Armed Polite Society
Main Forums => Politics => Topic started by: Ben on January 15, 2010, 09:53:53 PM
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Looks like Unions got a special exemption from the "Cadillac" health care tax in a backroom deal. Why are more people not up in freakin' arms over this??
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http://www.foxnews.com/politics/2010/01/15/democrats-hammered-room-deal-unions-health-care/
Democrats Hammered for 'Back-Room' Deal With Unions on Health Care
In pushing a giant step closer to a health care reform deal, Democratic leaders are once again drawing fire from their critics for extending special treatment to an interest group in exchange for its support of the bill.
In pushing a giant step closer to a health care reform deal, Democratic leaders are once again drawing fire from their critics for extending special treatment to an interest group in exchange for its support of the bill.
The latest deal was struck Thursday among the White House, Congress and union leaders over the proposed tax on high-value "Cadillac" health insurance plans."
Unions had objected strongly to the proposed tax on high-value insurance policies, fearing it would hurt their members, and they won several concessions from the administration. Under the deal, if it becomes law, union workers will be shielded from the 40 percent tax for five years -- until 2018. The threshold for the tax also was raised so that it will kick in for plans worth $24,000 instead of $23,000. And dental and vision coverage will not count toward that threshold.
But what about everybody else?
The unions, traditional supporters of the Democratic Party and a major factor in Obama's political infrastructure, got a deal, but Republicans said that non-union workers will still have to pay the tax from the get-go starting in 2013.
"I guess this bill is only good if it doesn't apply to you," GOPAC Chairman Frank Donatelli said.
"Millions of non-union workers ... would be forced to pay higher taxes for the same benefits their union counterparts" receive, Republicans on the House Ways and Means Committee said in a written statement.
The deal also leaves a $60 billion hole in the projected revenue stream, meaning Democrats will have to find the money elsewhere if they want to meet Obama's pledge to keep health care reform deficit-neutral.
"There's a $60 billion hole now in the legislation," Democratic strategist Doug Schoen said. "Not sure it's fair, not sure it's paid for."
Neither union leaders nor the White House offered any specifics on where that money would come from.
Lawmakers, though, have been considering applying Medicare payroll taxes to capital gains and other dividend incomes above $200,000 for individuals and $250,000 for families.
Critics of the legislation called the union deal another back-room favor handed out in secret talks that violated Obama's promise of transparency. They say special treatment has gone to interests ranging from the pharmaceutical industry to the state of Nebraska, which was offered extra federal funding for Medicaid patients in exchange for moderate Sen. Ben Nelson's support.
"If this bill is so good, why does everyone need an exemption in order to vote for it? ... We see the drug companies get a special deal. We see what happened in Louisiana and most notoriously Nebraska in the Senate where they got special deals. And now the unions get a special deal." Donatelli said.
"This union kickback is the latest in a long line of back-room pay-offs and sweetheart deals on a health care bill that the American people overwhelmingly do not support," Michael Steel, a spokesman for House Minority Leader John Boehner, said in an e-mail Friday.
But the White House trumpeted the "solid progress" it was making toward a final package.
Obama held a meeting with House and Senate Democratic leaders late into the night Thursday to discuss the apparent breakthrough.
House Speaker Nancy Pelosi said on Friday that her members, who were fiercely opposed to the earlier version of the Senate bill's "Cadillac" tax, liked what they saw in the union compromise.
"We are very optimistic" that common ground will be found on other issues, she said.
Gerald McEntee, president of the American Federation of State, County and Municipal Employees, said his workers were "very pleased" by the deal.
"They're ready to go out and fight for it and even improve it down line. We're for this health care reform and ready to fight for it."
AFL-CIO President Richard Trumka called the agreement the biggest hurdle for union support. Absent any last minute changes, he said the AFL-CIO's on board.
"We will endorse it and do it proudly," Trumka said of the emerging health care bill.
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It's time for all of you to do what Newt advises. Send e mails to all of your reps and senators.
Say only one thing. 2+2=4 and sign your name and address.
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Gotta say one thing about those Progressive scumbags, they deal right off the top of the deck. It's just a sad state of affairs when they can be so brazen as to be willing to do almost anything to advance their agenda and don't care who see's how they do it.
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Who says we're not outraged?
I'm appalled that they think they can tax people for choosing not to be in a union.
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Seems like it might be a good potential for an equal protection lawsuit.
