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Thread: What should we spend on medical care?

  1. #1

    What should we spend on medical care?

    OK, on to question number two. Gut feeling, what percentage of the Federal budget should be spent on medical care for the elderly and indigent (Medicaid and Medicare)?

  2. #2
    It is not an appropriate role of the Federal Govt. to pay anything for healthcare. They have also proven grotesquely ineffecient at trying to do so despite it not being a Federal power.

    If any Govt. Agent should pay for it, it should be the decision of the individual States to determine, as the individual state sees fit, and as the State chooses to tax/pay for.

    So the answer is "0%". Medicare and Medicair should be abolished, and those responsabillites taken up by the States, with a due change in Federal and State taxation to suit.

    I'm curious my friend, is there a point at the end to these questions?

  3. #3
    Universal Health Care coverage for all citizens as just about every civilized nation does.

    Costs can be reduced by covering only things that make medical sense and are evidence based. Focus should be on reducing the spending on the persons last few months of life, something that this nation does not understand and needlessly spends way too much money on.

  4. #4
    [QUOTE=kennyo7;4475760]Universal Health Care coverage for all citizens as just about every civilized nation does.

    Costs can be reduced by covering only things that make medical sense and are evidence based. Focus should be on reducing the spending on the persons last few months of life, something that this nation does not understand and needlessly spends way too much money on.[/QUOTE]

    OK - so how much of the budget are you willing to allocate towards that goal (note that the US is fairly significantly behind countries like the UK, Sweden and Denmark in GDP per capita, and would need to deliver services across a far vaster geographic area)

  5. #5
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    [QUOTE=Warfish;4475733]Medicare and Medicaid should be abolished.[/QUOTE]

    +1

    And they should be replaced by a baseline, nationalized HDHP which covers basic and catastrophic care for all people. This baseline plan can be supplemented by employers and individuals by purchasing more comprehensive coverage from private insurance companies.

    This government plan would account for roughly 25% of the federal budget.

  6. #6
    [QUOTE=doggin94it;4475786]OK - so how much of the budget are you willing to allocate towards that goal (note that the US is fairly significantly behind countries like the UK, Sweden and Denmark in GDP per capita, and would need to deliver services across a far vaster geographic area)[/QUOTE]

    We both know his answer, even if he won;t say it:

    "As much as it takes. If it's more than we have, raise taxes on the rich till we have enough"

    There is no top-amount % that would chase away a guy like Ken. 100% coverage, his way, no matter the cost, waste or inefficientcy.

    It's a basic human right after all.

  7. #7
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    [QUOTE=Warfish;4475733]It is not an appropriate role of the Federal Govt. to pay anything for healthcare. They have also proven grotesquely ineffecient at trying to do so despite it not being a Federal power.

    If any Govt. Agent should pay for it, it should be the decision of the individual States to determine, as the individual state sees fit, and as the State chooses to tax/pay for.

    So the answer is "0%". Medicare and Medicair should be abolished, and those responsabillites taken up by the States, with a due change in Federal and State taxation to suit.

    I'm curious my friend, is there a point at the end to these questions?[/QUOTE]

    I am with you on this one. This is definitely a states rights issue. The federal government is too big and slow to manage this properly. They have proven this in the mismanagement of Medicare and Medicaid which has driven costs through the roof and enabled fraud at a huge rate.

  8. #8
    [QUOTE=Warfish;4475829]We both know his answer, even if he won;t say it:

    "As much as it takes. If it's more than we have, raise taxes on the rich till we have enough"

    There is no top-amount % that would chase away a guy like Ken. 100% coverage, his way, no matter the cost, waste or inefficientcy.

    It's a basic human right after all.[/QUOTE]

    Not true at all. We currently spend about 15% of GDP on healthcare. This is more than most western nations with universal health care systems do. Of course we would have to cover more people now.

    I think 25-30% would be a good goal. This could be achieved by eliminating all the wasteful overhead that private insurance charge for, directly negotiating with pharmaceuticals for drug prices, doing a better job with end of life care as is done in the rest of the world and eliminating unneccessary diagnostic testing and procedures that make no medical sense and are not supported by the medical literature.

    Its funny Fish talks about waste and innefficiency because that is the biggest problem with the private sector in health care. Thats why the VA does so much better not only in eliminating waste but outperforming the public sector in most health care measures.

  9. #9
    [QUOTE=kennyo7;4476197]Not true at all. We currently spend about 15% of GDP on healthcare.[/quote]

    For clarity, when you say "we" do you mean the Federal Govt. spends specificly, or do you mean "all spending, public [U]and[/U] pirvate, in the U.S. on Healthcare". Becuase there is a big difference in what I may or may not choose to spend on my own care, and what the State chooses to spend under a State System.

