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Topic Proposed Health Care for Seniors - how can it affect those with PD? Go to previous topic Go to next topic Go to higher level

By dkleinert On 2009.07.14 10:39
I have received several emails in the last week with different takes on the new proposed health care bill which is before Congress. I have heard that those over 59 will just have to "accept" the frailities of "old age" and will be denied treatment for things like bypass surgery, stints, heart catheterization, on and on. What about those with PD? Will they be denied drug coverage and other needs, nursing home care? Today my husband Joe will be having an MRI to check his prostate for issues arising from the botched procedure that occurred last Fall. Will this type of procedure still be available to him? Will all of our collective Medicare benefits and, in our case, United Health Care, benefits be greatly reduced? We already pay a large premium for the United Health Care supplemental coverage....... Last year we spent over $10,000 on co-pays and premiums alone.....I don't have the resources to pay even that much this year.....I would really appreciate your input and thoughts on this subject that affects all of us.

By annwood On 2009.07.14 11:07
I have studied this issue for some time and have come to the conclusion that we will not benefit from the new health care legislation. Although they are not saying it, there will be a cost annalysis on each disease and the benefits of proposed treatment (will the disease be cured by the treatment or just delayed = more cost). There is much concern about the aging population so I personally don't believe there will be an effort to prolong life for this group. I realize that many people don't have health care but many of these do have new cars and are taking vacations. It is a matter of priorities. I want to be able to select my own physicians and treatments instead of depending upon the government to do it for me. Right now I am paying to cover the people who do not have health care (taxes) and with the new legislation I will still be paying for it but I will have lost many of my benefits. I have read the Constitution and fail to see where our Founding Fathers declared that health care was a right. This is not a popular opinion - Just my opinion.

By caregivermary On 2009.07.14 11:38
This is from AARP-hopefully it is helpful. I believe it is too early to declare who will and will not benefit from the current admin's Health Care Plan. It is my hope that we all will.

AARP Answers Your Questions
Health Care and the Stimulus Plan
Source: AARP | February 18, 2009

I’ve heard the economic package will ration health care for older people. Why would AARP support that?

We don’t. AARP would fight—with the strength of our 40 million members—any attempt to prevent a doctor or hospital from giving the best possible care to their patients.

Opponents of health reform are distorting the truth on something called “comparative effectiveness research.” That is a long name for a simple thing: researching two or more treatments and giving that information to you and your doctor so you can decide which option will keep you healthier.

Right now, this research is done all the time—both by government agencies and by the private sector (like pharmaceutical companies and health plans). All the legislation would do is to provide additional funding for more independent research.

No part of this bill will prevent your doctor from prescribing the treatments that are most appropriate for you. In fact, the legislation makes clear that this research will not mandate any coverage policies for any private or public payer [see Section 804(g)]. The legislative language specifically says: “Nothing in this section shall be constructed to permit [the government] to mandate coverage, reimbursement, or other policies for any public or private payer” [see Section 804(g)(1)].

Isn’t this bill going to create socialized medicine?

Absolutely not. Nothing in the economic recovery bill will take away your doctor or your health coverage or create a system of socialized medicine. Opponents of health reform are trying to distort the information by combining two separate issues—creating a better health information technology (IT) system, and funding independent research on health care options.

The legislation contains strong provisions to protect the privacy of your medical records, ensure that they are only used for legitimate purposes, and increase penalties for misuse of your sensitive personal health information.

In fact, the bill specifically prohibits the government from mandating any coverage decisions based on this research, or issuing guidelines that would suggest how to interpret the results [see Section 804(g)]. Instead, the package will help your doctors get up-to-the-minute information on your health—whether you’re seeing a new doctor at home or wind up in the hospital while traveling. And it’s going to fund more medical research so that you and your doctor always have information about the best treatments available.

Why didn’t Congress debate the bill openly and in the public eye?

Both comparative effectiveness research and health IT have been around for years, if not decades, and they were in the economic recovery package from the beginning. They’ve been debated in congressional committee hearings and on the floors of Congress.

And the research that this bill funds has been going on for years at agencies such as the National Institutes of Health, the Agency for Healthcare Research and Quality, the VA program, as well as at private entities, like some health plans. All the legislation does is to provide more funding for research that’s been going on for years.

These aren’t partisan issues, either. They have enjoyed support from both Republicans and Democrats, as well as consumer advocates like AARP. Republicans such as former Senate Majority Leader Bill Frist (R-Tenn.)—a medical doctor—have supported comparative effectiveness research (CER). Democrats such as former Congressman Tom Allen (D-Maine) and former Senator Hillary Rodham Clinton (D-N.Y.) have also supported CER. The nonpartisan, independent Medicare Payment Advisory Commission (MedPAC) and the Institute of Medicine have also called for more comparative effectiveness research.

How are these programs going to stimulate the economy?

The economic package is supposed to create jobs, help out people who are getting squeezed by the economy, and lay the foundation for future economic growth. The health provisions, including both health IT and health research, will help accomplish all three. This package will create jobs and give a needed boost to our broken health care system. Fixing our health care system is critical to getting our economy back on track.

Why does my doctor oppose this bill?

Many doctors groups, including the American College of Physicians, support these provisions because they will help doctors keep patients healthier. Health IT will make it easier to prevent mistakes like drug interactions that could make you sicker instead of healthier. And getting more objective medical research will help your doctor choose the treatment that’s best for you.

AARP agrees with some concerned doctors that every piece of research will not necessarily apply to every patient. We will fight—with the strength of our 40 million members—any attempt to prevent a doctor or hospital from giving the best possible care to their patients.

Will the new bill prevent me from getting experimental treatments?

Absolutely not. This bill does not affect the availability of any type of treatment. You and your doctors will still be able to choose the treatments that are best for you. And this bill will fund more medical research so that we can all get the best treatments available.

Does the health IT provision put all of my information into a government file?

The legislation contains strong provisions to protect the privacy of your medical records, ensure that they are only used for legitimate purposes, and increase penalties for misuse of your sensitive personal health information.

In fact, the bill specifically prohibits the government from mandating any coverage decisions based on this research, or issuing guidelines that would suggest how to interpret the results [see Section 804(g)].

With the switch to electronic medical records, how can I be sure my personal information is safe?

One of the biggest concerns about having doctors move their records from paper onto computers is making sure that the privacy of their patients is safe. That is one of the biggest reasons for the health IT provisions in this economic recovery package—to establish protections that keep medical records confidential to patients and their health providers.

AARP and other leading consumer advocacy groups are working with Congress to make sure these protections best work for individuals and their doctors. It’s taken a long time, but everyone agrees this legislation will give our doctors the information they need while protecting your privacy.

Were these policy ideas created by former Sen. Tom Daschle?

However people feel about Sen. Daschle, these issues have been around for much longer than his book.

Both comparative effectiveness research and health IT have been around for years, if not decades, and they were in the economic recovery package from the beginning. They’ve been debated in congressional committee hearings and on the floors of Congress.

And the research that this bill funds has been going on for years at agencies such as the National Institutes of Health, the Agency for Healthcare Research and Quality, the VA program, as well as at private entities, like some health plans. All the legislation does is to provide more funding for research that’s been going on for years.

These aren’t partisan issues, either. They have enjoyed support from both Republicans and Democrats, as well as consumer advocates like AARP. Republicans such as former Senate Majority Leader Bill Frist of Tennessee—a medical doctor—have supported comparative effectiveness research. Democrats such as former Rep. Tom Allen of Maine and former Sen. Hillary Rodham Clinton of New York have also supported CER. The nonpartisan, independent Medicare Payment Advisory Commission (MedPAC) and the Institute of Medicine have also called for

By dkleinert On 2009.07.14 11:45
Annwood: Thanks for your educated input. I agree with you 100%. I have a friend who is from Canada. When it was determined that her Father had Prostate cancer, it took him another 7 months to see an oncologist, and when that appointment happened they had to meet with 4 other doctors to give their opinion as to his "treatment", and what the "panel" determined was to basically let him die. She was outraged but there was nothing that they could do within their health care system. He was even denied the pain relief that patients in the USA now can have. It was so awful that she and her husband decided to move to the US so they could have health care for their is really a ver scary thought. Does anyone see that there is anything we can do to stop this ludicrous health care proposition from becoming a reality??? Do you think there will be any kind of revolt in the US if it does become "law"?

