Rethuglican Congresswoman: "There are no Americans who don't have healthcare"

[ready4ONE 5,400]

Hint for where not to look: republicantalkingpoints.com

[rebeccajo 14]

If there are millions without health care, where will all the additional medical personnel come from to treat those individuals?

Very very good questions. Certainly not going to come from those with liberal arts degrees.

Australia: 2.5 physicians / 1000

USA: 2.3 physicians / 1000

Canada: 2.1 physicians / 1000

I don't see the problem with the medical personnel.

Dude he has a point. If 50+ million people are to be covered, we are going to need doctors to treat them. Considering a medical degree costs about 1 zillion dollars, people are going to have to wait weeks for doctors.

According to americanprogress.org, there are about 150 uninsured Americans for every US doctor.

I doubt adding 150 patients would break anybody's case load.

[luckytxn 2,265]

There is a basic disconnect between for-profit health insurance providers and the insured. The first priority of an insurance company is their fiduciary responsibility to their shareholders. The health of the insured is not their first priority.

When a portion of your health insurance dollar is spent on shareholder profit, that portion does not go toward providing for your health care. Health insurance providers also divert your health care dollars away from your health care when they spend your health care dollars on lobbying politicians, campaign donations to politicians, and advertising. Excessive salaries and golden parachutes for executives further dilute every dollar you spend on private health insurance.

Medicare has an overhead cost of 3%. Health insurance companies have overhead costs averaging 20% (and it is rising every year).

Note: there are 300,000 people in the United States employed by the insurance industry whose sole job is to minimize your health care claim, or to outright deny it. Denial of claims is an important profit center for the industry. Successful careers are made by those with the highest rate of claim denial.

Also, the argument that there will not be enough doctors to care for everyone in the United States is a red herring. The number of doctors in this country (per 1000 population) is on par with other industrialized countries. If one is concerned about this non-issue, then they should be asking what is preventing our medical schools from training a few more.

Yep, it's really not that hard to grasp.

I am not talking about taking money away from doctors. I am talking about cutting the useless dead weight that the insurance company is and creates - all $350bn-$500bn per year less whatever it really takes to run an insurance and pay the doctors and hospitals. Governments do this at 1%-5% of total expenditure while the private industry here takes 20%-30% to do the same. If they can do it at 5%, let them have at it. If not, they ought to be put out of business for the benefit of the overall economy and hence, for the benefit of each and ever American. If there are 20% to be saved (of a current total of roughly $2tn) - that's a full $400bn year after year. Not sure why anyone would want to keep wasting this kind of cash but it does explain why the nation is in such poor fiscal condition.

The government will save nothing over even the wasteful current system.

That's nonsense - doctors wouldn't need to hire and employ people that do nothing but handle the private insurance companies - authorization of procedure, claim filing, re-filing, referrals, etc. That's savings. The insurance companies wouldn't need to employ claim deniers. That's savings. The CEO of one of the major health insurance companies - I believe it was UnitedHealth - walked away with a 1.1 billion dollar severance package when he left the company. That's $1,100,000,000.00 that comes out of your health care spending and mine. And that's just one of the companies and that's just the severance package. Needless waste all around. Roughly one out of every three dollars spent on health care in this country goes to overhead and red tape. That's an insane proportion on top of an overall insane expenditure. Any and all government systems in the developed world - including here in the US - come in at 1% - 5% of overhead. I take that over the 30% we have here any day of the week.

I would love to see the real figures for this. Usual Fed bureaucracy is way above this. Also if you you do get rid of the claims deniers and paperwork people and others that are needed to do the papers for the insurers (and Government programs by the way) and the Feds take over then wouldn't they still be needed to handle the huge bureaucracy that will be in place?

Honestly is there not a wasteful Federal bureaucracy. One that year by year gets more huge and unwieldly and needs even more money thrown at it?

1=5 % of overhead for a Federal bureaucracy is wishful thinking.

It's the reality. Look it up.

