QUOTE (Innocent @ Aug 7 2009, 02:31 PM)

Would that I had the power to make insurance companies act in my interest. Wouldn't that be nice. But that's not the way it works. I have a much better shot at influencing my care if I have the power to vote out the controlling authority.
How about you have the immediate power to drop a provider and hire another?
Seen what the rate of incumbents winning is? With gerrymandering your idea of voting somebody out over one particular policy disagreement is laughable. You can't get rid of the most useless bum that you disagree with all the time, much less tossing somebody out for one issue.
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Policy is set at the top. That's were it needs to change. None of us have any influence on the insurance company policy, but we can have an effect on the government, since I have a voice via voting.
To that end the real choice we get is a strategic one. Government that takes most of our disposable income and spends it as the top sees fit, or a government that leaves most of the money in our hands and expects us to do the best we can with it.
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Were it not for the Iraq war Medicare would be just fine. It's worked for generations and can continue to do so if we choose. We just have a "baby boomer hump" to get over.
Medicare and SS have structural and demographic problems, not some cash flow problem fixable by removing one discretionary expense.
Not to mention the fact that if we were on defense in the WOT and Saddam were still causing trouble and bankrolling/supporting Islamic radicals there is no telling what the geopolitical situation might be. Another 9-11 in the last 8 years and who knows what the tax receipt situation might have been for some portion of the last 8 years. You just don't know what might have transpired, and there's no way we will agree on the possibilities. The bottom line is for whatever reason there was NOT another 9-11 style attack. Something that would have cost trillions had it occured.
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Unless you just won the lottery recently, out of pocket medical expenses are prohibitively expensive. It's not realistic to expect that Grandma is going to be able to spend several hundred thousand dollars on medical care out of pocket every time she needs a procedure.
Grandma is the worst case scenario. A lot of basic stuff isn't prohibitively expensive. Those cuts, scrapes, coughs, colds, flu etc could probably be handled for a small cash charge at the local clinic by any competent nurse or GP. Which we could use more of.
Ongoing treatment for BP, arthritis, chronic pain and the like could be taken care of by the local doctor with regular appointments. A lot of the stuff that doesn't change too much and is controllable by some testing and regular prescriptions would be a LOT cheaper if we didn't require people to pay a doctor ten times what the medicine costs just to refill the same damned prescription constantly. It's insane. A fifty dollar or more office visit to refill a $4 prescription. It's the AMA keeping us away from our meds, not helping us get them.
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However, there are two sides to this equation in opposition to each other. There's the level of service provided, which you speculated about negatively yesterday, and there's the cost associated with the services provided, which you are speculating negatively about today. Pick a side. When you argue against one side of the equation you are arguing in favor of the other. If you want Grandma to have expensive medical service in the last days of her life you have to pay for it. It's certainly a good conversation to have, but at some point realism has to enter the debate. With insurance companies running the show the expectation is lower service and higher cost - since resources are diverted into profits and bonuses - when Grandma gets sick she may lose all benefits. With a government option the expectation is higher service (Grandma is safe since the service provider's job depends on satisfying constituents) but there is a higher cost.
I'm all for realism. I'm not for forcing grandma to do anything she doesn't want to. If she wants a LOT of pain med and to slip off that's fine with me. Euthanasia doesn't drive me over the edge like some folks you argue with. But those lines and wait times aren't just for the old and deeply infirmed. They hit everyone. Young folks were cruising the hospital parking lots just like the oldsters, and it was as a result of government rules from on high not working.
I'm no fan of tying medical insurance to work, just like I'm not a fan of single payer. At this point enough people are satisfied with what they have that I don't want Obamacare changing the whole system to cover a small minority, and I am part of that small minority. If anyone ought to want the intrusive plan that gives me care paid for by somebody else it ought to be me. But I'm not likely to EVER believe in single payer or it's economic equal, the command economy. It's a very basic strategic debate, that can pretty much be used to compare and contrast most any country or economic model in the world today.
It's hitting me very close to home. Day before yesterday my dad was checked back into the hospital with a recurrence of the infection in his blood that was spread when he had an infected stent. He isn't in condition to have any operation so there is pretty much nothing to be done. The dialysis cost was more than poor countries could have paid in any case, but at this point most of the decision making revolves around nursing home care and how agressively to treat him. They could do more in the hospital than the nursing home, but I don't see that it changes the outcome. In all likelyhood he never leaves the hospital, and only the doctor has much control over the cost. And this doctor isn't very communicative. It's like he's playing God, but doesn't really give a damn about the lowly humans around him.