President Obama

[Marksmu]

What in particular do you not like about the healthcare reform?

The single largest thing not to like about reform is the lack of access to care under the new plan. Currently if you have a good job with good insurance you can get good care and you can get it fast. Under the new plan everyone becomes insured...The reimbursement rates that the government has set for the care are so low that employers who do not drop their high quality coverage will eventually become priced out of their markets....some employers are large enough it wont matter, but smaller employers will universally drop their coverage in favor of the far cheaper government plan.

Democrats would have you believe that is a good thing because there is savings to be had in terms of sheer volume getting better pricing....Its not true though because there simply are not enough doctors to meet the new demand. Right now if you don't have insurance you only goto the doctor when you are very sick because it is too expensive to just wander into a doctors office (or the doctor wont accept patients without insurance)....People without insurance go to rediclinics or other PA run places b/c they are cheaper than a doctor....but once everyone has insurance, people will expect to be able to use it. These people who currently don't go to the doctor will start going to the doctor more often because they have paid for it and expect a service for what they have paid.

So now a hard working person, who has done everything right their whole life, and has earned better access to care is going to placed in the same line for health care with people who do not work nearly as hard as they do, and legitimately have not earned the same access to care...The law puts everyone on the same plan with the same priorities. So the accountant or lawyer who is far more productive, actually pays taxes, and has a net positive impact on our Economy has insurance dropped from a great plan, to the same plan as the people who have not worked as hard as he and whom are detractors from our economy....actually consuming more services than they contribute back.

One size fits all care does not work. It sounds cruel but there are not enough doctors to care for the productive and the non-productive. There needs to be a graduated scale for care.

Look at it from a primary care physicians perspective......College + Med School = $200,000. Time lost with zero income -8 years. Residency -3 years- income $30,000 (hardly a living wage for a doctor)....this doctor can now be a primary care physician....12 years and over $200,000 in debt....Monthly payments on that $200,000 loan over 15 years $1687/month. Median primary doctors income $168,000.....that puts them in the 28% tax bracket...take home pay of approximately $120,000/yr...minus their annual student loans of $20,244 = $99,750.

Why would a person put themselves through that much school for 11 years of their life, to earn $99,000? They could have gotten an engineering degree in 1/3 of the time, started working, and been earning $99,000 within 4 years....if they are smart enough to be a doctor they are likely to be in the $125-$200,000 range in engineering by year 10....

The incentive for a doctor just isnt there and the programs that the government offers are not nearly a strong enough incentive.

There are lots of other bad things about the law...the reduction in govt payments for medicare/medicaid has already driven doctors away from accepting new patients, and a recent survey I read showed that something like 30% of doctors that are currently in their 50s or above plan to retire or close thier practice rather than take the new rates and mandates...turns out doctors wont work for free....even if you legislate that they have to.

Edited August 1, 2012 by Marksmu

[RedScare]

The single largest thing not to like about reform is the lack of access to care under the new plan. Currently if you have a good job with good insurance you can get good care and you can get it fast. Under the new plan everyone becomes insured...The reimbursement rates that the government has set for the care are so low that employers who do not drop their high quality coverage will eventually become priced out of their markets....some employers are large enough it wont matter, but smaller employers will universally drop their coverage in favor of the far cheaper government plan.

Democrats would have you believe that is a good thing because there is savings to be had in terms of sheer volume getting better pricing....Its not true though because there simply are not enough doctors to meet the new demand. Right now if you don't have insurance you only goto the doctor when you are very sick because it is too expensive to just wander into a doctors office (or the doctor wont accept patients without insurance)....People without insurance go to rediclinics or other PA run places b/c they are cheaper than a doctor....but once everyone has insurance, people will expect to be able to use it. These people who currently don't go to the doctor will start going to the doctor more often because they have paid for it and expect a service for what they have paid.

So now a hard working person, who has done everything right their whole life, and has earned better access to care is going to placed in the same line for health care with people who do not work nearly as hard as they do, and legitimately have not earned the same access to care...The law puts everyone on the same plan with the same priorities. So the accountant or lawyer who is far more productive, actually pays taxes, and has a net positive impact on our Economy has insurance dropped from a great plan, to the same plan as the people who have not worked as hard as he and whom are detractors from our economy....actually consuming more services than they contribute back.