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This bill is good for many, many lawsuits. I only wish those pushing it could do jail time.
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All the courts would do is strip out minor portions of the bill, while leaving it mostly intact. At best all they'd do is nibble around the edges a bit.
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What does it mean when I read the topic and would have sworn it was:
Unicorns Get Backroom Deal on Health Care
I thought someone was posting something from the Onion.
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I would have preferred unicorns getting the backroom deal...
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All the courts would do is strip out minor portions of the bill, while leaving it mostly intact.
I don't know about that. Requiring citizens to buy something is pretty blatant, and the money from that requirement is needed to sustain the plan. I would think that even a wise Latina would find it hard to justify making people buy something whether they want it or not.
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That seems like a stretch.
I must buy roads whether I want them or not.
I must buy k-12 school whether I want it or not.
I must buy car insurance whether I want it or not.
I fail to see how this is different.
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The Great Uniter is hell-bent on driving wedges, creating Two Americas. I'm sure he'll get his wish.
And people ARE up in arms, more every day.
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Gerald McEntee, president of the American Federation of State, County and Municipal Employees, said his workers were "very pleased" by the deal.
"They're ready to go out and fight for it and even improve it down line. We're for this health care reform and ready to fight for it."
FYI, AFSCME has probably cost the taxpayer more money poured down a drain than any single source. If you wondered why the nonfederal government is as inefficient and wasteful as it is, thank AFSCME for it. Wish my state would be kind enough to ban it from all of Pennsylvania.
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That seems like a stretch.
I must buy roads whether I want them or not.
I must buy k-12 school whether I want it or not.
I must buy car insurance whether I want it or not.
I fail to see how this is different.
You're talking about taxes for roads and schools, not a consumer product.
You do not have to buy car insurance if you don't drive or own a car. But you would be forced to buy health insurance merely by virtue of your existence. If the courts rule that the government can force you to buy health insurance whether you want it or not, why can the government not force you to buy a car made by Obama Motors?
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That seems like a stretch.
I must buy roads whether I want them or not.
I must buy k-12 school whether I want it or not.
I must buy car insurance whether I want it or not.
I fail to see how this is different.
None of those are taxes on existence. They are taxes on behavior or property. Your roads come from state/local income taxes and theoretically from a sin tax on gas. Your K-12 school tax is on your property. Car insurance is only required if you wish to operate a car on government property.
Health insurance tax/fines will be a tax on you sucking oxygen. That's a new one. I'm not familiar with any other 'being alive' tax.
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We have a "death tax," but that's a tax on the stuff you have left when you die. There is no tax for becoming dead (although we shouldn't give these folks ideas).
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I think more people aren't (visibly) upset because they know this thing has been backroom deals from the get go. The insurance mandate, IIRC, was the only way to get the insurance companies to support reform. Rinse and repeat.
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That seems like a stretch.
I must buy roads whether I want them or not.
I must buy k-12 school whether I want it or not.
I must buy car insurance whether I want it or not.
I fail to see how this is different.
Because compulsory government schooling is entirely awesome and non-socialist. No sirree Bob.
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I must buy roads whether I want them or not.
To me the current deal is more like we all had to buy the road, but unions members don't have to stop at the tollbooth to use it like the rest of us do.
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There is an interesting article on using the equal protection clause to fight this. I don't remember where I saw it, but I'll see if I can find it again. I'm in a union and probably have what they consider a Cadillac health plan. And I don't know if my union is part of the agreement. But, this agreement is wrong and it's probably unconstitutional to boot. And it won't save me. In the end, I'm just as screwed as every other working person. This bill has a large footprint. It's going to hit every taxpayer hard. We'll end up paying ridiculous amount of our income for a plan that ultimately reduces our quality of care. Pay more for less- what's not to like about that plan? ???
But, in the long term, the joke may be on the unions as I saw something else that says the exemption expires in a few years. Won't all of the union members who blindly follow their reps be surprised when that happens?
It's another example of the union bosses kissing up to the politicians and politicians kissing up to the unions for votes. Each side does what they think will best help them. When speaking of the union side, , I mean the union bosses. The average union member is usually not part of the sweetheart deal and isn't usually that better off when one is made. The union bosses and the politicians on the other hand- well, they do great.
One of these days, I'll rant about my view of unions. Being in one isn't all it's cracked up to be and frequently the union makes deals that are counter-productive to the members. Kind of like what politicians do after we elect them.
