How to cut healthcare costs
Mon, 03/15/2010 - 3:18pm — Central TX Mom
Well, it is time that we had this discussion (and MaryMoo has been wanting to have it for a long time).
I have a lot to say about this, but I don't have time at this moment. I plan to add my comments later, but I thought I would go ahead and get the thread started.
Well, Republicans and Blue
Well, Republicans and Blue Dogs would not let us near the real options that would actually cut costs the most. MaryMoo (and many in the GOP) seem very interested in lowering costs, but are not supportive of these. They follow the "I don't want government take-over" or "governmnet can't do it right" train of thought, yet we somehow trust insurance companies who jacked up rates 100% over 10 years and give huge bonuses to CEO's while dumping at-risk pools of people? That's who we trust more than government?
Here are 3 ways to lower cost that just did not make it.
From Physicians for Single Payer
1. Single payer system.
2. Public Option
CBO shows public plan lowers cost significantly
3. Proposal to lower Medicare to 55.
This Opinion Piece offers some good points on cost savings.
The time for talk is over. The plan is not perfect but was the best we could get with such powerful lobbyist influence. It will move us in the right direction. I trust we will address the cost issue more as we improve the bill in years to come. If we do nothing, our economy is doomed.
that's not 'lowering' costs
that's not 'lowering' costs only controlling costs which is completing different - haven't we learned by now that price controls and wage controls have nothing but ill effects on the economy?
at what point will you actually look at the root cause of the problem?
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If one rejects laissez faire on account of mans fallibility and moral weakness, one must for the same reason also reject every kind of government action. Ludwig von Mises
Economy could be doomed
Economy could be doomed either way. I would like to see those who support the current bill dispute the following piece by Robert Samuelson in today's Washington Post:
http://www.washingtonpost.com/wp-dyn/content/article/2010/03/14/AR2010031401389.html?nav=rss_opinion/columns
Please note that Samuelson is not some kind of Fox News/Beck/Free Republic conservative. He would be considered a liberal before a conservative on most issues.
Still got a lot to say, but
However it is simple
However it is simple economics - overutilitization of the system with people that have insurance currently. We are too removed from the actual cost of treatment and prefer to be led around by the vilification of the evil, boogeyman insurance companies to really see past it to this problem. People use ERs b/c there's not enough family physicians - proven study after study - 83% according to the Urban institute. No transparency in the medical services of prices, overtesting (defensive medicine) b/c of the current fee for service system. There is no competition now for these services and little incentive for medical folk to lower prices. Hell - I can jump from auto/home insurer based on my ability to pay and lack of claims/driving record to get the best price. Why can't healthy people be afford this opportunity? Be rewarded for using the system less or only as needed.
Then added to the basic priniciple above you have fraud, cost of medical education, salaries (saw an article where nurse anethestists (SP?) make more than FPs), lack of responsibility for self (exercising, eating healthy, following doctors orders), and the current regulations and mandates of the 50 states. Add to that, and probably could be added up above, that an enormous amount of money is used for end of life care. Something along the lines of 70% of medicare dollars are spent in the last 2 years of life. There really needs to be guidelines in place and frank discussions with family as to what is beneficial versus not in those times. While the GOP may harp against death panels if they were intellectually honest with themselves (yes I KNOW the chances of that), these are needed discussions given the $$'s spent during this time. These decisions have to be rationally made and not emotionally b/c emotions is what got us here in the first place.
When Paul Ryan is the only voice of reason (or at least somewhat) I would think it should all give us pause.
I am more than happy to rationally discuss this issue as it is the core reason to anything to the health system. However, to do so means we have to move from talking points - both sides and deal in reality knowing both sides are on the wrong side of what should be the core issue.
BTW Brandon's link - is fabulous. I linked to the RCP yesterday of the same thing:
Though it seems compelling, covering the uninsured is not the health-care system's major problem. The big problem is uncontrolled spending, which prices people out of the market and burdens government budgets. Obama claims his proposal checks spending. Just the opposite. When people get insurance, they use more health services. Spending rises. By the government's latest forecast, health spending goes from 17 percent of the economy in 2009 to 19 percent in 2019. Health "reform" would probably increase that.
