:Canuck:
http://www.vpr.net/news_detail/90403/
QuoteHouse Gives Preliminary Approval To Health Care Bill
Wednesday, 03/23/11 5:50pm and Thursday, 03/24/11 7:34am
(Host) After a full day and evening of debate, the Vermont House gave preliminary approval to health care reform legislation that's designed to put the state on the path toward a single payer system.
The vote on the measure was 89 to 47.
Backers of the bill say it's needed because the state's current health care approach is broken. But opponents say it could dismantle the high quality system that's already in place.
VPR's Bob Kinzel reports:
(Kinzel) The legislation is one of Governor Peter Shumlin's top priorities and represents the signature issue of his first term in office.
The heart of the bill is the creation of a 5 person Health Care Board, modeled after the Public Service Board, which will oversee virtually every aspect of health care in the state.
The Board will establish a total state budget for health care, it will review hospital budgets and private insurance rates, and it will design a new payment system for health care providers.
Health Care chairman Mark Larson says the bill, known as H 202, is needed because costs are rising at an unsustainable level.
(Larson) "H202 represents an historic opportunity to fix our broken health care system and unleash the potential of the Vermont economy that has struggled with the cost of health care it would provide health care security to Vermonters and allow us to bend the curve on health care costs in short H202 is the right thing for us to do."
(Kinzel) Larson says the Board is needed to provide a centralized approach to health care reform.
(Larson) "At this point we have nowhere to turn because we have a system that is too fragmented and too complex where there are many cooks but no one is really in charge of dinner."
(Kinzel) Many Republicans and some Democrats opposed the bill. Arlington Rep. Cynthia Browning said the legislation was too ambitious and had too many unanswered questions.
(Browning) "So the uncertainty about the benefits, the coverage, the costs, the financing, the tax structure the uncertainty to our businesses I feel is a very, very detrimental effect to our economy and to the grow of the economy and he creation of jobs and this is not the direction in which I wish to go."
(Kinzel) Earlier in the day, the House rejected an effort to remove $24 million in health care provider taxes from the miscellaneous tax bill.
Lowell Rep. Mark Higley offered the amendment because he said the taxes would ultimately be passed along to consumers.
(Higley) "The governor told this body that we must not and cannot succumb to the idea that Vermonters have the capacity to pay higher taxes and this amendment is offered in that spirit."
(Kinzel) But Ways and Means chairwoman Janet Ancel said the taxes were needed to draw down millions of dollars in federal funds for the state's Medicaid program.
(Ancel) "If this amendment passes we're looking at a potential decrease of $34 million."
(Kinzel) The legislation is scheduled to come up for final approval on Thursday.
For VPR News, I'm Bob Kinzel in Montpelier.
Anyone want to place bets how quickly they will lose all their doctors?
Quote from: Hansmeister on March 26, 2011, 11:33:55 PM
Anyone want to place bets how quickly they will lose all their doctors?
OK, I will bat that Vermont has at least one doctor in the state one year from today. How much should we bet?
Quote from: sbr on March 26, 2011, 11:42:24 PM
Quote from: Hansmeister on March 26, 2011, 11:33:55 PM
Anyone want to place bets how quickly they will lose all their doctors?
OK, I will bat that Vermont has at least one doctor in the state one year from today. How much should we bet?
I'm sure there will be many University professors with doctorates in the soft sciences hanging around.
Quote from: Hansmeister on March 26, 2011, 11:33:55 PM
Anyone want to place bets how quickly they will lose all their doctors?
About as fast as Canada?
There will be doctors who won't leave... some doctors don't mind being poor and actually do the job because they like to help people.
It's pretty tough to be a Canadian Family Practice doc. You have a higher salary on average than your American counterpart and you have substantially lower malpractice insurance costs. Single payer = doctor poverty! Oh yeah, and death panels!
Quote from: Fate on March 27, 2011, 08:30:47 AM
It's pretty tough to be a Canadian Family Practice doc. You have a higher salary on average than your American counterpart and you have substantially lower malpractice insurance costs. Single payer = doctor poverty! Oh yeah, and death panels!