I am and nothing that I have read so far even comes near to this wishful thinking.

Care to share what you read?

I am still waiting to see where you are getting your figures. So far any google has shown you to be wrong so now looking at Cato's figures

[Mr. Big Dog 10,747]

Right. Here's a bit in support of what I'm saying:

Administrative complexity and costs. By international standards, the U.S. approach to financing health care is extremely complex. Research suggests that a sizable fraction of higher U.S. health spending, not explainable by higher GDP per capita, can be traced to the higher administrative overhead required by such a complex system. To quote economist Henry Aaron on this point: "Like many other observers, I look at the U.S. health care system and see an administrative monstrosity, a truly bizarre mélange of thousands of payers with payment systems that differ for no socially beneficial reason, as well as staggeringly complex public system with mind-boggling administered prices and other rules expressing distinctions that can only be regarded as weird."

Aaron’s comment was part of his response to a recent paper by Steffie Woolhandler, Terry Campbell, and David Himmelstein, who find that administrative costs for insurers, employers, and the providers of health care in the U.S. health system (not even including the time costs patients bear in choosing health insurance and claiming reimbursement) were "at least" $294.3 billion in 1999, or about 24 percent of total U.S. health spending.

Aaron’s remarks may leave the impression that public insurance programs are the chief culprits in this "administrative monstrosity." However, as Commonwealth Fund president Karen Davis observed in her recent testimony before Congress, administrative expenses for private insurance in the United States are two-and-one-half times as high as those for public programs.

At current expenditures, 24% of health care spending ($2.4tn total) equates to more than half a trillion dollars. Annually. Most of it is money spent w/o adding any value to the delivery of health care. It's waste. Good to know that the "fiscally conservative" crowd supports wasting trillions of dollars.

[Heracles 417]

If there are millions without health care, where will all the additional medical personnel come from to treat those individuals?

Very very good questions. Certainly not going to come from those with liberal arts degrees.

Australia: 2.5 physicians / 1000

USA: 2.3 physicians / 1000

Canada: 2.1 physicians / 1000

I don't see the problem with the medical personnel.

Dude he has a point. If 50+ million people are to be covered, we are going to need doctors to treat them. Considering a medical degree costs about 1 zillion dollars, people are going to have to wait weeks for doctors.

According to americanprogress.org, there are about 150 uninsured Americans for every US doctor.

I doubt adding 150 patients would break anybody's case load.

Assuming every US doctor will cover these patients, which they will not. Also assuming that these uninsured will be able to travel to any doctor, rather than their local doctor who will most likely be booked until next Christmas. I've lived under a NHS so I know how it works first hand. If you or anyone thinks that everyone will be covered and that it will be business as usual, you are mistaken.

I support covering everyone too, however, I know for a fact that the quality will drop while the time to see a doctor will increase dramatically. Especially for those in poor areas.

Edited July 25, 2009 by haza

[Kathryn41 3,205]

One other factor that may be added into the equation, regarding how to 'treat' everyone in the US if there is universal health care. . . In Canada, at least, there is a lot of focus placed on preventative medical care. Education and access to appropriate treatment before a medical emergency erupts means fewer costs and less need for later medical intervention. Prevent someone from getting sick in the first place and you won't end up having to treat them with expensive surgeries or medications in the long term. Here I find it is much more reactive- people don't do preventative care because it costs them money so they end up delaying medical treatment until it is something serious - and more expensive to treat. So, rather than preventing people from getting sick in the first place and not incurring a lot of the high ticket medical expenses afterwards, many Americans end up with huge medical bills to treat illnesses and diseases that could have been managed/treated more easily if treated early.