Unless we change the fee-for-service system, costs will remain hard to control because providers are paid more for doing more. Obama might have attempted that by proposing health-care vouchers (limited amounts to be spent on insurance), which would force a restructuring of delivery systems to compete on quality and cost. Doctors, hospitals and drug companies would have to reorganize care. Obama refrained from that fight and instead cast insurance companies as the villains.
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If one rejects laissez faire on account of mans fallibility and moral weakness, one must for the same reason also reject every kind of government action. Ludwig von Mises
Some good points in the
Some good points in the article, Brandon, but the use of "some studies" and "many studies conclude" without enough citing of sources kind of makes me wonder or at least want to explore further. He doesn't really give an alternative, either, which would have been nice to compare workable ideas (my guess is that nobody can come up with a better plan that will achieve the same goals and cover that many people.) In addition, the bill is just a start. As many point out, look how civil rights legislation began and evolved over time, or the history of Social Security since it was first passed, etc. If we abandon this bill, the idea of real, comprehensive health care reform will be dead for at least another decade (the current system is truly unsustainable, let's not forget) and we won't even have the chance for good cost control measures to be implemented. When the GOP says start over, they mean keep the status quo. We both know that. They don't care if reform is needed-they'd rather see this president fail and they'd love to keep getting rewarded by lobbyists.
Doesn't your article point to the fact that my 3 suggestions make the most sense? Why are you so reluctant to support single payer when it will save costs and is easiest to understand for Americans (Medicare for all)?
If the GOP was so concerned with health care costs, why did they do NADA while in power? Why did they let the insurance companies increase abuse and allow the the system to be out of control for so long? Why is the GOP current proposal only helping a few milliion people while President Obama's insures 30 million, yet their program has been scored by the CBO and shows it will reduce the deficit much less than the Democratic plan?
But maybe, you say, the Republican bill does a really good job cutting costs. According to CBO, the GOP's alternative will shave $68 billion off the deficit in the next 10 years. The Democrats, CBO says, will slice $104 billion off the deficit.
The Democratic bill, in other words, covers 12 times as many people and saves $36 billion more than the Republican plan. And amazingly, the Democratic bill has already been through three committees and a merger process. It's already been shown to interest groups and advocacy organizations and industry stakeholders. It's already made its compromises with reality. It's already been through the legislative sausage grinder. And yet it saves more money and covers more people than the blank-slate alternative proposed by John Boehner and the House Republicans. The Democrats, constrained by reality, produced a far better plan than Boehner, who was constrained solely by his political imagination and legislative skill.
Sorry, but they had their chance and chose to sit idle and care more about insurance companies than the uninsured (and they still seem to, along with many Blue Dogs.) They just don't have a good track record here so it's hard to take them seriously. Many, many ideas in this bill are Republican ideas. Sen. Brown and Romney supported them for New Hampshire. The GOP proposed many identical things back when Clinton tried health reform as an answer to his "extreme" ideas. The fact that they've decided to create lies and distortions rather than debate real ideas and concerns tells me their ideas and concerns have no validity or else they'd be confident enough to have an honest debate/discussion. IMO, once they introduced death panels, they lost all credibility.
Dr. Aaron Carroll (who has been critical of the Senate bill for not enough cost controls) says some cost controls are better than none. It's an interesting read.
Hard as it is to believe, had President Nixon’s health care reform proposal been enacted – Nixon! – and costs been slowed by as little as 1.5%, our health spending as a percentage of GDP might be 7% lower than it is today. That’s a massive amount of money.
Maybe incremental reform would do more to contain costs than I thought.
And here's an article by Dr. Carroll about uninsurace and the ER.
So there you have it. Being uninsured is associated with an increased risk of children dying, from injuries, in an emergency room. Maybe someone should tell the people who claim there’s no evidence that uninsurance leads to a higher chance off death.
It’s unlikely you can get the whole article, because it’s probably behind a paywall, but it’s entitled, “Lack of insurance negatively affects trauma mortality in US children.”
Kelly do you understand
Kelly do you understand that this is not about what DEMS put forth or about what GOP has said? It is so much bigger than that and obviously you didn't want to address or understand what the article and many critics have said - there is no cost savings....simple ecomonics. Demand is far outstrips supply but I guess it is much easier to complain about what Republicans have done or not done rather than to address the core issue.