You're supposed to allow them to frame the debate as comparing the salaries of Canadian family practitioners vs. highly paid US specialists.
That said, I don't think it's fair to expect US malpractice insurance rates to drop all that much.
No, they won't. There will still be plenty of lawyers.
Quote from: Darth Wagtaros on March 27, 2011, 10:40:55 AM
No, they won't. There will still be plenty of lawyers.
Indeed. And because of the rampancy of poverty in the US, the only escape is to scam the legal system.
Quote from: Fate on March 27, 2011, 08:30:47 AM
It's pretty tough to be a Canadian Family Practice doc. You have a higher salary on average than your American counterpart and you have substantially lower malpractice insurance costs. Single payer = doctor poverty! Oh yeah, and death panels!
Very interesting, would never have guessed that Canadian GPs make more than American GPs.
But the malpractice premium is hardly a function of the payment scheme.
I wish more states would experiment with policies considered "crazy" by others. We need to get the federal government out of a lot of things and let the state governments start experimenting again with various policies. Then we'd see how hilariously some states (California) crashed.
Quote from: Admiral Yi on March 27, 2011, 12:11:55 PM
But the malpractice premium is hardly a function of the payment scheme.
Indeed. The structure of the US insurance system is far more damaging, as is the US legal culture.
Quote from: Neil on March 27, 2011, 12:32:43 PM
Indeed. The structure of the US insurance system is far more damaging, as is the US legal culture.
Why is it that the left never brings that up whenever they say "the US is the only country in the developed world that does it this way? :P
Is Fate for universal health care?
Quote from: Grey Fox on March 27, 2011, 12:41:56 PM
Is Fate for universal health care?
You know bro, there are no real penalties for addressing Fate directly. :mellow:
I just quoted one of his posts and I'm still alive.
The penalty is that he attracts grumbler's attention. :lol:
Quote from: Admiral Yi on March 27, 2011, 12:53:33 PM
Quote from: Grey Fox on March 27, 2011, 12:41:56 PM
Is Fate for universal health care?
You know bro, there are no real penalties for addressing Fate directly. :mellow:
I just quoted one of his posts and I'm still alive.
:lol:
Of course, Canadians have bags of milk. Do we really want to copy a nation that does that?
Yes. The milk bags are awesome!
Quote from: Admiral Yi on March 27, 2011, 12:35:09 PM
Quote from: Neil on March 27, 2011, 12:32:43 PM
Indeed. The structure of the US insurance system is far more damaging, as is the US legal culture.
Why is it that the left never brings that up whenever they say "the US is the only country in the developed world that does it this way? :P
Because the only hope for public health care in the US on a federal level is through the Democratic Party. You have absolutely no chance of convincing the Democrats to do anything that the trial lawyers don't want them to do.
Quote from: Fate on March 27, 2011, 08:30:47 AM
It's pretty tough to be a Canadian Family Practice doc. You have a higher salary on average than your American counterpart and you have substantially lower malpractice insurance costs. Single payer = doctor poverty! Oh yeah, and death panels!
I don't think our docs have higher salary on average than their american counterparts.
EDIT: Found data.
US: 121k$ to 165k$
http://www.payscale.com/research/US/Job=Family_or_General_Practitioner/Salary
Canada: 98k$ to 160k$
http://www.payscale.com/research/CA/Job=Family_or_General_Practitioner/Salary
My take:
Vermont won't see a reduction in health care costs, unless it starts making hard choices.
Malpractice insurance costs won't go down, they are irrelevant in this scenario.
The real effects will be when the State enforce a cap on doctors, nurses and other professionals to maintain the budget afloat. And then, when they start asking for quotas, to avoid spending too much money.
Having an Health Department to coordinate the efforts of all agents in this sector is a good idea. Having health care costs covered for the poorer elements of society is a good thing.
I remain unconvinced, as per financial insurance theory that a single payer solution is automatically the best.
