Okaaaaay.....

iVillage Member
Registered: 03-25-2007
Okaaaaay.....
214
Fri, 09-19-2008 - 11:22pm

Crazy:


 


http://krugman.blogs.nytimes.com/2008/09/19/mccain-on-banking-and-health/


 


September 19, 2008,  7:24 pm
McCain on banking and health


OK, a correspondent directs me to John McCain’s article, Better Health Care at Lower Cost for Every American, in the Sept./Oct. issue of Contingencies, the magazine of the American Academy of Actuaries. You might want to be seated before reading this.


Here’s what McCain has to say about the wonders of market-based health reform:



Opening up the health insurance market to more vigorous nationwide competition, as we have done over the last decade in banking, would provide more choices of innovative products less burdened by the worst excesses of state-based regulation.


So McCain, who now poses as the scourge of Wall Street, was praising financial deregulation like 10 seconds ago — and promising that if we marketize health care, it will perform as well as the financial industry!>>>

Sopal


Sopal

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iVillage Member
Registered: 08-20-2008
In reply to: sopall1953
Sun, 09-21-2008 - 11:36am
LOL - the Republicans know best about fillibustering - they've threatened it on every bit of legislation they didn't propose since 2006 and then declare it a "do nothing" Congress.....
iVillage Member
Registered: 08-29-2008
In reply to: sopall1953
Sun, 09-21-2008 - 11:43am

He calls for accountability, too. I will print the entire article. It's a good read.

"The need for health policy reform is a pressing national issue about which people
care very deeply. Beyond the deeply personal life and death concerns of millions of Americans, health care also presents substantial challenges to our pocketbooks as consumers, to the sustainability of major government health programs as beneficiaries and taxpayers, and to our economy’s growth and competitiveness as employers, workers, and investors. As president, I pledge to address our health care problems proactively and comprehensively, as part of an ongoing reform process that respects our traditional values, reflects our diverse preferences, promotes market-based competition,
insists on accountability, and encourages personal responsibility. We need a more patient-centered and quality-focused health care system that delivers better value in terms of improved outcomes at lower costs.

In this presidential campaign year, a wide range of health reform plans have been advanced by candidates. But will many of these solutions actually improve our health care system? We can no longer continue to promise more than we can deliver. Nor can we risk misdiagnosing the problem and devising a cure that might harm the patient.

The problem, my friends, with the U.S. health care system is
not that Americans don’t have fine doctors, medical technology,
and treatments. The state of our medical science is the envy of
the world. The problem is not that most Americans lack adequate
health insurance. The vast majority of Americans have
private insurance, and our government spends billions each year
to provide even more. The biggest problem with the American
health care system is that it costs too much, and the way inflationary
pressures are actually built into it.

Reining In Health Costs
Rapidly rising costs are the greatest threat to our health care system.
Within the next decade, health care costs will approach 20
percent of our gross domestic product (GDP). The growth of
costs affects everyone: government budgets, taxpayer burdens,
business costs, and family budgets. It hurts those who have insurance
by making it more expensive to keep. And it hurts those who
don’t have insurance by making it even harder to attain. Health
spending that grows faster than the resources available to pay for
it causes employers to drop coverage, shift more costs to their
employees, and/or slow the rate of wage growth. More individuals
cannot afford to accept their employers’ coverage offers or
purchase insurance on their own. State and local governments
find their budgets overstretched by health care costs that crowd
out other necessary areas of investment and spending. Rising per
capita health care costs contribute even more than the demographics
of an aging population to the mounting fiscal stress on
our largest federal health care entitlement programs—Medicare
and Medicaid. Medicare’s costs in particular are growing astronomically
faster than its financing, and leaving its structural flaws
unaddressed will hasten its bankruptcy.

My highest priority in health reform will be to slow the rapid
growth in the cost of care and transform the practice of medicine
to help produce better health across the population. Fundamental
health care reform must begin with restoring control
to individuals and their families as health care consumers and
patients and making them the central focus of our health care
system. They need to be in charge of their health care dollars,
with stronger incentives and improved access to enhanced information
tools that facilitate better health behavior and smarter
health care decisions.

I offer a genuinely American vision for health care reform that
preserves the most essential value of our lives—freedom. We believe
in the pursuit of personal, political, and economic freedom
for everyone. My vision expects and encourages free people to
voluntarily unite, but they cannot be compelled to do so under the
principles of limited government that best protect our individual
freedom. In health care, we believe in enhancing the freedom of
individuals to receive necessary and desired care. We do not
believe in coercion and the use of state power to mandate care,
coverage, or costs.

I believe Americans want to be part of a system that offers
high-quality care, that respects their individual dignity, and that
is available at reasonable cost. Unfortunately, the American health
care system as it is currently structured fails this test. It is too expensive.
It insults our common sense and dignity with excessive
paperwork, disconnected visits with too many specialists, and by
elaborately hiding from us any clear idea of what we are getting
for our money. We must reform the health care system to make
it responsive to the needs of American families. Not the government.
Not the insurance companies. Not tort lawyers. Not even the doctors and hospitals.

