• gingersoul said on Sep 08, 2009....

  Thank you for sharing this article, Bloc....
  
  About half the money you should be earning for being more productive is being sucked up by ever more expensive health-insurance premiums.
  
  
  Health-care reform is going to cost a bundle only if you think that covering the uninsured is our only priority. Yes, making health care available to all citizens is the right thing to do. But it isn't the only thing to do. We also have to fix the spectacularly wasteful and expensive way doctors and hospitals deliver care.
  
  
  
  

• bloc said on Sep 08, 2009....

  One of the interesting things from the second link is that our administrative costs are a lot higher than other countries. A lot of people believe this is due to doctors having the navigate many different payment provides all of whom have very different requirements and methods. Most of the countries talked about have a standard process for doctor's to collect payment. 

• gingersoul said on Sep 08, 2009....

  Bloc.....i am Italian.....in my country mandatory health insurance was established in 1943 and that system was replaced in 1978 by the institution of the Italian
  National Health Service (NHS), Servizio Sanitario Nazionale.
  
  The NHS was created to achieve the objective in article 32 of the
  Italian Constitution, which declares that the Italian state has the
  responsibility of safeguarding the health of each citizen as an
  individual asset and a community interest. Moreover, article 32
  affirms that the Italian state guarantees free care to the indigent.
  
  Universal coverage entitles all citizens, regardless of
  their social status, to equal access to essential health care services,
  services that are necessary and appropriate to promoting, maintaining,
  and restoring health in the population (universalism).
  
  Essential health services are provided free of charge, or at a minimal
  charge, and include general medical and pediatric services;
  essential drugs and those for chronic diseases; treatments administered
  during hospitalization; rehabilitation and long-term post acute
  inpatient care; instrument and laboratory diagnostics, as well
  as other specialized services for early diagnosis and prevention.
  
  Finally, the NHS guarantees that the system is subject to popular
  democratic control at the national, regional, and local level (participation).
  The Italian NHS is structured into three different levels
  of public authority: the central government, the regions, and the
  local health care agencies (LHAs)—Agenzie Sanitarie Locali.
  
  Based on criteria of efficiency and cost–quality, the LHAs
  might provide care either directly, through their own facilities
  (directly managed hospitals and territorial services), or by paying
  for the services delivered by providers accredited by the
  regions, such as independent public structures (hospital agencies
  and university-managed hospitals) and private structures
  (hospitals, nursing homes, and laboratories under contract to
  the NHS).
  
  Patients can freely choose among the public or
  accredited private providers. They can also choose to be treated
  either in the LHA in the area where they reside or in another
  LHA; if they choose the latter, the cost of care will be paid by
  the other LHA.
  
  Therefore, LHAs operate simultaneously as a
  payer and a supplier of services, and patients’ choices of
  providers might indirectly affect the services delivered. These
  two elements, introduced by recent reforms, create a model in
  which providers, regardless of public or private status, are
  expected to compete on cost and quality, and the NHS, through
  the LHAs, acts as a third-party payer, creating what is called a
  quasi-market.
  
  The purpose of a quasi-market is to make the
  LHAs more accountable for the provision of services. Indeed,
  by law, the LHAs must guarantee the quality of all services
  directly delivered or externally acquired, as well as control the
  overall expense, so that it does not exceed the budget.
  
  In this system you can understand how the administrative costs are strictly observed via standard processes.
  
  The Italian NHS is funded mainly by general
  tax revenue. The annual budget for health
  financing is established by the government
  on the basis of the “per capita quota” system,
  representing the national sum per person
  needed to cover the essential health
  care levels guaranteed by the Italian NHS.
  
  Over the years, the financing of the NHS has undergone important
  changes. Before the recent fiscal reforms, there were three
  principal sources of tax contribution, for the national health budget:
  (1) general taxation, determined each year by the Parliament
  with the national budget, the so-called National Health Fund
  (NHF); (2) regional taxes, paid by employers to the region of residence
  of their employees; and (3) revenues of LHAs, from the socalled
  “direct” contributions associated with co-pay by users of
  some service costs, such as prescriptions, outpatient treatments,
  and diagnostic tests.
  
  The NHF provided the largest portion of
  money needed for public health care. The NHF was annually allocated
  to the 20 regions, which, in turn, allocate resources to the
  Local Health Agencies (LHAs).
  As the Italian NHS reforms transferred power to the regions,
  health care funding has also become a regional responsibility
   
  If this system works in Italy, can work everywhere, i am sure of this. ...;-)
  
  Its not immune by abnormalities and overspending and favoritism but i have never shelled one cent any time i went to the ER or I have been admitted to an hospital.
  
  We also have a system of private clinic: there is where the riches go.
  
   But very often the same doctors who work there work in public structures too. 

• sheltercrow said on Sep 08, 2009....