One size fits all care does not work. It sounds cruel but there are not enough doctors to care for the productive and the non-productive. There needs to be a graduated scale for care.

Look at it from a primary care physicians perspective......College + Med School = $200,000. Time lost with zero income -8 years. Residency -3 years- income $30,000 (hardly a living wage for a doctor)....this doctor can now be a primary care physician....12 years and over $200,000 in debt....Monthly payments on that $200,000 loan over 15 years $1687/month. Median primary doctors income $168,000.....that puts them in the 28% tax bracket...take home pay of approximately $120,000/yr...minus their annual student loans of $20,244 = $99,750.

Why would a person put themselves through that much school for 11 years of their life, to earn $99,000? They could have gotten an engineering degree in 1/3 of the time, started working, and been earning $99,000 within 4 years....if they are smart enough to be a doctor they are likely to be in the $125-$200,000 range in engineering by year 10....

The incentive for a doctor just isnt there and the programs that the government offers are not nearly a strong enough incentive.

There are lots of other bad things about the law...the reduction in govt payments for medicare/medicaid has already driven doctors away from accepting new patients, and a recent survey I read showed that something like 30% of doctors that are currently in their 50s or above plan to retire or close thier practice rather than take the new rates and mandates...turns out doctors wont work for free....even if you legislate that they have to.

There is simply so much untruth and speculation in this post that I won't post a long response, but just say that it is untrue. I see doctors often without insurance. I've had to, since insurance was unaffordable under the old rules. If Obamacare lowers prices, I am all for it...and I am a small businessman.

Obamacare is not one size fits all. That is the propaganda put out by opponents. And, if there are currently enough doctors to serve the people with insurance PLUS the uninsured who go to emergency rooms, then there will be enough doctors to serve them when they have insurance. Frankly, the reason that healthcare cost so much is that doctors over-practice, giving numerous unneeded tests to drive up the bill. Maybe now they will stop doing so, since more people will have insurance.

I don't know any poor doctors, so I am unsympathetic to their supposed plight. When they make what I make, or less, I'll start to feel sorry for them.

I find it strange that conservatives are complaining that government funded Medicare payments are dropping. Maybe all of this deficit spending rhetoric is just deficit spending rhetoric. They do it on defense spending, too.

[TheNiche]

So, to summarize.

American healthcare was thousand dollarsed, is thousand dollarsed, and will continue to be thousand dollarsed.

Every party's deficit spending rhetoric is a different flavor of absurd that nobody honestly believes in. Every party's deficit cutting rhetoric is superficial, and thousand dollarsing meaningless. No need to worry, just get young people to pay for it. They're young; thousand dollars'em.

That is why I object to Obamacare (and every other politically feasible outcome regardless of the party in power). There is not and cannot be justice.

Edited August 1, 2012 by TheNiche

[Marksmu]

There is simply so much untruth and speculation in this post that I won't post a long response, but just say that it is untrue. I see doctors often without insurance. I've had to, since insurance was unaffordable under the old rules. If Obamacare lowers prices, I am all for it...and I am a small businessman.

Try going to a surgeon without health insurance....try getting an elective surgery, like an ACL repair without insurance. They will not do it....unless you pay cash in advance of the procedure. Most people who cant afford insurance don't have $35,000 laying around to book an O.R. anesthesiologist, and a surgeon. So good luck with that.

Obamacare is not one size fits all. That is the propaganda put out by opponents. And, if there are currently enough doctors to serve the people with insurance PLUS the uninsured who go to emergency rooms, then there will be enough doctors to serve them when they have insurance. Frankly, the reason that healthcare cost so much is that doctors over-practice, giving numerous unneeded tests to drive up the bill. Maybe now they will stop doing so, since more people will have insurance.

Under the ACA there are relatively few choices of significance. That is not propaganda or misinformation....The law states what must be covered and every single plan in America must fit that bill. What must be covered is so broad, that it is essentially comprehensive insurance for everyone....I am intimately aware of the nuances of this law. I run a self insured health care trust for our company and I purchase health care for more than 800 lives . I have been through over 30 classes, lectures, and compliance lunches and they are all being put on by compliance experts, many of whom favor the law...ie, not people I politically agree with.