Improving Choice in the Private Market
One essential reform is to improve our choices in private health
insurance markets. It must begin with changing the current tax
treatment of health care spending. It is good health policy to reward
having insurance no matter where your policy comes from.
I propose to spread the tax subsidy for health insurance more
equitably. I would change it to a refundable credit amounting to
$5,000 for all families and $2,500 for individuals purchasing health
insurance—regardless of the source of that coverage, regardless of
how one purchases it, and regardless of one’s income. The tax credit
would ensure that everyone has access to the same level of financial
support through the tax code to obtain basic health insurance. By
putting consumers more in control of their tax subsidy dollars and the
rest of their health spending, health insurers and health care providers
will be more accountable and responsive to their real customers.

My tax credit proposal remains fully compatible with employer sponsored
insurance as the primary vehicle for workers and their
families to gain coverage. People can still gain access to the tax
credit if they receive their insurance through their employer. Many
workers are already content with the choices and advice offered by
their employer, and any reform must respect the freedom to keep
your care and insurance just as they are. But Americans should be
able to choose whom they trust, just as we should trust them to
make the best decisions for themselves and their families.

Individuals who currently don’t have access to employer sponsored
insurance where they work can use the tax credit
to purchase individual insurance coverage. Everyone purchasing
health insurance would gain access to exactly the same tax
benefits. The tax credit also helps those people who want to have
insurance that is fully portable and can move with them whenever
they change jobs. One of the complications in getting insurance
through your employer is that it disappears once you change your
place of employment or go in and out of the labor market. Insurance
should follow the individual, not the job. Individually owned,
portable insurance coverage would last longer and help realign the
incentives of your insurer to provide more preventive care and
design benefits to preserve your health and treat chronic conditions
more effectively.

I would improve the non-employer, individual insurance
market by building on existing Health Insurance Portability and
Accountability Act (HIPAA) protections for people with pre-existing
conditions and by expanding support for guaranteed access
plan (GAP) coverage in the states that would insure them if they
are denied private insurance coverage or only offered it at very high
premium costs. We would commit necessary federal resources
to ensure that states finance GAP coverage more generously and
provide more targeted disease management and case management
tools to address the special health needs of those needing such
assistance. No American, just because of a pre-existing condition,
should be denied access to quality and affordable care.

I would also allow individuals to choose to purchase health
insurance across state lines, when they can find more affordable
and attractive products elsewhere that they prefer. Opening up
the health insurance market to more vigorous nationwide competition,
as we have done over the last decade in banking, would
provide more choices of innovative products less burdened by
the worst excesses of state-based regulation. Consumer-friendly
insurance policies will be more available and affordable when
there is greater competition among insurers on a level playing
field. You should be able to buy your insurance from any willing
provider—the state bureaucracies are no better than national
ones. Nationwide insurance markets that ensure broad and vigorous
competition will wring out excess costs, overhead, and
bloated executive compensation.

Transforming Medical Practice
We must remember that reforming our insurance markets to make
them more competitive and accountable to consumers is important,
but the fundamental long-term focus must remain on improving and
transforming the practice of medicine to ensure the broader and more
consistent delivery of high-quality care. Health insurance is simply a
financial device that shifts around the apparent costs of the nation’s
overall health care bill among various payers. The fundamental problem
remains that the bill is too large, particularly for the value of what
it delivers in quality care and improved health outcomes.

As daunting a challenge as it poses, merely controlling the growing
cost of health care is not enough. The current system of care
also fails to produce sufficient quality of health outcomes. We have
to change the practice of medicine in America, to make sure that
we can get better care at lower cost for every American. My comprehensive
reform plan would move us away from a fragmented
system to one that rewards prevention and better-coordinated care.

We need to shift our focus from mere volume of care to quality of
care that is grounded in coordination of care and achievement of
good health outcomes. We need to provide strong incentives to
move the practice of medicine away from a siloed provider-based
approach into a more patient-centric coordinated approach.

We are paying too much now for the kinds of outcomes we
receive. We need to pursue opportunities in collaboration with
providers for lower costs through incentivizing better practice
patterns that reflect the latest in medical science and more effective
treatment regimens for costly chronic conditions.

Government health programs such as Medicare and Medicaid
should lead the way in health care reforms that improve quality and
lower costs. Medicare practice patterns in particular often drive
private practice patterns. Reforming Medicare is an essential part
of moving our health care system from a fragmented fee-for-service
approach to care and toward paying for coordinated care and
prevention. Paying for coordinated care means that every single
provider finally is united on being responsive to the needs of a single
person: the patient. This is an essential step to ensure that our seniors
have access to high-quality care that they deserve.

Like most of our system, Medicare reimbursement now rewards
institutions and clinicians on volume of services rather
than quality. We need to change the way providers are paid to
focus their attention more on chronic diseases and managing
their treatment. Changing the way we do business in Medicare
can have a dramatic impact not only on the nation’s health care
bill but also on the health of our nation’s seniors.

