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Advisor
LeadSinger
Total Posts: 544
Registered on: ‎12-07-2009

Re: Patient Protection and Affordable Care Act

One presumes too that if everyone who owned a car or house carried insurance, it too would be cheaper.  Sorry.  Those who do NOT carry insurance are often (definitely not all) the higher risks or those least able to afford it.  Add them to the pool and the claims will cause everybody's rate to jump, maybe significantly.  You can easily see this from the credit scoring of people with home & auto insurance and loan acquisition.  Those with the better scores are rewarded and vice versa.  Personally, while I can see the companies and banks points of view, I think (as far as insurance goes) that the pool changes in size (gets smaller) with each "fine tuning" that is performed and actually causes rates to rise.  At present the PCIP is essentially a government high-risk pool running until 2014 when the insurance companies will (presumably) be forced to take all comers.

Diagnosed T2 on 3/1/2007 with A1c of 13.0
Member of the 5% club for past 3 years
Trusted Contributor
morrisolder
Total Posts: 10,543
Registered on: ‎11-28-2009

Re: Patient Protection and Affordable Care Act


jgspringer wrote:

I agree with you in part...

Romney had every right to do what he did, as did the state of Tennessee with it's failed attempt at State run health care. But that is because they are State run programs, which are well within Constitutional authority.

 

I know we will disagree on this one, but I don't feel that Medicare, Medicaid and Social Security are Constitutionally justifiable either. I'm sure that is an unpopular position with many and I'm not too far from being eligible for Medicare and social security myself. I realize that those programs have helped millions of people, because they have come to depend on them, but that doesn't make them right.

 

I am a diabetic and without group coverage from an employer I am pretty much un-insurable, and that stinks.

I have not saved for retirement the way I should have been when I have made money, and now it is impossible based on my current economic situation, that stinks too.

 

However, I still don't feel that any doctor owes me medical treatment, that any drug company owes me med's, and that anyone owes me any more than what I have been forced to pay in to social security and Medicare. Even though I believe those programs to be outside the governments Constitutional authority, I have paid in, so I am owed that money back. Other than that I don't feel that anyone owes me anything.

 

It is unfortunate but if I cannot afford to go to the doctor or buy my med's, then I will get sicker and eventually will die. That is not my fault, but more than that it is not the fault or the responsibility of anyone else. If people of their own free will wish to give to charities that support people with conditions such as mine and they want to help me that is fine and good and I will greatly appreciate their help, but if not, that is a part of the cost of freedom, and I am willing to accept it and pay it, no matter how painful or unfair it may feel.


We are getting to the core here...

 

I really don't see how the federal government doing it is different from Massachusetts doing the same thing.

 

To me freedom doesn't mean just freedom of speech or religion or to vote, but also means that a civilized wealthy civilization should be organized in a way so that all people have

  • freedom to learn and get an education, freedom from hunger (hence unemployment insurance and disability),
  • freedom to earn a guaranteed pension for their old age (social security),
  • and freedom from fear (of medical issues causing bankruptcy).

I see these as kind of a birthright, well within our means as humanity to provide for all of our citizens.  I see this, that everybody be guaranteed a certain minimum,  as much more important than the

I don't feel that any doctor or other individual owes you anything, but I just feel that we as a society can arrange things so that people do not go hungry, uneducated, and without medical care.  And it seems as if our definition of  "freedom" can sometimes get in the way of actual freedom...

 

 

Morris

Diagnosed Type 2, with an A1c of 11.4 in 2003; averaging a 5.0 A1c since then with diet, exercise and Glipizide XL + meds for blood pressure and cholesterol. 
A bit dated, but scroll down on this page if you want to know more ...


Responder
SteveType2CT
Total Posts: 19
Registered on: ‎04-06-2012

Re: Patient Protection and Affordable Care Act

Having read a lot, but not all, the responses to this post, I'd like to offer my own opinion.

 

First, I agree with Lizzy - we shouldn't have a 'war' on this board over political issues.  We're all here for one thing - to discuss our disease.  That said, Lizzy is correct in pointing out that the politics of health care and the effects of controlling and managing Diabetes are cloely related.