By the way if I show 10 years of taxes and only 6 years of spending I bet I can finagle a reduction in the deficit as well. Seems Obama keeps learning more from Bush with each passing day in office.
I see you calling out the Republicans now but what about the Democrats, Ted Kennedy, that foiled Nixon's healthcare plan back then?
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If one rejects laissez faire on account of mans fallibility and moral weakness, one must for the same reason also reject every kind of government action. Ludwig von Mises
I still want you to give me
I still want you to give me the "MaryMoo comprehensive health care plan"-or point to a great plan you support. But a real plan with numbers and methods-not just a general list of suggestions. Oh, and be sure it will cover at least 30 million people and show us cost savings and deficit reduction. And throw in no tax increases while you are at it. It simply does not exist. This is the best we can do but this plan has tons of room for improvement!
Hey, I'm mad at anyone-including Kennedy-who stood in the way of health reform over the century-or those, like Hillary Clinton, who did not sell it properly and failed. I'm mad at the Dem's who refused to consider single payer or a public option this time around. Such obstacles are why we are where we are today and must take desperate measures that may not be popular. Medicare was not super popular when it was ready to be passed and now look at it's popularity. Give people time to see it work for them and opinions will be changed-maybe even yours.
medicare was supposed to
medicare was supposed to curb medical costs b/c it would insure more people and have the backing of the gov't....now it is an unfunded liability - yet you want to increase the gov't involvement??
show me how this bill does anything to cut costs without creative accounting.
this bill is pointless unless it attacks the root cause of the problem - something you refuse to do or acknowledge.
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If one rejects laissez faire on account of mans fallibility and moral weakness, one must for the same reason also reject every kind of government action. Ludwig von Mises
"...show me how this bill
"...show me how this bill does anything to cut costs without creative accounting."
Maybe it doesn't. But you still miss the forest for the trees. Doing nothing (leaving the system as is) costs much more than reforming the system. How do I know? The increases in premiums, and also the increase in costs of services provided. You think, if we do nothing to change the system, these increases will evaporate?
What about that don't you understand?
my point exactly - this
my point exactly - this bill does nothing to attack costs of medical care and will only increase them and at a higher rate than if we do nothing.
I am not advocating for the status quo or is it your view that if you are against this bill then you are against reform?
how we pay for and utilize services is the problem of medical costs
just look at Massachusetts since enacting that version - costs are 27% than the rest of the nation.
simple economics - demand and supply
high utilization and low supply = higher prices so until we as a nation take ownership of our health this isn't going to change. We are the change we have been looking for, no? But it is too easy to depend on a miracle drug to solve our ills rather than eat right and exercise.
thoughts???
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If one rejects laissez faire on account of mans fallibility and moral weakness, one must for the same reason also reject every kind of government action. Ludwig von Mises
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I was wondering where you
Old article from NEJM on
Old article from NEJM on reducing healthcare costs by reducing need and utilization of services. While old still very relevant today - C. Everett Koop is one of the authors.
Well over 30 million Americans are uninsured, partly because of rising premium costs2,3. We propose an approach to part of this problem that has been neglected, one that focuses on systematically reducing the need and thus the demand for medical services. This approach requires expanding the definitions of "health promotion" and "preventive care," paying selective attention to strategies that have been found to result in net cost savings. During the past 30 years, while health care expenditures have risen in the United States from 4 percent to 14 percent, many cost-control strategies have been tried to varying degrees, without success4,5,6. The inflation of costs, influenced by technology, specialization, and a variety of other factors, has continued unabated6. Thoughtful criticisms of administrative cost-control solutions have been advanced, and it has been noted that these measures ration productive and nonproductive activities alike7. Despite their merits, proposed programs of reform introduce new problems, such as reduced access, increased costs, rationing, or adverse economic effects on small businesses2,3,4,8,9,10. On the face of it, broadening access and reducing costs at the same time is difficult.
http://nejm.highwire.org/cgi/content/full/329/5/321
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If one rejects laissez faire on account of mans fallibility and moral weakness, one must for the same reason also reject every kind of government action. Ludwig von Mises
From Rational
From Rational Arguments:
The Bill is Imperfect. Pass it Now.
