Free to good home, Pocket Constitution -- never used, only waved around once at a Town Hall meeting.

I have always voted for Bart Gordon but have been very disappointed in his actions the past couple of years and was not going to vote for him if he ran for another term and made sure he knew that. I guess since he is not running again, he really does not care how terrible this healthcare bill actually is. It seems the healthcare bill actually keeps getting worse as the Democrats try to find loopholes in getting it past . . . the same tactics the Democrats use to complain about the Republicans using. I guess the Democrats are no better than the Republicans.

But really, what I hate most about this bill is that it is forcing people to have insurance no matter what their situation may be and the fact that it is going to add a huge burden to our deficit even as the USA faces the risk of having its credit status downgraded which people evidently don't understand the severity of the problem if that occurs.

I just don't get how na*ve (or stupid) people are in believing that this makeshift healthcare bill that is full of earmarks and special deals is going to solve the real problem . . . many economists are saying that this bill will actually increase premiums for people like me who do have insurance and work hard to maintain it. Here is an example of the situation the bill creates . . .

"Caterpillar: Health care bill would cost it $100M

Published on March 19, 2010 7:10 AM | Submit a comment

Dow Jones Newswires | Caterpillar Inc. said the health-care overhaul legislation being considered by the U.S. House would increase the company's health-care costs by more than $100 million in the first year alone.

In a letter Thursday to House Speaker Nancy Pelosi (D-Calif.) and House Republican Leader John Boehner of Ohio, Caterpillar urged lawmakers to vote against the plan "because of the substantial cost burdens it would place on our shareholders, employees and retirees."

Caterpillar, the world's largest construction machinery manufacturer by sales, said it's particularly opposed to provisions in the bill that would expand Medicare taxes and mandate insurance coverage. The legislation would require nearly all companies to provide health insurance for their employees or face large fines.

The Peoria-based company said these provisions would increase its insurance costs by at least 20 percent, or more than $100 million, just in the first year of the health-care overhaul program.

"We can ill-afford cost increases that place us at a disadvantage versus our global competitors," said the letter signed by Gregory Folley, vice president and chief human resources officer of Caterpillar. "We are disappointed that efforts at reform have not addressed the cost concerns we've raised throughout the year."

Business executives have long complained that the options offered for covering 32 million uninsured Americans would result in higher insurance costs for those employers that already provide coverage. Opponents have stepped up their attacks in recent days as the House moves closer toward a vote on the Senate version of the health-care legislation.

A letter Thursday to President Barack Obama and members of Congress signed by more than 130 economists predicted the legislation would discourage companies from hiring more workers and would cause reduced hours and wages for those already employed.

Caterpillar noted that the company supports efforts to increase the quality and the value of health care for patients as well as lower costs for employer-sponsored insurance coverage.

"Unfortunately, neither the current legislation in the House and Senate, nor the president's proposal, meets these goals," the letter said."

Closer to home, a local company is going to terminate 50 positions in about 3 months.Hope and change is rapidly changing to Hopeless Change.And by this time next year it will be mandatory that we tune in daily to the Obama Hour or our children will be asked to turn us in. Sounds rediculous does it not? It did back in Nazi Germany also. And his promise of a 3000% rate cut on insurance. That means the Insurance Companies will be giving us back monstrous amounts of money. Get real Obama. Far as I'm concerned, you are nothing but a snake oil salesman.

I am glad that our government is at least trying to take some kind of action to control the cost of health care in this country. Reform or not, we are all bearing the cost of the uninsured and something must be done sooner than later. I think we can all agree that doing nothing is not a reasonable course of action as our insurance premiums go up each and every year. This bill has been shown to reduce the deficit 138 billion dollars over the next ten years. More people get insured and we save money in the process. The good news is that we have the ability to change laws when they do not work as intended. REFORM - make changes for improvement in order to remove abuse and injustices

Oh yeah, we can stand on the ledge and try to survive Nathan or .......... we can jump off of it just on the offchance that we will fly rather than fall. The track record lately indicates that we will plummet rather than float. And they have written these laws in such away that we are not supposed to be able to change them. And answer me this. Has our government ever run anything at a profit? I say nay. Our politicians (both sides) only know how to lie cheat and steal.

Nathan - $138 BILLION over ten years is NOTHING compared to the fat that between FY 2011 and FY 2020, annual deficits would total $8.53 trillion. So, even if this bill would reduce the deficit $138 billion, that's a drop in the bucket compared to the $8.53 TRILLION that we're going to be on the hook for now. Let's take a REAL look at those numbers.

