Explanation: I was driving home last night listening to WWL and financial adviser, Dave Ramsey, was on. Now don't get me wrong, I think overall he's probably putting folks on the right track (debt free can't be a bad thing), but last night he started stumping against Obama's health care plan with a fervor which bordered on Glenn Beckishness. His tone had this "they don't know what they're about to do...but I do" vibe. It reeked of propaganda. I just couldn't help but wonder how much dinero he's getting for pushing that agenda to his audience who follows him religiously...literally. He mixes a little Christianity in with his show just for good measure.
It's amazing how long and pervasive the reach of insurance and pharma companies has become. They've successfully convinced the American public that public health care is not in their best interest because "it's socialist! It will kill our economy!!". This is what our society has come to...we are willing to sacrifice our own health for the idealism of "The Free Market".
A nation of Boxers.
I am a big fan of Dave when it comes to giving financial advice, but he can be a blowhard at times. I apply his own advice he gives to people, when you want to know how to run a marathon, you go to the people that have done it successfully, not the fat guy in the cubicle next to you.
When I want financial advice, I look to him and other sources, he is by no means the last say in how I spend my money, that resides with me and my wife. I did not hear his rant on healthcare, so I will neither try to defend his view or rant last night.
I will say that many people that are opposed to public healthcare is because they (and I am one of those they) agree that the government is incapable of running a healthcare plan successfully, since they have ZERO track record in doing so with other significant and not so significant programs in the past and present.
It is not the intention of healthcare for everyone that has these people in a dither or for some a rage. It is the fact that our elected representatives are not listening or at best not properly communicating how this program will work without making this country go bankrupt. The politicans have whined for years that the electorate is apathetic and not involved - well they just got their wish but now its inconvenient.
These politicians are supposed to be there voicing the majority of the constituents choice, not having an opinion and going against the peoples wishes. That is not and never has been the job of our elected representatives.
I make this recommendation, if the government can fix Military and Veterans healthcare and show that running successfully within budget and quality customer care and service, than we can look at how to push that model out to the general public. I have been in the government healthcare system and I promise you, it is worse than what we have in place right now.
Here are my questions, I would like you and E's opinion on:
Why are things like taxing healthcare benefits to help pay for this program or tort reform off the table?
Do you really believe this is a sound choice to make for the fiscal/economical state of this country at this time? If so, please explain where the money will come from and your view on how we pay for it.
Have you read the bill (in whole or parts) currently being introduced (I'm working through it)? Thoughts or ideas if you have.
Do you believe our representatives should be able to come up with one bill and be able to explain that bill effectively to get the populace on board or just vote it in to law?
Always here to liven the party, you're friendly neighborhood Sparky.
- I will say that many people that are opposed to public healthcare is because they (and I am one of those they) agree that the government is incapable of running a healthcare plan successfully, since they have ZERO track record in doing so with other significant and not so significant programs in the past and present.
You mean besides the most efficiently run program in the history of insurance known as Medicare?
Why is it "Propaganda" when they disagree with you? Can't a reasonable person object to the currently proposed health care bill? I do.
I think if you heard him you would agree. It was almost scripted. It's not a matter of disagreeing with me, its not a ego issue. You just had to hear it. As I said, I actually like Dave Ramsey on the whole, that's why I was listening to him but this was pure parroting which just soured me as I thought he was above that.
paid parroting...it was like an infomercial.
Medicare, are you serious, Medicare....bahhhhhhhhh!!!!! You have to be messing with me, sometimes your sarcasm doesn't come across.
If that was a genuine point, please post proof and not a puff piece done by CNN or MSNBC. Also, if it was so efficient than why do we need healthcare reform?
Have you seen the latest report about how much Medicare is over budget and how they have such a poor internal control system to track fraud/abuse? How can you possibly call that efficient? Do me a favor and take a trip to gao.gov and lookup Medicare.
Medicare’s administative cost are 3% as opposed to Health Insurance Industry standard of 30%. Before Medicare was established, more than 40 percent of elderly Americans lacked any kind of health insurance. Today, Medicare — which is, by the way, a “single payer” systems — covers everyone 65 and older. And surveys (Gallop, New York Times/WSJ, Pew) show that Medicare recipients are much more satisfied with their coverage than Americans with private insurance.