Pass the bill. There — I said it.
They should pass this bill.
Whenever you debate a medical treatment or procedure, you have to weigh the benefits versus the harms. If the harms outweigh the benefits, it’s probably not a good idea. If the opposite is true, it’s a path you likely should consider. And when it comes to this bill, I think that it does more good than harm, if only for the following reasons:
And there’s more. There’s money for federal Community Health Centers, which serve over 16 million people and likely more in the future. There’s money for increased training of primary care providers. And – it’s projected to decrease the deficit, unlike Medicare Part D, passed by many of the Republicans and Democrats who’ve now suddenly become averse to spending, which will add about $1 trillion to the deficit over the same time.
...If they don’t pass this thing, then no one – NO ONE – is going to attempt to fix this at all in the foreseeable future. And one thing you’re hearing as a scare tactic is true. We are spending almost $2.5 trillion a year on health care. It is 16% of our economy. And it’s growing too fast. If no one touches this, then we’re doomed, fiscally. Costs will continue to rise, politicians will put it off, and we will crash. Then, when we have to fix it, there will be nothing left to fix it with.
We need real cost control, and the only way to do that is to build on this. There needs to be a success to build on. We need to get everyone covered. We need to improve quality. We need to make it even more efficient. And all of those things require some momentum, or something to convince future politicians to act.
Moreover, to truly contain costs, we will need to take more drastic action someday soon. If you think this iteration of reform is unpopular, wait until you see someone honestly try and talk about reining in spending. That will work if – and only if – it applies to everyone equally; it will work only if everyone is covered.
And none of that will happen if they don’t pass the bill.
So pass the bill.
I don't doubt Dr Carrolls
I don't doubt Dr Carrolls passion about this but this woman has not one clue about economics and why would would listen to anyone that doesn't as the economics is the crux of this issue is beyond me.
I can't understand with all of the historical data - Medicare and Massachussetts disaster that these reforms to do not solve the increase in medical costs. It is beyond me that you do.
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If one rejects laissez faire on account of mans fallibility and moral weakness, one must for the same reason also reject every kind of government action. Ludwig von Mises
"I can't understand with
"I can't understand with all the historical data - Medicare and Massachusetts disaster that these reforms to do not solve the increase in medical costs."
Here is a point for you: 30 million more people covered by health insurance means that 30 million people will no longer be using emergency rooms as their primary care physician. A great part of the reason why insurance premiums and cost of medical services are so sky high is precisely to pay for those uninsured who are using emergency room treatment (the costliest way of dispensing medical care) in lieu of family practice physicians. If you don't think hospitals, clinics, and health insurance companies (even the so-called non profits) have already built this into their fee or premium schedules, then I have a bridge in Brooklyn I would like to sell you; cheap! With far fewer emergency room visits, this cost can be taken out of the system, thus reducing these costs, or at least reducing the rate of increase in these costs.
"Here is a point for you:
"Here is a point for you: 30 million more people covered by health insurance means that 30 million people will no longer be using emergency rooms"
Read the article I posted above from the Washington Post.
There is evidence that your assurance is not accurate.
Brandon, your quote of me
Brandon, your quote of me was inaccurate: you left off the "as their primary care physician." That part makes a BIG difference. I did not assert that emergency room treatment would be non-existent for the additional 30 million who would receive coverage under HCR. I said that they would, in essence, no longer be using the emergency rooms for non-emergency treatments. as they are now forced to do because they have no access to primary care physicians.
If you are going to quote me in the future, please make sure that you do so accurately.
I'm sorry I left off the
I'm sorry I left off the last part of your quote.
But it actually doesn't change my point, please read the article where it states:
"A study by the Robert Wood Johnson Foundation found that the insured accounted for 83 percent of emergency-room visits, reflecting their share of the population. After Massachusetts adopted universal insurance, emergency-room use remained higher than the national average, an Urban Institute study found. More than two-fifths of visits represented non-emergencies."