Doctors do over practice, but the run-up of the bill is just as much to blame on lawyers as doctors. What is needed in this regard is significantly more patient education. Doctors do not spend enough time talking to patients about their options and the costs of those options. They just come in and tell you what is happening. That is a problem, the ACA did not solve that problem...it just blanket dictates what tests are authorized for what symptoms. Its basically a redi-clinic for all doctors who want to be paid. If your patient does not have all of the symptoms necessary to justify the test it will be denied coverage.

I don't know any poor doctors, so I am unsympathetic to their supposed plight. When they make what I make, or less, I'll start to feel sorry for them.

Well I for one do feel sorry for them. They provide an extremely valuable service and to make ends meat now they have see WAY too many patients in order to make what they deserve, or they have to charge an annual fee just to have access to them

Our pediatrician is trying to make it without doing either, and I dont see how much longer she can do it. I told my daughters pediatrician the other day that I felt sorry for her....I told her that I got her bill from the last time we visited for my daughters fever and sore throat and that I was not sure how she could stay in business based on the rate of pay the insurance gave her.

We called for an appointment, got one, saw a nurse for about 5 minutes to go through the temperature, weight, height, etc....then the doctor came in talked to us for about 10 minutes about her symptoms and how everything was going - answered another 5 minutes of unrelated child health care questions, and then did a step test. We used about about 15 minutes of the doctors time, 5 minutes of the nurses time...couple that with building rent, medical record filing staff, receptionist, and insurance and her overhead is pretty substantial. I paid my co-pay $15 and she billed insurance $185....her time, plus lab work on the strep test. My insurance paid - $18....so on my visit she received $33 and I was being tended to for about 20 minutes..

Why would anyone go through all that school/money for such a pathetic sum of money? Doctors deserve to make more so that we always have the best in the medical field...take away the incentive to be a doctor and you will be left with terrible doctors.

[kylejack]

Try going to a surgeon without health insurance....try getting an elective surgery, like an ACL repair without insurance. They will not do it....unless you pay cash in advance of the procedure. Most people who cant afford insurance don't have $35,000 laying around to book an O.R. anesthesiologist, and a surgeon. So good luck with that.

Under the ACA there are relatively few choices of significance. That is not propaganda or misinformation....The law states what must be covered and every single plan in America must fit that bill. What must be covered is so broad, that it is essentially comprehensive insurance for everyone....I am intimately aware of the nuances of this law. I run a self insured health care trust for our company and I purchase health care for more than 800 lives . I have been through over 30 classes, lectures, and compliance lunches and they are all being put on by compliance experts, many of whom favor the law...ie, not people I politically agree with.

Being someone intimately involved with purchasing healthcare plans, what is the name of the "government plan" that you are saying that companies can sign up for?

Edited August 1, 2012 by kylejack

[Marksmu]

There is not currently a name for any plan in Texas as they are not available yet. All major carriers though (Blue Cross, Aetna, UMR, etc) are expected to administer the plans but nothing has happened yet. Texas has chosen not to extend some of the benefits, and its still undecided how that is going to play out. Under the ACA the states were supposed to lose funding for not complying, but that was the one part of the ACA the Supreme Court declared unconstitutional...As its not currently required by law none of the carriers are offering anything yet as their base plan is more profitable.

[kylejack]

There is not currently a name for any plan in Texas as they are not available yet. All major carriers though (Blue Cross, Aetna, UMR, etc) are expected to administer the plans but nothing has happened yet. Texas has chosen not to extend some of the benefits, and its still undecided how that is going to play out. Under the ACA the states were supposed to lose funding for not complying, but that was the one part of the ACA the Supreme Court declared unconstitutional...As its not currently required by law none of the carriers are offering anything yet as their base plan is more profitable.

I'm not aware of a government plan. What I've heard of is they're going to create a market where you can shop private market plans.