Genuine and effective health care reform requires accountability
from everyone. Drug companies, insurance companies, doctors,
hospitals, medical technology producers, the government, and
patients must operate in a more transparent environment that
reveals what particular elements of health care cost and the outcomes
they produce. Protecting the ability of Americans to have
access to quality health care through affordable insurance products
will involve expanded use of such policy tools as comparative
effectiveness research to guide decision-making by medical practitioners;
greater transparency and coding of health outcomes; and
all-in costs for episodes of treatment so that people can actually
make more effective and meaningful decisions about their care.

More rapid and wider implementation of effective health information
technology will provide a necessary, but not sufficient, foundation
for a value-driven health system. We first need to provide incentives
to strengthen the business model for investment in effective HIT.
By paying for better outcomes, we would provide strong reasons for
people to integrate their care-delivery systems and exchange data and
measures of care quality through modern information systems. Those
systems will be much more likely to examine patterns of medical practice,
identify those that produce better and worse outcomes, measure
the total costs they incur, and determine how we can produce improved
outcomes at lower costs through more effective prevention
efforts and better models of medical treatment.

Also long overdue is fundamental reform of our medical liability
system so that providers can perform their vital tasks by following
best practices without fear of being sued, instead of being pushed
toward costly and redundant forms of defensive medicine. We cannot
let the search for high-quality care be derailed by frivolous
lawsuits and excessive damage awards. We must pass medical liability
reform, and those reforms should provide protection from
frivolous lawsuits for doctors who follow clinical guidelines and
adhere to patient safety protocols.

Rediscovering Personal Responsibility
The final important principle of reform is to rediscover our sense
of personal responsibility to take better care of ourselves and our
children. We must personally do everything we can to prevent expensive,
chronic diseases through better health behavior. Our rights
in this country are protected by our personal sense of responsibility
for our own well-being. Cases of diabetes are going up, not only in
the baby boom generation but among younger Americans where
obesity, diabetes, and high blood pressure are all on the rise. Parents
who don’t impart to their children a sense of personal responsibility
for their health, nutrition, and exercise—vital quality-of-life information
that political correctness has expelled from our schools—have
failed their responsibility. Also, parents have to share in the responsibility
to ensure that their children are covered by health insurance
if, as is often the case, options are already available to them.
We can build a health care system that is more responsive to
our needs and is delivered to more people at lower cost.

The “solution,” my friends, isn’t a one-size-fits-all big-government takeover
of health care. It resides where every important social advance has
always resided—with the American people themselves, with well informed
American families making practical decisions to address
their imperatives for better health and more secure prosperity. The
engine of our prosperity and progress has always been our freedom
and the sense of responsibility for and control of our own destiny
that freedom requires. The public’s trust in government waxes and
wanes. But we have always trusted in ourselves to meet any challenge
that required only our ingenuity and industry to surmount.
Any “solution” that robs us of that essential sense of ourselves is a
cure far worse than the affliction it is meant to treat."

=John McCain

iVillage Member
Registered: 08-29-2008
In reply to: sopall1953
Sun, 09-21-2008 - 11:50am
I am sure that the extreme on the right do, but I don't.
iVillage Member
Registered: 08-29-2008
In reply to: sopall1953
Sun, 09-21-2008 - 11:56am
Believe whatever you want. I think when this all shakes out, you will see some of your greedy Democrats in jail right along with the likes of Franklin Raines and other crooks put in by the Clinton administration who greased Democrat palms and walked away with millions.
iVillage Member
Registered: 03-25-2007
In reply to: sopall1953
Sun, 09-21-2008 - 11:57am
He was NOT outnumbered.

Sopal

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iVillage Member
Registered: 08-29-2008
In reply to: sopall1953
Sun, 09-21-2008 - 12:00pm
He wasn't President then, only one in a hundred senators. Just wait until he is president! He's going to shake things up!
iVillage Member
Registered: 08-29-2008
In reply to: sopall1953
Sun, 09-21-2008 - 12:04pm
Isn't it funny that the Democrats ran on "Impeaching Bush" and "Stopping the War" and they haven't even tried to do either. Republicans didn't have to threaten to filibuster those things, did they?
iVillage Member
Registered: 08-29-2008
In reply to: sopall1953
Sun, 09-21-2008 - 12:06pm
He's NEVER been lock step with the party. That's something Democrats used to like about him, remember? No matter, HE was on the right side of this issue. You have to admit that.
iVillage Member
Registered: 03-25-2007
In reply to: sopall1953
Sun, 09-21-2008 - 12:08pm

Remember the "nuclear option" that Bill Frist continued to threaten (primarily on judicial nominees)?

Sopal

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iVillage Member
Registered: 09-16-2008
In reply to: sopall1953
Sun, 09-21-2008 - 12:12pm
Oh - right - he can't do anything until he is president - how would this have changed his position on the legislation he allegedly couldn't pass because of the minority party?
Wouldn't any legislation still have to come to the floor for a vote before the president could sign it into law? Oh I see, then he could blame the democrats for not passing the bill his party didn't put of for a vote. Great argument you got going there!

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