The Note, 5/11/2009: Dollars and Sense — Obama seeks light touch in healthcare push

Why does he have to tread lightly?
He is all for socialism, so making us a socialized healthcare nation should be a task too large for his pea brain.

Wait… he’s a socialist? Gasp. And a Muslim? Ugh. He has no birth certificate? Eek gads. Quick, someone get us a fat radio talk show host. We need to let the country know of this outrage.

Here is how I know the “average” healthcare receiver is getting a FAIR SHAKE……When the health care and pharma industry is screamming bloody murder how unfair these changes will be to them and their profits!!!! Then I know it is TRUE REFORM for the rest of us AND I’LL BELIEVE IT WHEN I SEE IT..WE ALWAYS GET SCREWED OVER BY THE BIG AND POWERFUL LOBBYIST SLIME .
Mackie

$2 trillion seems too high but if the captains of health care industry are in agreement than it is more believable.
Now I want to see what these reforms are.
Ryan

Real Healthcare Reform
Changing Priorities, Incentives and the Rules of the Game; Creating an Electronic Health Record for Every Citizen Who Wants One
If you have the financial resources of Bill Gates or Warren Buffett you needn’t pay money to a health plan each month, since if you get sick or injured – even very seriously – you have more than enough money to pay all your medical bills yourself.
But those of us who have significantly less financial resources must find some other means of dealing with the thousands or even hundreds of thousands of dollars or more of medical expenses that we might incur should a serious illness or injury be our fate.
Enter the concept of “health insurance”.
Large numbers of individuals and/or their employers pay some money each month into one or another big pot called a “health plan”. Those individuals who remain essentially very healthy for many years and then suddenly die or perhaps leave a particular health plan for some other reason – if they have put more money into the pot than was taken out to pay all their medical expenses – wind up helping to pay the medical bills of those members of the health plan who become seriously ill or injured and incur a lot of medical expenses.
Many Americans covered by some form of health insurance don’t seem to fully understand or perhaps choose to ignore the fact that if they become seriously ill or injured, for the most part their medical bills will be paid by the members of their health plan who have remained healthy. Keeping members of a health plan healthy by preventing illness and injury is critically important, but is something not currently given the high priority and attention it deserves.
Some Americans believe that healthcare should become a “right” of every American citizen. If a nationalized single payer health plan were enacted, every American citizen who became ill or injured – for any reason whatsoever – and incurred significant medical expenses would for the most part have his or her medical bills paid by U.S. taxpayers. Many Americans oppose such a system for America recognizing that significant difficulties such as long waiting periods and rationing of care exist in such types of government healthcare systems that currently operate in other countries such as Canada and the United Kingdom.
For any health plan to work which has a large number of people pooling their money to essentially pay the medical bills of whichever members of the plan become seriously ill or injured, rules must be established as to when and how much money may be taken out of the pot e.g. “legitimate” doctor bills and hospital bills. Equally important is keeping track of the amount of money that is being put into the pot each month in premiums paid by health plan members or their employers. If too much is being paid out in expenses as compared with the amount being received in premiums, the pot will soon become empty and the health plan will go broke.
As previously mentioned, the monthly premiums paid by individuals or their employers go into a health plan’s big pot from which “covered” healthcare expenses are paid. But also from this pot are paid all the health plan’s administrative expenses including what may be big salaries and golden parachutes for CEO’s and other “healthcare executives” – individuals who may be paid to find technicalities of one sort or another in the health plan’s agreements so the health plan can deny or reduce payments, raise premiums, cancel insurance, or in one way or another minimize or exclude “bad risks” from the health plan. All such questionable business practices are done to enable the health plan to make a profit and remain in business.
Currently we are experiencing continual increases in healthcare costs that are unsustainable and which, if unchecked, will soon seriously threaten the future of the entire American economy. Healthcare costs must be controlled, but how? If a healthcare system made up of health plans is going to have a chance of both meeting the needs of health plan members and simultaneously develop the ability to keep costs under control, priorities, incentives, and the rules by which the game is played all must be changed.
The good news is that a lot of illnesses and many injuries are actually preventable. But how will prevention ever become a top medical priority when doctors, hospitals, and other providers get paid largely for diagnosing and treating illness and injury, not for preventing it?
Although health promotion and disease and injury prevention receive fashionable and socially acceptable lip service, the fact is that most of the participants in what should be more appropriately called our “sickness and injury care system” actually have no significant financial incentive whatsoever to spend any significant time and energy in genuinely promoting health and helping to prevent disease and injury.
Much to the contrary. Other than the actual members of a health plan – patients and potential patients – and their employers and perhaps the employees of some health plans, most participants in our sickness and injury care system – because of the way they are paid – have an enormous (if unspoken) financial incentive for massive amounts of disease and injury – much of which is preventable – to continue to occur in America. Strictly from a financial point of view, for those whose incomes come solely from the treatment – not the prevention – of illness and injury, the more illness and injury that occurs, the better. And if the illness or injury is serious and requires perhaps many expensive tests, multiple surgical procedures, and other very complicated prolonged treatment in an intensive care unit, so much the better; just as long as those unfortunate individuals who happen to be ill or injured are “covered” by “good insurance”, i.e. health plans that are reliable bill payers.