By dkleinert On 2009.07.14 11:51
One more thing I want to mention - my friend from Canada says that what is being proposed for the US is exactly the way the health care system started in Canada, and what they found was the Canadian government could not handle the cost, and so they began chipping away at what was "allowed" until it is what is is today. She and her family are looking for somewhere else to live than the US. Fortunately for them, her husband's job can be done anywhere in the world.

By dkleinert On 2009.07.14 11:53
caregivermary : Thank you so much for this information from AARP - I had not seen this. It is very interesting. I hope they are indeed advocates for all of us, as they sound in the Q & A. Maybe their voice will be loud enough to make a difference.

By caregivermary On 2009.07.14 12:13

where have you found " the plan" specifics? there are so many hypotheticals going around that I don't believe we know yet whether there is something to stop. I do believe change in the current system is long overdue.

By WitsEnd On 2009.07.14 13:49
Personally, this is just my opinion, but usually there's no such thing as "straight forward legislation" about anything. If they tried to pass a law that simply said "12 noon means the same thing as 12 pm"--by the time they were finished--the law they actually wound up passing would be so convoluted most people wouldn't even understand it. On top of that, another couple of billion dollars of pork would have been tacked on to do exciting things for the economy such as protect wooden toy arrow makers.

I do personally think there's some truth to the socialism concerns. GM could have filed bankruptcy like the airlines and other companies had. It wouldn't have been the end of the world--yet we now have Government Motors. It's a slippery slope. No one is going to drop in and say "bam" health care is socialized. It will happen one step at a time until before you know it we are there.

Personally I think we need to start with overhauling the government. If we cut down on some of the wasteful crap they do there's no telling how much money we could find to spend on health care!

By lurkingforacure On 2009.07.14 20:55
We have very close friends in Canada who now live here. They have nothing good to say about the health care system, and we have heard a lot about it. They have no plans to move back, because their taxes were too high.

I also have a very good friend who used to be the COO of a huge hospital in my town. She told me, and she should know, that what we will end up with under the proposed system is two systems: one for those who cannot afford to pay privately, and who will have to go to whoever they can for whatever treatment is allowed under the national program, and another for those who can afford to go private. Personally, I'm with annwood and don't see how in the world government taking this on is a good thing. Additionally, all of the promises about "privacy" are no assurance whatsoever, with some federal computers being hacked into just last week, and all of the pressures to gain access to very private and personal health information. I'm not so sure that I trust the government not to use that health information to its advantage somehow. Who wants to worry about their great-grandchildren being somehow "marked" because their great-grandaddy had PD or cancer?

Something noone has mentioned is the staggering cost of this "health reform" (and no one is being honest about how much it will really cost), and how it is going to be paid for. I'm all for reform, but everyone except our politicians seem to understand that you can't put two pennies into the pot and take three out. What happens when there are more people getting benefits than there are working to pay for those benefits? We are not too far away from that situation right now, particularly in this economy. I have read that medicare/medicaide liabilities will be unfunded by 2017, give or take a year or two depending on which report you read. I don't see that the current proposal takes care of this problem at all, unless they are planning on not providing adequate and full-choice care to the boomers (and that seems pretty likely, unfortunately)....and I have a huge problem with that.

By annwood On 2009.07.14 20:56
I would ask all of you to study the Canadian system and what patients have to go through to get treatment. That is what we will have if this passes. I don't think AARP will be able to alter this and the comments they have posted are right from the legislation proponents' handbook. Like all socialism - it sounds lofty and good but it reduces everyone to mediocore standards. Yes, your physician will be able to write an order for anything you need but by the time it is approved it may be too late for you. There will be so many hoops to jump through and delays in services that many people will be lost along the way.

By dkleinert On 2009.07.14 21:14
Unfortunately, annwood and lurkingforacure, both of you are echoing what so many of our nation are not seeing - socializism of healthcare is not a good thing. 2017 is not very far off, and I know if today we did not have Medicare, my husband would be going without treatment and the drugs he needs. What a sad and scary thing to look forward to. And yes - as I said - my Canadian friend, as did yours (lurkingforacure) had only really bad things to say about the Canadian healthcare system and its problems. Now to hear it from a former COO of a hospital, it only adds fuel to the simmering fire..... England has the same problems with their system as Canada. There are many reports in the news online to read about the autrocities that are happening in their socialized "heathcare" system. Thanks for the great, honest comments by all of you.

By caregivermary On 2009.07.14 22:01
I think many in our nation believe changes need to be made to our current system. As one said by 2017 Medicare, Medicaid will not have any funds.(??) Everyone needs health care whether they can pay for it or not and especially if they have a disease like PD. I'm not afraid of change and know from experience change is good. No one in government has been willing to take this on and fight for it but I think we do have that someone now.

I also have friends in Canada and I really don't hear the kind of stories that are often referred to by those opposed to providing health care for all people in our country. In fact, one friend(60) who lives in a very small town has brain cancer and has had no trouble getting care. I hear stories here in the US about how long it takes to get certain tests. Fortunately, many people do understand that the changes on the table now will give everyone more options and will ensure everyone is covered. I don't believe that is socializism and nor do I believe the changes will lead to socialized care. If you have health coverage today and you like it, under the plan you keep it. The focus will be staying healthy and getting better care.

By lurkingforacure On 2009.07.15 09:22
I gotta post to explain something I wrote here...someone posted the following after I posted:

"As one said by 2017 Medicare, Medicaid will not have any funds.(??) Everyone needs health care whether they can pay for it or not and especially if they have a disease like PD...."

This means that at some point, Medicare and Medicaide will run out of money. Those programs are funded by tax dollars. This means that there will be more claims for reimbursement than there are tax dollars to pay for them. In reality, this really means that there will be more people pulling off the system than there are putting into it. Even now, we have MILLIONS of people in this country, some legal, many not, getting all kinds of government benefits (food stamps, medicaide, etc.) who have NEVER paid a DIME of tax. I know, my mom worked in that sector and the stories are shocking. I think everyone can see that such a system is simply not sustainable. Making MORE benefits available to even MORE people, regardless of whether they ever worked to pay into that system, in my opinion, is only going to dilute the quality and timeliness of care and bankrupt not only our government but our working population and its descendants. It will also bloat our government beyond recognition.

The other reality: who can live with an effective 70% tax? If you start adding up all the taxes we pay, we are not that far off....gas tax, sales tax (8.25 in my state), property tax (another 6K a year for our little house), food tax (yes, food is taxed, check your receipt next time you buy a box of cereal)...these are all necessities we have to have to live. I'm not even talking about the "luxury" taxes one can avoid, like liquor tax, cigarette tax, yatch tax (ha!), cell phone ring tone tax (yes, Obama is considering that one if you can believe), etc. High taxes are why our Canadian friends left their country and moved here. There are already reports of businessmen fleeing California and New York because of the taxes there...what happens when even more employers/wealthy citizens leave the US and our tax base shrinks even more? The taxes gotta come from somewhere to fund this program that no one will mention the price tag of. I didn't know until recently that the top 5% of income tax filers pay something like 40% of the taxes...if you do the math and even a few of those filers leave the US, we are in deep doo-doo, regardless of whether we have national healthcare or not. And just yesterday I read that Congress is going to have a "surtax" of over 5% on people making over a million a year, boy, that is going to really encourage those folks to stay US residents, huh? Byb-bye, celebrities, CEO's, etc., and farewell to all those lovely tax dollars.

Yes, everyone needs health care, and actually, everyone also needs food. But just because someone needs something, that doesn't mean everyone else has to pay for it. As annwood said, nothing in our Constitution guarantees healthcare (or food), only the rights to pursue those for ourselves.

Perhaps "Little Red Hen" should be required reading for all politicians. If you remember, it's the story of the little red hen who busted her butt planting wheat, tending it, harvesting it, grinding it into flour, baking it into bread, all the while asking her little chicks if they would help her....not one would. At the end, she asked who would help her eat it, and everyone of them lined up to get "their share" of the bread they had no part in making. She ate it herself, the moral of the story being obvious. And little red hen didnt' even have a Constitiution like we do!