For example, until recently an American friend of mine was living on about $600 a month; she has type 2 diabetes. She had medical insurance until her support center job was outsourced to India and there were no other jobs available in her small community for a 55 year old woman. She could not afford to move to an area with better employment opportunities. Given the choice between going to a doctor and paying for her medication or eating, she choose eating. For 6 years she did not treat her diabetes - then had a major heart attack, caused by her untreated diabetes. She was unable to afford her hospitalization either so has a huge bill that she now is not able to pay. She has recently qualified for medicare and her pension so her monthly income has now doubled. She has finally been able to afford her diabetes medication again because it is covered under Medicare but those years of untreated diabetes have caused irreversible complications. Her medical requirements are always going to be more expensive now than if she had been able to afford preventable medical care earlier.

Edited July 25, 2009 by Kathryn41

[one...two...tree 2,762]

There is a basic disconnect between for-profit health insurance providers and the insured. The first priority of an insurance company is their fiduciary responsibility to their shareholders. The health of the insured is not their first priority.

When a portion of your health insurance dollar is spent on shareholder profit, that portion does not go toward providing for your health care. Health insurance providers also divert your health care dollars away from your health care when they spend your health care dollars on lobbying politicians, campaign donations to politicians, and advertising. Excessive salaries and golden parachutes for executives further dilute every dollar you spend on private health insurance.

Medicare has an overhead cost of 3%. Health insurance companies have overhead costs averaging 20% (and it is rising every year).

Note: there are 300,000 people in the United States employed by the insurance industry whose sole job is to minimize your health care claim, or to outright deny it. Denial of claims is an important profit center for the industry. Successful careers are made by those with the highest rate of claim denial.

Also, the argument that there will not be enough doctors to care for everyone in the United States is a red herring. The number of doctors in this country (per 1000 population) is on par with other industrialized countries. If one is concerned about this non-issue, then they should be asking what is preventing our medical schools from training a few more.

Excellent post.

[ready4ONE 5,400]

One other factor that may be added into the equation, regarding how to 'treat' everyone in the US if there is universal health care. . . In Canada, at least, there is a lot of focus placed on preventative medical care. Education and access to appropriate treatment before a medical emergency erupts means fewer costs and less need for later medical intervention. Prevent someone from getting sick in the first place and you won't end up having to treat them with expensive surgeries or medications in the long term. Here I find it is much more reactive- people don't do preventative care because it costs them money so they end up delaying medical treatment until it is something serious - and more expensive to treat. So, rather than preventing people from getting sick in the first place and not incurring a lot of the high ticket medical expenses afterwards, many Americans end up with huge medical bills to treat illnesses and diseases that could have been managed/treated more easily if treated early.

For example, until recently an American friend of mine was living on about $600 a month; she has type 2 diabetes. She had medical insurance until her support center job was outsourced to India and there were no other jobs available in her small community for a 55 year old woman. She could not afford to move to an area with better employment opportunities. Given the choice between going to a doctor and paying for her medication or eating, she choose eating. For 6 years she did not treat her diabetes - then had a major heart attack, caused by her untreated diabetes. She was unable to afford her hospitalization either so has a huge bill that she now is not able to pay. She has recently qualified for medicare and her pension so her monthly income has now doubled. She has finally been able to afford her diabetes medication again because it is covered under Medicare but those years of untreated diabetes have caused irreversible complications. Her medical requirements are always going to be more expensive now than if she had been able to afford preventable medical care earlier.

And those of us who are insured are paying for her extra costs.

Curse our current inefficient socialized medicine system!

In seriousness though, it does greatly increase not just costs, but pain and suffering of individuals having the 'system' we do. A few people make trillions, most of us are not nearly as covered as we believe, and we continue to pay extra costs for those without insurance. It is absolutely beyond me how our system can be defended by anyone not currently profiting from it.

[Mr. Big Dog 10,747]

If there are millions without health care, where will all the additional medical personnel come from to treat those individuals?

Very very good questions. Certainly not going to come from those with liberal arts degrees.

Australia: 2.5 physicians / 1000

USA: 2.3 physicians / 1000

Canada: 2.1 physicians / 1000

I don't see the problem with the medical personnel.

Dude he has a point. If 50+ million people are to be covered, we are going to need doctors to treat them. Considering a medical degree costs about 1 zillion dollars, people are going to have to wait weeks for doctors.