Tangled webs....
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This bill is good for many, many lawsuits. I only wish those pushing it could do jail time.
last i checked the punishment for t... [tinfoil]
There is an interesting article on using the equal protection clause to fight this. I don't remember where I saw it, but I'll see if I can find it again.
that was my first thought when i heard this, i'm looking forward to that link. hope you can find it, lately i can't find any of my old links. it's almost like there being taking down or something. =|
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It's another example of the union bosses kissing up to the politicians and politicians kissing up to the unions for votes. Each side does what they think will best help them. When speaking of the union side, , I mean the union bosses. The average union member is usually not part of the sweetheart deal and isn't usually that better off when one is made. The union bosses and the politicians on the other hand- well, they do great.
I used to be in a public employees union when I worked for a county government. I agree with you completely. Just before every election, the union rep would come out to field sites to tell us who we were supposed to vote for. It was almost always the candidates that we, as run of the mill members, had already had discussions on and had decided would be who we WOULDN'T vote for. Of course we always made those decisions based on how things would affect us away from work, and not just at the workplace.
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Your roads come from state/local income taxes and theoretically from a sin tax on gas. Your K-12 school tax is on your property.
And, both of these can be foot-voted against, thus providing some incentive for localities to use reason when setting the rates. Is that dynamic going to be in place with Obamacare? I suppose you could move to another country. Or to Texas after they get around to seceding.
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Local union thug lays down their basic argument.
We control the .gov and set the rules so quit complaining and fall in line.
http://www.adn.com/opinion/letters/story/1095838.html
Want health care? Join a union
In "Backroom health deals hurts contractors" (Jan. 12), Rebecca Logan appears to have answered her own question about portability of heath care benefits. She bemoans the fact that large employers and unions are able to join together for portability of health care benefits while contractors are left out in the cold.
Well, Rebecca, as the president and CEO of Associated Builders and Contractors, you should encourage your members to join unions for access to health care portability. Along with that, there will be other benefits such as pension portability and quality of life portability.
But, as usual, the small business community will probably just complain about how unfair everything is and continue to work to put more money in their own pockets, balanced as always on the backs of their employees.
-- Sam Rouse
Anchorage
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But, as usual, the small business community will probably just complain about how unfair everything is and continue to work to put more money in their own pockets, balanced as always on the backs of their employees.
-- Sam Rouse
Anchorage
BWWWAAAAHAAAHAAHAHAHAAA!!! ;/ =D
I have known several small-business owners over the years, as customer, employee, and friend. NONE, repeat, NONE of them were rich.
Neither was I when I worked at any of them--but to be honest, it was never really about the money. =)
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I thought the Democrat/union complaint was that things are not "fair."
But when the unions drive more companies to bankruptcy as they did GM and Chrysler, those of us getting screwed on health care will get screwed again bailing out the companies.
I love paying for my neighbor's homes, cars, and health insurance. It's just so...fair.
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I swear, economic illiteracy is going to be the death of our country.
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Not sure who said it but,
"If this is such a great deal, then why is everyone trying to get out of it ??"
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None of those are taxes on existence. They are taxes on behavior or property. Your roads come from state/local income taxes and theoretically from a sin tax on gas. Your K-12 school tax is on your property. Car insurance is only required if you wish to operate a car on government property.
Health insurance tax/fines will be a tax on you sucking oxygen. That's a new one. I'm not familiar with any other 'being alive' tax.
I know where your coming from, I really do.
But I am playing devil's advocate. The health insurance tax will be another income tax. So technically, I don't have to pay it, if I don't have a job. And I am sure the rate will be incremental with income.
But to say these examples aren't taxes on existence seems pretty weak. Take for example the property tax. Even if you rent, your still paying that tax rolled into the land owner's rent. Because he has to pay that tax for you. The only way to really avoid it is to literally be homeless. [Kinda like not having a job to avoid the health care tax.]
Or just ponder not owning a car. That might work in downtown NY or Chi-town; but for the vast majority of America, the concept is not really possible to follow and thrive.
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I know where your coming from, I really do.
But I am playing devil's advocate. The health insurance tax will be another income tax. So technically, I don't have to pay it, if I don't have a job. And I am sure the rate will be incremental with income.
But to say these examples aren't taxes on existence seems pretty weak. Take for example the property tax. Even if you rent, your still paying that tax rolled into the land owner's rent. Because he has to pay that tax for you. The only way to really avoid it is to literally be homeless. [Kinda like not having a job to avoid the health care tax.]