By caregivermary On 2009.07.15 10:17
I posted regarding your 2017 comment and yes I understand the issue completely.

Again, changes in this system must take place or as you said quality, timeliness of care will be deluted and financial impact for the gov is a possibility.

However, to stand by now, as we have done in the past is not the answer.

I am also completely aware of the taxes I pay and have been for a long time. We have lived in 4 different states including Ca. Business people have been fleeing Ca. and others entering Ca. for the last 30 yrs. I've heard this story too many times and it doesn't hold up anymore. My experience with the health care system goes back a long way and my business experience(mostly in Ca.) is extensive also.

I think we just disagree on this issue which is ok. It will be very interesting to see how this all ends up. My vote was and continues to be for change. We can't keep doing the same thing that hasn't worked. I believe we are all in this together and that means helping my neighbor.

the lone ranger

By number1daughter On 2009.07.15 12:54
Well said Lurking, I totally agree with you and Annwood on this issue.

By Newcaregiver On 2009.07.15 14:56
I agree with caregivermary. I just talked with an economist who says the proposed plan, as she reads it looks to be pretty good. Our current healthcare in the U.S. is broken and is going to have to be changed. Change is scary for everyone. Whether change is good or bad, we all seem to fear it. Add to that the emphasis on partisanship in politics. People receive misinformation that is based on partisanship fears and that creates more panic. I say we relax and watch what happens. So much will still be changed no matter how we think. Hopefully, the changes will be for the good!

By WitsEnd On 2009.07.15 17:31
The local radio station this morning said that the democrats had launched their health care reform bill which includes 1) mandated health care coverage for everyone including a government sponsored plan if needed 2) a trillion dollar price tag (with a "T") and a 3) surcharge on the "wealthy" to pay for the plan.

My vote is with Annwood and Lurking and Daughter.

The Chinese practically own us because they already hold a big chunk of our trillion dollars of debt which we don't know how to pay back--and now congress put another trillion dollar spend program out there?

Exactly how long do politicians think a small percentage of "wealthy" people can pay for trillions of dollars for an entire country before "wealthy" gets redefined to include a larger percentage of people--including hard working already over taxed folks. It's easy for politicians to say--spend, spend and somebody else--those "wealthy people" over there--are going to pay the tab. If you want to know who is really going to pay the multi trillion dollar tab--look in the mirror. Frankly, the true "wealthy" don't have to keep their assets or income in the US. These folks can take their money and move to Mexico or other countries where the effective tax rate is less. They have options.

As for Medicare--the government committed to that years ago. I've paid taxes for years specifically for Medicare--not to mention all of my other income taxes. Let them cut out the pork in the budget and figure out a way to fund what they have already committed to with the taxes they already get rather than coming up with a new black hole program.

I don't get to ask my employer to give me more money because I want to spend more. I don't get the privilege of telling my employer "I know I committed to work today--but I'd rather spend my time on other things" either. Why does the government get a free ride instead of us all holding them accountable? I believe they are the ones who are really trying to scare people by saying "Medicare is at risk" when in reality they've gotten more tax dollars than most people can even imagine and they chose to spend it on things other than Medicare.

Let's see. Who was it that decided that it was more important to spend our tax dollars on a tunnel for turtles under a road in Florida than on Medicare? That was part of last year's economic stimulus package that was supposed to create jobs and boost the economy. Maybe they should have called that the Turtle Transportation Act....oh but then, taxpayers might have objected to that if they knew how their tax dollars were really being spent. They might have wanted their money spent on something really dumb like Medicare.

By colettem On 2009.07.15 22:19
Here's a link to a summary of the bill.

It's worth reading through so that we know exactly what we're talking about.

I think it's a good bill, a good place to start. But that's because I think that the system really needs improvement. In my mind, to do nothing has far greater (and worse) consequences - both economic and healthwise. So I'm with the Lone Ranger on this one.

By Newcaregiver On 2009.07.16 08:41
Colletum: you are not the Lone Ranger - or if you are, I am Tonto. I agree. We need to fix this!

By WitsEnd On 2009.07.16 10:51
There's actually three bills/proposals--one in the House and two in the Senate. According to the Wall Street Journal today, here's the "Key Elements" of the proposals:

House: Require individuals to have insurance or be taxed 2.5% of adjusted gross income less the cost of the average premium for a basic plan. Require employers to offer coverage or pay up to 8% of payroll as a penalty (some small businesses exempt). Provide premium and cost sharing credits to those with incomes up to 400% of the federal poverty level (about $88,000 for a family of four). Surtaxes ranging from 1% to 5.4% on household incomes of $350,000 or more.

Senate Health Committee: Require individuals to have insurance or pay penalties of about $750 annually. Require employers to offer coverage or pay $750 to each employee who is not offered coverage (employers with 25 or fewer employees exempt). Provide premium credits to those with incomes up to 400% of the federal poverty level (excludes those with access to existing coverage). Tax increases not included in bill.

Senate Finance Committee: Likely to require all individuals to have insurance or be taxed a percentage of the premium for the lowest cost option available through the Health Insurance Exchange. Considering requiring employers to offer or help pay for coverage (except small employers). Considering refundable tax credits to purchase insurance for those with low to middle incomes. Likely to include a range of new levies including some on health care industries.

I understand the Senate is trying to agree on its final version of a bill before both the House bill and Senate bill go to committee to come up with a single version of the bill for both houses to vote on.

By lurkingforacure On 2009.07.16 16:35
I read about the surtax yesterday-effective tax rate for NYC wealthy will be 59%. And many others will see a tax increase as well-so much for his promise to not raise taxes...I think these rates are the highest our nation has had in over 30 years.

Businesses will raise prices because they will have to in order to pay for complying with this program. You may not see a direct increase in your income taxes if you are under the 350K income, but boy will everything you buy go up. I can't wait to pay ten bucks for a loaf of bread.

My husband has a small business, at least for now. I predict many small business owners will "shed" enough employees so that they qualify for the exemption, of one makes it into the final bill. What will happen to those folks?

Forcing people to have coverage, or pay a penalty, is, to me, atrocious. Is this not a free country? That is like forcing someone to eat. Why in the world would the government care if someone is covered or not, and further, what business is it of the government's in the first place? There are very legitmate reasons people may have in not wanting to be covered under some health plan, privacy being one, control over care, another huge one. This is very concerning to me and is present in all the proposed bills.

More federal freebies: cell phones for the poor, in Colorado to start with (up to 70 minutes of free talk time a MONTH and unlimited 911 calls), and now, they are considering, being able to "rent" your home if you can't make the payments, courtesy of the fed. Too bad my husband and I didn't live way beyond our means and overextend ourselves while the gettin' was good, we could be living in a million dollar house now for a hundred bucks a month under the "pick a payment" plan. And when he's no longer able to work, we can qualify for disability, food stamps, aid to families with dependent children, help with our mortgage, free phone service, and even utility help. I believe we even get free transportation (and I'm talking a bus that comes to my front door!), and actually, now that I think about it, we can even get a reduced property tax rate on our home. I can hardly wait to sit on my butt and collect all the checks. We will live better than we ever have!

I mention this because all of these programs add up! It's not just the healthcare, with its finally-released price tag of one TRILLION dollars, but the bailout, and they are talking about more bailout money for 2010. How can our loved ones receive the health care they need, and are going to need, with a system that is going to be so strapped? I don't see it, not at all.

I care about my neighbors just as much as anyone, but that doesn't mean I have to pay for their needs (or wants), particularly when it jeopardizes the needs of my loved ones, those with, and without, PD.

By susger8 On 2009.07.18 14:33
We're already paying for health care for those who don't have insurance. When people use the ER as their main source of treatment, that cost gets passed along to the rest of us. When people forgo preventative care because they can't afford it, and develop serious illnesses as a result, that cost gets passed along as well. Ignoring this problem just makes it worse. And more expensive. I don't like paying higher taxes any more than anyone else does, but I don't see an alternative.

By lurkingforacure On 2009.07.19 00:46
My understanding of the proposed health plan, now that more information is finally coming out, is this (and we all dont' agree, and that's fine, I just ask this: will all of the beauracracy established by this bill REALLY result in better care????):

The Congressional Budget Office has come out and put the price tag of the House Democrats’ health care takeover plans at $1.5 trillion over 10 years, but with this caveat:

“We have not yet estimated the administrative costs to the federal government of implementing the specified policies, nor have we accounted for all of the proposal’s likely effects on spending for other federal programs.” ...and those costs are huge.

