Now I remember why I was an independent all those years.

[Guest Jules]

We pay about 75% of the cost for our employees. It's a lot of money. We have about 20% still turn it down due to cost. Am I not providing?

 

Or, should we pay everyone more and more, and cover everything, to the point where we can't compete, lose all our business, and 160 people have no job at all? Let me know.

[Guest Speed Racer]

We pay about 75% of the cost for our employees. It's a lot of money. We have about 20% still turn it down due to cost. Am I not providing?

 

Or, should we pay everyone more and more, and cover everything, to the point where we can't compete, lose all our business, and 160 people have no job at all? Let me know.

 

Oh, the drama.

 

At our business, we probably have one or two fewer employees (10-20% of staff) than our ideal manageable caseload. We also have the Rolls Royce of health plans, and two employees with EXPENSIVE chronic health conditions. The pay is probably a little lower than I could find somewhere else, but the health plan is better and I can wear jeans and t-shirts and curse a lot. All told, I break even, if I'm not coming out ahead.

 

It's up to every company to decide what works best for them, and I don't think that paying the majority of a health plan is at all bad, so long as you pay your employees the prevailing wage for their job and skill level.

 

But not factoring in a health care plan for full-time employees to the cost of running a business is short-sighted and ingnorant.

[Beltmann]

Or, should we pay everyone more and more, and cover everything, to the point where we can't compete, lose all our business, and 160 people have no job at all? Let me know.

I understand this point, but what it suggests is that the current model is unsustainable--which is why real reform is so desperately needed. The rising costs of health care are stifling small businesses across the country. Reform is an economic need at least as much as a medical one.

[Edie]

I am pulling from the case that my new favorite NPR show This American Life talked about -- but the insertion of a person's employer into to one's healthcare choices is crazy.

[Guest Jules]

Oh, the drama.

Yeah, I was a little dramatic, I guess.

 

I understand this point, but what it suggests is that the current model is unsustainable--which is why real reform is so desperately needed. The rising costs of health care are stifling small businesses across the country. Reform is an economic need at least as much as a medical one.

Agreed. I do wish we could pay 100%. The double digit increases in cost every year just make it impossible.

[Guest Speed Racer]

the insertion of a person's employer into to one's healthcare choices is crazy.

 

Depends. If it's the choice between no health care and health care, then I think the employer's role is important.

 

As Beltmann rightly points out (as if that even needed to be said), the fact that employers cannot afford to provide their workers health care is telling of the state of health care costs. That doesn't make it any less of a responsibility to include health care as an expense, though.

 

Agreed. I do wish we could pay 100%. The double digit increases in cost every year just make it impossible.

 

Our Blue Cross representitive (the guy employed by Blue Cross to sell us the plan) pays several thousand more per year out of pocket than we do on HIS Blue Cross plan. Our whole office was speechless when we found that out.

[bjorn_skurj]

We pay about 75% of the cost for our employees. It's a lot of money. We have about 20% still turn it down due to cost. Am I not providing?

 

Or, should we pay everyone more and more, and cover everything, to the point where we can't compete, lose all our business, and 160 people have no job at all? Let me know.

No. Insurance companies should be eliminated and the government should pay it all (single-payer). We would all pay more in taxes, but less in net health care costs. That's how it seems to work in every other industrialized nation. We as a people may be too dumb to understand that, though.

[Sir Stewart]

I do wish we could pay 100%.

Behold the power of Beltmann.

[uncool2pillow]

Help me out here. How do the current Democratic bills, lower costs? They will extend coverage, which means covering riskier people, which drives up costs. The "public option" will supposedly increase competition, but as coverage expands, will this be all that meaningful?

 

Here are 2 ideas to lower costs: 1) tort reform, 2) ban TV and Internet advertising of prescription drugs. There was a time when prescription drugs could not be advertised on TV. They have hugely expanded the demand for their products through clever marketing.