Or just ponder not owning a car. That might work in downtown NY or Chi-town; but for the vast majority of America, the concept is not really possible to follow and thrive.
No, I get what ya mean. While no current tax is on existence, in order to practically live, you must pay taxes. I getcha. I'll acknowledge it's just taking the matter a step further. But it is still the first "citizenship tax" and that fails to give me a warm or squishy feeling. Not even a tingle up my leg, unfortunately.
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Personally, I'd rather the surtax on higher earners (which I'd probably end up paying.)
Getting more people insured by taxing people that are insured is one of the dumbest things I've ever heard.
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Sure but don't forget, we're also going to be levying fines against(aka taxing) the people who DON'T buy insurance too (but only if they can afford it), so eventually they'll be able to funnel everyone into the "approved" policies.
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Taxing people who don't buy insurance is one thing (a big problem, to be sure).
But this new exepmtion for unions is an entirely new problem all on its own. It's a tax on not being in a union. I don't know how America got to the point that taxing people for not being union members became OK, but it's a huge, huge problem. It oughta scare the bejeezus out of people.
Government does NOT get to tax people for not being members of particular political organizations.
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Sure but don't forget, we're also going to be levying fines against(aka taxing) the people who DON'T buy insurance too (but only if they can afford it), so eventually they'll be able to funnel everyone into the "approved" policies.
I might have listened to an argument for this back when we were looking at some kind of public option, as a means to make it solvent. (Let's not argue that whole thing here, I'll probably agree with you)
Now that there's no public option, I see absolutely no reason for the govt to force anyone to buy insurance.
Personally, I feel if we're going to play socialism, we might as well go all the way and do it British-style, or not at all
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we want this? why?
http://www.opinionjournal.com/extra/?id=110006785
There's No Place Like Home
What I learned from my wife's month in the British medical system.
by DAVID ASMAN
Wednesday, June 8, 2005 12:00 A.M. EDT
"Mr. Asman, could you come down to the gym? Your wife appears to be having a small problem." In typical British understatement, this was the first word I received of my wife's stroke.
We had arrived in London the night before for a two-week vacation. We spent the day sightseeing and were planning to go to the theater. I decided to take a nap, but my wife wanted to get in a workout in the hotel's gym before theater. Little did either of us know that a tiny blood clot had developed in her leg on the flight to London and was quietly working its way up to her heart. Her workout on the Stairmaster pumped the clot right through a too-porous wall in the heart on a direct path to the right side of her brain.
Hurrying down to the gym, I suspected that whatever the "small" problem was, we might still have time to make the play. Instead, our lives were about to change fundamentally, and we were both about to experience firsthand the inner workings of British health care.
We spent almost a full month in a British public hospital. We also arranged for a complex medical procedure to be done in one of the few remaining private hospitals in Britain. My wife then spent about three weeks recuperating in a New York City hospital as an inpatient and has since used another city hospital for physical therapy as an outpatient. We thus have had a chance to sample the health diet available under two very different systems of health care. Neither system is without its faults and advantages. To paraphrase Thomas Sowell, there are no solutions to modern health care problems, only trade-offs. What follows is a sampling of those tradeoffs as we viewed them firsthand.
As I saw my wife collapsed on the hotel's gym floor, my concern about making the curtain was replaced by a bone-chilling recognition that she was in mortal danger. Despite her protestations that everything was fine, her left side was paralyzed and her eyes were rolling around unfocused. She was making sense, but her words were slurred. Right away I suspected a stroke, even though she is a young, healthy nonsmoker. Over her continuing protests, I knew we had to get her to a hospital right away.
The emergency workers who came within five minutes were wonderful. The two young East Enders looked and sounded for all the world like a couple of skinhead soccer fans, cockney accents and all. But their professionalism in immediately stabilizing my wife and taking her vitals was matched with exceptional kindness. I was moved to tears to see how comforting they were both to my wife and to me. As I was to discover time and again in the British health system, despite the often deplorable conditions of a bankrupt infrastructure, British caregivers--whether nurses, doctors, or ambulance drivers--are extraordinarily kind and hardworking. Since there's no real money to be made in the system, those who get into public medicine do so as a pure vocation. And they show it. In the case of these EMTs, I kick myself for not having noticed their names to later thank them, for almost as soon as they dropped us off at the emergency room of the University College of London Hospital, they disappeared.