$8,530,000,000,000 minus your "savings" of

$138,000,000,000 equals

$8,392,000,000,000.

You're right, that looks MUCH better. Good thing Obama is here to save us all.

I am glad that our government is at least trying to take some kind of action to control the cost of health care in this country.

-- Posted by nathan.evans

Noting this bill, in any way, controls the cost of health care. Nothing!

All obamacare does is reassign who gets the bill.

Thinking that we can cover people who are currently uninsurable and cover procedures that are now not covered, and do it cheaper than not covering them, is apt example of the disconnect in logic that should keep liberals out of positions of power.

Insurance companies and some doctors have gotten us in the shape we are in now by over charging.

Yes you can go to the emergency room an get help but what about people who need yearly test like physicals mammagrams pap smears etc. people with no insurance need proventive care to keep cost down.

-- Posted by lets be real

What has gotten us into "this mess" is people expecting insurance to pay for every single thing and giving no thought to the actual cost.

How many people do you know who "shop" doctors to get the best price for those yearly procedures?

In most cases preventive screening is not cost effective.

http://content.nejm.org/cgi/content/full...

What would be cost effective is for people to take responsibility for themselves and apply preventive measures of their own. Like not being obese, not smoking, drinking, or doing drugs.

But preaching self reliance would leave a certain political party with nothing to sell.

Dianatn,

In the broad strokes you are making my point for me. The reason healthcare and insurance is so expensive is because of the overuse of health insurance.

If everyone had insurance just for catastrophic events, like a heart attack or cancer, and paid for other things out-of-pocket like people used to do, two things would happen.

First, people would be more concerned with their personal health because they would feel the financial pain,or lack thereof, of their choices.

Second, people paying their bills for smaller things, like a physical, instead of relying on insurance would bring competition back to healthcare.

I have made the analogy several times before, we don't expect our homeowner's policy to cover routine home maintenance like painting or pressure washing because we know that the premiums would be prohibitively expensive.

Many financial planners advise having higher deductibles on car insurance to save on rates.

Yet when it comes to health insurance we expect everything to be covered and to only pay a $20 co-pay. Then we are furious that health insurance is too expensive.

Do explain how paying out of pocket for a doctor's visit is going to relieve price pressures when compared to an insurance company being the middle man paying for a doctor's visit. I don't see any economic logic in your statement.

-- Posted by nathan.evans

If Wal-Mart announced it would no longer charge on a per item basis but would instead charge a per visit fee would people be more scrupulous about their purchases or less?

People always want to save money, so we watch sale papers, use coupons, or shop different stores to get the best deal for groceries and household items.

But with healthcare it is somehow different.

Even if you only go to the doctor for stitches, do you check the prices among the various doctors (in advance, of course)?

We don't drive our car until it dies and walk to the closest dealership to buy a new one. We realize that one day the car will quit and plan ahead so we are not left stranded on the side of the road and forced to accept someone else's price. We check various places before we need their service.

In the vast majority of cases, this is never done with healthcare, in large part because we never stop to think we could negotiate a better price. Even though we do so in every other area of our life, and evidence such as Dianatn's story tells us it is possible with healthcare.

Personal payment would cause people to pay more attention to what is happening as well.

When was the last time you told your doctor "No, I don't think that test is necessary, so we won't be doing it."? If you were responsible for the full bill this would be at least a part of the decision process. Because insurance pays for everything, this thinking almost never happens.

I would challenge everyone to ask their doctor if he/she would be willing/able to charge less if visits were paid in cash rather than through insurance.

The point I have consistently made is that people would be much better served by having catastrophic insurance that would cover heart attacks, lifeflight rides, and other very expensive procedures, leaving smaller, less expensive procedures to be paid with cash, without insurance, just as we do with car or house insurance.

Doctors and hospitals charge more to those with insurance because insurance disconnects free market competition. Blue Cross sends out a list telling all providers they will pay X amount of payment for Y procedure. If a doc can do the work more cheaply they still charge the set amount partially because they can and partially to cover the times they are shorted by payments.

No, we can't shop for every possible treatment for every ailment, but there is virtually no healthcare shopping done at all, except by those who choose not to have insurance.

If people put as much effort into finding a good deal for treatment as they do finding a good deal for a flatscreen TV a lot of the cost of care would drop tremendously.

Not nearly as many people have vision care or dental care insurance as they do regular health care insurance.

Do you think your free market approach has worked in those health fields?

If you think so you haven't been to a dentist lately.

Call and check what the prices of a root canal is and you will find most dentist charge pretty dang close to the same thing and it isn't cheap by any sense of the word.

