit is essentially a measure of unfair advantage and waste. If I buy can get something for $10 and sell it for $20, sure I make a $10 profit, but where did that come from?
Don't get me wrong. I love capitalism. I think it's the best system we have. But people need to be realistic about its limitations and especially its necessity to exploit for profit, so that its harshest effects can be blunted and we can be sure it's really working for the common good.
It turns out the "invisible hand" really doesn't magically do the right thing. Sometimes it picks your pocket and other times it just needs to be washed.
True capitalism would work for healthcare if it were not for some of the silly government controls, for instance, any insurace company should be able to sell policies anywhere they wish. Let's start with true capitalism in healthcare and allow true competition.
All companies do live for profit, government lives so that it can perpetuate itself, that includes giving away money for the most insane reasons.
A long time ago I remember a statistic that showed for every dollar that was spent by the government on welfare twenty eight cents got to the actual welfare recipient, I would be willing to bet that insurance companies yield far more % of money spent on actual healthcare.
I am blown away by the people who actually think that our government is going to provide efficient and cost effective product called healthcare for us when EVERY other social program has been a wasteful bust.
We're heading towards the same system that failed when Russia was the USSR, look at them now, which direction are they heading towards? Socialism or Captialism. Is China heading to or away from capitalism.
Hopefully in November the Senate and House goes to the Republicans, I always feel safer when the power is split between the Executive Branch and Congress. Maybe in December we'll get a Christmas present, a repeal of this asinine law that Obama just signed.
Chuck
Quote from: Bionic on March 24, 2010, 05:51:24 PM
The US Patent & Trademark Office has been operating at a profit. This is despite the fact that neither it, nor any other government agency or program, is designed to operate at a profit. This is where the comparison to private industry falls short.
Private companies must consistently make profits or die. They exist to make profits. Corporations may be in a particular industry, like electronics or insurance, but the only measure of their success is their profits. Corporations have a duty to do what's best for their shareholders--not their customers or their employees--and they have no other duties to anybody else, except to the extent that government regulation (what Republicans call "socialism") requires it by law.
This is why the goal of insurance companies is to collect maximum premiums while paying out as little as possible. With all the talk about how health care reform was going to kill Grandma, nothing pleases insurance companies more than when old people die as soon as possible after becoming sick. Remember the "I'm not dead yet" skit from Monty Python. The insurance company is the guy carrying the old man out to the wagon.
Government programs, on the other hand, are not driven by the profit motive. In fact, they are designed not to operate at a profit, since profit is considered a sign of poor budgeting and a waste. In recent years, the USPTO's profits have been funneled into the military.
Once again, the government isn't running anything here. Contrary to what people may hear from Fox News, this is not a government takeover of health care. It's just some new rules of the road for insurance companies and individuals. I'm not aware that there's even any new government agency or organization involved.
Bionic,
I totally agree with you, but, please read what a number of us said, this bill is a pathway to socialized medicine. All during and before the healthcare debate politicians have been saying this is only step one.
I could live with some of what is in the current bill, forcing people at the end of a huge fine is wrong, forcing states to put more money into the kitty is too much, it's an unfunded mandate that should not be there.
Bionic, I really think you have the good of all in mind, so do I, but we have different ways of doing so.
Chuck
I want to say this from the bottom of my heart, I want everyone to know what a great group we have here, we have discussed something that has torn this nation in two and nobody has gotten personal with one another on this forum.
I've always said this, we have the best group of people on this forum.
I love all you guys and girls.
Chuck
Well, even if it's in somebody's playbook to fully socialize health care, I think the experience with this bill has shown that it could only happen in the US in tiny, baby steps and with a lot of opposition along the way. I wouldn't be surprised if this bill is all the healthcare reform we get for the next decade.
It's quickly getting time to move on to climate change policy and financial reform. Obama has a long to-do list, and health care has already taken way too much time.
You may be interested to hear that treatments in the British National Health Services have to be approved for cost-effectiveness. The organisation (NICE) that does the approval has come in for a lot of criticism for being too strict, and blocking treatments that some patients would like.
Nevertheless, their recommendation for hip resurfacing is that "MoM hip resurfacing is recommended as an option for people with advanced hip disease who would otherwise receive a conventional primary total hip replacement (THR) and are likely to live longer than the device is likely to last." See http://guidance.nice.org.uk/TA44 for full details.
Hopefully, your new heathcare arrangements will take a similar line.
Quote from: Bionic on March 24, 2010, 09:09:12 PM
Once again, the government isn't running anything here. Contrary to what people may hear from Fox News, this is not a government takeover of health care. It's just some new rules of the road for insurance companies and individuals. I'm not aware that there's even any new government agency or organization involved.
Correct me if I'm wrong - but isn't Medicaid expanding to cover more people? I'm glad there isn't *more* of a "government option" but it still is expanding I think.
It's way more than just "rules of the road" - if it were just rules, there wouldn't have to be a way to pay for the program. The billions additional this will cost is going somewhere!
I agree though with your previous take - capitalism can promote greed and extravagance at others expense, and CEO’s make way to much (the corporate boards are a joke).
But, I wonder how many people would be in "the public service" if lobbyists and the corresponding money flow weren't involved.
Quote from: dw on March 25, 2010, 09:31:28 AM
Correct me if I'm wrong - but isn't Medicaid expanding to cover more people? I'm glad there isn't *more* of a "government option" but it still is expanding I think.
I'm pretty sure the push to extend Medicare to younger patients was killed. I'll try to find out.
Quote from: dw
It's way more than just "rules of the road" - if it were just rules, there wouldn't have to be a way to pay for the program. The billions additional this will cost is going somewhere!
That's where the rules for individuals come into play. Health insurance will now be mandatory for everyone who can afford it, and the expectation is that 30 million new people will be signed up. That's a boatload of new premiums flowing to the insurance companies, and that's what's expected to pay for the enhanced services.
Some people are saying it's unconstitutional to force individuals to buy health insurance. They view this new requirement as a "tax." However, there's a strong argument that this aspect of the new law is similar to helmet laws, seatbelt laws, and other laws that certainly constrain individual rights but also promote the public safety. 14 attorneys general from around the country have filed a lawsuit challenging the constitutionality of this provision. It will be interesting to see how far that gets.
I know I'm too late for this debate but I have found it fascinating. I agree with Chuck that it was pretty darn impressive that there were actually a group of Americans (& at least one Brit) who could have a honest debate on healthcare without resorting to name calling.
I have one minor contribution for those who might stumble across this thread the way I did. While I am a card carrying Republican, I did want to have an honest discussion on the facts of the issue and I found myself frustrated trying to separate the facts from the name calling on Fox and MSNBC.
I happened to come across a book on the different types of health care programs around the world, including Europe, Japan, the UK, and India. It was called, "The Healing of America," by T.R Reid. I was really surprised to read that there was no uniform health care programs in Europe, but different types of health care programs and in each country health care developed a little differently. The French health care system for instance uses a system of private doctors who charge a fee for their services and everyone is required to take out health insurance. In the UK you have everyone covered, they don't pay when they visit the doctor, and it is more in line with what Americans think of when the term "national health care" is brought up in the debates. The truth is there are a lot of choices out there and for us to have a true national debate, perhaps we might profit by looking at what other countries have done and then come up with a system that is truly an American one and fits our needs.