This is not to say that there are not some excellent very dedicated and hardworking doctors and other health professionals – although they are paid on a fee for service basis to care for illness and injury – who nevertheless attempt to essentially work themselves out of a job by making health promotion and disease and injury prevention a top priority with their patients.
It should also be recognized that some existing health plans – e.g. Kaiser and Group Health – combine insurance, doctors, and hospitals into a single entity in such a way that provides everyone – including all the health plan’s doctors – a real incentive to spend time and effort with patients on health promotion and disease and injury prevention as well as on early diagnosis and treatment.
But unfortunately the above examples represent only a small part of the sickness and injury care system that currently exists throughout America.
For the most part – because of the way they are compensated – the majority of doctors and other professional providers, acute care hospitals and long term care facilities, pharmaceutical manufactures and pharmacists, medical and surgical equipment manufacturers and personal injury and malpractice attorneys – among others – depend mightily on massive amounts of disease and injury occurring in America; and these participants in our sickness and injury care system would be significantly negatively impacted if a lot of the preventable illnesses and injuries were actually prevented. This must be changed.
Unless the incentives and rules are changed to give as many participants as possible a real financial stake in health promotion and disease and injury prevention, in early diagnosis and treatment, and in maximizing health and minimizing disease and injury, healthcare costs in America will never be brought under control. Making appropriate changes in the incentives and the rules of the game is the real task and challenge of “healthcare reform”.
What about financial incentives for individual health plan members? Should individuals receive a financial incentive to be healthy? It is well recognized that engaging in regular exercise, abstaining from tobacco, and eating moderately so as to maintain a reasonably normal body weight are all significant factors in helping to promote an individual’s health and wellness. These healthy behaviors can all be confirmed by simple tests performed or ordered in a doctor’s office. Why shouldn’t those individuals who practice these health promoting behaviors and comply with recommended immunization schedules and appropriate preventive screening examinations such as for colon cancer and breast cancer pay significantly less in premiums to their health plan each month than those who don’t?
To really reform healthcare we must find ways – through changes in incentives and the rules of the game – to actually prevent what is preventable, to maximize early diagnosis and treatment, and minimize disease and injury with all its associated cost. We must find ways for participants to be part of our “healthcare system” and not just a part of our “sickness and injury care system”.
Significant changes in the rules of the game for our legal system – tort reform – is also critically important so that the gaming of the system now being done by personal injury and malpractice attorneys and their clients can be ended and so that the exorbitant costs to physicians and other professionals for malpractice insurance can be dramatically reduced.
Truly transforming our “sickness and injury care system” into a “healthcare system” by making significant changes in the incentives and the rules of the game may seem to be a formidable task and one that probably has never really been done before on a large scale anywhere in the world. But it is a worthy task and a critically important task for the future of America and its people.
One significant part of this process is developing the capability of creating an electronic health record for every American citizen who wants one. We need a standardized framework that will allow every American citizen to have an individual electronic health record – a computerized medical record – that can be accessed by all the doctors who care for a particular individual, regardless of wherever on the planet the doctors or the patients happen to be. It would be like having your own personal online banking account that only you have the password to, but which you can share with the doctors who are caring for you, wherever you or they may be.
I applaud those who are using their energy and expertise to upgrade our deplorable current paper medical records system and bring medical records in America into the 21st century. Developing a standardized framework for an electronic health record – for every citizen who wants one – created by your doctor with your assistance, with proper security and safeguards – is something that our national government can and should do as a part of healthcare reform.
If done well, electronic health records will be transformational in helping doctors efficiently and effectively care for patients and will save an enormous amount of time, effort, and money which is currently wasted on needless and frequently inaccurate duplication. And having an accurate electronic health record for an individual will also facilitate appropriate health promotion and disease and injury prevention for that individual. Like the telephone and the computer, someday we will all wonder how we ever got along without individual electronic health records.
All this requires action, not just words. Now is the time for Americans and their leaders and doctors and other health professionals to step up to the plate and begin the process of transforming our “American Sickness and Injury Care System” into an “American Healthcare System” that is worthy of our great country.
Robert Westafer M.D.