[Beltmann]

Here are 2 ideas to lower costs: 1) tort reform

I agree that the Democrats' plan does not do enough to control costs, but tort reform is no answer. While I'm not opposed to tort reform--if we can find savings there without undermining patients' rights, let's do it--it is wrong for Republicans to focus on that as a silver bullet. Consider this: “It’s really just a distraction,” said Tom Baker, a professor at the University of Pennsylvania Law School and author of “The Medical Malpractice Myth.” “If you were to eliminate medical malpractice liability, even forgetting the negative consequences that would have for safety, accountability, and responsiveness, maybe we’d be talking about 1.5 percent of health care costs. So we’re not talking about real money. It’s small relative to the out-of-control cost of health care.”

 

And consider this, from the Congressional Budget Office: "In short, the evidence available to date does not make a strong case that restricting malpractice liability would have a significant effect, either positive or negative, on economic efficiency. Thus, choices about specific proposals may hinge more on their implications for equity--in particular, on their effects on health care providers, patients injured through malpractice, and users of the health care system in general."

[uncool2pillow]

Fair enough. The cost savings of tort reform may be minimal to non-existent. How do we control costs?

[ikol]

I agree that the Democrats' plan does not do enough to control costs, but tort reform is no answer. While I'm not opposed to tort reform--if we can find savings there without undermining patients' rights, let's do it--it is wrong for Republicans to focus on that as a silver bullet. Consider this: “It’s really just a distraction,” said Tom Baker, a professor at the University of Pennsylvania Law School and author of “The Medical Malpractice Myth.” “If you were to eliminate medical malpractice liability, even forgetting the negative consequences that would have for safety, accountability, and responsiveness, maybe we’d be talking about 1.5 percent of health care costs. So we’re not talking about real money. It’s small relative to the out-of-control cost of health care.”

 

And consider this, from the Congressional Budget Office: "In short, the evidence available to date does not make a strong case that restricting malpractice liability would have a significant effect, either positive or negative, on economic efficiency. Thus, choices about specific proposals may hinge more on their implications for equity--in particular, on their effects on health care providers, patients injured through malpractice, and users of the health care system in general."

 

I have heard this argument before, but I just cannot believe that it has such a small effect on the cost of healthcare. For one thing, it's hard to calculate the indirect costs (defensive medicine, physician shortages due to disgruntled docs retiring early, etc.). Think of how many more C-sections are done now compared to before John Edwards did his thing. If we're going to adopt a system where doctors will inevitably be paid less and have to work longer hours (which will happen with any sort of public option), we're going to have to do something about malpractice premiums. I think a good alternative to capping malpractice awards would be capping the amount that lawyers could make from malpractice cases.

[bleedorange]

Tort reform has worked down here.

[mountain bed]

Tort reform has worked down here.

Well, it sure as hell hasn't done anything for the astounding percentage of the uninsured, or the lack of physicians, or the ever-spiraling cost of premiums.

 

http://crooksandliars.com/jon-perr/gingrich-and-perry-tout-dismal-texas-health-care

[bleedorange]

Well, it sure as hell hasn't done anything for the astounding percentage of the uninsured, or the lack of physicians, or the ever-spiraling cost of premiums.

 

http://crooksandliars.com/jon-perr/gingrich-and-perry-tout-dismal-texas-health-care

 

It has led to a large influx of doctors to the state in areas that were previously underserved and the number of people with access to quality healthcare has definitely increased, and the number of doctors getting licensed in Texas has outpaced the population growth. Don't let statistics cloud the results. Texas is an expansive state with very poor regions in the south and the west. It's unfortunate that we still remain low on the list, but progress is being made. I suppose it is arguable how much tort reform has impacted that progress, but it seems silly to ignore it as a factor.

[Tweedling]

Well, it sure as hell hasn't done anything for the astounding percentage of the uninsured, or the lack of physicians, or the ever-spiraling cost of premiums.

 

http://crooksandliars.com/jon-perr/gingrich-and-perry-tout-dismal-texas-health-care

The uninsured get health care all the time at the hospitals I visit. Texas does pretty damn good considering our neighbor. And if health care gets the overhaul we all seem to be talking about then there will no longer be a shortage of doctors. Foreign doctors will be lined up to practice here. (More than they already are!)