Page 14: Across all
Page 14:
Across all usual source of care settings, a need for care outside of normal business hours was a common reason for making an ED visit for non-emergency care. While many of those after-hours visits were also attributed to difficulty getting an appointment to see a provider, a substantial share (30%) were not reported to be related to difficulties getting care. This suggests the potential for preventing some unnecessary ED visits by expanding after hours care in the community, especially in outpatient departments, community health centers and public clinics, where frequent ED users and non-emergency ED users are more likely to go for care.
absolutely wrong - the
absolutely wrong - the accurate estimate is that $200 is the amt that is per person due to those using ER services and uninsured but as I have posted several sources about that you still don't want to admit that this is a non issue in the realm of real medical inflation
funny how in Mass the use of ER as PCP went up after their universal coverage. there is a fundamental lack of PCPs to care of current insurance enrollees. that is just a fact and not that i don't want people covered but to think that what you have posted is anywhere near accurate is just plain silly.
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If one rejects laissez faire on account of mans fallibility and moral weakness, one must for the same reason also reject every kind of government action. Ludwig von Mises
Medical field... Sounds
Medical field... Sounds like an excellent occupation to go into.
Source: Medscape Medical News
The results highlight the "dire need" for more primary care physicians, Peter Smulowitz, MD, an emergency physician from Beth Israel Deaconess Hospital and Harvard University in Boston, Massachusetts, told reporters at a press conference here at the American College of Emergency Physicians 2009 Scientific Session.
"Now that people who were previously uninsured can go to the doctor, they need to have the doctors to go to. But they don't because we have a serious shortage of primary care physicians," Dr. Smulowitz told Medscape Emergency Medicine. "Universal coverage does not equal universal access to care. Faced with the lack of primary care physicians, where else is a sick patient to go but to the emergency department."
Still no time, but the main
Still no time, but the main tenet of my plan to reduce the amount of dollars spent on healthcare is for everyone to have a High Deductible Health Plan with a Health Savings Account. I have seen the dollars spent on healthcare by my own company reduce drastically and we have had absolutely no increases in premiums in three years by having this plan. Individuals spend their money very wisely when they know that the first $2,500 will come out of their deductible, but they are not discouraged from seeing a doctor for something serious because they know that the costs over the $2,500 will be covered completely if need be. The other side of this coin is that people do not run to the doctor for every hangnail like they tend to do if they have low deductibles.
So my proposal is for the government to set up a pool for individuals to join High Deductible Health Plan with a Health Savings Account for any American who chooses to join to do so. Realistically, you do need to require that everyone join something so people do not wait until they are ill to join. These plans tend to have lower premiums so they are more cost effective to join.
Oh yeah, I forgot to
Oh yeah, I forgot to mention my pipe dream...
Americans need to stop worrying that every little twinge they feel is some incurable cancer. Yes, I know that strange things do sometimes happen, but not everything needs to be checked out by an MRI. I know a ton of people who run to the doctor for every little thing. It is ridiculous. A fortune is spent in this country on every tiny sniffle. We are a very dramatic group. If I had a nickel for every girlfriend I have who was terrified that a little fluctuation in her menstrual cycle was cancer, I'd be pretty well off.
Oprah's tv show and women's magazines and the like do not help, either. Yes, occasionally there is someone who does recognize the signs of some disease that they do have, but the other side of that is freaking out everyone else that every freckle is skin cancer or something. At one point Oprah seemed to be encouraging everyone to go get whole body scans. Yikes. Sounds like overkill to me. There is a happy medium that can be found in common sense.
And it seems like some of us have lost sight of the fact that we are all going to die of something some day. No matter how many times you go to the doctor for a physical, how many mammograms you have, how well you eat, etc., etc., we are all going to die at some point. Some sooner, some later. I feel like when a grandma gets sick and dies at age 82, people act like "Oh, we lost her so young!" Uh, not really. Not everything can be cured and fixed no matter how much money we throw at it.
But I don't expect for people to become realists any time soon.
Whoa, hold on a minute
Whoa, hold on a minute CTM! You are throwing way too much common sense at the world at one time! LOL.
Extremely valid points on all accounts. I hope that in the end, we see something vaguely as you describe (high deductible plans, HSA's) along with some strong campaigns on being somehow partly responsible for our own health.
