Originally posted by crimvelvet
I have read through this entire post and I have a few questions. I am hoping the people who did the research can clarify these points.
First hospitals, nursing homes etc are going to be looked at in terms of "quality " of care. Those that do not meet standards are cut from the
government program. Is this correct?
The relevant pages in the bill are (in part) ppg, 525-620. From what I've read it is more about the efficiency of care vs cost of care, not much at
all about quality of care. This Post
discusses the .gov definition of
"Quality" in Health Care
Doctors and their families may keep their investments in hospitals and other facilities but they may not INCREASE that investment. In other
words doctors can not put another dime into facilities. Is this correct?
Hospitals are not allowed to add operating rooms or patient rooms. The loop hole is community demand. This means either an advertising
campaign to gain support or waiting times so long it gets the general population's attention. Is this correct?
Did anyone see anything about how new hospitals are going to be built, old hospitals are going to be repaired or how new state of the art
equipment is going to be purchased? Is this going to be done by the government or private enterprise?
Good question!!! I don't recall seeing anything about "new Hospitals" or "new equipment" or "new technologies"
I do not see the mechanism that allows new facilities to be built and older facilities to be brought up to date. More importantly I do not see
HOW it will be paid for.
Second topic: I see several additional programs added to basic health care. First the perscription change another poster mentioned also:
1. End of life counciling every 5 years. That may not seem like much until you look at this
Today, about 13 percent of Americans are over age 65. By 2030, more than 20 percent of Americans will be in that group. By 2050, about 89 million
Americans will be over age 65, more than double the number today.
That looks like over 40 million additional consultations in the first year if all those over 65 receive the mandatory talk and 5 to 10 million a year
there after. Where are the doctors performing these consultations coming from and who is paying?
US Taxpayers and Businesses that employ them
2. Home parenting visits. I think this is something brand new. How are these people being trained and where are they coming from?
Well, there are quite a few provisions for scholarships for training doctors. nurses, occupational therapists, techs, etc. in the bill
3. Expanded health care at schools. Who pays for the facilities? Where do the doctors come from?
Again the US taxpayer and the businesses that employ them will be the ones paying, I do not expect to see many doctors at these school clinics, I
expect to see more Physician Assistants & Nurse Practitioners.
4. Task force to track and analyze medical devices. This looks like it will be a HUGE on going study. where do the doctors/researchers come
from? Who is paying for the trust that funds this.
I doubt that this will be much different than how things are now. The major difference I foresee is the national database of who has what in their
Right now, the manufacturers know what unit is being used by a registration of the unit/device ID in a "blind" database, the patient is assigned a
number, their name is not used to identify them, only the doctor who placed the device is privy to the name AND number of the patient.
If, say a pacemaker, is in 200 people and 40 of those pacemakers show symptoms of being defective in some way, the manufacturer can tell this trough
the blind database and order the recall.
I doubt that this mechanism for monitoring the efficiency of devices will change in any material way, but the US taxpayer will be paying for it twice.
Once as we pay for the device to be prescribed and implanted and once when we pay the .gov to monitor the monitoring already happening by
5. Preventative care studies (and implementation) This looks like another HUGE on going study.
6. Quality of care and whether a treatment actually works. Again both of these are HUGE on going studies. Where do the doctors/researchers come
from? Who is paying for the studies.
again, these types of studies are already in effect, and in many cases, already funded through .gov medical research grants. It will consolidate what
is already happening, and being paid for in some way, by the taxpayers.
With all these additions to the cost of "healthcare Insurance" I do not see how the actual costs to the consumer will go down without denying
care to the elderly at the very least. I also do not see where new hospitals to replace the old are coming from. No Venture Capitalist is going to
front the money and if the government is trying to hold down costs, building new facilities and buying new equipment is going to be very low priority.
Also if a treatment is new how do you show the government gate keepers it works without it being implemented so the gate keepers can do their study
thing (#5 above)
Oh this is gonna cost, I've seen estimates running from $3,900 per person (including children) to $52,000 per working taxpayer.
As for new treatments, I see little change in the current system to the new system, for drugs, medical devices, etc.
My biggest question is how this is going to be paid for. The USA just got her credit card yanked, foreigners will not buy any more of the US
of A's treasury bonds. US citizens are hurting so they are not buying bonds and with increasing unemployment overall tax revenue is down. If this
program wipes out private insurance and this program tanks what happens to the US citizens health care?
That's the biggest question, where is the $$ going to come from. Last month ALONE we sold HALF THE DEBT FROM LAST YEAR (2008) and we are going to
try and sell one half of that again This Week!!!
When the $$ really does run out for the US, the last thing most people will be focusing their worry on is health care, survival yes, healthcare, not
An additional tax of 6% for $50,000 a year generates 3000 dollars in additional
revenue. That will not buy health insurance. When I was self insured I was paying 500 a month and that was over ten years ago. I just can not see
this costing Americans less than 15% to 20% in actual taxes. A tax on your employers payroll is really a tax on you because he will adjust his wages
accordingly or go out of business. (Business taxes are the way Congress hides the true cost of a program, with the side effect of driving business
overseas.) Again any comments?
Many comments, and I've added them along the way. Thank you for your thought provoking questions!!