How are the Australian and Canadian physicians able to treat the entire population of those countries seeing that their physician to population ratio is just about the same as that in the US? Wouldn't the fact that Australia and Canada, which offer 100% coverage and have similar ratios, suggest that there are already enough physicians available in the US to care for the entire population? Or are US physicians that much less efficient than those in Canada and Australia?

There was a transition period. America simply does not have enough doctors to take care of all these people. Let alone the specialists. Heck, Australian has a shortage of both too. 50+ million are currently not covered, which most likely means they do not see any doctors. Most doctors are busy at it is, therefore, how will the doctors handle the load of an extra 50+ million people. Probably even more actually considering many are currently under-insured and don't visit the doctor anyway.

The thought that 50+ million people will be able to see a doctor is a huge challenge. Not to mention that not all doctors will accept people covered by the government single payer plan. I certainly don't want to end up like Australia where you were rushed in and out of the doctors, that is, considering a doctor has to rely on quantity to make ends meet and keep the system affordable. As a kid I remember having to wait 1.5 hours in waiting rooms, surrounded by 10 or 20 other sick people to see a GP. Of course, as the system matured it has improved. However, the first two decades after the 1984 launch of a single payer system there was really tough transition period for Australia. Anyone who 'assumes' that after we switch to a single payer system that they will be able to see a doctor or specialist in an hour is deluding themselves.

You also have to consider who is covered. If they don't cap this at legal residents and citizens, then there will be a huge drain on the system. The country will simply not afford to cover both or have the means (doctors and co) to support them. I doubt any country could afford to cover 15+ million extra illegal immigrants.

You're evading the question here, buddy. I'll put it out there again: 2.3 doctors per 1000 - give or take 0.2 - is sufficient to treat everyone in Canada and Australia but not enough to treat everyone in the US. So, US doctors are less efficient than those in Canada and Australia, yes?

By the way, wait times of an hour or more in a physician's office in exchange for five minutes fact-to-face time with the physician are absolutely not unheard of in the US. It's quite common, actually.

[rebeccajo 14]

One other factor that may be added into the equation, regarding how to 'treat' everyone in the US if there is universal health care. . . In Canada, at least, there is a lot of focus placed on preventative medical care. Education and access to appropriate treatment before a medical emergency erupts means fewer costs and less need for later medical intervention. Prevent someone from getting sick in the first place and you won't end up having to treat them with expensive surgeries or medications in the long term. Here I find it is much more reactive- people don't do preventative care because it costs them money so they end up delaying medical treatment until it is something serious - and more expensive to treat. So, rather than preventing people from getting sick in the first place and not incurring a lot of the high ticket medical expenses afterwards, many Americans end up with huge medical bills to treat illnesses and diseases that could have been managed/treated more easily if treated early.

For example, until recently an American friend of mine was living on about $600 a month; she has type 2 diabetes. She had medical insurance until her support center job was outsourced to India and there were no other jobs available in her small community for a 55 year old woman. She could not afford to move to an area with better employment opportunities. Given the choice between going to a doctor and paying for her medication or eating, she choose eating. For 6 years she did not treat her diabetes - then had a major heart attack, caused by her untreated diabetes. She was unable to afford her hospitalization either so has a huge bill that she now is not able to pay. She has recently qualified for medicare and her pension so her monthly income has now doubled. She has finally been able to afford her diabetes medication again because it is covered under Medicare but those years of untreated diabetes have caused irreversible complications. Her medical requirements are always going to be more expensive now than if she had been able to afford preventable medical care earlier.

For your friend, the thing she did without wasn't hospital or doctor visits - she went without her medication.

This is where you get into the concept of "all things medical" in the US being so outrageously expensive - in other words it's not just about insurance costs. It's about the price of the service. Medications in the US are unaffordable unless they happen to be generic.