The real reform we need is to provide HC to children. They are the ones who have no choice. Just sayin

[Guest Speed Racer]

Foreign doctors will be lined up to practice here.

 

Um...where have you been? Foreign doctors don't have a damned problem practicing in the U.S. right now.

 

As far as health care for children, I would point you toward the school lunch program kids can participate in - as far as I can tell, it does nothing to help them once they reach adulthood. Now isn't the time to keep patching things up with bandaids - what you talk about isn't reform, just more wasteful spending. This really needs to be upended.

[ikol]

As far as health care for children, I would point you toward the school lunch program kids can participate in - as far as I can tell, it does nothing to help them once they reach adulthood.

 

Supposedly, that's the purpose of the rest of the school day.

[Guest Speed Racer]

Supposedly, that's the purpose of the rest of the school day.

 

Yeah, if only those dumb poor kids would pay attention once in a while, they could be rich like me.

[ikol]

Well, at least wealthy enough to afford lunch.

[Good Old Neon]

as far as I can tell, it does nothing to help them once they reach adulthood.

 

That’s not true, my grandfather was given palatial, granite-block-sized chunks of cheese and tubs of butter so large, we’d swim in them on hot summer days, minus the butter (most of the time). Of course, when my grandfather passed, and an autopsy was performed, the doctors observed that his blood looked, smelled and, as one starved intern discovered, tasted just like Cheez Wiz.

 

At his funeral, after the hors devours were served, it was announced that cheese on the cheese and Ritz cracker combos was “donated” by our dear beloved.

 

It was pretty incredible.

[Guest Jules]

That’s not true, my grandfather was given palatial, granite-block-sized chunks of cheese and tubs of butter so large, we’d swim in them on hot summer days, minus the butter (most of the time). Of course, when my grandfather passed, and an autopsy was performed, the doctors observed that his blood looked, smelled and, as one starved intern discovered, tasted just like Cheez Wiz.

 

At his funeral, after the hors devours were served, it was announced that cheese on the cheese and Ritz cracker combos was “donated” by our dear beloved.

 

It was pretty incredible.

Don't quit your day job, GON.

[Tweedling]

Um...where have you been? Foreign doctors don't have a damned problem practicing in the U.S. right now.

 

As far as health care for children, I would point you toward the school lunch program kids can participate in - as far as I can tell, it does nothing to help them once they reach adulthood. Now isn't the time to keep patching things up with bandaids - what you talk about isn't reform, just more wasteful spending. This really needs to be upended.

I've been in a hospital almost every weekday and weekend since I graduated from High School.(15+ years) So you don't have to "um" me. I'm absolutely aware of all the foreign doctors willing to work in this great country of ours. I'm also aware of their.....ahem....skills. I'm also aware that when you take away the exceptional compensation doctors (more importantly specialty doctors) make then you will start pulling from the bottom of the barrel because your bright American students will look at other professions for their income. But don't worry about a lack of doctors....... Your foreign doctors will be lined up for a nice 80k a year to tell you they can see you in 6 months. Oh and did you know medical schools in other countries aren't up to the standards that our medical schools are? I think the old saying, "you get what you pay for" could apply for this entire issue. You're right, this should be upended.

[Good Old Neon]

Don't quit your day job, GON.

 

That’s a true story Jules.

[Guest Speed Racer]

I've been in a hospital almost every weekday and weekend since I graduated from High School.(15+ years) So you don't have to "um" me. I'm absolutely aware of all the foreign doctors willing to work in this great country of ours. I'm also aware of their.....ahem....skills. I'm also aware that when you take away the exceptional compensation doctors (more importantly specialty doctors) make then you will start pulling from the bottom of the barrel because your bright American students will look at other professions for their income. But don't worry about a lack of doctors....... Your foreign doctors will be lined up for a nice 80k a year to tell you they can see you in 6 months. Oh and did you know medical schools in other countries aren't up to the standards that our medical schools are? I think the old saying, "you get what you pay for" could apply for this entire issue. You're right, this should be upended.

 

So...

 

All foreign doctors suck.

All foreign medical schools suck?

All foreign doctors are paid less than American doctors?

 

You don't know a hell of a lot about professional immigration, do you?