    You think 25-30% would be a good goal, eh. And if only 75% of the people could have 75% of their health covered by that #, you'd be ok with that? Or would you then propose raising taxes until the cost was covered, regardless of the total costs? I think we know what the truth is here.

    Ken, don't treat us like we've never read you before. Honesty is the best policy, and we both know where you stand on Univeral State Run Healthcare, and the power and authority of the State over the Individual on this topic. To you, Healthcare is a basic and sacrosanct Human Right that must, without exceptions or concerns of costs, be provided by the State.

    [QUOTE]This could be achieved by eliminating all the wasteful overhead that private insurance charge for[/QUOTE]

    Because the Federal Govt. is well known for it's low costs and efficientcy in doing massive things, right?

    [QUOTE], directly negotiating with pharmaceuticals for drug prices[/QUOTE]

    I.e. Telling Private Business they must sell to the Feds at drasticly reduces rates or else, since in a Universal system, who else are they going to sell to after all....

    [QUOTE], doing a better job with end of life care as is done in the rest of the world[/QUOTE]

    I.e. Rationing and denials and long, long, long wait times for service.

    [QUOTE]and eliminating unneccessary diagnostic testing and procedures that make no medical sense and are not supported by the medical literature.[/QUOTE]

    I.e. If they miss something, and you die, so what.....sue the State, lol. Best of luck.

    Tell me Ken, why not let the people decide? Why not allow the States, as the Constitution originally intended, choose what kinds of systems they want to run for their people? Why should your view be forced upon every State, including States who don't want it, and majorities of their people who don;t want it?

    This is my issue Ken. Democracy isn't enough for you, it MUST be Federal Tyrany or nothing. I'm content to let States choose, including choosing state Universal systems, paid for with State taxes as they see fit. But you, you would deny my State the right, and the people of my State the right, to choose for ourselves what we want and how we want to pay for it.

    This, like so much, is clearly a States issue. They can and should choose based on the will of their people. Since so many of our States have economies that rival foreign Universal-System-Running Countires, it shouldn't be a problem....as long as you can live with the Feds lowering THEIR tax requirements so the States can tax instead.

    Why would you ignore democracy Ken? Why would your force Federal Tryany upon the unwilling Ken? Isn't it enough to vote your mind in your own State? Why force it on the rest of us?

  10. #10
    [QUOTE=kennyo7;4475760]Universal Health Care coverage for all citizens as just about every civilized nation does.

    Costs can be reduced by covering only things that make medical sense and are evidence based. Focus should be on reducing the spending on the persons last few months of life, something that this nation does not understand and needlessly spends way too much money on.[/QUOTE]


    Sounds like granny is going over the cliff. The death panels that Democrats deny but, in fact, endorse.
    Hey, let's make "Logan's Run" the law of the land. Carousel for all.

  11. #11
    [QUOTE=Warfish;4475733]It is not an appropriate role of the Federal Govt. to pay anything for healthcare. They have also proven grotesquely ineffecient at trying to do so despite it not being a Federal power.

    If any Govt. Agent should pay for it, it should be the decision of the individual States to determine, as the individual state sees fit, and as the State chooses to tax/pay for.

    So the answer is "0%". Medicare and Medicair should be abolished, and those responsabillites taken up by the States, with a due change in Federal and State taxation to suit.

    I'm curious my friend, is there a point at the end to these questions?[/QUOTE]

    I paid into Medicare my entire career. Why should it be abolished? Controlled - yes. Made fraud free through harsh confiscatory penalties - like fraud $ amount X 10.
    Handled by states - maybe, but the population is mobile. Accounting nightmare.
    Medicare is another story. That is money for people who pay zero. I know of a case where a person was totally disabled in the commission of a felony (involving death). Total health care for life - free. Better health care than I can buy.
    As best I can determine, Warfish, you're under 40. So you're screwed anyway it turns on SS and Medicare.

  12. #12
    [QUOTE=palmetto defender;4476240]Sounds like granny is going over the cliff. The death panels that Democrats deny but, in fact, endorse.
    Hey, let's make "Logan's Run" the law of the land. Carousel for all.[/QUOTE]

    Death Panels, thats funny.
    No, i just dont want thousands of dollars per day spent on a terminally demented 88 year old sitting in some ICU receiving care that is not going to change the outcome.

  13. #13
    [QUOTE=kennyo7;4476263]Death Panels, thats funny.
    No, i just dont want thousands of dollars per day spent on a terminally demented 88 year old sitting in some ICU receiving care that is not going to change the outcome.[/QUOTE]


    A death apnel is withholding care.