Suddenly we were in the hands of British Health Service, and after a battery of tests we were being pressured into officially admitting my wife to UCL. As we discovered later, emergency care is free for everyone in Britain; it's only when one is officially admitted to a hospital that a foreigner begins to pay. I didn't know that. But I did know that I was not about to admit my wife to a hospital that could not diagnose an obviously life-threatening affliction. And even after having given her an MRI, the doctors could not tell if she had a stroke.
Now, the smartest thing I did before we left the hotel was to delay the ambulance driver long enough to run back to my room and grab my wife's cell phone. With that phone I began making about a thousand dollars worth of trans-Atlantic calls, the first of which was to the world-renowned cardiologist Dr. Isadore Rosenfeld, who I'm lucky enough to have as my GP. As it turned out, not only did Izzy diagnose the problem correctly, he even suggested a cause for the stroke, which later turned out to be correct. "There's no reason for her to have a stroke except if it's a PFO." I didn't know what Izzy meant, but I wrote down the initials and later found out that a PFO (a patent foramen ovale) is a flap-like opening in the heart through which we get our oxygen in utero. For most of us, the opening closes shortly after birth. But in as many as 30% of us, the flap doesn't seal tight, and that can allow a blood clot to travel through the heart up to the brain. Izzy agreed that I should not admit my wife to UCL but hold out for a hospital that specialized in neurology.
As it happened, the best such hospital in England, Queen's Square Hospital for Neurology, was a short distance away, but it had no beds available. That's when I started dialing furiously again, tracking down contacts and calling in chits with any influential contact around the world for whom I'd ever done a favor. I also got my employer, News Corp., involved, and a team of extremely helpful folks I'd never met worked overtime helping me out.
Suddenly, a bed was found in Queen's Square, and by 2 a.m. my wife was officially admitted to a British public hospital. The neurologist on call that night looked at the same MRI where the emergency doctors had seen nothing and immediately saw that my wife had suffered a severe stroke. It was awful news, but I realized we were finally in the right place.
That first night (or what was left of it) my wife was sent off to intensive care, and the nurses convinced me that I should get a few hours sleep. We found a supply closet, in which there was a small examination table, and the nurses helped me fashion fake pillows and blankets from old supplies. The loving attention of these nurses was touching. But the conditions of the hospital were rather shockingly apparent even then.
The acute brain injury ward to which my wife was assigned the next day consisted of four sections, each having six beds. Whether it was dumb luck or some unseen connection, we ended up with a bed next to a window, through which we could catch a glimpse of the sky. Better yet, the window actually opened, which was also a blessing since the smells wafting through the ward were often overwhelming.
When I covered Latin America for The Wall Street Journal, I'd visit hospitals, prisons and schools as barometers of public services in the country. Based on my Latin American scale, Queen's Square would rate somewhere in the middle. It certainly wasn't as bad as public hospitals in El Salvador, where patients often share beds. But it wasn't as nice as some of the hospitals I've seen in Buenos Aires or southern Brazil. And compared with virtually any hospital ward in the U.S., Queen's Square would fall short by a mile.
The equipment wasn't ancient, but it was often quite old. On occasion my wife and I would giggle at heart and blood-pressure monitors that were literally taped together and would come apart as they were being moved into place. The nurses and hospital technicians had become expert at jerry-rigging temporary fixes for a lot of the damaged equipment. I pitched in as best as I could with simple things, like fixing the wiring for the one TV in the ward. And I'd make frequent trips to the local pharmacies to buy extra tissues and cleaning wipes, which were always in short supply.
In fact, cleaning was my main occupation for the month we were at Queen's Square. Infections in hospitals are, of course, a problem everywhere. But in Britain, hospital-borne infections are getting out of control. At least 100,000 British patients a year are hit by hospital-acquired infections, including the penicillin-resistant "superbug" MRSA. A new study carried out by the British Health Protection Agency says that MRSA plays a part in the deaths of up to 32,000 patients every year. But even at lower numbers, Britain has the worst MRSA infection rates in Europe. It's not hard to see why.
As far as we could tell in our month at Queen's Square, the only method of keeping the floors clean was an industrious worker from the Philippines named Marcello, equipped with a mop and pail. Marcello did the best that he could. But there's only so much a single worker can do with a mop and pail against a ward full of germ-laden filth. Only a constant cleaning by me kept our little corner of the ward relatively germ-free. When my wife and I walked into Cornell University Hospital in New York after a month in England, the first thing we noticed was the floors. They were not only clean. They were shining! We were giddy with the prospect of not constantly engaging in germ warfare.