Historically, in 1966, the Office of Management and Budget put the total taxpayer costs for Medicare at $64 million. In 2011, Medicare costs are expected to balloon to nearly $500 billion, that's some increase. Medicaid cost $770 million in 1966. By 2011, that program will cost taxpayers an estimated $264 billion, again, wowee. The Virginia-based Council for Affordable Health Insurance estimated that the administrative expenses of both programs last decade were 66% higher than those of private sector health insurance companies. How is the proposed plan better than what we have-not all change is good....some change can make things WORSE. Check out what I have read:

The new plan would call for at least 31 new federal programs, agencies, and commissions to oversee the government-run health insurance regime-beauracracy galore, with what real core health care being provided? Here are some highlights (you won't read about these in the newspaper, by the way):

The plan adds a new “Health Choices Commissioner” who would helm the new “Health Choices Administration” (Section 141 of the bill) – separate from the already existing Department of Health and Human Services, Centers for Medicare and Medicaid Services (formerly the Health Care Financing Administration), the Veterans Health Administration, and the Indian Health Service.

Also proposed is the creation of a “Public Health Investment Fund” and a “Health Insurance Exchange Trust Fund.” The latter would create a “transparent and functional marketplace for individuals and small employers to comparison shop among private and public insurers.”

No matter that state insurance departments already operate such systems. Health care must be “fixed.” The federal cure is redundancy.

The plan also creates a new “Bureau of Health Information” (not to be confused with the already existing National Center for Health Statistics) within the department of Health and Human Services. The BHI will be led by a new “Assistant Secretary for Health Information.” The new assistant secretary will coordinate with the recently-created “National Coordinator for Health Information Technology” – who is responsible for monitoring the $19.5 billion in the stimulus law to implement “a nationwide interoperable, privacy-protected health information technology infrastructure.” The federal government is so good at protecting its information that several of its own databases were recently hacked into, so this is worrisome.

The new Bureau of Health Information will house its own “Office of Civil Rights” and “Office of Minority Health.” The information czar will be required to collect health statistics in the “primary language” of ethnic minorities – and thus, the need for a new “language demonstration program” to showcase their efforts. The plan includes provisions to ensure “cultural and linguistics competence training” and establish “a youth public health program to expose and recruit high school students into public health careers.”

How does this improve core health care? Good question.

And there's more, if you can stomach it. The bill would add a new “Senior Advisor for Health Care Fraud” and require the Attorney General to appoint a “Senior Counsel for Health Care Fraud Enforcement.” There’s already a national Health Care Fraud and Abuse Control Program, but who’s counting?

To coordinate all the new bureaucrats, there would also be created a new “Health Care Program Integrity Coordinating Council” to “to coordinate strategic planning among federal agencies involved in health care integrity and oversight.” Dont' you feel good?

Not too sure why it's in there, but hell, everything else is so why not, a new “Coordinated Environmental Public Health Network” to “build upon and coordinate among existing nvironmental and health data collection systems and create state environmental public health networks.”

Also new, a “National Health Care Workforce Commission” will be “tasked with reviewing health care workforce and projected workforce needs.” New funding will be available for a “demonstration program to improve immunization coverage”, I am not too sure what that means but dislike the idea of any attempt to coerce anyone to vaccinate him/her self or their child....this smacks of intimidation and no doubt the pharmaceutical companies are loving this (which explains their unprecedented lobbying the first quarter of 2009, Merck and others spent over 6 million each in those few months, after all, Obama calls this the "Prescription for America", and if that's not a conflict of interest, I dont' know what is),

Who’ll be looking out for you? The House bill creates a “public plan ombudsman” and a “special health insurance exchange inspector general” to police spending and guard against waste, fraud, and abuse. Thank heavens, I was beginning to be worried, but with this ombudsman in place, I feel so much better.

Still think this particular plan is the way to go? This is just the tip of the iceberg, the bill is over 1,000 pages. Now, if they were offering funding for say, 500,000 more doctors to actually go out and care for folks in rural areas, or low income areas, or vouchers for necessary surgeries or treatments for folks strapped financially, I'd feel different. I don't see how this bill will really improve care at all, and in the process it will enslave our taxpayers. I guess one thing: it sure does create a lot of federal jobs, if you want to live and work in DC (I hear they have great doctors).

By caregivermary On 2009.07.19 11:20
As someone mentioned previously there are 3 bills/proposals under consideration. I believe there are probably many others. The final plan is not in cement yet.

I hestiate to do this but I want to be sure all information is available. To access this information directly go to

Otherwise, keep reading.

President Obama's Fiscal 2010 Budget
Transforming and Modernizing America’s Health Care System
One of the biggest drains on American pocketbooks is the high cost of health care. Many families are one illness or accident away from financial ruin. Health insurance costs reduce workers’ take-home pay to a degree that is both underappreciated and unnecessarily large. At the same time, health care costs are consuming a growing share of federal and state government budgets. The United States spends over $2.2 trillion on health care each year—almost $8,000 per person. That number represents approximately 16 percent of the total economy and is growing rapidly. If we do not act soon, by 2017, almost 20 percent of the economy—more than $4 trillion—will be spent on health care.

At the same time that we strive to contain costs, we cannot stand by as tens of millions of Americans lack health care coverage. An unhealthy workforce leads to an unhealthy economy, and moving to provide all Americans with health insurance is not only a moral imperative, but it is also essential to a more effective and efficient health care system.

For too long, we have recognized the problems with health care, but have not taken responsibility for them. We can no longer afford to wait. That is why the President has already begun the process of reforming health care by:

•Instituting Temporary Provisions to Make Health Care Coverage More Affordable for Americans Who Have Lost Their Jobs. As part of the Recovery Act of 2009, the Administration will provide Americans who lose their jobs or have recently lost their jobs a tax credit to keep their health insurance through COBRA. These steps are estimated by the Joint Committee on Taxation to help provide coverage for approximately seven million Americans.
•Increasing Health Care Coverage for Children. In one of his first official acts, the President signed into law the reauthorization of the Children’s Health Insurance Program (CHIP)— bipartisan legislation vetoed twice by the previous President. It provides the support, options, and incentives for States to provide coverage for an additional four million children on average in CHIP and Medicaid who are now uninsured by FY 2013. The President is committed to implementing this law quickly and aggressively to help families whose children are at risk of losing coverage in this weak economy.
•Computerizing America’s Health Records in Five Years. The current, paper-based medical records system that relies on patients’ memory and reporting of their medical history is prone to error, time-consuming, costly, and wasteful. With rigorous privacy standards in place to protect sensitive medical record, we will embark on an effort to computerize all Americans’ health records in five years. This effort will help prevent medical errors, and improve health care quality, and is a necessary step in starting to modernize the American health care system and reduce health care costs.
•Developing and Disseminating Information on Effective Medical Interventions. Medicine is changing so rapidly it is almost impossible for any individual physician to keep abreast of all the latest research studies. Without the most recent information on effective treatments, it is increasingly more difficult for a doctor to give a patient the type of individualized treatment he or she deserves. To help physicians get the information they need to provide the highest quality care for patients, the Recovery Act of 2009 devotes $1.1 billion to comparative effectiveness research—the reviews of evidence on competing medical interventions and new head-to-head trials. The information from this research will improve the performance of the U.S. health care system.
•Investing in Prevention and Wellness. Over a third of all illness is the result of poor diet, lack of exercise, and smoking. Indeed, obesity alone leads to many expensive, chronic conditions including high blood pressure, heart disease, diabetes, and even cancer. Furthermore, there are important vaccines that can prevent diseases, and screening tests that can detect cancer and other diseases at an early stage when they are more curable. Yet many Americans are not getting these effective treatments. The President has devoted in the Recovery Act an unprecedented $1 billion for prevention and wellness interventions. This will dramatically expand community-based interventions proven to reduce chronic diseases.
Transforming and Modernizing America’s Health Care System
To build on these steps, the Budget sets aside a reserve fund of more than $630 billion over 10 years that will be dedicated towards financing reforms to our health care system. The President recognizes that while a very large amount of money and a major commitment, $630 billion is not sufficient to fully fund comprehensive reform. But this is a first crucial step in that effort, and he is committed to working with the Congress to find additional resources to devote to health care reform. The Administration will explore all serious ideas that, in a fiscally responsible manner, achieve the common goals of constraining costs, expanding access, and improving quality.