 

Second, I do want to weigh in on this subject because I do think it's extremely important to us as diabetics, and to a greater extent, our way of life as we have known it as Americans.  I think that our core belief systems have a difficult time reconciling us to the need to do SOMETHING about the cost of healthcare, the availability of care to those who need it but can't afford it, and the absolute need of most of us to maintain both our privacy and our dignity.

 

I don't know of ONE person who will openly admit that they support Obamacare, Romneycare, or any socialized medicine bill - going back to the first real attempts at it back in the Bill Clinton administration.  This is not something that people want to openly, publicly be associated with - I guess out of fear that people will consider their opinions 'un-American'.  Actually, I can think of one - my dad.  But he's pushing 80 and doesn't care what people think.

 

I can truthfully say that I do not support socialized medicine.  Period.  But, over the years I've been an advocate for something that is equally upsetting, especially to those in the health field - and that is, government price-fixing for doctors and drug companies.  Now, I know that for the medical profession, this is anathama.  They feel that they go to school for 10+ years and get a doctorate, and feel that they should be financially rewarded for their efforts.  I can understand that, but for the same reason that I feel that Lawyers charge more than the people who need them the most can afford, I think medical care is priced out of the range of those who need it the most as well.  And we won't even talk about insurance reform, which is badly needed to ensure that insurance companies, A) accept everyone at whatever level they are able to pay, and B) stop not covering pre-existing conditions.

 

Oh, there are a lot of ideas I have that would accomplish more and be more in-line with American's core beliefs, but I'm fundamentally opposed to the government ORDERING that private citizens purchase private health insurance under the penalty of the law.  Its just wrong, and if we allow the government to do this, what's to stop the government from ORDERING citizens to do ANYTHING?  I called Romneycare when it was passed, "The Insurance Company Profit Protection Act".  And that's all Obamacare is as well.  It ensures that the insurance industry will always have an endless supply of income, provided graciously by the government in which it bribed (under the table, of course) to pass the bill in the first place.

 

That's my view on it, and I hope that nobody is offended.  We're just here to discuss diabetes.  This had to be said though.

 

Steve S.

Diagnosed Type 2 December 1996
Metformin 500 MG X2 Daily
Lisinopril 10mg x1 Daily
NPH Insulin 60mg x2 Daily
Reg Insulin 6mg one hour before meals
ADAMateo
Total Posts: 794
Topics: 183
High Fives: 163
Registered on: ‎10-30-2009

Re: Patient Protection and Affordable Care Act

[ Edited ]

SteveType2CT wrote:

I don't know of ONE person who will openly admit that they support Obamacare, Romneycare, or any socialized medicine bill - going back to the first real attempts at it back in the Bill Clinton administration.  This is not something that people want to openly, publicly be associated with - I guess out of fear that people will consider their opinions 'un-American'.  Actually, I can think of one - my dad.  But he's pushing 80 and doesn't care what people think.


Wait, really?

 

I just thought this was a peculiar paragraph in your post because I have personally talked to several hundred people myself. And I know that there are hundreds of thousands more who support PPACA.

 

I'm not saying that there aren't people who oppose it, of course. But I'm surprised that you've not talked to any who support it. There are many, many who do.

 

Cheers,


Matt Emery (ADAMateo)
Community Administrator
American Diabetes Association
www.diabetes.org

Feel free to email me (community@diabetes.org) if you have questions about the community or the variety of programs and online resources available from our Association. Please note, however, as a matter of precaution that I do not have diabetes.
lizzylou
Total Posts: 13,930
Topics: 565
High Fives: 1,989
Solutions: 142
Registered on: ‎10-31-2009

Re: Patient Protection and Affordable Care Act

I have personally talked to several hundred people myself. And I know that there are hundreds of thousands more who support PPACA.

 

Add one more to the list, I support PPACA. :smileyhappy:

 

Lizzy

Knowledge is Power!