However, I will say that not all MRI's are the fault of the patient. I had lots of weird symptoms going on, and all I wanted was for a doctor to look at the holistic picture and advise me what might be going on. Instead, there was a litany of tests performed -- all on the same day. I would have been okay with just one of the tests, then if that didn't pan out another one later. I cringed at the thought of what it was going to cost my insurance company (not b/c they're warm fuzzy people but b/c I'm cost conscious, even with OPM).
Yeah, I found out the answer to the mystery (turns out there were several issues all at same time), but all I really wanted was a doctor who listened and advised me before rushing me off to get tests.
Doubts that I have about HCR lie in the stories of that nature.
Yes, we need reform. Is the path we're on the right one? I can't answer that; only time will tell. I just realize there are huge political issues at play, seemingly as much as there are human dignity stories at play, and it's very difficult to discern between them.
Actually Kim it isn't the
Actually Kim it isn't the right path. As CTM pointed a large problem is the fee for service nature and overutilziation of tests and services driving costs upward. We are so separated from what the cost really is b/c of insurance and copays that we never stop to ask if tests are necessary.
What would happen if everyone had to pay out of pocket? We would be finding the best doctor for the most value wouldn't we - just like approaching everything else. That is what real competition would do - highlight and make transparent costs.
That is my fundamental disagreement with this bill. It infuriates me to no end that the core reason to reform should be about cost b/c at the end of the end of you are able to reduce costs it makes services more affordable for everyone.
I feel like I am going round and round about this and making no headway. It amazes me that people would rather believe what is handed to them without questioning every bit of information that comes from the government. Really it is just pointless for me to continue as no one seems to want to have a rational, reasoned discussion about this issue. Quite frankly this bill will do more harm for everyone than good it will do for many b/c at the end of the day medical costs will continue to increase and the problem will not be solved only made worse.
This is where Obamacare is. Everyone knows it won’t work. As liberal Sen. Dick Durbin just admitted, “Anyone who would stand before you and say well, if you pass health care reform next year’s health care premiums are going down, I don’t think is telling the truth.”
Dose of Truth.
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If one rejects laissez faire on account of mans fallibility and moral weakness, one must for the same reason also reject every kind of government action. Ludwig von Mises
Mary: If I've ever given
Mary:
If I've ever given the impression on this board that I buy into the plan as perfect, then I ask for forgiveness. I've never believed this legislation to be perfect, and cost issues are at the heart of that.
I respect your passion about the subject; however, you'll find I don't engage in as much of the discussion as others simply because I'm so torn about it. We need some sort of reform; however, if left solely to the GOP it won't get done. They'll happily await the November elections and hope for a majority again and then kick the can down the road. I also wish the WH and the Dems would stop telling us it's going to "save" us money... I'm far from convinced that's going to happen.
OTOH, it is absolutely appalling to me that we allow people to go into bankruptcy b/c they had the misfortune to contract an serious illness.
I get your point about what if we had to pay out-of-pocket. However, that's a pipe dream -- that tide turned a long time ago, so even considering it seems futile. We have the insurance culture that we have and we need to figure out how to work within those parameters. I still hold out that a high deductible plan with an HSA would be a reasonable middle ground. If we had to pay $2,500 or more out of pocket, we'd be pickier about how the money is spent, and perhaps be more consumerish with our HC providers than just accepting whatever tests they instruct us to get.
I don't know all the answers, Mary, so I really think I'll stop my posting about any HC issues right now.
Kim - sorry if I seemed
Kim - sorry if I seemed curt as I didn't mean it :)
I highly value your opinion but am just frustrated about the lack of reason that has gone into this bill by our elected representatives - Dems by their sheer stupidity of the issue and Republicans for refusal to do something constructive.
It is politics at its worst and we will all suffer for it. Do people need access to quality care, yes. Should people go bankrupt, no. But continuing the model as it is doesn't solve any issues and will create more I'm afraid.
And like you I am tired of posting about it but didn't want you to think I was being critical of you far from so. I'm sure I can learn a lot from you (and already have).
One last thing - High deductible HSAs which help curb costs will be a victim of this legislation.
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If one rejects laissez faire on account of mans fallibility and moral weakness, one must for the same reason also reject every kind of government action. Ludwig von Mises
Kim - sorry if I seemed
Kim - sorry if I seemed curt as I didn't mean it :)
I highly value your opinion but am just frustrated about the lack of reason that has gone into this bill by our elected representatives - Dems by their sheer stupidity of the issue and Republicans for refusal to do something constructive.
