I should of gone along with Aqqizar and just stayed out of this. I'll post something from the wall street journal and that will be the end of it from me. I don't want any enemies from this
Tennessee Experiment's High Cost Fuels Health-Care Debate
In 1994, Tennessee launched an ambitious public insurance program to cover its uninsured. The plan, TennCare, fulfilled that mission but nearly bankrupted the state in the process.
As originally envisioned, the Tennessee plan expanded Medicaid, the government health-care program for the poor, to cover people who couldn't afford insurance or who had been denied coverage by an insurance company.
With an initial budget of $2.6 billion, TennCare quickly extended coverage to an additional 500,000 people by making access to its plans easy and affordable. But the program became so expensive that Tennessee was forced to scale it back in 2005.
Now, as Congress debates a national health-care overhaul, state experiments like Tennessee's are informing the discussion.
Unlike Massachusetts's more recent universal coverage law, the TennCare plan is most often cited by opponents. They say TennCare's runaway costs show that the public health-insurance proposal by House Democrats could bankrupt the federal government.
In a letter to Congress last month, Rep. Marsha Blackburn (R., Tenn.) compared the public plan envisioned in the House bill to TennCare, warning that TennCare became so costly at its peak that it ate up one-third of Tennessee's budget.
"The promise of TennCare has gone unrealized," she wrote.
The Obama administration says TennCare is different from the proposed public plan because its administration of the Tennessee program is contracted out to private companies. A federal public plan would more likely be run by the government, although the White House on Sunday signaled that it wouldn't insist on having a public option.
Another difference, the administration says, is that a public option would increase competition in the health-insurance market by offering an alternative to private insurers; TennCare was the primary option for Tennessee's uninsured.
What the Tennessee experiment did share with health-care-overhaul supporters was its ambition to cover the uninsured. To qualify, patients only had to show a denial letter from an insurance plan. TennCare charged $2.74 a month in premiums for people earning just above the poverty level. Its rolls quickly swelled to 1.4 million people, leaving only 6% of Tennessee's population without health insurance. It never achieved complete universal coverage in part because of an income cap.
"The lesson is you can quite quickly cut the number of uninsured," said Alan Weil, executive director of the National Academy for State Health Policy.
TennCare had its failings. The plan, for example, paid health providers less than private insurance plans, prompting some physicians and hospitals to increase charges to private insurers. Some of this resulted in so-called cost shifting, with insurance companies passing on the costs through higher premiums. Opponents of a public option warn the same thing will happen nationally, to the detriment of people who already have health insurance.
Rep. Blackburn says TennCare shows that a public plan would undermine the current employer-based health-care system, citing data from University of California at San Diego that showed 45% of people claiming TennCare's benefits had left employer-provided insurance. Darin Gordon, TennCare's current director, says the switching was more limited than critics allege.
Another Tennessee congressman, Republican Phil Roe, says that as a physician who worked under the program, he saw TennCare's shortcomings up close. He says TennCare reduced access to care: physicians refused to see TennCare patients because of the program's lower reimbursement rates.
TennCare aimed to pay for much of its expanded coverage with cost savings -- mostly by reducing unnecessary care.
In its first five years, TennCare had the lowest per capita cost of any Medicaid program in the country, saving between $245 million and $2 billion by cutting down on emergency-room visits by uninsured patients, for example, according to the Tennessee Justice Center, a public-interest law firm for the poor. It has championed the program and sued the state over cutting people from its rolls.
"TennCare covered the majority of people and did it with the money that was saved by squeezing waste out of health-care infrastructure," said Michele Johnson, managing attorney at the Center.
However, the program's costs quickly escalated. After rising at a roughly $300 million annual rate in its early years, TennCare's budget swelled from $5.4 billion in 2000 to $8.5 billion in 2004. During that period, the state re-assumed much of the risk of managing the program from private insurers who complained they were losing money administering it.
In 2005, with the state's solvency in jeopardy, Gov. Bredesen reduced TennCare's rolls by about 170,000 by booting some people who weren't eligible for Medicaid. He also created a separate limited insurance option called CoverTN that covers only up to $25,000 in annual medical costs. (Damn that was a pain to type. I should of just found an internet article or scanned the paper)
Anywho...
1. It was more expensive than they thought. Hmmm, sound familiar? Social security, medicare, medicaid all cost around seven times more money than originally thought when they were first created. If the federal government thinks that this new health care policy will cost about $600 billion (give or take) then they better multiplay that number by seven to 4.2 trillion.
2. In a free market, competition lowers prices. How can private companies compete with a government plan? Obama may say that people can keep their current policy if they like it under the new plan, but realistically people will be drawn to the considerably cheaper option. For those who want to keep their plan it may not be possible because costs will actually rise for the private companies just trying to stay in business. The reason costs won't go down for the private companies is because the government is running a non-profit organization. Private companies will now have to increase premiums just to stay afloat from losing all their clients. Eventually everyone will turn to the public option and there goes any private option. As I said in previous posts I am FOR healthcare reform but AGAINST a public option. What is next? Car insurance, life insurance?
3. There will need to be a rather large influx of new doctors and nurses to cover the newly insured. Since the public option is going to be almost free get ready for long ass waiting times. Medical Schools would have to lower their standards for admission to get more doctors out there. Even your average med school woul have to increase the admission rate by like 100%.
4. Salaries for doctors drop a whole lot. The rising cost of education and all the hard work it takes to become a doctor you will see a massive decline in med school applications as well. Don't deny it that doctors are in it for the money.
5. You have around 45 million uninsured people in the United States. 37 mil are of working age. 38% of those working can actually afford it but choose not to get it so they can buy whatever else with that money. Many college grads don't get insurance because they are young, generally healthy, and use the money for other things. 9.7 mil are not U.S citizens. That leaves us with roughly 21 mil not insured. A quarter of uninsured have to option of medicare or medicaid. Now you have 10 million people who REALLY can't afford health insurance. Is the public option the best way to adress those 10 million people? I have no idea to be honest with you.
6. They say of the $600 billion it would cost for public care most of it would just be cutting cost of uncessary care. I didn't know people would go see a doctor for no reason. How else they gonna do it if it isn't enough? Raise taxes. If costs go out of control expect a tax increase from the poor and all the way to the rich. Obama kind of promised no new taxes during his campaign. Whoops.
7. I voted for Obama, but I am starting to regret it. It is pretty obvious that I am more of a conservative than a liberal. I voted for him because I belived he had the stronger economic plan and a stronger foreign policy compared to McCain and that was my main concern back on election day. I never imagined this even though he did mention this a lot during his campaign. Looks like I'll have to do my homework even more in 3 years.
8. I'm going to go watch some TV and avoid the news like a plague. Then fall asleep on the couch hoping everything is fixed when I wake up.
EDIT:
http://www.nytimes.com/2009/08/18/health/policy/18talkshows.htmlIntresting indeed...
“The public option, whether we have it or we don’t have it, is not the entirety of health care reform,” Mr. Obama said. “This is just one sliver of it, one aspect of it.”Yet this is what everyone is yelling about. Must be one painful sliver.
In an interview on Sunday, Mr. Obama’s senior adviser, David Axelrod, said the president remained convinced that a public plan was “the best way to go.”But I thought it was just an aspect of the reform? If it is the best way to go Mr. Obama lied to me by saying it is just a sliver.
Okay, I'm done.
Author
Topic: This American Health Debate thing (Read 12779 times)