As for the caliber of medicine practiced at Queen's Square, we were quite impressed at the collegiality of the doctors and the tendency to make medical judgments based on group consultations. There is much better teamwork among doctors, nurses and physical therapists in Britain. In fact, once a week at Queen's Square, all the hospital's health workers--from high to low--would assemble for an open forum on each patient in the ward. That way each level knows what the other level is up to, something glaringly absent from U.S. hospital management. Also, British nurses have far more direct managerial control over how the hospital wards are run. This may somewhat compensate for their meager wages--which averaged about £20,000 ($36,000) a year (in a city where almost everything costs twice as much as it does in Manhattan!).
There is also much less of a tendency in British medicine to make decisions on the basis of whether one will be sued for that decision. This can lead to a much healthier period of recuperation. For example, as soon as my wife was ambulatory, I was determined to get her out of the hospital as much as possible. Since a stroke is all about the brain, I wanted to clear her head of as much sickness as I could. We'd take off in a wheelchair for two-hour lunches in the lovely little park outside, and three-hour dinners at a nice Japanese restaurant located at a hotel down the street. I swear those long, leisurely dinners, after which we'd sit in the lobby where I'd smoke a cigar and we'd talk for another hour or so, actually helped in my wife's recovery. It made both of us feel, well, normal. It also helped restore a bit of fun in our relationship, which too often slips away when you just see your loved one in a hospital setting.
Now try leaving a hospital as an inpatient in the U.S. In fact, we did try and were frustrated at every step. You'd have better luck breaking out of prison. Forms, permission slips and guards at the gate all conspire to keep you in bounds. It was clear that what prevented us from getting out was the pressing fear on everyone's part of getting sued. Anything happens on the outside and folks naturally sue the hospital for not doing their job as the patient's nanny.
Why are the Brits so less concerned about being sued? I can only guess that Britain's practice of forcing losers in civil cases to pay for court costs has lessened the number of lawsuits, and thus the paranoia about lawsuits from which American medical services suffer.
British doctors, nurses and physical therapists also seem to put much more stock in the spiritual side of healing. Not to say that they bring religion into the ward. (In fact, they passed right over my wife's insistence that prayer played a part in what they had to admit was a miraculously quick return of movement to her left side.) Put simply, they invest a lot of effort at keeping one's spirits up. Sometimes it's a bit over the top, such as when the physical or occupational therapists compliment any tiny achievement with a "Brilliant!" or "Fantastic!" But better that than taking a chance of planting a negative suggestion that can grow quickly and dampen spirits for a long time.
Since we returned, we've actually had two American physical therapists who did just that--one who told my wife that she'd never use her hand again and another who said she'd never bend her ankle again. Both of these therapists were wrong, but they succeeded in depressing my wife's spirits and delaying her recovery for a considerable period. For the life of me, I can't understand how they could have been so insensitive, unless this again was an attempt to forestall a lawsuit: I never claimed you would walk again.
Having praised the caregivers, I'm forced to return to the inefficiencies of a health system devoid of incentives. One can tell that the edge has disappeared in treatment in Britain. For example, when we returned to the U.S. we discovered that treatment exists for thwarting the effects of blood clots in the brain if administered shortly after a stroke. Such treatment was never mentioned, even after we were admitted to the neurology hospital. Indeed, the only medication my wife was given for a severe stroke was a daily dose of aspirin. Now, treating stroke victims is tricky business. My wife had a low hemoglobin count, so with all the medications in the world, she still might have been better off with just aspirin. But consultations with doctors never brought up the possibilities of alternative drug therapies. (Of course, U.S. doctors tend to be pill pushers, but that's a different discussion.)
Then there was the condition of Queen's Square compared with the physical plant of the New York hospitals. As I mentioned, the cleanliness of U.S. hospitals is immediately apparent to all the senses. But Cornell and New York University hospitals (both of which my wife has been using since we returned) have ready access to technical equipment that is either hard to find or nonexistent in Britain. This includes both diagnostic equipment and state-of-the-art equipment used for physical therapy.
We did have one brief encounter with a more comprehensive type of British medical treatment--a day trip to one of the few remaining private hospitals in London.