  Question two is particularly relevant. In study after study this fact has been explained and still quite a few believe it's true. Like anything that your employer gives you comes out of his pocket. You would think it would be common sense to all that wealth does not mysteriously appear in the owners pocket to bestow on his employees and that it is ultimately based entirely on the effort of the work force and nothing more.
  
  The concept of capitalism in our society is so shrouded in a unhealthy myth-like existence that it inevitably has become almost a religion. In our society capitalism seems to have literally replaced Christianity. The rulers of old used the religious myth to keep the people in line. In our society the rulers use the capitalist myth to keep people in line. From 'lose Gods favor' to 'lose your bosses favor.' How f****d up can you get?
  
  All wealth is derived from human effort, and capitol, being the accumulation and utilization of another persons effort for selfish gain, good or bad, is still based on human effort. It's just that in our capitalist society you have to give away some of your effort to the gods of capitol to put food on the table. And still they want you believe it's they who a giving you all these benefits when actually it comes from your own efforts.
  
  
  2. Somebody else is paying for your health insurance.
  
  Nope. Even when your employer offers coverage, he isn't reaching into his own pocket to cover you and your fellow employees; he's reaching into your pocket, paying you lower wages than he would if he didn't have to pay for your health insurance.

• sheltercrow said on Sep 08, 2009....

  In case your wondering Baucus just released his 'framework of a plan for consideration by the Bipartisan Six' dated 9/5/09.
  
  There is no public option.
  
  Outside of 'Medicare, Medicaid, or CHIP' the insurance companies will have the market to themselves. And since the McCarran-Ferguson Act, which gives states the authority to regulate the “business of insurance,” also exempts the business of insurance from the federal antitrust laws. The Insurance business is now to be a literal monopoly enshrined in law. The framework says:
  
  
  Beginning in 2013, all US citizens and legal residents would be required to purchase health insurance or have health coverage from an employer, through a public program (i.e., Medicare, Medicaid, or CHIP), or through some other source that meets the minimum creditable coverage standard. Exemptions from the requirement would be allowed for religious objections consistent with those allowed under Medicare and for undocumented immigrants. Individuals who choose to keep the plan they have today would be deemed to have satisfied the requirement.
  
  
  From: CRS Report for Congress March 19, 2003 Medical Malpractice Liability Insurance and the McCarran-Ferguson Act
  
  
  The McCarran Act did three things: Section 1 of the Act reaffirmed the power of the states to tax and regulate the business of insurance. Section 2 declared that Acts of Congress, except those specifically relating to the business of insurance, did or would not invalidate state laws regulating or taxing the business of insurance, and that the federal antitrust laws – specifically, the Sherman Act, the Clayton Act, and the Federal Trade Commission Act – did not apply to the business of insurance as long as such business was regulated by state law. Section 3(b) declared, however, that boycotts and acts of coercion or intimidation remained subject to federal antitrust law. Thus, under current law, the regulation of the business of insurance in the United States is carried out at the state level, the business of insurance is substantially exempt from federal antitrust statutes, and collective activities may qualify for an antitrust exemption, but the activity in question must not be an act or agreement to boycott, coerce or intimidate.
  

• D6fer said on Sep 08, 2009....

  sheltercrow.....I am curious.....what do you think would happen to production if employers made no more than employees?

• sheltercrow said on Sep 08, 2009....

  D6fer: You will have to be more specific. I assume you are trying to be sardonic.
  
  My first paragraph uses the employer as defined as 'company, business, firm, organization, establishment, outfit (informal).' As such the employer is not defined as having a wage or salary.
  
  My third paragraph references 'capitol, being the accumulation and utilization of another persons effort for selfish gain.' Unfortunately I spelled it incorrectly. The word should be 'capital.' And, technically, it actually should be 'capital accumulation.'
  
  
  Real capital refers to factors of production used to create goods or services that are not themselves significantly consumed (though they may depreciate) in the production process.
  
  
  So the accumulation of capital is nothing more than the total of human effort to create the 'factors of production...'
  
  
  All wealth is derived from human effort, and capital accumulation, being the accumulation and utilization of another persons effort for selfish gain, good or bad, is still based on human effort. It's just that in our capitalist society you have to give away some of your effort to the gods of capital accumulation to put food on the table. And still they want you believe it's they who a giving you all these benefits when actually it comes from your own efforts.
  
  
  I assume you though I defined employer as:
  
  
  boss, (informal) manager, head, leader, director, chief, executive, owner, owner, master, chief executive, governor (informal) skipper, managing director, administrator, patron, supervisor, superintendent, et.el
  
  
  In our next lesson we will discuss what is meant by 'gods of capital accumulation.'
  

• mobil said on Sep 09, 2009....

  You say allot Sheltercow,  the truth is not in what you say, it's in what you don't say. I find that interesting, not what you say, but what you don't say and why.
   
