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Health Care Reform: Granny Knows Why You Need a Public Health Care Plan: Opinion

 
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Roger Ebert, famous film reviewer and also a cancer patient, thinks we should enact universal health care because it is morally right. Bill Moyers, 75, is devoting his acclaimed Journal to examining health care reform. And I, in the shadow of giants, have spent the summer immersed in advocacy for health care reform. Ebert, Moyers, and I have one thing in common: we are all on Medicare. Our health care is assured.

There is truly a generational divide on the issue of health care reform. Those of us who, through advancing age have been forced to connect with the health care system, are agitating for reform. Is it for ourselves? No way. We are already on the public plan. We have no reason to fight. But we’re doing it because we have children and grandchildren, relatives and friends, and we are all part of America.

On my Facebook wall, people keep writing that they don’t want the government running health care, that they don’t think they need health insurance, that they can go it on their own.

All I can say is, they’ve never been ill — which is wonderful. But bound to come to an end. And it’s not until you, or a family member, are sick, that you understand why this is such an important issue.

Who understands? Veterans. Elderly people. People with disabilities and chronic conditions. People with sick children, or with HIV. People forced to contact the system.

The rest of you, Obama’s liberal children and conservatives who fear government intervention can sit out this fight, because we are going to get health care reform for you. Not so much for ourselves, because we are on, or nearly on, Medicare. We will be okay. It’s you who may suffer.

Fortunately, there are a lot of us. It’s very difficult to be a Boomer or older and be against health care reform, because you may have ten years until you can limp over the finish line to Medicare, and those will be ten years of very expensive insurance– even if you work for a large corporation. Unfortunately, the sheer demographic impact of an aging population will drive up premiums as well as costs. And during that time, you may find yourself uninsurable if things go on the way they are now. And then if you get sick, you will be bankrupt. We will be forced to use the system more as we age, because we will need those inhalers, stents, radiation treatments, mammograms, hip replacements, and glycometers.

We already know this, because we are either there, or have already been there. I spent ten years paying for my entire health care. I arrived at Medicare nearly unable to walk. Luckily, I had always taken care of myself and didn’t have any internal problems, just orthopedic decrepitude from running and lifting weights. Still, I was damned glad to get on the public plan and get my hip replacement. Could I have waited another six months if I had been in Canada? Sure. What I wanted was to be free of pain and not have to pay $50,000 for that privilege.

We are not afraid anyone will pull the plug on us. In fact, the closer we get to that time, the more we pray we can get someone to stop treating us when our conditions are hopeless and let us go quietly without pain and suffering, without toxic chemo that won’t help or surgeries that are unproven and just weaken us further.

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Theme : 6 Main Lies Have Nothing To Do With This Promising Reform.

Inaction cost, $9trillion over the next decade, can not be compared to the balance between estimate and outcome in a worst case of scenario. Time does not fix endless greed and energy depletion.

When the public health is also one of commodity like a house, we come to a tragic and unthinkable conclusion : As to for-profit business, the more and longer ill patients get, the more profits they make, and it will debilitate the overall economy involving education for the future, not to mention continued bankruptcy of middle class.

Of young adults ages 19 to 29, 13.2 million, or 29 percent, lacked coverage in 2007, and that implies the total of this promising reform will be cheaper than expected, I guess.

1. The contents of savings (below) in this reform 'have nothing to do with' limit to medical access, rationing, tax raise, and deficit etc.

Rather, without wiping out these wastes and roots of bankruptcy for middle class, all fronts are sure to face larger financial ruin than this recession, which leads to more limit to medical access, more rationing, more tax raise, and more deficit etc than today.

$1.042trillion (cost of reform) + $245bn (cost to reflect annual pay raise of docs) = $1.287bn (actual cost of reform).

$583bn (the revenue package) + $80bn (so-called doughnut hole) + $155bn (savings from hospitals) + $167bn (ending the unnecessary subsidies for insurers) + 129bn(mandate-related fine based on shared responsibility) + $277bn (ending medical fraud, a minimum of 3% , the combined Medicare and Medicaid cost of $923.5bn per year, as of July,) = $1.391trillion + the reduced cost of ER visits (Medicare covers some 40% of the total) + the tax code on the wealthiest more reduced than originally proposed = why not ? (except for a magic pill, an outcome-based payment reform & IT effects and so forth).

As lawmakers debate how to pay for an overhaul of the nation's health care system, a new report from The Commonwealth Fund claims that including both private and public insurance choices in a new insurance exchange would save the United States as much as $265 billion in administrative costs from 2010 to 2020.

"Health reform can help pay for itself, but both private and public insurance choices are critically important," said Commonwealth Fund President Karen Davis, who coauthored the new report. "A public insurance plan can help drive new efficiencies in the system that will produce large cost reductions. Without a public plan, much of those potential savings will be lost."

Unlike high fuel price and mortgage rate in recent years as the roots of great recession and bankruptcy of middle class, the severity in the high cost of health premiums has come to light lately. Similarly, in an attempt to hide these deficit-driven corruptions and wastes, the greed allies struggle to turn the savings via removing these wastes into limit to medical access, rationing, tax raise, and deficit etc.

In contrast, not to mention a wide range of consumer protection, options across state lines, this promising reform takes initiatives in more primary care docs and improved long-term care. Unnecessarily, hope should not be replaced with all forms of malign lies, fear, just like people don't have to fear quitting drug.