Large companies have been required to offer HMO for their employees for some time now. Small companies have not been required to, and I don't think Obamacare forces them to either. Obamacare does have an individual mandate, though, whereby if you make over a certain amount you have to either buy a plan or pay more taxes not to buy a plan.

Edited August 1, 2012 by kylejack

[Marksmu]

Many of the requirements of the ACA such as no preexisting condition exclusions, no cost coverage of birth control no wait for benefits to begin, etc will quickly bankrupt employer sponsored plans. That is, at least I believe, the governments plan all along as they really want a single payer system anyway.

The expectation among the professionals I deal with is that the states will each end up offering a government plan at a reduced price from federal subsidies and it will be administered through existing TPA's such as blue cross or united, etc. Essentially the only options will be deductible and max out of pocket.

[RedScare]

You can always tell when an ACA opponent is lying through his teeth. How? When they say this...

Many of the requirements of the ACA such as...no cost coverage of birth control...

Pregnancies, which are covered by insurance, cost thousands of dollars. In 2007, the average full term pregnancy cost over $7500. C-sections averaged nearly $11,000. A premature delivery averaged over $51,000.

And the cost to insurance companies to avoid all of that through birth control? As little as $16 per month.

It takes a special kind of math to claim that the $16 prevention will bankrupt the insurance company, but the $11,000 C-section will not.

[kylejack]

You can always tell when an ACA opponent is lying through his teeth. How? When they say this...

Pregnancies, which are covered by insurance, cost thousands of dollars. In 2007, the average full term pregnancy cost over $7500. C-sections averaged nearly $11,000. A premature delivery averaged over $51,000.

And the cost to insurance companies to avoid all of that through birth control? As little as $16 per month.

It takes a special kind of math to claim that the $16 prevention will bankrupt the insurance company, but the $11,000 C-section will not.

Correct, it is in the financial interest of insurances companies to provide birth control. That's why almost all of them do. Many of the ones that don't have an ideological objection, not a financial one (such as the Catholic Church).

[Marksmu]

You can always tell when an ACA opponent is lying through his teeth. How? When they say this...

Pregnancies, which are covered by insurance, cost thousands of dollars. In 2007, the average full term pregnancy cost over $7500. C-sections averaged nearly $11,000. A premature delivery averaged over $51,000.

And the cost to insurance companies to avoid all of that through birth control? As little as $16 per month.

It takes a special kind of math to claim that the $16 prevention will bankrupt the insurance company, but the $11,000 C-section will not.

I used birth control as an example b/c it is the most talked about & debated drug. There are actually a litany of free pharmaceutical products included in the act...Most are preventative care type that are supposed to reduce future illness costs, but there is no such thing as free anything....if the insurance company previously charged the individual for the drug, now they must charge the whole group. Its not free. Instead of a single person paying for their own lifestyle, everyone must pay for it. Its the democrats mentality....its cheaper for most people if everyone pays for it. However most people is not all people. Under the ACA an 18 yr old male in great health is now subsidizing birth control for a woman,b/c she is unable or unwilling to be personally responsible and pay $16/mo to not get pregnant.

Its always easy to tell when your talking to an uninformed supporter of the ACA because they make ridiculous statements like pregnancy is covered by insurance. It has been and continues to be an option for an employer to choose to cover or to exclude.

There is no question that a pregnancy costs much more than a bottle pills. However, many insurance policies, exclude pregnancy. Ours does not and most employer provided comprehensive plans do not. However all individual plans that you buy outside of a group option, ie directly from Blue Cross, or United, do exclude pregnancy....if you are a woman its specifically excluded unless you pay extra for it....

You need to do more research on Group/Individual health insurance plans before you make blatantly incorrect statements like the one above.

[Specwriter]

Bush Sr.

Before that Carter and before that Ford. That's three within the last nine elections. Apparently, and thankfully, the electorate is not so tolerant of that which displeases them.

[RedScare]

I used birth control as an example b/c it is the most talked about & debated drug. There are actually a litany of free pharmaceutical products included in the act...Most are preventative care type that are supposed to reduce future illness costs, but there is no such thing as free anything....if the insurance company previously charged the individual for the drug, now they must charge the whole group. Its not free. Instead of a single person paying for their own lifestyle, everyone must pay for it. Its the democrats mentality....its cheaper for most people if everyone pays for it. However most people is not all people. Under the ACA an 18 yr old male in great health is now subsidizing birth control for a woman,b/c she is unable or unwilling to be personally responsible and pay $16/mo to not get pregnant.