    Here's an idea. How about no health care for prison inmates.
    No viagra for anybody on the government nickel. No birth control on the government nickel or private insurers for that matter.
    How about no health care for the totally diaabled soldier.
    There are tests than CAN be done away with for all. We ARE overtested.

    There is a POS professor at Princeton University that advocates putting to death all babies with a birth defect or all adults who can no longer function. Beginnng to sound like Nazi Germany?

    Speaking of that 88 year old. hey, we're all going to die eventually. How about no treatment for ANYBODY.
    As you may or may not know, they do have a hospice section in many hospitals which alllow terminally ill patients to die in peace with a minimum amount of treatment. Perhaps you advocate a little cyanide in the IV? or perhaps a quick slice across the jugular ( no drug cost)?

  14. #14
    [QUOTE=kennyo7;4476263]Death Panels, thats funny.
    No, i just dont want thousands of dollars per day spent on a terminally demented 88 year old sitting in some ICU receiving care that is not going to change the outcome.[/QUOTE]

    So you'd kill my Father-in-Law. Permanently 'demented', but physically healthy. You would deny him healthcare, and sentence him to death with whatever the next issue he got. Maybe even deny him his diabtetes meds now, eh? To save costs.

    A man, it should noted, who worked his entire life and paid for his insurance his whole life. You would kill him, so some illegal immigrant can have free tittie screenings, condoms and cough syrup.

    Well, thats good to know.

    One wonder if you're just talk, or if your the real deal, and would flip off the switch yourself. Perhaps even with a little smirk on your lips.

  15. #15
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    [url]http://www.youtube.com/watch?v=8Sp-VFBbjpE[/url]

    2 birds one stone

  16. #16
    [QUOTE=Warfish;4476220]For clarity, when you say "we" do you mean the Federal Govt. spends specificly, or do you mean "all spending, public [U]and[/U] pirvate, in the U.S. on Healthcare". Becuase there is a big difference in what I may or may not choose to spend on my own care, and what the State chooses to spend under a State System.

    [B]I believe that is all spending. I dont care what you want to spend on your care. If it does not make medical sense or is not medically necessary then you should pay for it out of your own pocket. [/B]

    You think 25-30% would be a good goal, eh. And if only 75% of the people could have 75% of their health covered by that #, you'd be ok with that? Or would you then propose raising taxes until the cost was covered, regardless of the total costs? I think we know what the truth is here.
    [B]
    No. 100% should be covered for 100% of what is medically necessary and makes medical sense. Of course taxes are going to cover it. You have no problems using taxes for the military, why is this any different? [/B]

    Ken, don't treat us like we've never read you before. Honesty is the best policy, and we both know where you stand on Univeral State Run Healthcare, and the power and authority of the State over the Individual on this topic. To you, Healthcare is a basic and sacrosanct Human Right that must, without exceptions or concerns of costs, be provided by the State.
    [B]
    I think ive been clear as to where i stand. Not hiding from anyone[/B]


    Because the Federal Govt. is well known for it's low costs and efficientcy in doing massive things, right?[B]

    When it comes to healthcare, yes it is more efficient. The data does not lie[/B]

    I.e. Telling Private Business they must sell to the Feds at drasticly reduces rates or else, since in a Universal system, who else are they going to sell to after all....
    [B]
    The VA does it. Just about every other nation does it why should we be different? The difference is the USA has been subsidizing these reduced costs for everyone else. If the pharmaceuticals are concerned about profits, stop exploiting the average US citizen. They can start slashing costs by stopping these stupid advertisements, stop the free dinners and lunches to MDs, and maybe cut the salaries of some of the bean counters. These are all paid for by you and me[/B]

    I.e. Rationing and denials and long, long, long wait times for service.
    [B]
    You call it rationing I call it care that makes medical sense.
    There are no long long long wait times for emergent medical care and routine care in countries like France, Germany, Sweden and Finland do not require long long long waits. The problem with guys like you who do not have a medical background is you dont understand what medically is truly urgent and what is elective.[/B]


    I.e. If they miss something, and you die, so what.....sue the State, lol. Best of luck.