To achieve these goals and finance reform, the President looks forward to working with the Congress over the coming year, and as he does, the President will adhere to the following set of eight principles:

•Guarantee Choice. The plan should provide Americans a choice of health plans and physicians. People will be allowed to keep their own doctor and their employer-based health plan.
•Make Health Coverage Affordable. The plan must reduce waste and fraud, high administrative costs, unnecessary tests and services, and other inefficiencies that drive up costs with no added health benefits.
•Protect Families’ Financial Health. The plan must reduce the growing premiums and other costs American citizens and businesses pay for health care. People must be protected from bankruptcy due to catastrophic illness.
•Invest in Prevention and Wellness. The plan must invest in public health measures proven to reduce cost drivers in our system—such as obesity, sedentary lifestyles, and smoking—as well as guarantee access to proven preventive treatments.
•Provide Portability of Coverage. People should not be locked into their job just to secure health coverage, and no American should be denied coverage because of preexisting conditions.
•Aim for Universality. The plan must put the United States on a clear path to cover all Americans.
•Improve Patient Safety and Quality Care. The plan must ensure the implementation of proven patient safety measures and provide incentives for changes in the delivery system to reduce unnecessary variability in patient care. It must support the widespread use of health information technology with rigorous privacy protections and the development of data on the effectiveness of medical interventions to improve the quality of care delivered.
•Maintain Long-Term Fiscal Sustainability. The plan must pay for itself by reducing the level of cost growth, improving productivity, and dedicating additional sources of revenue.
Financing Health Care Reform. The reserve fund is financed by a combination of rebalancing the tax code so that the wealthiest pay more as well as specific health care savings in three areas: promoting efficiency and accountability, aligning incentives towards quality and better care, and encouraging shared responsibility. Taken together, the health care savings would total $316 billion over 10 years while improving the quality and efficiency of health care, without negatively affecting the care Americans receive. These savings include:

•Reducing Medicare Overpayments to Private Insurers Through Competitive Payments.
Under current law, Medicare overpays Medicare Advantage plans by 14 percent more on average than what Medicare spends for beneficiaries enrolled in the traditional fee-for-service program. The Administration believes it’s time to stop this waste and will replace the current mechanism to establish payments with a competitive system in which payments would be based upon an average of plans’ bids submitted to Medicare. This would allow the market, not Medicare, to set the reimbursement limits, and save taxpayers more than $175 billion over 10 years, as well as reduce Part B premiums. These overpayments threaten Medicare’s finances and increase the premiums paid by participants in traditional Medicare.

•Reducing Drug Prices. Prescription drug costs are high and rising, causing too many Americans to skip doses, split pills, or not take needed medication altogether. The Administration will prevent drug companies from blocking generic drugs from consumers by prohibiting anticompetitive agreements and collusion between brand name and generic drug manufacturers intended to keep generic drugs off the market.
The Administration will accelerate access to make affordable generic biologic drugs available through the establishment of a workable regulatory, scientific, and legal pathway for generic versions of biologic drugs. In order to retain incentives for research and development for the innovation of breakthrough products, a period of exclusivity would be guaranteed for the original innovator product, which is generally consistent with the principles in the Hatch-Waxman law for traditional products.

Additionally, brand biologic manufacturers would be prohibited from reformulating existing products into new products to restart the exclusivity process, a process known as ever-greening.

Finally, the Budget will bring down the drug costs of Medicaid by increasing the Medicaid drug rebate for brand-name drugs from 15.1 percent to 22.1 percent of the Average Manufacturer Price, apply the additional rebate to new drug formulations, and allow States to collect rebates on drugs provided through Medicaid managed care organizations. All the savings would be devoted to the health care reserve fund.

•Improving Medicare and Medicaid Payment Accuracy. The Government Accountability
Office (GAO) has labeled Medicare as "high risk" due to billions of dollars lost to overpayments and fraud each year. To save Medicare and Medicaid, increase quality, and make sure Medicare and Medicaid patients get the care they deserve, we need to rein in these abuses and use this money for reform. The Centers for Medicare and Medicaid Services (CMS) will address vulnerabilities presented by Medicare and Medicaid, including Medicare Advantage and the prescription drug benefit (Part D). CMS will be able to respond more rapidly to emerging program integrity vulnerabilities across these programs through an increased capacity to identify excessive payments and new processes for identifying and correcting problems.

•Improving Care after Hospitalizations and Reduce Hospital Readmission Rates. Nearly
18 percent of hospitalization of Medicare beneficiaries resulted in the readmission of patients who had been discharged in the hospital within the last 30 days. Sometimes the readmission could not have been prevented, but many of these readmissions are avoidable. To improve this situation, hospitals will receive bundled payments that cover not just the hospitalization, but care for certain post-acute providers the 30 days of care after the hospitalization, and hospitals with high rates of readmission will be paid less if patients are re-admitted to the hospital within the same 30-day period. This combination of incentives and penalties should lead to better care after a hospital stay and result in fewer readmissions—saving roughly $26 billion of wasted money over 10 years. The money saved will also be contributed to the reserve fund for health care reform.

•Expanding the Hospital Quality Improvement Program. The health care system tends to pay for quantity of services not quality. Experts have recommended that hospitals and doctors be paid based on delivering high quality care, or what is called "pay for performance." The President’s Budget will link a portion of Medicare payments for acute in-patient hospital services to hospitals’ performance on specific quality measures. This program will improve the quality of care delivered to Medicare beneficiaries, and the higher quality will save over $12 billion over 10 years. Again, the money saved will be contributed to the Reserve Fund for health care reform.
•Reforming the Physician Payment System to Improve Quality and Efficiency. The Administration believes that the current physician payment system, while it has served to limit spending to a degree, needs to be reformed so that physicians are paid for providing high-quality care rather than simply for more procedures and exams. Thus, while the baseline reflects our best estimate of what the Congress has done in recent years, we are not suggesting that should be the future policy.
As part of health care reform, the Administration would support comprehensive, but fiscally responsible, reforms to the payment formula. The Administration believes Medicare and the country need to move toward a system in which doctors are paid for high-quality care rather than simply more care.

•Reducing Itemized Deduction Rate for Families With Incomes Over $250,000. Lowering health care costs and expanding health insurance coverage will require additional revenue. In the health reform policy discussions that have taken place over the past few years, a wide range of revenue options have been discussed—and these options are all worthy of serious discussion as the Administration works with the Congress to enact health care reform. The Administration’s Budget includes a proposal to limit the tax rate at which high-income taxpayers can take itemized deductions to 28 percent— and the initial reserve fund would be funded in part through this provision. This provision would raise $318 billion over 10 years.

By SCSally On 2009.07.19 16:13
Even though the original subject has changed into a generalized discussion, I found this thread very informative. Where do I stand? In need of more creative ideas than the current proposals are showing. I fear socialistic medicine, but yet feel we need changes to the current system. I am still of the opinion that government control of private industry never works. Health care is part of morality and I don't think it is wise to legislate morality in any case.

By trapper On 2009.07.19 22:25
I am a Canadian and am surprised at the horror stories some of you are telling about the Canadian health-care system!

It certainly isn't perfect! But, I do believe that it is a whole lot better than what our American friends have currently. In Canada we do not have the thousands of people that have to declare bankruptcy because they can't afford the medical bills that arise.

We are good friends with Americans and a majority of us feel that you have a very good Leader in President Obama. Who would have thought 50 years ago that the USA would have a black President? Hopefully, he will be able to bring about improvement in your Health Care System.

I thank God that I live in Canada because of our Health Care System. Health care should be available for the poor as well as the rich.

We hope that Michael J. Fox can be a positive force in the quest for a cure for Parkinson's Disease!

By Tara On 2009.07.20 03:26

I have refrained from commenting on this thread mainly because I think the subject is beyond the scope of this forum; moreover, it almost instantly strayed from the original question (PD? Seniors?).