The program now covers 45 million Americans 65 or older, as well as younger people with permanent disabilities, among them patients afflicted with End Stage Renal Disease. About half of Medicare beneficiaries live at or below 200 percent of the federal poverty line (i.e., $20,800 annual income for a single person and $28,000 for a couple). Over a third of the beneficiaries are afflicted with three or more chronic conditions.
In 2009, Medicare is expected to cost the federal government about $480 billion. That represents over a fifth of total national health spending on personal health care, 13 percent of the federal budget and close to 3.5 percent of the country's gross domestic product. These outlays are financed with a combination of payroll taxes (41 percent), general tax revenues (39 percent), premiums paid by the elderly (12 percent) and sundry other sources, including interest earned on a trust fund established for the program.
John-Christoper, I think you were trying to justify effective, which isn't the same thing as efficient. Entities can be effective but not efficient due to fraud, waste and abuse. That is where the impact of a profit margin is the ultimate decision maker in a capital market. Since I brought up efficiency, I will stick with that discussion. In your post, you found:
In 2009, Medicare is expected to cost the federal government about $480 billion.
Now back to looking at the word efficient. Efficient is not running a program/service/business and whenever you come along a problem you throw money at it, in fact that means it was poorly managed and poorly controlled. Please see our education system and MEDICARE as two primary examples.
For example, in 1966, Medicare cost $3 billion. The House Ways and Means Committee estimated that Medicare would cost only about $12 billion by 1990 (a figure that included an allowance for inflation). This was a supposedly "conservative" estimate. But in 1990 Medicare actually cost $107 billion. Why?
Once the flood gates were open, no one planned for the increase in demand and the inevitable cost increase of hospital services. Do you really think they have learned that lesson and figured that into the new system, I doubt it. Why, you might ask, because of the difference in cost projection from the White House to the CBO (who is an impartial entity and I challenge you to justify that they are not).
I am a big proponent of doing your best the first time, not let's just see how this goes and then constantly looking for ways to improve the little things to maximize the efficiency of the process. For once, I would like to see the government run something like a business. I would have no problem if the government made a 10 - 15% profit to assist in paying down debt or deficit if they ran a successful insurance program.
- John-Christoper, I think you were trying to justify effective, which isn't the same thing as efficient.
really? come on.
- That is where the impact of a profit margin is the ultimate decision maker in a capital market
And you consider public health nothing more than a capital market? You believe that simply capitalizing health care will produce efficient, effective health care in this country? Much like say the way unfettered, unregulated capitalism produced the gloriously healthy economy we're currently experiencing. You're suggesting market forces alone, without government regulation, will resolve this country's health care needs?
Medicaid, while helping lots of people, is ultimately economically unsustainable.
If it works so efficiently, why wouldn't they just extend it to all citizens and be done?
Debate is healthy. People that have concerns about the current health bill are not all puppets of right wing christ nazi's.
I don't think the debate was wether or not Medicare was sustainable...it was wether or not our government can run a social program efficiently.
About that efficiency comment. I get what you're saying. But as someone who works in a medical setting, I see things differently. There are very smart health economists that work for Medicare/Medicaid who decide reasonable costs for each service from speech therapy to kidney transplants. Insurance companies are constantly referring to Medicare/Medicaid to figure out smart reimbursement rates. In many ways, Medicare/Medicaid has forced hospitals and clinics to scale back on costs because Medicare/Medicaid will only reimburse so much -AND they will only cut a check when services provided were accurately documented and consistent with "best practices." Fraud, waste, and abuse was much more prevalent in the medical industry before the behemoth of Medicare/Medicaid tightened their restrictions on reimbursement criteria. Insurance companies took note and adopted the same criteria for themselves. As far as insurance companies are concerned, Medicare/Medicaid is the paragon of efficiency.
Now to address the costs of these programs from the 1966 estimates. The quality of healthcare is a lot better than it was in 1966. So those estimates didn't take into account the unforeseeable advances in medical research and how improvements to healthcare access would extend our life spans. Conditions considered fatal back in 1966 are now considered treatable.
That said, there health care reform absolutely needs include controlling costs. Even with Medicare/Medicaid reimbursing the bare minimum, fee for service tends to incentivize (yeah, that's not a real word) more and more services.
Nevertheless, my point is that the guvmint actually tends to run a pretty tight ship when it comes to providing healthcare through Medicare/Medicaid. I have to counter all the dogging I hear because the for-profit insurance companies largely pale in comparison.
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