The Free market approach can only work on products if it is something you can do without if you can't afford it.

Health Care is not a privilege, it is a right.. we all should have the right to fair priced health care. We should not be charged as much as a house cost just because we get sick.

Health Care is not a privilege, it is a right.. we all should have the right to fair priced health care.

-- Posted by Dianatn

Hogwash!

To force someone else to provide you with "fair priced" health care means either a doctor will be forced to work for a below normal wage or someone else will be forced to pay for your care. Either way, you are forcing someone to work against their will. I think we had a civil war to prevent that type of activity.

What makes you have a "right" to something you can't pay for? Should Wal-Mart security keep a closer eye on you since you have this type of attitude?

I've got a simple question. Why does reforming health care cost taxpayers BILLIONS of dollars? This sounds like 'providing' instead of 'reforming'. Reform should regulate insurance companies, medical facilities, and physicians business practices. This health care bill is not reforming the health care industry. I agree it makes it 'available' to everyone. Billions of dollars of taxpayer money annually looks like a handout to me. Health care is a self supporting industry. Why does it need billions of tax dollars for reform? There is enough money in the health care industry to regulate cost and make it affordable for everyone. I don't hear of many health insurance company executives losing money and losing their homes. Health care is a business that affects many lives and the current laws (state and federal) make it a booming industry. The laws allow them to make business decisions (that allow them to be profitable) that in turn effect someones life. We need reform laws to insure that everyone gets the health care they need and make it affordable.

Monthly health insurance premiums for a family of four are equal to monthly mortgage payments on a $200,000 dollar house. Messed up don't you think?

Dianatn,

There is a good reason that the patient using insurance is charged more than the individual paying himself. Since MD's rarely do their own office work, your doctor has to have a full time employee to file all that paperwork. Not only must he pay wages but must also pay social security taxes and such. Throw in the cost of vacation pay for that employee and suddenly you've got an additional 30,000 going out the window.

Please show me where I said you were entitled to addition coverage other than what you had agreed upon with your insurance company.

It sounds to me like insurance companies are no more evil than your doctors or hospitals when it comes to money.The insurance company is not the one who charged me 15,000 for life flight nor are they the one who charged me 79,000 for 4 days in the hospital.

Please show me where I said you were entitled to addition coverage other than what you had agreed upon with your insurance company.

-- Posted by Dianatn

If that is your definition, we already have fairly priced health care, so no reform is needed.

http://coburn.senate.gov/oversight/?Fuse...

-- Posted by nathan.evans

Your link shows insurance companies making a 3% profit.

Do you really believe we need a multi-trillion dollar "reform" program to address a 3% profit margin?

To Dianatn.... Dr.s charge less to those "cash" paying customers for the same reason that you or I can get a house built less for cash. There are no man hours involved in lengthly paperwork..and in the Medical industry the paperwork involved in filing just the basic of claims cost money. Dr's have to hire a billing company's or hire a full time employee to do nothing more but sit there 40hrs a week and file claims. Hospitals spend and estimated 75 million dollars every year in payroll expenses to billing dept's. and even then after all those man hours invested in trying to get paid for services they still take a cut in revenue.

I can understand why it is so frustrating to understand and very much empathize with your story but also remember that no matter what your EOB from your insurance company says that there is a negotiated rate that a Dr' HAS to acccept as part of their provider contract and usually after all is said and done most Dr's make less than $50.00 for a normal office visit.

Take Medicare for example after this bill passes and the Medicare cuts take effect every Dr. no matter what they do for the patient or how long it takes will walk away with a whopping $28.00 per visit!!! Yes $28.00. There are factory workers who can make more an hr. than that.

As for this "ObamaCare" its a sad day for America...people just really dont grasp how deep and wide the fall-out will be. God save us all....

They sell Louis Vuitton at Wal-Mart? Wow, they've changed a lot since I stopped shopping there last year.

Take Medicare for example after this bill passes and the Medicare cuts take effect every Dr. no matter what they do for the patient or how long it takes will walk away with a whopping $28.00 per visit!!! Yes $28.00. There are factory workers who can make more an hr. than that.

As for this "ObamaCare" its a sad day for America...people just really dont grasp how deep and wide the fall-out will be. God save us all....