[luckytxn 2,265]

Right. Here's a bit in support of what I'm saying:

Administrative complexity and costs. By international standards, the U.S. approach to financing health care is extremely complex. Research suggests that a sizable fraction of higher U.S. health spending, not explainable by higher GDP per capita, can be traced to the higher administrative overhead required by such a complex system. To quote economist Henry Aaron on this point: "Like many other observers, I look at the U.S. health care system and see an administrative monstrosity, a truly bizarre mélange of thousands of payers with payment systems that differ for no socially beneficial reason, as well as staggeringly complex public system with mind-boggling administered prices and other rules expressing distinctions that can only be regarded as weird."

Aaron’s comment was part of his response to a recent paper by Steffie Woolhandler, Terry Campbell, and David Himmelstein, who find that administrative costs for insurers, employers, and the providers of health care in the U.S. health system (not even including the time costs patients bear in choosing health insurance and claiming reimbursement) were "at least" $294.3 billion in 1999, or about 24 percent of total U.S. health spending.

Aaron’s remarks may leave the impression that public insurance programs are the chief culprits in this "administrative monstrosity." However, as Commonwealth Fund president Karen Davis observed in her recent testimony before Congress, administrative expenses for private insurance in the United States are two-and-one-half times as high as those for public programs.

At current expenditures, 24% of health care spending ($2.4tn total) equates to more than half a trillion dollars. Annually. Most of it is money spent w/o adding any value to the delivery of health care. It's waste. Good to know that the "fiscally conservative" crowd supports wasting trillions of dollars.

So from what you are saying then is that when a federal bureaucracy is now going to be involved that the medical industry is now going to have a free hand to just ask for money for care? There will be no paperwork at all? No new rules and steps one has to take? There wil be no bureaucrat to say if anyone one person can have that certain procedure or get that medication?

Also the bureaucrats will only be in Washington and there will be none at the state level or local? So the same probe that are very expensive now in health care will go away? Just disappear like that. I am sure that no expects that there will be no bureaucrats at all. No one expects the Feds to just write a check for anything needed. Also not to mention that it will now be at a Federal level and not local where since it is an entrenched bureaucracy that it will be more responsive than if it were local.

After all many of these pencil pushers and deniers are doing most of this because of a Federal bureaucracy so I doubt they will disappear.

[rebeccajo 14]

Assuming every US doctor will cover these patients, which they will not. Also assuming that these uninsured will be able to travel to any doctor, rather than their local doctor who will most likely be booked until next Christmas. I've lived under a NHS so I know how it works first hand. If you or anyone thinks that everyone will be covered and that it will be business as usual, you are mistaken.

I support covering everyone too, however, I know for a fact that the quality will drop while the time to see a doctor will increase dramatically. Especially for those in poor areas.

I agree there might be a 'transition period'. But I certainly don't think you'd see anything close to a breakdown in care.

I mean really - it's not like all 45 million people without coverage would be running to their doctor as soon as they were able to go see one without it breaking their bankbook.

I do think what you would see is a flood of people getting medications filled.

[Tahoma 2,292]

If there are millions without health care, where will all the additional medical personnel come from to treat those individuals?

Very very good questions. Certainly not going to come from those with liberal arts degrees.

Australia: 2.5 physicians / 1000

USA: 2.3 physicians / 1000

Canada: 2.1 physicians / 1000

I don't see the problem with the medical personnel.

Dude he has a point. If 50+ million people are to be covered, we are going to need doctors to treat them. Considering a medical degree costs about 1 zillion dollars, people are going to have to wait weeks for doctors.

According to americanprogress.org, there are about 150 uninsured Americans for every US doctor.

I doubt adding 150 patients would break anybody's case load.

Assuming every US doctor will cover these patients, which they will not. Also assuming that these uninsured will be able to travel to any doctor, rather than their local doctor who will most likely be booked until next Christmas. I've lived under a NHS so I know how it works first hand. If you or anyone thinks that everyone will be covered and that it will be business as usual, you are mistaken.