Here's some useful links, click on the titles


Testing 101
 
 All About Carbs

Resources For The Un-insured and Discount Medicine and Equipment

LizzyLou Videos



Lizzy's Blog
for lots more  


Super Advisor
jpg391
Total Posts: 5,794
Registered on: ‎05-22-2011

Re: Patient Protection and Affordable Care Act


ADAMateo wrote:

SteveType2CT wrote:

I don't know of ONE person who will openly admit that they support Obamacare, Romneycare, or any socialized medicine bill - going back to the first real attempts at it back in the Bill Clinton administration.  This is not something that people want to openly, publicly be associated with - I guess out of fear that people will consider their opinions 'un-American'.  Actually, I can think of one - my dad.  But he's pushing 80 and doesn't care what people think.


Wait, really?

 

I just thought this was a peculiar paragraph in your post because I have personally talked to several hundred people myself. And I know that there are hundreds of thousands more who support PPACA.

 

I'm not saying that there aren't people who oppose it, of course. But I'm surprised that you've not talked to any who support it. There are many, many who do.

 

Cheers,



I personally support Obamacare. There is only one part that I do not like. I do not like the requirement that in 2014 every one will be required to buy health insurance.

James G

I'm just a guy who has had type 2 diabetes for 30+ years.

"It is common sense to take a method and try it. If it fails, admit it frankly and try another. But above all, try something." – Franklin D. Roosevelt

"When you get to the end of your rope, tie a knot and hang on." – Franklin D. Roosevelt

"I always wondered why somebody doesn't do something about that. Then I realized I was somebody." – Lily Tomlin

"Happiness is a state of mind." - Walt Disney

On 9/5/14 had amputation of my right leg, below the knee.

Latest A1C 5.6 on 6/23/14

Lipids test on 8/22/13
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Medications
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Super Advisor
Talvie
Total Posts: 3,422
Registered on: ‎10-30-2009

Re: Patient Protection and Affordable Care Act

Add me to the list, as well,.  I fully support the Patient Protection and Affordable Care Act because I've seen up close and personally how not having insurance has affected the long term health of family members.  Through no fault of his own, insurance hasn't been available to my brother, whose life will likely be considerably shortened for lack of insurance of any kind.  Another brother has COPD because of lungs damaged as a child for want of good medical care.  They could both have benefited from health care as children - good preventative care that my family could not afford -- and now suffer the consequences.  We supposedly have the best health care in the world, but what good is it if no one can afford it?

 

In response to another post:  I don't think freezing doctor's salaries makes sense as long as their liability insurance continues to soar.  How do you justify reducing their income while their costs continue to rise?  Who will become a doctor if they have to pay to practice and gain nothing?  It's not just the time spent and the expense of an education, but the ongoing costs to doctors.  If you're paying $250,000.00 a year in liability insurance, you don't want to only make $260,000.00 that year.

 


Talvie


"Life shrinks or expands in proportion to one's courage." Anais Nin
Type 2 Diabetes diagnosed December 13, 2000 w/A1c of 7.6. June 2014 A1c 5.6 Controlling with diet and exercise, and 500mg daily of metformin.
Super Advisor
ffmaya
Total Posts: 1,532
Registered on: ‎10-29-2011

Re: Patient Protection and Affordable Care Act

Add me as well.  Life is scary without insurance due to lack of funds, I am speaking from experience.  We are an industrialized country, one of the best in the world, with one of the worst attitudes toward health care for everyone.  I am not sure why "socialized or universal health care" is considered evil or devious in any way.  As I stated in an earlier post, I had socialized health care until I moved to the States in '87, I never felt that I received sub-par care, EVER, while at the same time I never had to worry about getting sick or how to pay for my medical bills.  Medical bills are the number one reason people file for bankruptcy, shameful.

 

As Talvie said, dictating Drs. charges is not going to work.  Training is a long-term commitment that is very expensive, we would have a rapid decline in Drs. in a very short time.  After paying their insurance (that is something that needs to be addressed), paying for their student loans, paying all the office costs, they want to make some money as well that reflects their time investment.

Farida

" Remember, Google is your friend"

Dx'd Type II on Halloween 2011
Current 8/20/14 - A1c 5.8
Metformin 1000 mg twice daily
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Trusted Contributor
morrisolder
Total Posts: 10,543
Registered on: ‎11-28-2009

Re: Patient Protection and Affordable Care Act

Arguing against malpractice insurance reform, Make them Accountable.com, reasonably asks


"Do we allow 98,000 deaths per year in airplane accidents in the U.S.?  No.  And the way we prevent many airplane deaths is by having strict, enforceable rules on how airplanes must be built, tested, and maintained; and by doing exhaustive studies on every accident.