  Most of what you say isn't even you saying it and most of what you don't say isn't you as well. So I guess you aren't really saying anything which is pretty much what you have to say.

• secretlife said on Sep 09, 2009....

  when my representatives in Washington are willing to have the same health insurance as the average american, then i will trust them.  until then, i want the government to stay out of health care. 
  what they're proposing isn't reform. 
  it's destruction and rebuilding which is not what the government does well.  it's big government which isn't what i want.
   
  i'm not sure how loud i have to say that or how often before my president gets it.
   
   
   
   

• bhalah said on Sep 09, 2009....

  submit coment.

• D6fer said on Sep 09, 2009....

  sheltercrow......dance around it anyway you want, but I think you know what i mean.....I bet everyone else does.....you obviously think that workers should get compensated much more than they do......and in many cases, I could agree......It's easy to slander business owners across the board as "the gods of capital accumulation", but the fact of the matter is, those are the people that take the risk....invest the money.....and in many cases, pay the ultimate price from the weight of the world on their shoulders, to provide a financial vehicle for many people to feed their families, pay their mortgages, cars, boats, clothes....etc.
  
  You show me a socialist country that doesn't have a divide between haves and have nots.....it doesn't exist......every society has a hierarchy...it's all a pyramid scheme, and someone has to be at the top.....at least in the USA there is a better chance that it can be you or me.
  
  I was not being sardonic....I was merely trying to get you to openly admit how you feel rather than hiding behind cut and paste illustrations.
  
  My guess is, you are feeling a bit Marxist.
  

• sheltercrow said on Sep 09, 2009....

  mobil: aren't you the one that thinks neo-liberalism is about liberals? If your purpose is to remain ignorant. You're doing a hell of a job.
  
  D6fer: Your first paragraph somewhat contradicts your second. But I bet we agree on the core features.
  
  How have 'those people' accumulated their capital to invest? Most capital investment of magnitude, when done on a personal basis, is done with inherited wealth in one form or another. There are very few Horatio Alger's. Inherited wealth, especially over generations, is just another form of capital accumulation to which the average Joe does not have access.
  
  You seem to elude to this with the observation 'it's all a pyramid scheme.' Money buys power, which definitely makes making money easier. It's a no-brainer. Continue this long enough and we get to the 'haves and have-not's' that are, in the real world, forever hooked-in or locked-out. There are exceptions of course. No system is absolute. Socialist leaning countries, as you point out, are no different.
  
  Yes. 'It's easy to slander business owners.' I was a contractor for some 30 years and worked for a dozen or more corporations. The more a corporate manager had invested in the company the more sociopathic symtoms he displayed. When I was a direct employee for a couple short stints, the sheer personal corruption of the pecking order drove me f*****g insane. To go from an solo independent contractor to an employee was too much to endure. It's extremely degrading.
  
  Having started out as an idealist (I was fostered a five with no parents to explain the facts of life) I was quite horrified to find that ability and qualifications have many meanings not found in the average text book. It's ability and qualifications applied to 'who you know and who you blow' that counted. And I failed badly in that area.
  
  They 'pay the ultimate price from the weight of the world on their shoulders?' I think you may be indulging yourself here. If 'those people' have lost what they never earned, that is, inherited wealth, how could they 'pay the ultimate price?'
  
  There is only a finite amount of wealth in the world. The 'haves and have-not's' are a sure indication that the few gain at the expense of the many.
  

• D6fer said on Sep 09, 2009....

  when I say the ultimate price, I mean the ultimate price......I have had two family members die as a direct result (in my opinion) of the pressures that rest on the shoulders of a business owner....and they never really got to enjoy the fruits of their labor.....their heirs rightfully inherited their estates, after our blood sucking government took more than their fair share of the estates.
  
  My views have changed somewhat in the past year or so I must admit......I used to believe in a much less restrictive capitalist system, but the likes of Goldman Sachs, G.E., The Republican Party, The Democrat Party, G.M., Chrysler, Bush, Obama, etc. Have left me feeling a bit raped.......Moderation is the key, and to have moderation, you must have regulation.....not just regulation on industry, but also on government.
  
  If you think about it, all of the financial mess came about in the most heavily regulated industries......and there are massive conflicts of interest within the political parties with those corporations i mentioned.....so where is regulation needed most? Who's the fox? Who's the hen?
  

• D6fer said on Sep 09, 2009....

  when I say the ultimate price, I mean the ultimate price......I have had two family members die as a direct result (in my opinion) of the pressures that rest on the shoulders of a business owner....and they never really got to enjoy the fruits of their labor.....their heirs rightfully inherited their estates, after our blood sucking government took more than their fair share of the estates.
  