It is politics at its worst and we will all suffer for it. Do people need access to quality care, yes. Should people go bankrupt, no. But continuing the model as it is doesn't solve any issues and will create more I'm afraid.
And like you I am tired of posting about it but didn't want you to think I was being critical of you far from so. I'm sure I can learn a lot from you (and already have).
One last thing - High deductible HSAs which help curb costs will be a victim of this legislation.
Also interesting (and wonder how many will follow?)
http://seattletimes.nwsource.com/html/localnews/2011367936_walgreens18m.html
In a news release, Walgreens said its decision to not take new Medicaid patients stemmed from a "continued reduction in reimbursement" under the state's Medicaid program, which reimburses it at less than the break-even point for 95 percent of brand-name medications dispensed to Medicaid patents.
Walgreens follows Bartell Drugs, which stopped taking new Medicaid patients last month at all 57 of its stores in Washington, though it still fills Medicaid prescriptions for existing customers at all but 15 of those stores.
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If one rejects laissez faire on account of mans fallibility and moral weakness, one must for the same reason also reject every kind of government action. Ludwig von Mises
Just one other note... I
MaryMoo-I don't understand
MaryMoo-I don't understand why there is an either/or. We all agree that this bill does not go far enough to control costs. But there is still so much good in this bill. Almost right away kids who would have been rejected for pre-existing conditions will now be covered. Women can no longer be rejected if they've been victims of domestic violence. Those aspects alone are enough to cheer. But why is it not an option to improve the bill with cost saving measures down the road? Have you seen the GOP in action recently? Do you really think if this bill goes down they will lift a finger to improve the status quo, including cost controls? No-they will be doing a victory lap on making the president fail. We will not see reform for at least a decade. Who would want to try? So if they played fair, I could see it as possible. They don't. As you probably agree, it's been frustrating seeing all the outreach this president has made to the GOP where they could have offered ideas on cost control, but they would not "play" since this is a game to them.
As for your article, crazy redflags go up when I see the words "Obamacare" in any article (somebody please let these authors know that many of us can't take their words seriously even if they might have a point to make.) A little about the author...
Graham was:
-a graduate of Oral Roberts University,
-worked as the primary election coordinator for South Carolina[1] for Pat Buchanan's failed Presidential campaign in 1992.
-In 2002, Graham released his first printed book of original material, Redneck Nation: How the South Really Won the War through Warner Books.
-Graham appeared on Real Time with Bill Maher. In addition, he made a number of appearances during 2005 on The O'Reilly Factor, Hardball with Chris Matthews,and Fox & Friends pertaining to his "America is at war with islam" controversy. G
-Since 2005, Graham airs a weekly guest slot on George Hook's drivetime show, The Right Hook on Ireland's Newstalk. Speaking from right-wing, US perspective, many of Graham's views are often controversial to the European audience, and so his weekly slot has proved popular with the show's regular listeners.
-He recently appeared on the Dr. Phil Show Special 'The N-Word', a debate-format special of the show. Of the 6 guests, Graham was the only Caucasian. They debated the use of the word 'nigger' and the relevance of its use today by both whites and blacks.
Three Years Into
Three Years Into Implementation... "There appears to be broad support among physicians in Massachusetts for the reforms that led to almost all state residents having health coverage,"...
A study published in New England Journal of Medicine finds that a large majority (70 percent) of practicing physicians in Massachusetts support health reform three years after its passage in 2006. The study, funded by the Robert Wood Johnson Foundation and the Blue Cross Blue Shield of Massachusetts Foundation, was designed and conducted by researchers at the Harvard School of Public Health (HSPH).
The poll found similar levels of support among primary care doctors and specialists.
The poll of 2,135 Massachusetts physicians was conducted between August 11 and September 15, 2009.
Also,
Boston, MA--A poll by the Harvard School of Public Health and The Boston Globe finds 59% of Massachusetts residents who are aware of the state's health reform legislation, which was enacted in 2006, support it. Support for the law varied by party affiliation, with 76% of Democrats, 56% of Independents, and just 35% of Republicans saying they support the legislation. The poll was conducted September 14-16, 2009.