 

We can only speculate about why our government doesn't hold doctors as accountable as it does the airline industry, but until we have a system in place that works, we had better allow victims of errors and outright malpractice to sue for unlimited damages.  It is the only way available to us right now of making the medical community accountable for its actions."

 

I have read the claims about medical malpractice insurance causing the rise in medical premiums, but after doing some research it really seems like that aspect has been greatly exaggerated. Rates of up to $250,000 are usually for a medical group, not for an individual doctor.

 

The rates can vary greatly from state to state and by specialty--in Minnesota, "As of 2009, the average cost for malpractice insurance for general surgeons hovered around $10,000 per year; for internal medicine, $4,000 per year; and for OB/GYNs, up to $17,000 per year." In California, "at the low end, doctors in internal medicine may only pay $6,000 per year from premium coverage. However, in 2009, OB/GYNs could end up paying more than $55,000 per year for insurance coverage. Insurance for general surgeons can cost between $22,000 per year and $34,000 per year."  Nevada and Florida are perhaps the highest rate states; "In 2009, one of the highest rates of insurance in Nevada is for OB/GYNs, who may pay between $85,000 for malpractice liability insurance per year up to $142,000 per year for a premium plan by a prominent insurance company."  Then again those obstretricans average salary, after all expenses, including insurance, was still $180,000 annually. Read more on average costs HERE


In 2009, the National Consumers Leagueconducted a study which found that "after adjusting for inflation:
  • Medical malpractice premiums are nearly the lowest they have been in 30 years.
  • Medical malpractice claims are down 45 percent since 2000.
  • Medical malpractice insurer profits are higher than the rest of the property casualty industry, which has been very profitable over the last five years.
  • In states that have substantially limited consumers’ ability to go to court for medical malpractice, the insurance premiums for doctors are basically the same as in other states."

Furthermore they reported that  "in fact, medical malpractice claims constitute one-fifth of one percent of annual health care costs in the country," leading to the conclusion that "cutting costs through medical malpractice reform is not likely to result in significant savings in health care reform legislation."

 

An earlier report showed that

  • States that have enacted so-called “tort reform” have only seen their insurance rates continue to shoot up after passing severe liability limits.
  • Most malpractice is caused by a small number of doctors who are never sanctioned. Nothing is being done to crack down on the 5 percent of doctors (1 out of 20) that are responsible for 54 percent of malpractice payouts.
  • More die in a given year as a result of medical errors than from motor vehicle accidents (43,458), breast cancer (42,297) or AIDS (16,516). (1999 figures)

 

The DesMoines Register had noted that, "between 1988 and 1998, U.S. health-care costs increased 74.4 percent while malpractice premiums increased 5.7 percent. The total premiums paid in 2000 added up to 0.56 of the nation's total health-care bill."

 

And in 2003, around the time that our former President was advocating strongly for caps on malpractice awards, and the AMA was claiming that the cost of medical insurance was limiting care to patients, a study by the General Accounting Office spent 18 of its 41 pages debunking claims that doctors in AMA-designated "crisis states" were no longer providing medical care to patients.

 

I'm not saying that Talvie or anyone else here has suggested that malpractice awards are the big driver of health care inflation--of course you didn't.  Nonetheless special interests have made precisely that argument for two reasons--to lower their expenses, and to divert attention from the bigger problems that have escalated health care costs, and that is why I have added this long post on this aspect of it.
Morris

Diagnosed Type 2, with an A1c of 11.4 in 2003; averaging a 5.0 A1c since then with diet, exercise and Glipizide XL + meds for blood pressure and cholesterol. 
A bit dated, but scroll down on this page if you want to know more ...


Super Advisor
Talvie
Total Posts: 3,422
Registered on: ‎10-30-2009

Re: Patient Protection and Affordable Care Act


morrisolder wrote:

Arguing against malpractice insurance reform, Make them Accountable.com, reasonably asks


"Do we allow 98,000 deaths per year in airplane accidents in the U.S.?  No.  And the way we prevent many airplane deaths is by having strict, enforceable rules on how airplanes must be built, tested, and maintained; and by doing exhaustive studies on every accident.