But now I must respond to support a Canadian friend here (I'm in the States). My first thought at reading the Canadian horror stories here was this: Of course you're hearing bad stories from these people -- they are the ones who left Canada because they were dissatisfied. But what about the more than 33,000,000 Canadians who have STAYED? Nobody's forcing them to, so they must be happy with what they have. And since Canada is a democracy, they always have the power to change things if the majority of the people believe change is needed.

I am one of those people in the States who had to live without any medical insurance at all for three years, despite the fact that I had extensive liver disease. At one point, I was told that I would have to have a liver transplant. Basically, I was told that I would have to be at death's door, in an emergency situation, for anything to be done, and then I would be presented with a bill of about $300,000, with the cost of immunosuppressive medications (which I would have to take for the rest of my life) totaling about $20,000 per year. All paid out-of-pocket, of course. And no private insurer would accept me with that kind of preexisting condition.

Of course, there would always be the Medicaid route, wherein I would not only have to remain in poverty for the rest of my life to qualify for it, but also be crucified by those who brand anyone who is "on the dole" for being a "deadbeat".

What a hell of a life to have to live!

To all those who complain about how long it would take to see a doctor under government-run healthcare, I only say: Try not being able to EVER see ANY DOCTOR AT ALL because you can't afford the fees! Millions of people in this country are in exactly that position.

I agree with all those here who support this change. I am proud to say I voted for Obama and don't regret it for one minute.

And I'm sorry, SCSally, but I must also take this opportunity to respond to your comment about "legislating morality". The whole point of ANY law is to legislate morality, when you think about it. If you make a law that says it's illegal to kill someone, you are legislating morality. Regulating morality through regulating behavior is the whole point of any law on the books.

I feel that what's going on right now is about 20 years past due. It is high time that we put an end to people having to go bankrupt just to stay alive.

Whatever happens, I believe that an acceptable alternative to the current system will emerge, through just such discourse as is taking place here. I know that good arguments have been made here about the astronomical costs of implementing a government program, and the redundancies and irrelevant undertakings which need to be weeded out. All I am asking is that you consider the reasons why so many people believe that a change is needed. My story is only one of many. How that change takes place, and the ultimate result, is going to come from both sides of the argument being heard. And once the system is agreed upon, there will be a never-ending tweaking of it, as there should be. No one system is or ever will be perfect. But that is no excuse for not trying to come as close as we can to attaining it.

By WitsEnd On 2009.07.20 15:00
I agree about the for seniors with PD so back on point. First, I am having a hard time with the "problem statement". If you read the official propaganda, the problem is supposed to be the need to reduce health care costs. There's lots of other nice sound bites about "insurance and healthcare for everyone!"--but the government says they can't even afford to pay for Medicare and Medicaid now--so let's focus for the time being on "reducing health care costs" as "the reform goal".

Nothing being proposed is going to lead to meaningful cost reductions. Does anybody think medical claims are filed by rooms full of people handwriting claims, stuffing envelopes, licking stamps and mailing them? No, most of it is electronic and there's standardized billing codes already. So where's the huge cost savings in computerizing my medical records? Or how about the one about taxing the insurance companies and pharmaceuticals....anybody think that will increase research budgets and reduce costs?

In the end the only way to significantly reduce medical costs is to reduce the rates charged for the care or reduce how much the service is used. Medicare and insurance companies have already been trying to reduce rates by limiting the amount they pay by procedure. Some doctors even refuse to take new Medicare patients or certain insurance plans now because of it. They identified "formularies"--excluding drugs they will cover which already limits my prescription choices. Short of putting the doctors on the government payroll and socializing medicine-how else do you see the government driving market rates for medical services down?

That leaves us with reducing how much the service is used to bring down national health care costs. Statistically who uses medical services more often? You don't see too many 20 year olds sitting around complaining about Parkinson's or arthritis or heart disease or other age-related illnesses. So if they are going to reduce who uses the service.....who do you think they are going to start limiting access to health care first to reduce costs?

Free medical care for seniors (everyone)....sounds great doesn't it? Only problem is that's what Medicare was supposed to be--except seniors like I am soon to be have worked for literally decades paying Medicare taxes to cover the "premiums" on their "free" health care. Now the government wants to back out of the commitment....and hit me with higher taxes as a senior on a fixed income to cover all their other "free" health care ideas. Free health care for illegal aliens. Free health care for men and women who could work...but choose not to. Free health care for the 5 kids whose mommy and daddy chose to have more kids than they could support and provide health care for.

So this is my future with "health care reform"--now I am a senior, not in the best of health, have reduced access to medical care to cut costs, my doctors are limited because the government is telling them what they will or won't pay them, my Medicare taxes have been squandered, and I'm paying taxes for health care for others I can't afford to pay on a fixed income...... personally, I like them negotiating with the companies to insure everyone including people with pre-existing illnesses provided the person getting the insurance pays the premiums and they are reasonable. I don't think the other current health care "reform" being proposed is all that great for seniors with PD......

...and technically the federal government should NEVER have been involved in any of this because when the Constitution was set up they were supposed to defend the country and manage disputes been states.....this really is a states rights issue...not a federal one.....there's times I really miss Reagan...

By lurkingforacure On 2009.07.20 16:06
Yes, witsend, that pretty much sums it up, I think. I live in Texas and we already have, and have had for years, a risk pool for people with pre-existing conditions who are otherwise uninsurable. Why duplicate this, and other provisions already in place, at the federal level? This will be like our public school system, but administered at the federal level, and we all know what a shining example of educational excellence our public school system is. And they haven't gotten better with time.

The propaganda of reducing health care costs to me is a time when medicare/medicaide costs are set to be the highest they have ever been because of all us baby boomers, NOW is the time they think health care costs need to be reduced? Sure, they have to, our country is near broke, but what an unpersuasive argument-the only way to reduce health care costs when more people than ever are going to be getting health care is to severely limit access, choices, and quality. With more people who will be lining up for care (the boomers, the illegals, those who can't support the family they created, etc.), the only way to reduce costs is to reduce the quality and type of services that people can get.

Let me ask this: let's say the government said everyone should have food, and yes, that sounds great, and everyone does need food. But in order to actually provide everyone food, the government came in and told you, well, you were going to have chicken and potatoes tonight, but we can't afford for you to have that, so you will have to have beans and rice, so that everyone else can have beans and rice, so that everyone will have food. And the next time you go grocery shopping, there is no chicken or potatoes anymore, just beans and rice. You can't get chicken or potatoes anywhere, unless you go to another town where it is prohibitively expensive, or out of the country. Now, we can eat beans and rice, but my PDer will live longer, and better, eating chicken and rice. The current proposals take away my loved one's chicken and rice. And beans give him constipation. Who among us honestly wants to live with constipation 24/7?

By caregivermary On 2009.07.20 18:48

Hopefully, you have received some help regarding your original question. You will have options and I sincerely believe our PWPs will be taken care of.

I can't let it go...I live in Texas and unfortunately, Texas is number one in the nation for the highest number of residents who do not have health insurance and also number one for the highest number of children that are without insurance. This has been a growing issue in our state for some time.

By lurkingforacure On 2009.07.20 21:45
caregivermary, my Texas fellow resident, my data is that the uninsured in our state are overwhelmingly folks who are here illegally and/or who have never paid a dime in tax (ie, they are already on some sort of public assistance to begin with). We may as well insure folks from other countries who don't even live here and save them the trip. These proposals are going to compromise the health care of my PDer, no way around it.

By annwood On 2009.07.20 22:16
On NBC Evening News tonight there was a feature about the new health care proposal and wheelchairs. You would no longer be covered for purchasing one and would instead be allowed to rent one for 13 months. My guess would be PD pts would not get high priority because treatment is expensive and it is not curable. That has been the case in oncology for other countries with gov. ins. but I do not know about PD.

By Newcaregiver On 2009.07.21 08:31
I also heard a state governor on the news talking about how states pay a good portion of medicaid expenses and that alone will bankrupt most states within a decade. Therefore, our current system of caring for the uninsured is a scary proposition. Something must be done. Of course, there will be lots of rangling before anything is passed through the House and Senate so many things proposed will change.