Its always easy to tell when your talking to an uninformed supporter of the ACA because they make ridiculous statements like pregnancy is covered by insurance. It has been and continues to be an option for an employer to choose to cover or to exclude.

There is no question that a pregnancy costs much more than a bottle pills. However, many insurance policies, exclude pregnancy. Ours does not and most employer provided comprehensive plans do not. However all individual plans that you buy outside of a group option, ie directly from Blue Cross, or United, do exclude pregnancy....if you are a woman its specifically excluded unless you pay extra for it....

You need to do more research on Group/Individual health insurance plans before you make blatantly incorrect statements like the one above.

Sounds like you are the one who needs to bone up on the purpose of insurance, as you do not seem to understand the basic premise of insurance. The group ALWAYS pays for the "lifestyle" of the individual. That is the way insurance works. Because paying for cancer treatments or open heart surgery would be catastrophic for most people, they pool their money to pay the cost for those few individuals who need the surgery. People like me who have never needed surgery subsidize people like you, who have had two pregnancies covered by insurance. To pick out only birth control for ridicule, especially when it actually saves money, is to inflict your political beliefs on the group's insurance. I would think that you'd be mighty upset if single guys like me demanded that your wife's pregnancies not be covered, since you are forcing me to pay for your reckless fornicating lifestyle.

I've said this many times, so I'll repeat it here. NO ONE should get their ACA information from anyone with a strong political belief. They ALL lie about what it includes. This includes Marksmu. I have no opinion on the ACA yet, as many of its particulars are still unknown, especially the cost of individual policies. However, when falsehoods are proffered as truth, I do occasionally weigh in.

[Marksmu]

Sounds like you are the one who needs to bone up on the purpose of insurance, as you do not seem to understand the basic premise of insurance. The group ALWAYS pays for the "lifestyle" of the individual. That is the way insurance works. Because paying for cancer treatments or open heart surgery would be catastrophic for most people, they pool their money to pay the cost for those few individuals who need the surgery. People like me who have never needed surgery subsidize people like you, who have had two pregnancies covered by insurance. To pick out only birth control for ridicule, especially when it actually saves money, is to inflict your political beliefs on the group's insurance. I would think that you'd be mighty upset if single guys like me demanded that your wife's pregnancies not be covered, since you are forcing me to pay for your reckless fornicating lifestyle.

I've said this many times, so I'll repeat it here. NO ONE should get their ACA information from anyone with a strong political belief. They ALL lie about what it includes. This includes Marksmu. I have no opinion on the ACA yet, as many of its particulars are still unknown, especially the cost of individual policies. However, when falsehoods are proffered as truth, I do occasionally weigh in.

I am not actually opposed to birth control. I am opposed to the government dictating that it must be included in group policies when they object to it. Since I took over control of our Health Care plan I have implemented lots of changes...some went over well, others not so much....Year after year we look at how our plan operates and we make changes to our plan that are well thought out and based on trends in our individual group....the ACA takes away much of that freedom to make choices.

I added free birth control and free immunizations to our plan in 2008, long before the ACA came around. In 2009 I added penalties for tobacco users. In 2010 I drastically raised the price of emergency rooms b/c our employees over utilized them and I forced generic drugs when they were available....its changes like these that are no longer available under the ACA. Specifically written into the ACA is a clause that requires an employers plan to meet every single requirement under the act if you make ANY change to your plan.

Ive said it many times on this site - I am far closer to a libertarian than a republican...I am socially ambivalent...I dont care what you do to yourself...I only care when it affects me, and it costs me money...My objections to the ACA are primarily based on putting everyone, productive or not, on the same level, doctor access, and to the fact that the government is dictating to employers what they must provide...its all or nothing...they either meet all requirements or pay penalties for not offering insurance..

Finally, I understand well how insurance is a pool, but its a pool I voluntarily got into. I did not have to get in if I did not want.

