U.S. health care lagging

[PLC1]

trouble in paradise mate. hope things work out for you.

Me too. Nothing is ever for sure.

As a result, the state auditor has recommended that CalSTRS raise the contribution rates for teachers and employers. CalSTRS, unlike the California Public Employees Retirement System (CalPERS), must obtain permission from the state legislature to raise contribution rates.

Yes, I can see where that might become necessary, given the current sorry state of the economy.

Typical is the August 11 editorial by the Sacramento Bee entitled “Finally, a Crackdown on Pension Spiking,” which states: “Recent revelations about excessive payouts and questionable compensation calculations at CalSTRS suggest that the state’s second-largest retirement system may be losing tens of millions of dollars annually in overpayments

It's about time they cracked down on that one. What happens is that administrators (teachers are generally not able to do this) accept a one year pay hike that affects their pension calculations.


Personally, I'm not terribly worried. I have IRAs as well, and haven't had to use them yet. Maybe if I live to be 110, I could have a problem.

 

[Dr.Who]

You will see money out of it. You won't see as much as you would had you paid into a 401K or something, but you'll see a small stipend eventually. SS isn't dead, despite what is being said about it.

I got out of it because I was a part of a state retirement system. I paid 8%, matched by 8% from my employers, for 38 years. Since the money went to a real trust fund where the feds didn't pi** it away, and where that evil, socialistic, terrible teacher's union wouldn't let the state to pi** it away either, I wound up with a far better retirement than I would have from SS. Everyone should have such a system, really, and could if the SS were properly administered.

Maybe it would be if everyone had an advocate like that evil, socialistic, terrible teacher's union.

But, they don't, unfortunately.

I'm thankful for that evil, socialistic, terrible teacher's union.

My wife too gets a good salary and good benefits as a result of the evil teachers union. In this regard they have done well and selfishly for her while I agree they are evil in their methods.

Everyone could have a retirement as good as yours if they were allowed to. All that would need to happen is that they invested their own 8% in their own 401k which you already said was better than SS. Then they would merely need their employer to either pay a salary that was a bit more than 8% higher or for the employer to match the 8%. If we removed much of the costs associated with over regulation and over taxation there would be plenty of money available for that to happen. They probably would enjoy a compensation package that was far higher.

 

[PLC1]

My wife too gets a good salary and good benefits as a result of the evil teachers union. In this regard they have done well and selfishly for her while I agree they are evil in their methods.

Everyone could have a retirement as good as yours if they were allowed to. All that would need to happen is that they invested their own 8% in their own 401k which you already said was better than SS. Then they would merely need their employer to either pay a salary that was a bit more than 8% higher or for the employer to match the 8%. If we removed much of the costs associated with over regulation and over taxation there would be plenty of money available for that to happen. They probably would enjoy a compensation package that was far higher.

True enough, and that could happen had the government not blown the SS fund on everything from wars to welfare. Now that the fund is breaking even, no longer a cash cow, we start hearing about how SS is going under.

 

[Dr.Who]

How so? I'm not collecting a dime, nor do I ever expect to.




SS does not fund Medicare.



That is exactly what happened.



Why? I paid Medicare taxes right along with everyone else.

Of course, neither I nor anyone else actually paid the actual cost of Medicare out of the payroll taxes that were deducted. That is due to the escalating cost of medical care in general.





There is no way I or anyone else in my age group could ever have enough to pay for medical care, and no one is going to sell us medical insurance.

Medicare is the only option for seniors at this point.





Without Medicare, seniors would not have access to medical care. That's the big elephant in the room.

You have advocated a system in which young people take out a policy that can't be cancelled as they age. Now, that has possibilities. Such a policy did not exist when I was young, however.

Moreover, back in the '60s, medical insurance was cheap. Providing it to employees was not a problem. It was a perk that was expected with most jobs.

When my son was born in 1969, medical insurance didn't pay for childbirth. Somehow, the company thought a childbirth was something that was planned, not a medical emergency. It cost us $250 for a normal childbirth and an overnight stay in the hospital.