By caregivermary On 2009.07.21 10:17
Texas, Arizona, Florida, and California do have a portion of the uninsured that include people who are not citizens. We all pay for the healthcare of these individuals today. In my original comment on Texas and it's number one status in the country, I did know that about a quarter of the uninsured in Texas are not citizens. That number, of course, is a moving target. However, this example is another reason why we need change and this issue should not stop Congress or the President from moving forward. Healthcare reform or whatever you want to call it has been worked on for years and now is the time to begin the reform.

There are many people using examples of possible changes that this reform will bring. I believe we were told from the very beginning that everyone will need to contribute-sacrifice something to get the country going in the right direction. It won't be easy but we have to do it.

By WitsEnd On 2009.07.21 12:09
Frankly I doubt if much actually does pass. The Republicans generally didn't support a lot of the proposals and the news is now saying that the democrats are feeling heat from the higher income folks in their party (who have threatened to cut out contributions to financial re-election campaigns if they pass higher taxes that affect them).

Many of you may have sensed I am fairly critical of some of the health care proposals. That's not to say that I don't think there are some problems that need solving. I just disagree with the way the government is trying to solve it.

For those of you who say--well what's your idea?--this is what I would do. First, I'd separate the programs out and address each one separately: Medicare, Social Security and Medicaid. Many years ago the government started taxing its citizens with specific taxes to provide social security and medicare. (Coincidentally it was during a time of economic distress not unlike what we are seeing today.) The plan was flawed in that it allowed people who never paid taxes to benefit from the program and it should have been fixed years ago with a "catch up" funding out of general taxes--it wasn't--but that's history that can't be changed.

However, the government has a moral obligation today to provide the benefits citizens were taxed for, because had that tax not existed, these same citizens would have had a higher effective income and an opportunity to save money to support them in their retirement and pay for health insurance post retirement. It is a matter of integrity and the government should prioritize standing behind its obligations here.

So the government should determine how much tax has been paid in (both by employee and employer) and make a lump sum payment on behalf of the tax paying citizens effectively repaying the taxes paid in by the taxpayer (plus compounded interest for the time the tax was held). Let's assume for instance that a person made $30,000/yr and paid taxes of 16% for 30 years and could have earned 5% interest on average during those years. That would be about $335,000 of money Uncle Sam has held for that citizen's retirement and health care post retirement.

Since some people think the taxpayers wouldn't be able to manage their own money, the government, rather than paying the lump sum directly at age 65, should buy a risk free annuity that will be owned directly by the citizen. Paying $335,000 today should buy an annuity of about $1,540 per month for 20 years assuming a 1% discount rate.

Everybody should be notified that medicare and social security taxes going forward are going to be deposited directly in personal accounts owned by the citizens that can only be accessed at age 65 when an annuity is bought. Each person can spend their annuity payments any way they want to. The government should have to fulfill this commitment regardless of what other programs have to be cut. A reduction in foreign aid and government waste could pay a lot of folks.

Once the existing commitment to the taxed citizens is fulfilled, then comes the question of what else should be paid for with tax dollars. It should be done via what they call "zero budgeting". That means a budget is zero unless something is justified. Starting from the bottom, there are no programs and there are no taxes.

Each item that is added after that is based on priority and a reasonableness check. For instance, national defense should be the next item considered. If I stood up and asked if every citizen would be willing to pay 5% of his income to ensure he's safe from attack from foreign governments or terrorists and the answer is yes--it's added to the budget. No more pork or "you scratch my back and I'll scratch yours". Anything state specific is funded by the state. That state needs to tax its own citizens.

So now we are at medicaid, national health care for those who can't afford it, etc. Where specifically are the gaps (not these universal $4 trillion in health care spend statements). Who can't afford health care and why? Now is the time for the government to get their database out and every legal US citizen with needs need to be identified and the gap to buy insurance for those individuals in the private sector be determined. The government exits medicare and medicaid and barters to determine an effective insurance premium for these people as a group and and determines specific tax to cover this.

The government should let everyone debate this and decide on what taxes EVERYONE are willing to pay--not just the "wealthy" or "businesses". If everyone (that's me--and not the other guy) is or should be willing to pay a 25% tax--fine--it's a done deal. If not, then private policy coverage for this group of people is lessened so that the insurance premium is lessened to a tax rate that most people would be willing to pay. That's a responsible democratic society in action.

Also anyone able to work--must work--no "free" healthcare. If a man and woman are able to give birth to children, they are able to work and pay their own health care premiums for the kids or work and do the equivalent community service necessary to "work off" those kids' insurance premiums with a set number of hours per week. Any able bodied parent not participating in a work program doesn't get benefits and if they fail to provide private health care for the kids....they are subject to conviction for child neglect. People who play get to pay.

This leaves the health care tax dollars open to help the handicapped, elderly, chronically ill, and others who can't work and need healthcare.

These people should also get a disability payment. This won't come through Social Security in my government--but through a tax earmarked specifically for this. Charity begins at home. Why send millions of dollars to Africa when we have people who have needs right here at home? The question gets asked again--how much am I (not somebody else) willing to pay for this? If it's 20%--fine--if not what's the number? Payments are adjusted by what people are willing top pay.

I would go to a flat tax rate for everybody and assume that rate is zero unless proven it makes sense to be higher, reduce the number of taxing entities and duplication of services (either the state or county or federal--not all three), and if someone can't say this is a tax everybody is willing to say I, ME, ME, ME not THEM or THEY is or should be willing to pay--no tax, no program, no pork. Save the tax dollars for programs that all sectors of society (rich, poor, businesses) are willing to chip in their fair share.

Anyway that's what I think I would do unless somebody gave me some facts that show this is a totally idiotic plan.

By lurkingforacure On 2009.07.21 15:46
WitsEnd, great post, IMHO. Someone posted this:

"I believe we were told from the very beginning that everyone will need to contribute-sacrifice something to get the country going in the right direction. It won't be easy but we have to do it."

(not picking on the person who posted this, btw)...and therein lies a huge part of the problem...everyone will not be sacrificing, because if they were already, we would not have the problem we do now, because way more taxes would have been paid into the system and we wouldn't be facing insolvency for medicare, medicaide, ss, etc. Maybe if we made benefits available only to US citizens (and not their family members who are not citizens) that might help...I wonder how much of the health care issue might be solved if we simply started providing benefits only to citizens right now.

Thank you, annwood, for sharing the news article. Under any plan, I believe those with incurable and/or expensive to treat illnesses will not be given any priority, if they are even allowed treatment at all. A wheelchair for only 13 months? That's pretty bad.

By annwood On 2009.07.21 18:58
I believe that in the board rooms there will be much discussion of what is called "risk vs. benefit" and who will be allowed treatment. Having been in the medical field for longer than I care to remember I am well versed in this. Triage is another term that comes into play here. Bottom line is if you can't cure someone than you reserve the funds for those that can be treated successfully. The last time I looked PD is considered progressive and incurable. In that board rtoom you will hear this and also the dollar amounts spent for "palliative" treatment. That is reducing the symptoms but not curing. It is not cost efective my friends. This will have a very low priority but most funding will go to well baby care, prenatal care, etc. You will see it manifested in long delays for procedures, testing, drug approval. Do you think they are ever going to approve $100,000.00 for DBS - I don't think so! Neuro psych evals, MRIs, new drugs, etc will be delayed for months. There will be a cap on the dollar amount for drugs to treat PD, the number of visits to the physician, and rehab equipment.

Tonight I heard on the news that 38% of the people who are unisured have the funds but elect not to carry insurance. When I was a single mom raising three children I made insurance a priority rather than a new car with $10,000.00 spinning hub caps.

By lurkingforacure On 2009.07.21 20:37
Annwood, that is too scary, but ironic, because just last night I asked my husband if he thought we should go ahead and do DBS now while it is available rather than wait and risk it not (and I know it won't if any of this passes). Freaky to think you have to make a decision like this, brain surgery for pete's sake, under pressure that it might not be available to you in the future.

Do they delay treatments and cap visits, drugs, and treatment because they are hoping these people die (my husband said this and I hate to think he's right, this is almost criminal) or some other reason (and what would that be?). This is so sad not just for us but for everyone with a terminal illness, be it Alzheimer's, cancer, whatever.