2. Greedy insurers with no competitors by consolidation have nothing to do with the law of price, demand & supply.

Under the free market theory and the premise that the public health is also one of commodity like a house, if the demand decreases on a large scale, accordingly the price tends to reflect it, as in the case of house price, and it never happens for the price to spiral up. One step forward, in case the price is spiraling up, to be sure, the remaining clients should withdraw the contract or choose the other options. In practice, runaway premiums with no competitors by consolidation drive the enrollees out, and 4C + 2R (canceling, capping, cherry-picking, cash for special lobby, rationing, rapid premium hike) guarantee multiple times as much profit. Sadly, no way-out other than the prohibitive ER is allowed in America. Therefore, the victims today and tomorrow deserve long overdue protection from non-profit Government.

3. The plans to stem inflation in the House have nothing to do with crowd-out.
With the heartbreaking tears in mind (In no other industrialized country do 20,000 people die each year because they can’t afford to see doctor. Nearly 11 Million Cancer Patients Without Health Insurance), private market also needs changes and should join together to complete this reform , as promised, otherwise, the runaway premium only has itself to blame while new firms are filling the void with competitive deals.
And It can be said that fair competition starts with a fair, sustainable market value.

However, the plan in the House is designed to keep people in an employer-based health insurance system, and the public option would be offered to those for whom employer-provided insurance is not available. And job-based coverage (indirect payment), some mandate code, ample capital, the reduced exorbitant ER costs, IT base to streamline the administrative processes and trim the costs might be favorable to the private market. Over time, supposedly, the public plan will concentrate more on basic, primary cares, and the private insurers will provide their clients with differentiated services. And focus should be on the uninsured, the underinsured.

-- Except For The Underinsured, The Uninsured Alone Outnumber The Entire Population In Canada --

In an attempt to avert innovation, moderation, and social responsibility, accusing essential affordability, citing take-over, will be a dirty play.

4. Profit-driven markets have nothing to do with affordable, sustainable public health.

When the public health is also one of commodity like a house, we come to a tragic and unthinkable conclusion : As to for-profit business, the more and longer ill patients get, the more profits they make, and it will debilitate the overall economy involving education for the future (Of young adults ages 19 to 29, 13.2 million, or 29 percent, lacked coverage in 2007).

Under the most wasteful structure on the planet like no coordinated preventive care program waiting until people get ill, about 50% of idle world's best practices, a pay for each and every service reimbursement and frequent readmissions, no e-medical record and deaths, crushing litigations and the more profits via the unnecessary, risk-carrying procedures, and the most inefficient paper billing systems imaginable, overpriced pharmaceuticals, bloated insurance companies, incredible medial fraud, exorbitant costs by the tragic ER visits etc, it might be no wonder with the comprehensive, systematic reform in the pipeline, just one attitude of patient-oriented value in 10 regions has attained 16% of savings in Medicare while their quality scores are well above average.

Aside from the already allocated $583 billion and the savings of this reform package, 16% of $923.5bn (the combined Medicare and Medicaid cost per year, as of July) is around $147.76bn per year and 1.4776trillion over the next decade, and this patient-oriented value alone could be enough to meet the goal.

Please be 'sure' to visit http://www.nytimes.com/2009/08/13/opinion/13gawande.html?hp for credible evidences !

Today, another innovative, fundamental change in payment system, or patient's outcome based payment reform that is able to turn the profit-oriented malpractices and volume into the patient-oriented value and quality is waiting for a final decision.

5. Inflation-driven greedy allies backed by the insurers have nothing to do with deficit-neutral.

When some part of our body is ailing seriously, we are going to lose competitiveness, equally, when some part of a nation is ailing servery, it is going to loose competitiveness, too. In case somebody in the house gets ill, health will be put over house, in practice.

6. The analyses of CBO have nothing to do with common sense and practice.

Costs of Preventable Chronic Disease account for around 75% of the nation’s $2.4 trillion medical care costs. U.S. health care spending is also expected to double in the next 10 years. and they are largely preventable -- 80 percent of the risk factors are behavior-related.

Unlike the analyses of CBO, world-wide outstanding public programs put heavier emphasis on preventive program equally, and preventable swine flu pandemic is expected to cost about $2trillion dollars world-wide for the lack of prepared vaccines. (Genes included in the new swine flu have been circulating undetected in pigs for at least a decade, according to a team led by Rebecca Garten of the federal Centers for Disease Control and Prevention who have sequenced the genomes of more than 50 samples of the virus).

If CBO asks the profit-driven interests about why they have hindered the budget request for preventive program in Medicare and Medicaid, they will say, " just look at the health Catrina special lobbying has made, the more and longer ill, the more profits, we are professional, and we are obstructing this reform right now, too " .

7. Conclusion : The public health is a fundamental human right.

As I said above, patient-oriented value alone could be enough to meet the goal, and another innovative, fundamental change in payment system, or patient's outcome based payment reform that is able to turn the profit-oriented malpractices and volume into the patient-oriented value and quality is waiting for a final decision.

If At least, some media pay attention to this flower of reform, people will feel empty as the past and current discussion has been time-consuming for sure.

Thank You !

August 26, 2009 - 1:13pm
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