 

We can only speculate about why our government doesn't hold doctors as accountable as it does the airline industry, but until we have a system in place that works, we had better allow victims of errors and outright malpractice to sue for unlimited damages.  It is the only way available to us right now of making the medical community accountable for its actions."

 

I have read the claims about medical malpractice insurance causing the rise in medical premiums, but after doing some research it really seems like that aspect has been greatly exaggerated. Rates of up to $250,000 are usually for a medical group, not for an individual doctor.

 

The rates can vary greatly from state to state and by specialty--in Minnesota, "As of 2009, the average cost for malpractice insurance for general surgeons hovered around $10,000 per year; for internal medicine, $4,000 per year; and for OB/GYNs, up to $17,000 per year." In California, "at the low end, doctors in internal medicine may only pay $6,000 per year from premium coverage. However, in 2009, OB/GYNs could end up paying more than $55,000 per year for insurance coverage. Insurance for general surgeons can cost between $22,000 per year and $34,000 per year."  Nevada and Florida are perhaps the highest rate states; "In 2009, one of the highest rates of insurance in Nevada is for OB/GYNs, who may pay between $85,000 for malpractice liability insurance per year up to $142,000 per year for a premium plan by a prominent insurance company."  Then again those obstretricans average salary, after all expenses, including insurance, was still $180,000 annually. Read more on average costs HERE


In 2009, the National Consumers Leagueconducted a study which found that "after adjusting for inflation:
  • Medical malpractice premiums are nearly the lowest they have been in 30 years.
  • Medical malpractice claims are down 45 percent since 2000.
  • Medical malpractice insurer profits are higher than the rest of the property casualty industry, which has been very profitable over the last five years.
  • In states that have substantially limited consumers’ ability to go to court for medical malpractice, the insurance premiums for doctors are basically the same as in other states."

Furthermore they reported that  "in fact, medical malpractice claims constitute one-fifth of one percent of annual health care costs in the country," leading to the conclusion that "cutting costs through medical malpractice reform is not likely to result in significant savings in health care reform legislation."

 

An earlier report showed that

  • States that have enacted so-called “tort reform” have only seen their insurance rates continue to shoot up after passing severe liability limits.
  • Most malpractice is caused by a small number of doctors who are never sanctioned. Nothing is being done to crack down on the 5 percent of doctors (1 out of 20) that are responsible for 54 percent of malpractice payouts.
  • More die in a given year as a result of medical errors than from motor vehicle accidents (43,458), breast cancer (42,297) or AIDS (16,516). (1999 figures)

 

The DesMoines Register had noted that, "between 1988 and 1998, U.S. health-care costs increased 74.4 percent while malpractice premiums increased 5.7 percent. The total premiums paid in 2000 added up to 0.56 of the nation's total health-care bill."

 

And in 2003, around the time that our former President was advocating strongly for caps on malpractice awards, and the AMA was claiming that the cost of medical insurance was limiting care to patients, a study by the General Accounting Office spent 18 of its 41 pages debunking claims that doctors in AMA-designated "crisis states" were no longer providing medical care to patients.

 

I'm not saying that Talvie or anyone else here has suggested that malpractice awards are the big driver of health care inflation--of course you didn't.  Nonetheless special interests have made precisely that argument for two reasons--to lower their expenses, and to divert attention from the bigger problems that have escalated health care costs, and that is why I have added this long post on this aspect of it.

I hadn't even considered "tort reform" in my comments, because lives do depend on medical outcomes.  I'm just saying that as long as doctors need liability insurance, and that insurance goes up -- just like very other form of insurance -- then they can't take a "cut in pay" that would prevent them from having the incentive to become doctors, although pay shouldn't ever be the primary driver to become a physician, it is a factor in how readily some will take on the enormous costs of medical school. 


Talvie


"Life shrinks or expands in proportion to one's courage." Anais Nin
Type 2 Diabetes diagnosed December 13, 2000 w/A1c of 7.6. June 2014 A1c 5.6 Controlling with diet and exercise, and 500mg daily of metformin.