Before she could travel back home, my wife needed to have the weak wall in her heart fortified with a metal clamp. The procedure is minimally invasive (a catheter is passed up to the heart from a small incision made in the groin), but it requires enormous skill. The cardiologist responsible for the procedure, Seamus Cullen, worked in both the public system and as a private clinician. He informed us that the waiting line to perform the procedure in a public hospital would take days if not weeks, but we could have the procedure done in a private hospital almost immediately. Since we'd already been separated from our 12-year-old daughter for almost a month, we opted to have the procedure done (with enormous assistance from my employer) at a private hospital.
Checking into the private hospital was like going from a rickety Third World hovel into a five-star hotel. There was clean carpeting, more than enough help, a private room (and a private bath!) in which to recover from the procedure, even a choice of wines offered with a wide variety of entrees. As we were feasting on our fancy new digs, Dr. Cullen came by, took my wife's hand, and quietly told us in detail about the procedure. He actually paused to ask us whether we understood him completely and had any questions. Only one, we both thought to ask: Is this a dream?
It wasn't long before the dream was over and we were back at Queen's Square. But on our return, one of the ever-accommodating nurses had found us a single room in the back of the ward where they usually throw rowdy patients. For the last five days, my wife and I prayed for well-behaved patients, and we managed to last out our days at Queen's Square basking in a private room.
But what of the bottom line? When I received the bill for my wife's one-month stay at Queen's Square, I thought there was a mistake. The bill included all doctors' costs, two MRI scans, more than a dozen physical therapy sessions, numerous blood and pathology tests, and of course room and board in the hospital for a month. And perhaps most important, it included the loving care of the finest nurses we'd encountered anywhere. The total cost: $25,752. That ain't chump change. But to put this in context, the cost of just 10 physical therapy sessions at New York's Cornell University Hospital came to $27,000--greater than the entire bill from British Health Service!
There is something seriously out of whack about 10 therapy sessions that cost more than a month's worth of hospital bills in England. Still, while costs in U.S. hospitals might well have become exorbitant because of too few incentives to keep costs down, the British system has simply lost sight of costs and incentives altogether. (The exception would appear to be the few remaining private clinics in Britain. The heart procedure done in the private clinic in London cost about $20,000.)
"Free health care" is a mantra that one hears all the time from advocates of the British system. But British health care is not "free." I mentioned the cost of living in London, which is twice as high for almost any good or service as prices in Manhattan. Folks like to blame an overvalued pound (or undervalued dollar). But that only explains about 30% of the extra cost. A far larger part of those extra costs come in the hidden value-added taxes--which can add up to 40% when you combine costs to consumers and producers. And with salaries tending to be about 20% lower in England than they are here, the purchasing power of Brits must be close to what we would define as the poverty level. The enormous costs of socialized medicine explain at least some of this disparity in the standard of living.
As for the quality of British health care, advocates of socialized medicine point out that while the British system may not be as rich as U.S. heath care, no patient is turned away. To which I would respond that my wife's one roommate at Cornell University Hospital in New York was an uninsured homeless woman, who shared the same spectacular view of the East River and was receiving about the same quality of health care as my wife. Uninsured Americans are not left on the street to die.
Something is clearly wrong with medical pricing over here. Ten therapy sessions aren't worth $27,000, no matter how shiny the floors are. On the other hand my wife was wheeled into Cornell and managed to partially walk out after a relatively pleasant stay in a relatively clean environment. Can one really put a price on that?
Mr. Asman is an anchor at the Fox News Channel and host of "Forbes on Fox." This article appears in the May issue of The American Spectator.
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I swear, economic illiteracy is going to be the death of our country.
Are you referring to the country in general, or to posts in this thread specifically?
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I was referring mostly to the union attitudes quoted above. But yes, I mean it generally. There are way too many people in the country who don't understand how money works, how markets work, how the economy works, and don't realize what basic economic relationships are at play in the world. And they're voting accordingly.
My remark wasn't directed at anyone in this thread or on APS.
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Unions don't realise that the dems want to put them out of business. When the government provides healthcare, basic housing, and food there ceases to be a reason for unions to exist.
I'm in a union, it isn't all bad. The stereotype of lazy union workers does NOT fly where I work, if you are lazy, you are gone. The average person works harder at their job than any other non-union place I've worked. No one (well, nearly no one) slacks off. My pay/benefits are good, but not ridiculous by any standard. I can't envision anyone doing my job for any less pay/benefits than I recieve.