When my grandson was born in 2001, the same service was over $10,000.

Costs have to be reined in, or they will bankrupt the nation.

You and most everyone else paid medicare taxes. then you and plenty of seniors received care based on the taxes being collected from young workers today. So you certainly did benefit from the contributions of others. It might even be that you will benefit and people who are young today will pay in but not benefit as much. They are being ripped off in service of you.

If it were at all possible that payments into medicare could pay for the services that people get from medicare then it is equally possible that everyone could make their own payments into their own savings or insurance of other plan and pay for their own care. If it is not possible for the medicare taxes to pay for medicare benefits then the system should not exist.

We do need to create plans that work and are not coercive. I see no reason that as a country we could not do that.

 

[Dr.Who]

True enough, and that could happen had the government not blown the SS fund on everything from wars to welfare. Now that the fund is breaking even, no longer a cash cow, we start hearing about how SS is going under.

I wonder if it was planned. They blow the money on stuff people would never support then when the promised SS and the promised pensions are short people are willing to support more taxes to prop those up.

 

[PLC1]

You and most everyone else paid medicare taxes. then you and plenty of seniors received care based on the taxes being collected from young workers today. So you certainly did benefit from the contributions of others. It might even be that you will benefit and people who are young today will pay in but not benefit as much. They are being ripped off in service of you.

If it were at all possible that payments into medicare could pay for the services that people get from medicare then it is equally possible that everyone could make their own payments into their own savings or insurance of other plan and pay for their own care. If it is not possible for the medicare taxes to pay for medicare benefits then the system should not exist.

We do need to create plans that work and are not coercive. I see no reason that as a country we could not do that.

What would we do with people who don't buy insurance, and then get sick? Would we turn them out on the street, or treat them with tax dollars?

Another problem with the current system is that the uninsured pay a lot more than do the insured. Insurance depends on either a PPO, in which certain providers agree to what the insurance will pay, or to an HMO, in which there is an in house provider that takes care of members. Go out on your own, and costs go up astronomically.

 

[Dr.Who]

What would we do with people who don't buy insurance, and then get sick? Would we turn them out on the street, or treat them with tax dollars?

Another problem with the current system is that the uninsured pay a lot more than do the insured. Insurance depends on either a PPO, in which certain providers agree to what the insurance will pay, or to an HMO, in which there is an in house provider that takes care of members. Go out on your own, and costs go up astronomically.

First we create a system in which medical care is as inexpensive and available as possible. Something we have clearly not done.

Then we create a system in which insurance is as inexpensive and available as possible. Something we have clearly not done.

Then when someone has not purchased insurance, cannot afford care (and I mean that they really cannot afford it, not that they are sitting on a 100k house but their savings account is empty) what we do not do is pay for their care with tax dollars. Family, friends, neighbors, strangers, health care providers, and charity could easily provide for these needs.

 

[Dr.Who]

What would we do with people who don't buy insurance, and then get sick? Would we turn them out on the street, or treat them with tax dollars?

I find it hard to believe for as many times as this has been addressed you still make it a false choice between letting them die and using tax dollars.

Either there is some disconnect in our conversation or you are intentionally using rhetoric designed to obscure the obvious answers.

 

[dogtowner]

I find it hard to believe for as many times as this has been addressed you still make it a false choice between letting them die and using tax dollars.

Either there is some disconnect in our conversation or you are intentionally using rhetoric designed to obscure the obvious answers.

seriously... they seem to forget that & how this got addressed before Medcaid.

 

[PLC1]

First we create a system in which medical care is as inexpensive and available as possible. Something we have clearly not done.

Clearly, we have not done this, no.

Then we create a system in which insurance is as inexpensive and available as possible. Something we have clearly not done.

Clearly, that hasn't been done either.

Clearly, the failure to have an affordable health care system is bankrupting both the private and public sectors of our economy.

Clearly, no one in Washington wants to address this issue and confront the insurance lobby.