This stinks! Whatever happened to the promise of health care for all-the same policy as for the government workers?? Obama is just hope and image: when it comes down to real meaningful change, he has clay feet! Look st the bail out fiasco-where the bonuses are still standing; the stress tests that the bankers where in collusion;the minor credit card changes in two years; and now the “health reform” where the industry will wield power. Obama charms us away, while he is bidding time and apathy for the plutocrats.

This is a minimal-type problem created by the Pharmaceutical Industry; dropped off a RX for my Wife, calling for 15 tablets. Picked it up for only $3.85, however the RX Insurer (BC/BS) would ONLY Approve of 8 tablets for the month, but Approved a Re-Order for the additional 7 tablets for an additional $3.85. Say this happens maybe what, a million times a day? That’s an additional $3.85 Million/Revenue per day, or an additional $100.10 Million/Revenue per month!!! Just this one (1) SMALL RX type Idiocy adds up to $1.2 Billion Dollars Yearly, in UNDESERVED REVENUE! Now that’s ONE WAY the American people WITH INSURANCE are getting Ripped-Off and No One seems to care. I would BET if you could calculate insurance issues of this sort, for your RX Insurer, it would be “A Snap” to come up with $1 Trillion Dollars in Annual Undeserved Revenue. (And that could go a long way, toward providing RX Coverage for the 40%+ of those with No RX coverage!)

The Healthcare Insurance Industry volunteers to give back $2 Trillion Dollars over the next 10 Years. They should come back with $1 Trillion Annually for the next 10 Years. This could provide for a Basic Moderate Healthcare Insurance Policy offering through HHS for Anyone who would be Uninsured. (This would be administered
Much like Medicare.) Average Local area pricing for services should be mandated as part of the program. And then have the Industry Healthcare Insurance Providers compete for the Private Healthcare Insurance offerings which would be made available to INDIVIDUALS and ALL EMPLOYERS in the marketplace. Both the Employers and Providers would COMPETE for “Better Healthcare Plans” to Attract Higher Quality Employees and a Greater Volume of Sales, respectively.
The extent and complexity of services provided would likely exceed the Basic Moderate Healthcare Insurance Policy offered through HHS for the Uninsured.

PRIVATE FOR PROFIT HEALTHCARE IS AN OXYMORON!
As congress debates fixing Americas current private for profit healthcare disaster, global embarrassment, and national disgrace. The question is not weather we will have a public option. But rather what kind of public option we will have.
America is the only country in the developed world that has a GREED DRIVEN! PROFIT DRIVEN! IMMORAL! UNETHICAL! PRIVATE FOR PROFIT! healthcare delivery system.
As a result, hundreds of thousands of you are needlessly killed by your healthcare delivery system in America every year. And millions of you are crippled and injured. America is the only country in the developed World that does not have a NOT FOR PROFIT, PATIENT PROTECTING, government managed healthcare delivery option for all it’s people.
America currently has the most costly health care system in the developed world. And the lowest quality of healthcare in the developed world. And the most dangerous, deadly, and FEARED! healthcare delivery system in the developed world.
America is the only healthcare delivery system in the developed World that does not cover all it’s people automatically. And America has the most difficult healthcare system to access in the developed World.
Contact your representative and tell then that a single payer, government managed healthcare option is a must for everyone that wants it. Tell them that you demand that the public option be the finest in the World.
Tell them it should be available to everyone that wants it as a HUMAN RIGHT! Tell them it should be the easiest to access in the entire world. Tell them it should have the highest quality, with the greatest patient protections in the entire world. Tell them coverage should be automatic for everyone that wants it unless they choose to opt out. Tell them it should be the most affordable in the World. And tell them that NO ONE in the public option is to be reported to a credit agency, or driven into bankruptcy for unpaid medical bills just because they got sick, for FREEK’EN SAKES!
Tell them, none of the requirements above are negotiable. Tell them, that we are prepared to remove them from office. Tell them, we will rain down the political FIRES OF HELL! on any of them that would betray the American people. Or continue to compromise the life, health, safety, and National security of the American people for the GREED DRIVEN, PROFIT DRIVEN! private for profit Healthcare Industry.
TELL THEM NOW! AND PASS THE WORD ON.
God Bless You
Jacksmith — WORKING CLASS

Zolpidem tartrate.

Zolpidem tartrate.