If private clinics are allowed, and doctors allowed to practice in both private&public sectors, it could work. If they do it the Canadian way, they're fucked beyond what they could imagine in their worst case scenario.
Quote from: Grey Fox on March 27, 2011, 01:17:00 PM
Yes. The milk bags are awesome!
Those bags are friggin stupid.
Quote from: Peter Wiggin on March 27, 2011, 01:07:22 PM
The penalty is that he attracts grumbler's attention. :lol:
Where is Grumbler by the way? Haven't seen him in a while.
I hear he was tossed into the nursing home.
Quote from: Darth Wagtaros on March 27, 2011, 05:09:49 PM
I hear he was tossed into the nursing home.
Raz and Grumbler disappeared at the same time! :o
Quote from: viper37 on March 27, 2011, 02:12:19 PMIf private clinics are allowed, and doctors allowed to practice in both private&public sectors, it could work. If they do it the Canadian way, they're fucked beyond what they could imagine in their worst case scenario.
Aren't doctors allowed in private practice in Canada? :mellow:
Quote from: Sheilbh on March 27, 2011, 06:24:08 PM
Aren't doctors allowed in private practice in Canada? :mellow:
It is forbidden by a doctor to charge money for an act covered by the public insurance.
It's also forbidden by law to sell insurance for this type of coverage.
So the doctor makes a choice: 100% private or 100% public.
Given that there's really no health insurance, except for a really narrow field of practice, because of a supreme court judgement, there is not much doctors operating in private health care clinics.
Not to say there aren't any, there are, but they ain't that numerous. Not enough to make a real difference, and there are no private hospitals were you could get a surgery.
What do you mean there are no doctors operating in private clinics? Vancouver is full of clinics and I'm pretty sure most of them are private.
Also, we don't have bagged milk on the West Coast.
Bagged milk?
I'm unfamilar with this but it sounds awful. But then I also find milk in plastic bottles less than great, if it doesn't come in glass its not worth having.
Good news on the main subject I think. Though I am quite unfamiliar with this single payer term.
Quote from: Tyr on March 28, 2011, 03:12:42 AM
Bagged milk?
I'm unfamilar with this but it sounds awful. But then I also find milk in plastic bottles less than great, if it doesn't come in glass its not worth having.
(https://languish.org/forums/proxy.php?request=http%3A%2F%2Fsinsblog.com%2Fwp-content%2Fuploads%2F2010%2F08%2F128389322_be5f183849.jpg&hash=6196f742a20ae910f9dc2d7455f0c9b17406a247)
Quote from: Tyr on March 28, 2011, 03:12:42 AM
Good news on the main subject I think. Though I am quite unfamiliar with this single payer term.
All medical bills get paid by the same entity. In this case the Vermont state government.
Quote from: Grey Fox on March 28, 2011, 05:53:59 AM
Quote from: Tyr on March 28, 2011, 03:12:42 AM
Bagged milk?
I'm unfamilar with this but it sounds awful. But then I also find milk in plastic bottles less than great, if it doesn't come in glass its not worth having.
(https://languish.org/forums/proxy.php?request=http%3A%2F%2Fsinsblog.com%2Fwp-content%2Fuploads%2F2010%2F08%2F128389322_be5f183849.jpg&hash=6196f742a20ae910f9dc2d7455f0c9b17406a247)
That is fucking weird.
Good this is the way health care should be done: on a state-by-state basis. If a particular system proves superior to the others we can think about it on a national level.
Canada = Socialist hellhole.
Quote from: Valmy on March 28, 2011, 10:16:03 AM
Good this is the way health care should be done: on a state-by-state basis. If a particular system proves superior to the others we can think about it on a national level.
:yes: And if it fails miserably we can avoid it like the plague.
The problem with that approach is that, because healthcare has become a political football, it will be quite difficult to determine whether, going forward, any state healthcare system is well managed and healthy. The Democrats will find every reason under the sun to say that it is, and the Republicans every reason under the sun to say that it isn't.