  My views have changed somewhat in the past year or so I must admit......I used to believe in a much less restrictive capitalist system, but the likes of Goldman Sachs, G.E., The Republican Party, The Democrat Party, G.M., Chrysler, Bush, Obama, etc. Have left me feeling a bit raped.......Moderation is the key, and to have moderation, you must have regulation.....not just regulation on industry, but also on government.
  
  If you think about it, all of the financial mess came about in the most heavily regulated industries......and there are massive conflicts of interest within the political parties with those corporations i mentioned.....so where is regulation needed most? Who's the fox? Who's the hen?
  

• mobil said on Sep 10, 2009....

  Sheltercow, no I am the one who thinks we will never, NEVER ever change each others minds about these matters being discussed here or there or anywhere.

   

  We each use a set of preconceived notions, ideals and principles. I have to laugh about how seriously we toil to change each others minds while pointing to those things we believe in and leaving out the truth about those things we do not. I've been here three years and have as yet see anyone change anything about anyone's core beliefs.

   

  So to answer your question, yes it's me who thinks neo-liberalism is about your uncanny ability to site ridiculous sources AND the similarity of those sources to that that exits beneath a horses tail.

   

• sheltercrow said on Sep 10, 2009....

  mobil: What gives you the idea I am trying to change minds? I actually do the simple research because I enjoy it. And it doesn't always come out the way you may suppose it might. But I waste time with you so I leave you with your prejudices that you love so much. It's a pity that your ignorance is your badge of honer.
  
  D6fer: I myself was a democrat till around age 24. Then I got the understanding that both parties are pretty much the same. That was some 30 years ago. I cannot remember why, I think it was Jimmy Carter and his support for the contras:
  
  
  Carter told the Sandinistas they had to retain the National Guard, which had been Somoza's elite band of US-trained psychopathic killers. The Sandinistas said No. So Carter ordered the CIA to bring up the officers and torturers running the Argentinian death squads to train up a force of Nicaraguan exiles in Honduras, and launch them on terror missions across the border. They called them the Contras.
  
  Carter was a busy man. Not just content with forming the Contras, he harkened to the pain of South Korea, where workers and peasants were demonstrating. His envoy, Richard Holbrooke advised the South Korean military to hit back hard, and they did, killing around 3,000, the most horrible massacre since the Korean war. And yes, Carter started the covert CIA operation in Afghanistan, rallying the mujiddeen to fight the Soviets. Soon the CIA would bring Osama bin Laden to Afghanistan to lend a Saudi presence and Saudi cash.
  
  
  Anyway. You make a point, if you connect the dots, that defines the utter hypocrisy or our political system. A 'heavily regulated industry' and 'massive conflicts of interest' produce what kind of results? Reform or legislation that appears to be regulation but in the buried details is no more than a codification of corruption. The health care reform now emerging from our congress, with bipartisan support, is just that. In the details it has empowered the insurance industry to be the sole middleman between you and health care. The lodes of money the companies have paid the parties has paid of very well.
  
  There is one thing I learned years ago on what it takes to make tons of money without actually providing any service. You have got to position yourself in a large money stream and get the public to buy into the notion that you are indispensable. That is what the insurance companies have done and done well. Seems everyone takes it as a sacred now, that you give your money to the insurance companies and then they give it to the actual providers. What a cash cow. The most magnificent con job imaginable is now to be made a total monopoly and codified as the law of the land. Even the now defunct public option was to be run by the insurance companies. And this magnificent con job is to be subsidized by the government to boot. That is public corruption at it's finest.
  

• mobil said on Sep 10, 2009....

  Sheltercow, prejudice and ignorance, I love the former so much and the latter is my badge of honor? Yikes, I feel just awful now !!

• sheltercrow said on Sep 10, 2009....

  mobil: Keep up the good work mobil. Some day even your humor might be original.

• bloc said on Sep 11, 2009....

  @secret
  "when my representatives in Washington are willing to have the same health insurance as the average american, then i will trust them.  until then, i want the government to stay out of health care. "
  
  
  You realize that your representatives in washington have government run healthcare right? Also, what Obama is proposing is reform, it is not a tear down and rebuild plan. Going to single payer for example would be a tear down and rebuild plan. 

• bloc said on Sep 11, 2009....

  @ginger 
  
  
  Thank you for the thoughtful comment. 

• sheltercrow said on Sep 12, 2009....

  So why does Obama's healthcare agenda turns out to be a deal that usually red-state Wal-Mart has decided to buy into?
  
  Has Wal-Mart started to care? Hardly. The Baucus health care plan uses our taxes to reward Wal-Mart for keeping Its workers in poverty.
  
  Before you go wacko on me read the second link. Wal-Mart actually profits from the Baucus plan because it spells out "the one way--just about the only way--a large employer can dodge responsibility for paying something for its employees... if its employees happen to qualify for Medicaid."

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