I support covering everyone too, however, I know for a fact that the quality will drop while the time to see a doctor will increase dramatically. Especially for those in poor areas.

There is rationing of health care in every country. This includes Australia too. The difference between Australia and the United States is that the rationing in the U.S. is a particularly cruel form of rationing.

If Australia spent the same percentage of their GDP on health care as the U.S. spends, Australians could have better coverage and less waiting time.

[rebeccajo 14]

Right. Here's a bit in support of what I'm saying:

Administrative complexity and costs. By international standards, the U.S. approach to financing health care is extremely complex. Research suggests that a sizable fraction of higher U.S. health spending, not explainable by higher GDP per capita, can be traced to the higher administrative overhead required by such a complex system. To quote economist Henry Aaron on this point: "Like many other observers, I look at the U.S. health care system and see an administrative monstrosity, a truly bizarre mélange of thousands of payers with payment systems that differ for no socially beneficial reason, as well as staggeringly complex public system with mind-boggling administered prices and other rules expressing distinctions that can only be regarded as weird."

Aaron’s comment was part of his response to a recent paper by Steffie Woolhandler, Terry Campbell, and David Himmelstein, who find that administrative costs for insurers, employers, and the providers of health care in the U.S. health system (not even including the time costs patients bear in choosing health insurance and claiming reimbursement) were "at least" $294.3 billion in 1999, or about 24 percent of total U.S. health spending.

Aaron’s remarks may leave the impression that public insurance programs are the chief culprits in this "administrative monstrosity." However, as Commonwealth Fund president Karen Davis observed in her recent testimony before Congress, administrative expenses for private insurance in the United States are two-and-one-half times as high as those for public programs.

At current expenditures, 24% of health care spending ($2.4tn total) equates to more than half a trillion dollars. Annually. Most of it is money spent w/o adding any value to the delivery of health care. It's waste. Good to know that the "fiscally conservative" crowd supports wasting trillions of dollars.

So from what you are saying then is that when a federal bureaucracy is now going to be involved that the medical industry is now going to have a free hand to just ask for money for care? There will be no paperwork at all? No new rules and steps one has to take? There wil be no bureaucrat to say if anyone one person can have that certain procedure or get that medication?

Also the bureaucrats will only be in Washington and there will be none at the state level or local? So the same probe that are very expensive now in health care will go away? Just disappear like that. I am sure that no expects that there will be no bureaucrats at all. No one expects the Feds to just write a check for anything needed. Also not to mention that it will now be at a Federal level and not local where since it is an entrenched bureaucracy that it will be more responsive than if it were local.

After all many of these pencil pushers and deniers are doing most of this because of a Federal bureaucracy so I doubt they will disappear.

Good Lord.

We already have a national single-payer in place. Medicare. Do you not think that any national plan would not be modeled on that plan? The technology is already in place, you know.

It's not like the US would be jumping blindly into providing care for people. We already do it for people on Medicare.

[Heracles 417]

Assuming every US doctor will cover these patients, which they will not. Also assuming that these uninsured will be able to travel to any doctor, rather than their local doctor who will most likely be booked until next Christmas. I've lived under a NHS so I know how it works first hand. If you or anyone thinks that everyone will be covered and that it will be business as usual, you are mistaken.

I support covering everyone too, however, I know for a fact that the quality will drop while the time to see a doctor will increase dramatically. Especially for those in poor areas.

I agree there might be a 'transition period'. But I certainly don't think you'd see anything close to a breakdown in care.

I mean really - it's not like all 45 million people without coverage would be running to their doctor as soon as they were able to go see one without it breaking their bankbook.

I do think what you would see is a flood of people getting medications filled.

You mean you think a single payer plan will also cover medicine? Heck, Australia cannot even afford that and they are wealthy. No way in hell would a US system support that. Also keep in mind doctors and so on over there earn 1/5th what their equivalents earn here. They are also protected against frivolous malpractice suits and consequently having to spend thousands a year to protect themselves against that.

Edited July 25, 2009 by haza