    Tell me Ken, why not let the people decide? Why not allow the States, as the Constitution originally intended, choose what kinds of systems they want to run for their people? Why should your view be forced upon every State, including States who don't want it, and majorities of their people who don;t want it?
    [B]
    Because the average person does not have the medical background necessary to decide what is medically necessary, what constitutes a medical emergency vs elective, and what makes medical sense. [/B]

    This is my issue Ken. Democracy isn't enough for you, it MUST be Federal Tyrany or nothing. I'm content to let States choose, including choosing state Universal systems, paid for with State taxes as they see fit. But you, you would deny my State the right, and the people of my State the right, to choose for ourselves what we want and how we want to pay for it.
    [B]
    Not at all. I think you should be free to purchase private insurance if you like. But i think it is the governments duty to provide coverage to all its citizens for necessary medical care. Just like you feel its the governments duty to provide a military to defend the nation. I see it as no different.[/B]

    Why would you ignore democracy Ken? Why would your force Federal Tryany upon the unwilling Ken? Isn't it enough to vote your mind in your own State? Why force it on the rest of us?
    [B]
    I dont ignore democracy. Health care is a right that is seen universally except in the USA. Its crazy. Coverage for medical necessity should be provided at the federal level[/B].[/QUOTE].

  17. #17
    [QUOTE]I believe that is all spending. I dont care what you want to spend on your care. If it does not make medical sense or is not medically necessary then you should pay for it out of your own pocket.[/QUOTE]

    And you shouldn't. Thats my responsabillity.

    What we all should care about is what our collective Govt. spends, and on what.

    Right now, our Govt,. does not spend 15% of GDP on Healthcare, the Govt. spends much less than that.

    And you want to raise that to the Govt. spending 20-30% of ALL Govt. spending to Healthcare. Thats a massive increase in federal Spending.

    And as stated, you're answer to that shortfall of available funds is "raise taxes" is it not? Your answer is "healthcare is a human right" is it not? Your answer is "pay whatever the costs" so everyone, legal, illegal, worker, non-worker, productive or sociatal leach, can have whatever Govt. Commissions deem "medically needed" gets covered, right?

    Tell me Ken, is a condom medically needed enough to be covered under your system?

    [QUOTE]No. 100% should be covered for 100% of what is medically necessary and makes medical sense. Of course taxes are going to cover it. You have no problems using taxes for the military, why is this any different?[/QUOTE]

    Because the Constitution says it is. It sets forth one (and we can debate Millitary spending and use elsewhere Mr. "I Strongly Supported the U.S. Libya Invasion and Slaughter for Euro Oil Interests" elsewhere, and perhaps even find much to agree about.

    It does not, in any way, set forth the other. If you'd like it to, then amend it, and we can have that political fight correctly, as it's intended in our system.

    [QUOTE]When it comes to healthcare, yes it is more efficient. The data does not lie[/QUOTE]

    Sure it does, via selectivitiy in reporting, outright omission, covering up things via exclusionary or dishonest accounting, and much much more.

    It's funny, the Govt. we all knwo cannot do anything efficiently or fairly or equally, and you think it can manage the Healthcare for 350,000,000 people....because Sweedon does it for 3,000,000.

    [QUOTE]The VA does it. Just about every other nation does it why should we be different? The difference is the USA has been subsidizing these reduced costs for everyone else. If the pharmaceuticals are concerned about profits, stop exploiting the average US citizen. They can start slashing costs by stopping these stupid advertisements, stop the free dinners and lunches to MDs, and maybe cut the salaries of some of the bean counters. These are all paid for by you and me[/QUOTE]

    I.e. Ken hates Capitalism and Business, and they should both be dismissed so illegals can have free condoms.

    [QUOTE]You call it rationing I call it care that makes medical sense.
    There are no long long long wait times for emergent medical care and routine care in countries like France, Germany, Sweden and Finland do not require long long long waits. The problem with guys like you who do not have a medical background is you dont understand what medically is truly urgent and what is elective.[/QUOTE]

    Outright lies. Yes there is rationing, and yes there is long waits, and yes the productive must wait so the unproductive can often be treated ahead of them.

    The trouble with guys like you, is you think because you're an MD, you get authoritarian dictator power to dictate fiscal and economic and human rights policy to the rest of us. This isn't an issue of if a cold or some other consition needs a pill Doc, it's a POLITICAL and ECONOMIC issue, not a medical one. And frankly, an MD is no more moral authority than anyone else.

    The trouble with guys like you Ken, is you'd choose to treat an illegal immigrant cold before you'd choose to treat mine. You do not want equallity, you want a Federal system that follows the usual Federal biases, things like affirmative action. I'll be damned is some unproductive welfare **** should get treated before someone whose worked hard their whole life just to please some socio-political hardon you have for utopian dreams.

    [QUOTE]Because the average person does not have the medical background necessary to decide what is medically necessary, what constitutes a medical emergency vs elective, and what makes medical sense. [/QUOTE]

    Irrelevant to choosing what system we wish to run in our Country. One need not be a Doctor to choose, via our Democracy, that we do or do not want to accept a Healthcare for everyone system via Federal Monopoly.