Also, I know that when I was in college and later law school, health insurance never entered my mind! In fact, it was never in my life until I went to work full-time after law school, and it was automatically provided. I was 27, and can tell you, I would not have paid for this for myself, I only had it because it came with the job. I think most people are the same, none of my friends gave health insurance a thought until we got married and started thinking about having a family. Like you said, we could all afford it, but chose not to.

By trapper On 2009.07.21 23:58
Here is the sad but true story:

By Theresa Tamkins

This year, an estimated 1.5 million Americans will declare bankruptcy. Many people may chalk up that misfortune to overspending or a lavish lifestyle, but a new study suggests that more than 60 percent of people who go bankrupt are actually capsized by medical bills.

Expert: "Medical bills ... are an issue that can very easily and in pretty short order overwhelm a lot families."

Bankruptcies due to medical bills increased by nearly 50 percent in a six-year period, from 46 percent in 2001 to 62 percent in 2007, and most of those who filed for bankruptcy were middle-class, well-educated homeowners, according to a report that will be published in the August issue of The American Journal of Medicine.

By trapper On 2009.07.22 00:21

The quote in my last post was from: CNN-Health.


By lurkingforacure On 2009.07.22 07:19
I doubt very seriously that medical bills are the only staggering debt these folks have and that it is solely medical bills that push them into bankruptcy. I have many friends who are bankruptcy lawyers and the vast, vast majority of these people have huge consumer debt (including nice houses where there has been a maid, college expenses, etc.) and the medical bills just add to the pile. I'm not minimizing medical bills, I know they can be huge, duh, my husband has PD, but I don't buy the claim that there are this many bankruptcy cases where the major (or only) debt is medical.

Even assuming this is true, however, so what? We still have the problem of care being delayed and/or denied for those with expensive, incurable illnesses. I am really sorry if someone finds themselves, through no fault of their own, with enormous medical bills they cannot pay, but that doesn't mean my loved one's care should be compromised. Hey, we are finding ourselves, through no fault of our own, with PD-where is my free ride? Oh, that's right, under national health care, it's only those with curable, cheap to treat illnesses that get the good, timely coverage, or any coverage at all.

No, thanks. I read a recent poll (it was on, I think, actually) that said only 1 in 5 polled folks thinks they/their family will be better off with national health care...despite this, the media is hyping this like it's the best thing since sliced bread. The hype sounds good until you realize the true implications for US, the caregivers, and our loved ones, and thank you, annwood, for sharing how treatment decision are made behind closed doors. We all know this, it's just so horrible to really acknowledge. I wonder how the AIDS community (not only expensive to treat and also incurable, but predominantly preventable) feels about the possibility of getting shut out of care? Oh, that's right, I think Obama already included the "partners" of federal employees who have AIDS in the federal health insurance and long term disability care program, so they are taken care of because the federal program won't be touched. Fair? Equal access? Quality care for all?

By WitsEnd On 2009.07.22 11:52
Actually, if you look at the studies on personal bankruptcies, at least half do cite medical issues as a factor--but not just the medical bills themselves. The ill individual (or their family member) loses time from work and their income is reduced. Also some become unable to work at all or lose their job because of excessive time off from work.

One 2005 Harvard study on the subject indicated a lot of these 2 million people also had their utilities shut off as well--but that doesn't mean we need to reform the entire electric industry and set up a whole new system where everybody in the US gets free electric service.

Also, not described in the studies were how many of these people chose not to buy insurance because they wanted to buy the plasma screen tv instead--and then their luck ran out healthwise--and they got hit with medical bills.

By caregivermary On 2009.07.22 15:06
With all due respect to everyone participating in this thread, if you think there are no boardroom discussion, caps, etc. right now, you are mistaken. There are and I know it. Also, the use of old stories and excuses as to why reform shouldn't happen is just a way of stalling the reform process now.

People are hurting financially for many reasons & are also hurting from lack of medical attention. Most people are good, decent, and hardworking. You will always have the people who will find a way to scam, cheat, steal, etc. from the government and others. Wheelchair scam involving Medicare went on for years, Madoff's stealing, food stamps, etc. Poor, middle class, and rich people have been known not to purchase health insurance. Some do not for legit reasons and others??

Again, we see these issues from a different perspective. We have to stop complaining that it is broken and then continue to do nothing about it.

By WitsEnd On 2009.07.22 15:56
I guess time will tell....unless you're interested in moving to one of the following states, which in any event should be watched closely:

Connecticut - on Monday their democratic controlled legislature overrode their republican governor's veto to cover uninsured residents. No plan on how to fund that except they are setting up a publically run health insurance option, it is to be in effect by 2012, is slated to cost the state $1 billion a year and sets up a board to figure out how to finance it. One of the Connecticut governor's objection was that the state's action overlaps with the federal. Connecticut did not pass a state budget.

Laura Tober, health-policy expert at the National Conference for State Legislatures advises much of the federal legislation being debated is being modeled after state experiments.

Massachusetts enacted legislation in 2006 requiring its residents to have insurance has attracted the most attention for its universal health-care program. States including Vermont and Maine also revamped aspects of their health systems. Massachusetts, per the Wall Street Journal, is "straining to finance its program".

California meanwhile is cutting $1.3 billion out of its Medi-Cal program now that banks are refusing to accept that state's IOU's.

...on another topic...Funny someone mentioned Madoff. I was telling someone just this morning that I was having a hard time distinquishing how Madoff's ponzi scheme differed from the US Government's Social Security ponzi scheme. It ain't people cheatin' the government I'm worried's the government cheating me!

By Newcaregiver On 2009.07.22 16:40
CaregiverMary: I agree with you! We are all really wanting the same thing. Affordable health coverage. We don't have it now. Hopefully, changes will be for the better. Change is always scary and political agendas (on both sides) make learning the truth of any changes difficult.

By annwood On 2009.07.22 18:44
I will isten to Obama's speech tonight and see what he is proposing.CNN reported last night that Obama's aides said it isn't a guarantee that those of us with health insurance now would be permitted to keep our policy as is.

The right to health care is not part of our Constitution. This will not be a utopia for everyone (anyone). I liked the comment about free electricity. Just where is all of this money going to come from?

By Newcaregiver On 2009.07.23 09:19
Annwood: you are so right. Just any plan won't work. Hopefully, Congress can work on all the issues and at least improve on what we have. Any plan must be thoughtfully discussed. I currently have good healthcare since I am working, but will that continue the way things are? Each year I pay more and more (and don't get much of a raise) - I hope they can find something that is a benefit to most everyone. You are right, though. There is no Utopia. On another post someone said that those in favor have no coverage and those against love their country. Well - that is making everything black and white and a gross generalization. I truly believe that most Americans just want the best for everyone and most love their country whether they are for or against.

By WitsEnd On 2009.07.23 10:48
Well what I got out of Obama last night was that we needed to cut costs and that medicare was "breaking the country." That sounds like health care rationing to me for the seniors.

Medicare was another ponzi scheme. People got taxed for it, but people who never paid those taxes got the benefits--and now the baby boomers who are last in line to get the benefits from the taxes they paid are being told "cut costs" and "you're breaking us".

Why a 13 month wheelchair rentally only? Because a young person who gets hurt in an accident can go to rehabilitation and get better and get out of the wheel chair in a year. An elderly person who can't walk due to a stroke or PD--or a permanently handicapped person--they can't get out of that chair in 13 months. The message - let's take care of the young and let those old folks buy their own because they are too expensive.

There's enough money for trillions in economic stimulus for every boondoggle someone can imagine...and for taking over government motors....but medicare, i.e., the old people, are breaking the country! As one of those soon to be old people...I object!

By annwood On 2009.07.23 10:56
My thoughts exactly, Witsend. If you study acturarial charts the baby boomers are going to break the Medicare system (I'm one of them). Not to mnetion that the government has been using Medicare funds for other programs but not putting it back. It is not economically sound to have a weighted elderly population.

What I think is going to happen - Obama promised health care reform, it won't happen, he will say I tried.

By susger8 On 2009.07.23 14:20
Sorry to sidetrack the topic a bit, but can I ask about the 13-months for the wheelchair? What I understand is that Medicare (plus supplemental insurance) pays for most or all of 13 months rental of durable medical equipment, and after that you own the item and there are no further charges. That's what happened with my dad's hospital bed -- we have just finished the 13 months, during which we paid $4 per month. It should be the same with wheelchairs.

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