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WRT to the article on the Brit health care system, this might put things into perspective:
The average household income in prosperous W Europe is roughly equivalent to that in America's poorest state, Mississippi.
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we want this? why?
http://www.opinionjournal.com/extra/?id=110006785
Many hospitals in the US are as far behind the curve as the hospital you initially saw in the UK. Also, those clot buster drugs are only effective if administered 2 hours or before symptoms start. If you are unable to tell when they started, they will not offer the drug, as it can cause more damage afterwards.
If you live in a suburban area, you have a 1 in 3 chance of getting your stroke diagnosed and taken care of properly (this comes from a friend who is a 20 year seasoned emergency room nurse)
If you are in a rural area in the USA, you have a 1 in 10 chance.
Most modern trained paramedics and nurses get stroke identification training when they get their CPR cert (I had this last time I was certified)
Stroke identification is something many emergency rooms are working at getting better at, all over
The article below is an example of how many emergency rooms in the United States, and other countries deal with the problem:
http://well.blogs.nytimes.com/2010/01/07/the-doctor-will-see-you-nowon-video-chat/
Basically, doing what the commentator in your story did; called a specialist.
Due to this, many emergency rooms will have specialists on call around town they can talk to for things outside of their expertise.
Notice the end of that WSJ story, they talk about costs. I think that's the end game everyone agrees on. One way to control costs is to nationalize the entire thing. Personally, I don't care how we do it, as long as we control costs and still keep a standard of care.
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Notice the end of that WSJ story, they talk about costs. I think that's the end game everyone agrees on. One way to control costs is to nationalize the entire thing. Personally, I don't care how we do it, as long as we control costs and still keep a standard of care.
It's called rationing. You might get the same standard of care (though I doubt it would last) so long as you don't count how long you have to wait for the care as part of the "standard."
If people wanting "single-payer" would be honest, we can at least argue about forcing people to wait for care in the interest of lowering costs.
They won't say that, though. They claim that we'll get a free lunch and lower costs and NOTHING BAD WILL HAPPEN.
It's fun to argue with either deluded or disingenuous people.
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I'm a union thug* with one of those gold plated Cadillac healthcare plans. That crap pisses me off. I am fully aware that my health coverage is part of my salary and as such (while I'd rather not) I'm OK with being taxed for it as income because in effect it is income. These special deals like LA and NE and this one for the unions are going to kill the healthcare bill (I hope).
*I'm the guy that shows up at local meetings in a NRA cap and/or a McCain/Palin shirt and dares anyone to say anything about it. On the rare occaison we have a candidate in to speak campaign I'll try to get in at least one "real" question, the answer to which will hopefully open the eyes of at least a few in the hall.
I'm also regular with purchasing my "liberal offsets" like campaign contributions, NRA/ILA, working for conservative candidates campaigns and such
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One way to control costs is to nationalize the entire thing.
Yeah. No. Fail.
Nationalizing health care will not lower costs.
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One way to control costs is to nationalize the entire thing.
Medicare is such a resounding success that its total unfunded liabilities are somewhere around $35 trillion. Also, it pays doctors so little that many are refusing to take Medicare patients.
Now take Medicare, multiply it several times, and you've got Obamacare.
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Medicare is such a resounding success that its total unfunded liabilities are somewhere around $35 trillion. Also, it pays doctors so little that many are refusing to take Medicare patients.
Now take Medicare, multiply it several times, and you've got Obamacare.
To be fair, that's what we'll have from the current legislation.
What Obama would REALLY like is take the VA, multiply it several times and get "single-payer healthcare".
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Yeah. No. Fail.
Nationalizing health care will not lower costs.
The act of nationalizing itself will only lower costs a bit. One place where a lot of the savings come from is the near elimination of medical torts.
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The act of nationalizing itself will only lower costs a bit. One place where a lot of the savings come from is the near elimination of medical torts.
Funny how that was SPECIFICALLY off the table for the Democrats, though...
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the check from the aba cleared the bank? =D someone once said putting the lawyers in charge of the money is like asking the rats to guard the cheese
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Yeah. No. Fail.
Nationalizing health care will not lower costs.
Ain't no goods/services as expensive as those that are "free" from the gov't.
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One place where a lot of the savings come from is the near elimination of medical torts.
Just when they are needed the most...