    Why do you think you have the right to choose for all of us Ken? Do you believe in Dictatorship and Tyrany, as long as it's "in the best interests of all" as you see it?

    What else would you forgo our Laws and system to put in place?

    [QUOTE]Not at all. I think you should be free to purchase private insurance if you like. But i think it is the governments duty to provide coverage to all its citizens for necessary medical care. Just like you feel its the governments duty to provide a military to defend the nation. I see it as no different.[/QUOTE]

    Might want to read the Constitution then, because the difference is clear. The purpose of the Federal Govt. is defense and other enumerated responsabillities.

    There is no mention of providing free Healthcare to one and all, nor of Healthcare as a human right, nor any power fo the Federal Govt. to simply take upon itself the power to nationalize an entire industry.

    By all means, IF you want these things, then amend the Constitution, and we'll have that debate, have those votes, and the winner will get what they want. You know, Democracy.

    Do you fear Democracy Ken? Do you hate it, hate Law and following Law? Do you think the people too stupid, and need a Leader-Class to tell us what we "need" and "deserve"?

    [QUOTE]I dont ignore democracy. Health care is a right that is seen universally except in the USA. Its crazy. Coverage for medical necessity should be provided at the federal level.[/QUOTE]

    The follow the Law, and amend the Constitution to describe Healthcare as a Human Right, and we'll have that fight as it was intended in our Country.

    Simply forcing it upon one and all via Federal power is wrong, in the Law, and in a Democracy.

    Tell me Ken, if Healthcare is a human right, if someone walked up to you on teh Street and asked you for treatment, would you give it? Should you be forced, under penalty of Law, to give it? If you choose not to in every circumstance where you conceivably could have, are you guilty of denying someone their human rights?
    Last edited by Warfish; 05-24-2012 at 11:55 AM.

  18. #18
    [QUOTE=palmetto defender;4476297]A death apnel is withholding care.[/QUOTE]

    No it is not.
    It is witholding care that makes no medical sense and switching goal of care to comfort managemet.

    Here is an idea. If you want care that makes no medical sense, dont expect the govt to pay for it. Govt health care should include only care that makes medical sense. If you want care that is not supported by the medical literature or will not change the outcome, pay for it yourself.

  19. #19
    [QUOTE=kennyo7;4476417]No it is not.
    It is witholding care that makes no medical sense and switching goal of care to comfort managemet.

    Here is an idea. If you want care that makes no medical sense, dont expect the govt to pay for it. Govt health care should include only care that makes medical sense. If you want care that is not supported by the medical literature or will not change the outcome, pay for it yourself.[/QUOTE]


    Does caring for illegals makes sense? How about Viagra? Birth control (which is cheaper yham dirt)?
    Smoking cessation? Care for druggies? Care for inmates? A nose job? A boob job? Tummy tuck? Penile implants?
    All of the above are coverned by one government med plan or another.
    But the Medal of Honor awardee at the end of his life? Give him the finger.

  20. #20
    [QUOTE=Warfish;4476299]So you'd kill my Father-in-Law. Permanently 'demented', but physically healthy. You would deny him healthcare, and sentence him to death with whatever the next issue he got. Maybe even deny him his diabtetes meds now, eh? To save costs.

    A man, it should noted, who worked his entire life and paid for his insurance his whole life. You would kill him, so some illegal immigrant can have free tittie screenings, condoms and cough syrup.

    Well, thats good to know.

    One wonder if you're just talk, or if your the real deal, and would flip off the switch yourself. Perhaps even with a little smirk on your lips.[/QUOTE]

    Dementia is an irreversible, incurable TERMINAL illness. To say that someone with dementia is "otherwise physically healthy" is like saying my Father in law has Stage IV Colon Cancer but is otherwise healthy.

    Your post clearly shows why the avg person like you should not set health care policy. You are all emotion but have no medical basis for what you are saying.

    Of course I would not withhold diabetic medication from him. Nor would i withold antibiotics, flu shots and standard care. What i would withhold is care that makes no sense and will not extend his life. When/if he gets to the point of no longer eating i would not provide artificial nutrition. I would not perform open heart surgery to replace a valve, i would not keep him indefinitely on mechanical ventilation when there is nor real hope for recovery, i would not provide him chemotherapy that will extend his life weeks to months if he develops metastatic cancer....these are all things that medically make little sense.

    Now if the family wants this care and will pay for it either out of pocket or through private insurance, by all means it would be provided. But not through govt sponsored insurance for all.

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