Then when someone has not purchased insurance, cannot afford care (and I mean that they really cannot afford it, not that they are sitting on a 100k house but their savings account is empty) what we do not do is pay for their care with tax dollars. Family, friends, neighbors, strangers, health care providers, and charity could easily provide for these needs.

I find it hard to believe for as many times as this has been addressed you still make it a false choice between letting them die and using tax dollars.

and when Family, friends, neighbors, strangers, health care providers do not step up to the plate, what do we do then?

Clearly, there are two alternatives.

 

[Dr.Who]

and when Family, friends, neighbors, strangers, health care providers do not step up to the plate, what do we do then?

Can you point to any example in which this has happened in recent history?

And if you can then just because someone dies of a curable illness can you show us that ignoring the constitution and empowering the gov to give them money for care is better? This has the potential to destroy our entire republic both because it is unconstitutional and because it fosters statism.

But suppose that people do not step up and help those in need. Then obviously they do not want to. I say two things, 1. step up yourself, 2. taxing people to do what they do not agree to do is contrary to a government by the people. If they refuse to give voluntarily what makes anyone think they will agree to be taxed to give. They will just vote not to be taxed, they will vote for someone else to be taxed - and that will only last so long before it collapses.

Regarding # 1 above. Conservatives are already giving generously to charitable causes. When liberals who complain that there is not enough help being offered start giving too then and only then will they have a right to complain. If liberals gave in the same amounts that conservatives gave there just might be enough money to replace medicaid completely (not that it could not already be replaced right now without liberals giving more. I am just stating that the liberals have that much money that they could be giving.)

So what do we do when no one steps up to the plate?

We could empower our gov to examine how much everyone has paid in taxes and how much everyone has given to charity and then to take the money from those who have given the smallest percent. It would be wrong. It would be unconstitutional. It would be statist. But it would create equality in giving. It would of course result in more money coming from liberals who do not donate to charity very much.

Here is a better idea. Restore institutions that encourage giving to a prominent place in our country ( in other words do not malign churches), give yourself, and get on your soapbox and encourage every single person in this country who is not giving enough voluntarily to give more. When my church runs a deficit it simply tells people that there is a deficit and then people step up. If there is a deficit in giving to provide for medical care then simply let people know. The truth of the matter is that there is no deficit and so few will give. that is why there are no charities that provide medical care. there are plenty of charities that appear to; march of dimes appears to provide care for those with MD. In reality it sends kids with MD to camp. Ronald McDonald house appears to help kids with medical problems. In reality it pays for parents to stay near their kids who are in the hospital. Good causes but not examples of charities that provide medical care. There just is not a need and if the gov programs did not exist there would still not be a need because the other sources of help would fill the gap quickly.

 

[PLC1]

Can you point to any example in which this has happened in recent history?

And if you can then just because someone dies of a curable illness can you show us that ignoring the constitution and empowering the gov to give them money for care is better? This has the potential to destroy our entire republic both because it is unconstitutional and because it fosters statism.

But suppose that people do not step up and help those in need. Then obviously they do not want to. I say two things, 1. step up yourself, 2. taxing people to do what they do not agree to do is contrary to a government by the people. If they refuse to give voluntarily what makes anyone think they will agree to be taxed to give. They will just vote not to be taxed, they will vote for someone else to be taxed - and that will only last so long before it collapses.

Regarding # 1 above. Conservatives are already giving generously to charitable causes. When liberals who complain that there is not enough help being offered start giving too then and only then will they have a right to complain. If liberals gave in the same amounts that conservatives gave there just might be enough money to replace medicaid completely (not that it could not already be replaced right now without liberals giving more. I am just stating that the liberals have that much money that they could be giving.)

So what do we do when no one steps up to the plate?

We could empower our gov to examine how much everyone has paid in taxes and how much everyone has given to charity and then to take the money from those who have given the smallest percent. It would be wrong. It would be unconstitutional. It would be statist. But it would create equality in giving. It would of course result in more money coming from liberals who do not donate to charity very much.

