Steve

No. If the ACA stands, which I doubt, it will effectively create two levels of care--Obamacare for most of us and something else for the wealthy. Perfect for the party that thrives on class warfare

You have a problem with people, who can afford it, paying for a higher level of care than the minimum standard?
Just trying to understand the consistency of your stance....

I have a problem with the Government mandating one group of people having to do something, while another group does not. That is discrimination.

green

I have a problem with the Government mandating one group of people having to do something, while another group does not. That is discrimination

Okay. How does the current health care act discriminate when it says that everyone has to have health insurance OR pay a higher tax as a penalty for failing to do so?
Everyone is treated equally under the law.

By giving some (based upon income) insurance, and not giving some insurance. What would the Federal health care costs be if all of America was on it? Would it have passed the legislative body? I think not. Therefore it is discriminatory, or deceitful. Your choice.

green

What would the Federal health care costs be if all of America was on it

Depends.US Medicare generally is a more efficient system at delivering health care than private insurance because part of its fee system is negotiated, mandated lower than most fee payments. (It could be better if EVERY part was allowed to be negotiated. but you've got these rules....)
If like all other universal systems in the world, fees were negotiated with providers, then probably the system would be cheaper than what people now pay. The average procedure cost or prescribed drug or therapy in the US is much higher than anywhere else in the world.
Plus, administration costs would be much lower. Both for the 'health insurance bureaucracy and much lower for doctors and hospitals. (A huge savings for hospitals going from 14% to about 3% of expense budget) .
But that would depend upon the experience of other nations, who care not for ideology but are simply looking for the most efficient and effective method of delivering a service which is - frankly - going to be universally required at some point in everyone's life.

What is the trade off for these supposed cost reductions, and are the American Public willing to sacrifice for that?

danivon wrote: Sounds to me like the Republicans lost straight up and down votes.

Yes and no. The Republicans were completely shut out of the bill development process. There was no attempt to even consider Republican proposals. The various bills were written entirely by the Democratic chairmen of the committees they originated in (or rather by their staff). There were no amendments allowed to be attached to those bills in committee. It was a straight up or down vote on the bills proposed. No Republican bill was even considered in committee. Only Democratic drafted bills. The one exception to this was Senate Finance committee chaired by Max Baucus. He worked with 3 Republican Senators to come up with a bipartisan bill. However, when Harry Reid took the three (I think) bills reported out of the different committees and merged them into one bill, he stripped out all of the Repubican proposal. Further, I don't believe he allowed any amendments to be introduced on the original bill. (the amendments were to the reconciliation bill) Therefore, the Republicans had no say in any of the final bills

danivon wrote: I'm sure that they put forward 100 amendments, but I wonder how many were constructive, and how many were attempts to derail the bill

I think it was a mix of both. Some were attempts to get Republican proposals like litigation caps into the final law while others were meant to slow the process down. This is where the straight up down votes were lost.

danivon wrote: Indeed, the main problem was the need to keep the Blue Dogs on board enough to get something passed, and in so doing the thing became unmanageable.

And this was the problem. The Democratic Leadership saw these super majorities and thought they could do the bill without Republicans. Unfortunately, most of the leadership are hard core Liberals and a large part of the Democratic Majority came from somewhat conservative districts. Combine this with an extremely inexperience President with little political capital to spend, it because hard for the Leadership to hold the entire caucus together. Hence the wheeling and dealing.

danivon wrote: But still, I'm not seeing from you guys what the actual proposals are that the Republicans would seek to deal with the problems that were evident before the Act. Vague stuff like 'less gubmint' is all very well, but what?
Interstate competition seems to be about the best one I've seen.

Well, here is the summary of the Republican bill introduced in May 2010. Here is the actual bill.

rickyp wrote:Depends.US Medicare generally is a more efficient system at delivering health care than private insurance because part of its fee system is negotiated, mandated lower than most fee payments.

I hate to tell you this Ricky but private insurance companies negotiate fees. For example, a Doctor bills $100 for an office visit but the insurance company pays him $45. Now I know your comeback is going to be that doctor bills the patient for the other $55 but I am sorry that is not the way it works. Just about every state (and I'm 90% sure it is acutally every state) has a law that says a doctor can not bill the patient for the difference if the doctor is a participating provider.

The Federal Government mandates fees. It says take our fees or don't see our patients.

rickyp wrote:Steve

No. If the ACA stands, which I doubt, it will effectively create two levels of care--Obamacare for most of us and something else for the wealthy. Perfect for the party that thrives on class warfare

You have a problem with people, who can afford it, paying for a higher level of care than the minimum standard?
Just trying to understand the consistency of your stance....

No, I have no problem with the rich spending their money. I do have a problem with the government, essentially, putting the rest of us in the same boat. Work hard? Obamacare. Don't work? Obamacare.

It is an effort, in the long run, to get the vast majority of us, including those perfectly satisfied now, to be unsatisfied. Why? So they can fully socialize health care.

Studies show the vast majority of Americans are happy with their medical insurance. This bill attempts to turn that upside down. When it succeeds, Americans will be clamoring for single-payer. That is the objective.

archduke

I hate to tell you this Ricky but private insurance companies negotiate fees. For example, a Doctor bills $100 for an office visit but the insurance company pays him $45. Now I know your comeback is going to be that doctor bills the patient for the other $55 but I am sorry that is not the way it works. Just about every state (and I'm 90% sure it is acutally every state) has a law that says a doctor can not bill the patient for the difference if the doctor is a participating provider.

The Federal Government mandates fees. It says take our fees or don't see our patients

.

I get this Archduke. However, the results aren't very good. By that I mean that if the cost for an identical procedure to the insurer is 50% higher in the US on average than France or Canada... than all the negotiating by the Insurance companies hasn't achieved any great success in combating spiraling costs.
In fact, the fact that all the insurance companies negotiate and battle submissions from hospitals and doctors is one reason that the administrative costs in the US are so high. Hospitals need dozens of administrators to deal with all the different providers and policies, as do doctors...
When you eliminate the need to battle with all the providers you save all kinds of money. When one policy is known, 99.9% of submissions are routinely and immediately approved. (At least in Canada) which means doctors and hospitals are Not left with uncompensated work and patients aren't left holding the bag for those kinds of instances...
Now, you may think that having only one insurer, negotiating a fee schedule for all providers is an enormous intrusion on the freedoms of the doctors and other health care providers.
In fact it frees them from administrative time for medicine. It eliminates the uncertainty of payment, and it removes friction from the patient doctor relationship. (same with hospitals)

And the trains will run on time... [sarcasm intended, no need for a Godwin...]

Green

And the trains will run on time.

Always nice to talk to someone with an open mind about the experience of other nations...
The train analogy might work... The US Amtrak system representing the American health care system.
The Japanese bullet trains or Korean high speed rail representing a single payer system.

rickyp wrote:Green

And the trains will run on time.

Always nice to talk to someone with an open mind about the experience of other nations...
The train analogy might work... The US Amtrak system representing the American health care system.
The Japanese bullet trains or Korean high speed rail representing a single payer system.

Except that Amtrak is not privately funded.

Don't even get me started about high-speed rail.

By the way, Ricky makes the claim about Medicare being run efficiently?
That's a bit of a shock to me, hell, here in New York only about 80% of Physicians participate in it. and the rate is dropping ...And if you get into other specialties that rate drops significantly, hardly a good system when so few accept it?

OK, anyone else catch this...

Rickyp:

Always nice to talk to someone with an open mind about the experience of other nations...

Ricky (a Canadian) is telling us all about how we should run things and points out how well our Medicare system works. I'm still laughing about that!