[KinkaidAlum]

I've got a pretty good understanding of Obamacare because I lived in Boston when it was Romneycare.

Have you seen the polls out of the Commonwealth? A huge majority love it. I know I did. My insurance costs went down by over half despite keeping the same coverage (Blue Cross Blue Shield). My coverage didn't change. Private insurers didn't flee the state. All in all, health care in Massachusetts > healthcare in Texas and it isn't even close.

Obamacare/Romneycare isn't perfect, but it's a good first step.

[Marksmu]

I've got a pretty good understanding of Obamacare because I lived in Boston when it was Romneycare.

Have you seen the polls out of the Commonwealth? A huge majority love it. I know I did. My insurance costs went down by over half despite keeping the same coverage (Blue Cross Blue Shield). My coverage didn't change. Private insurers didn't flee the state. All in all, health care in Massachusetts > healthcare in Texas and it isn't even close.

Obamacare/Romneycare isn't perfect, but it's a good first step.

Boston is not Texas. Texas borders Mexico and is a gigantic open border. It is well documented that Mexican nationals cross the border illegally to have children in Texas hospitals....Logic dictates that if you are going to start giving everything away for free that you first must establish who qualifies for it....This country can not afford to just give health care away to anyone who happens to be inside our imaginary borders - contributing or not....this begs others to come here for free...not only that it offers yet another incentive for someone not to work...we don't need to give more incentives to keep people on their butts at home. All you hear about is unemployment this, unemployment that...but at my office we have had and continue to have over 60 positions open on the night shift and NOBODY wants them. When people start fighting over a good paying job with good benefits then we can start talking about offering more freebies...until then, I am hugely in favor of cutting them all off and getting people back up looking for work.

If you want to work hard and be productive your whole life and then sit in line behind someone who has never worked a day in their life - that is your prerogative....I for one do not want that to be the case. Im all for everyone getting treatment, but not when it comes at my expense.

You may have liked the care in Boston better, but I assure the quality of Boston's care was not higher than that of Texas, and I dont care what a ridiculous rating system says (they are all skewed). Houston's medical center is consistently rated among the absolute best in the world. If you don't think your getting good care then you are obviously not looking for it in the right places...a doc in the box is not the same as a good doctor just b/c they have an MD behind their name.

[kylejack]

All you hear about is unemployment this, unemployment that...but at my office we have had and continue to have over 60 positions open on the night shift and NOBODY wants them. When people start fighting over a good paying job with good benefits then we can start talking about offering more freebies...until then, I am hugely in favor of cutting them all off and getting people back up looking for work.

Sounds like we need about 60 illegal immigrants.

[HoustonMidtown]

Traffic will probably be a mess this afternoon and evening with Obama arriving....plan accordingly...

 

http://www.khou.com/news/local/President-Obama-to-spend-Wednesday-night-Houston-several-downtown-streets-closed-254570391.html

 

 

Edited April 9, 2014 by HoustonMidtown

[Slick Vik]

Was awesome to breeze by the frustrated drivers downtown on my walk home.

[cloud713]

Forgive my ignorance.. What's he doing in town?

[democide]

I believe he's fundraising, having a good 'ole time.

[Chi-Char-Hou-Dal]

Hey I know the POTUS is in Houston but does anyone know why there are 20 plus COH dump trucks lined up right now on Louisiana?

[brian0123]

They're using them to block traffic. The city was using tree waste trucks in the museum district earlier to block roads.

[jt16]

Was awesome to breeze by the frustrated drivers downtown on my walk home.

So snarky

[Montrose1100]

Does the president normally fly into IAH?

[Houston19514]

No.  Historically the President has flown into Ellington.  Wonder why the change?

[gmac]

You gots to have something to tote the ca$h money

[ClutchCity]

You gots to have something to tote the ca$h money

That's funny because he is in town fundraising and probably getting trash bags full of cash. Sorry for having to point that out haha

[King Owl]

it was ridiculous that Houston had to suffer even more atrocious traffic today so Obama could raise money immediately after he mourned the dead at Ft Hood. 

 

(sorry it had to be said...)

[democide]

He's a historical president, a lot of what he does is unprecedented.