Here is a better idea. Restore institutions that encourage giving to a prominent place in our country ( in other words do not malign churches), give yourself, and get on your soapbox and encourage every single person in this country who is not giving enough voluntarily to give more. When my church runs a deficit it simply tells people that there is a deficit and then people step up. If there is a deficit in giving to provide for medical care then simply let people know. The truth of the matter is that there is no deficit and so few will give. that is why there are no charities that provide medical care. there are plenty of charities that appear to; march of dimes appears to provide care for those with MD. In reality it sends kids with MD to camp. Ronald McDonald house appears to help kids with medical problems. In reality it pays for parents to stay near their kids who are in the hospital. Good causes but not examples of charities that provide medical care. There just is not a need and if the gov programs did not exist there would still not be a need because the other sources of help would fill the gap quickly.

If health care providers had to depend on charity to get paid, what do you think that would do to costs and to quality of service?

 

[Dr.Who]

If health care providers had to depend on charity to get paid, what do you think that would do to costs and to quality of service?

No one is saying they need to depend on charity to get paid. First they depend on charging for services. Then after they are paid for billable services they can rely on charity for the remainder. It has been done before, is still done to an extent, and is a completely viable option. One that is not unconstitutional, is not contrary to the ideals of a gov by the people, and is not unethical or coercive.

You did not point to an example in which care has not been paid. Again, "Can you point to any example in which this has happened in recent history?"

 

[PLC1]

No one is saying they need to depend on charity to get paid. First they depend on charging for services. Then after they are paid for billable services they can rely on charity for the remainder. It has been done before, is still done to an extent, and is a completely viable option. One that is not unconstitutional, is not contrary to the ideals of a gov by the people, and is not unethical or coercive.

You did not point to an example in which care has not been paid. Again, "Can you point to any example in which this has happened in recent history?"

Are you serious?

Every time someone without insurance goes to an emergency room and gets treated, the health care provider doesn't get paid. Every time an uninsured, or self insured person goes to any provider, the bill is triple what insurance will pay. Health care providers bill far and away more than they expect to get, then have an army of clerks whose job it is to know what codes to put in and which entities to bill so that they have a chance of getting enough to actually pay for services. It is the most inefficient system imaginable. Were we to take government and private insurance out of the equation altogether, then costs would doubtless go down. There is no way that churches and charities could begin to make up the difference, however. We're talking about more money than the federal government spends on everything else but health care. Could we have a government that depends on charity? That would be interesting. Maybe have a cake sale to buy a new aircraft carrier, sure.

 

[Dr.Who]

Are you serious?

Every time someone without insurance goes to an emergency room and gets treated, the health care provider doesn't get paid. Every time an uninsured, or self insured person goes to any provider, the bill is triple what insurance will pay. Health care providers bill far and away more than they expect to get, then have an army of clerks whose job it is to know what codes to put in and which entities to bill so that they have a chance of getting enough to actually pay for services. It is the most inefficient system imaginable. Were we to take government and private insurance out of the equation altogether, then costs would doubtless go down. There is no way that churches and charities could begin to make up the difference, however. We're talking about more money than the federal government spends on everything else but health care. Could we have a government that depends on charity? That would be interesting. Maybe have a cake sale to buy a new aircraft carrier, sure.

Yes I am serious. Your facts are wrong.


In most instances when a person without insurance goes to the ER the very same person is billed and later pays the bill. The provider gets paid.

In the 5% of medical bills for uninsured persons that do not get paid by the person the costs are usually covered by the in house charity that all hospitals have. They are almost all non for profits and almost all of them do have fundraising programs.

Yes they do pass some of the cost on to other people. Costs that are then paid so that the hospital does get its money.

Could churches and private charity make up the difference? The 5% of costs that are not paid by the person needing the care? Absolutely, it is a small amount after all.

Is our system inefficient? Yes. What percent of that is due to gov regulations on one of the most highly regulated industries in the country?