(https://languish.org/forums/proxy.php?request=http%3A%2F%2F3.bp.blogspot.com%2F_kC5MT2r5U8s%2FS8ZlZe1BsjI%2FAAAAAAAAOX8%2FS_k7klOVAUo%2Fs1600%2Fpolitical%2Bfootball.jpg&hash=e94e57e35106a5e52f33b036ce41e54f8bbf6592)
Don't forget that Massachusetts also has had a health care plan for about five years. Hard to tell how well or badly it's going. I believe costs have gone up, and the State has a harder time affording it. However, most or a lot more people have some insurance, paying into the system. ED visits have gone up as people with health care apparently visit Hospital EDs more often, than the reverse which was the plan.
Quote from: Valmy on March 28, 2011, 10:16:03 AM
Good this is the way health care should be done: on a state-by-state basis. If a particular system proves superior to the others we can think about it on a national level.
I can see some difficulties with that approach. What prevents sick people from making Vermont their mecca? If you got cancer, and you got no insurance, move to Vermont.
The single payer system then would probably collapse, especially since Vermont is tiny and can't handle much "health tourism", but it would collapse precisely because it was the odd one out in US rather than because it was single-payer.
Quote from: DGuller on March 28, 2011, 01:31:42 PM
Quote from: Valmy on March 28, 2011, 10:16:03 AM
Good this is the way health care should be done: on a state-by-state basis. If a particular system proves superior to the others we can think about it on a national level.
I can see some difficulties with that approach. What prevents sick people from making Vermont their mecca? If you got cancer, and you got no insurance, move to Vermont.
The single payer system then would probably collapse, especially since Vermont is tiny and can't handle much "health tourism", but it would collapse precisely because it was the odd one out in US rather than because it was single-payer.
What prevents them from going to Canada or the UK now?
Quote from: Jacob on March 27, 2011, 11:46:19 PM
What do you mean there are no doctors operating in private clinics? Vancouver is full of clinics and I'm pretty sure most of them are private.
Also, we don't have bagged milk on the West Coast.
A doctor can have his private clinic, but he charges to the government, not the client. Such doctors practice at their clinic as well as in the hospital.
If he charges directly to the client, then he can no longer work in an hospital, or charge anything to the government.
What's the reasoning? Why not let him do both?
Possibility of fraud?
Because that would be "TWO-TIERED HEALTHCARE!!!". It's not like the healthcare debate in Canada is any more reasoned than here. They're just approaching it from a different direction.
Quote from: MadImmortalMan on March 28, 2011, 01:33:48 PM
What prevents them from going to Canada or the UK now?
Immigration laws?
Quote from: MadImmortalMan on March 28, 2011, 02:21:13 PM
What's the reasoning? Why not let him do both?
It's a Federal law voted by the Liberal Party of Canada, under Pierre-Elliot Trudeau, in the 70s. Pierre-Elliot Trudeau was a good friend of Fidel Castro. There's your reasoning.
Several fringe movements tried to have the law modified, but the Liberal party was always opposed to it.
I personally think the Conservatives are just waiting to be asked about this by a provincial political party.
It's silly, and it's actually increasing the shortage of doctors.
The original reasoning was that if doctors were allowed to practice in the private, they would desert the public, only do a minimum of work if any and it would harm our dead public health care system. Insert random threat about becoming just like the US, and you have a good description of our political debates on health care issues.
That wouldn't happen because the public system is the biggest source of customers. It can't be ignored.
Coincidentally, this week the Mass Inspector General office came out with a report that the State's free care was being given to those not qualifying - wealthy, or who ever. The law is too lax; doesn't check.
Then another report that said other state residents were coming to Mass for the free care. The care is supposed to be for residents only. People from all over - Texas, New Hampshire, etc coming here.
Lol... Try not to follow the Mass plan too closely, for the states that want to implement their own plan.
At first I was cautiously optimistic about this plan, and it still may get fixed, but so far it's really up in the air as to whether the plan is good or not, even if the above issues weren't there.
Its already costing us megabucks.