-- Posted by crystalclear2me on Sat, Mar 20, 2010, at 10:34 PM

The one thing you are failing to take in to consideration is that these patients that are only worth $28 to the good doctor is our elderly, disabled, and impoverished citizens. For many of them $100 a week is a small fortune and they are glad to get any help they can because it comes few and far in between. I am of the opinion that any doctor that took government grants should be required to take Medicare patients as a percentage of their client base. For that matter, I would require any doctor that wants to receive a license to operate in a state to accept a set percentage of medicare patients. These people are the ones that needs us most and doctors have taken an oath that they should live up to. We all have parts of our jobs that we don't like, doctors can join the club with the rest of us, even though I can think of worse things than helping someone for $28 and hour.

Nathan since you seem to have solved both the business and moral dilemmas facing those of us in medicine, I invite you to apply to the med school of your choice. We would be glad to have you.

doctors have taken an oath that they should live up to.

-- Posted by nathan.evans

Funny you should mention that.

Someone else takes an oath they should live up to, unfortunately 219 of them ignored it completely.

""I, _________, do solemnly swear (or affirm) that I will support and defend the Constitution of the United States against all enemies, foreign and domestic; that I will bear true faith and allegiance to the same; that I take this obligation freely, without any mental reservation or purpose of evasion; and that I will well and faithfully discharge the duties of the office on which I am about to enter. So help me God.""

I love that post. After 8 years of higher education and 3-5 years of residency, you can have the privilege of working for $28 and hour. Medical school is hard though. While your liberal arts friends are busy doing bong hits and funneling beers, you'll have to study. When you're done, you'll probably be about 30, be $150,000 in debt, have no savings or retirement fund to speak of, and you may have a divorce under your belt. Then you can maintain the expense of an office space, medical equipment, and try to pay your office staff a decent wage. Meanwhile aside from your usual taxes, you can pay for board certification exams probably every 10 years, state license every two years, oh and TN has a $400 Professional Tax every year for the privilege of keeping its citizenry in xanax and vicodin. You'll be sued at least once within the first 10 years no matter how brilliant you are but don't worry you'll get to pay malpractice insurance premiums to cover that. You won't be reimbursed $28 an hour to mount a defense to the lawsuit though nor for the 40 hours of continuing medical education you'll be required to complete every 2 years. I would also recommend a personal liability umbrella policy from your insurance company because if you are involved in any accidents, dollar signs magically appear in people's eyes when they find out you are a doctor. You'll get to explain to your wife why you can't stand to go on vacation because every hour your office is vacant, you are losing income. Every once in a while you may get assaulted, cussed out or told off by a patient's daughter to boot. That's not to mention the relatives that think you have a money tree hidden somewhere or the "friends" you'll have to defend your greedy profession to on Facebook. Those are the same friends that were doing the bong hits in college who can't understand why they're barely making ends meet with their history degree.

-- Posted by cortnerkin on Tue, Mar 23, 2010, at 1:50 AM

Such a tragic story. You should have a telethon to take charitable donations for those poor doctors that so desperately need our help.

School is expensive. I decided that serving in the Marine Corps would be my best option to pay for school, so I did. No student loans, but it did cost me 5 years of my life if you wanted to look at it that way. Sure, the GI Bill doesn't carry you forever, but every little bit helps.

Continuing education and license renewals are a fact of life in many professions, and not all of them make the big bucks like docs do. You should probably scratch that off your list, because it will not gain you too much sympathy.

Not everyone that attends college is doing bong hits and partying late. Not everyone wants to be a doctor. Some of us would rather be teachers, police officers, mathematicians, and computer programmers. That doesn't make us a lesser class of people because we did not aspire to become and MD. I knew since the age of 13 that I wanted to work in computers. I do my job for the same reason that most doctors do theirs. It isn't about money or trying to impress others, it is about doing something I enjoy doing.

As far as lawsuits go, we all get sued. People that build houses, police officers, teachers, manufacturers, shop owners, and virtually everyone else gets sued for anything anytime these days. I don't agree with it, and I am on your side on that. If a doctor takes out a left kidney when he/she was supposed to take out the right that is one thing, but doctors should never be held responsible for simple mistakes that are easily fixed or random acts of God. I would have liked to have seen some liability reforms in this bill, and I know it will happen in the near future because I have a feeling that this is just the first of many changes that will be made over the next few years to fix our broken medical system.

Not everyone that attends college is doing bong hits and partying late. Not everyone wants to be a doctor. Some of us would rather be teachers, police officers, mathematicians, and computer programmers.

But apparently everyone wants to pretend to be an expert on how health care should be delivered. This fact confounds me. I use computers everyday for 10-12 hours at a time. At no time should I be confused with an expert on computers.

The same can be said of congress. For the vast majority the only experience the have with the healthcare system is that of a patient (well that and writing pork projects into bills for the medical community back home). Yet somehow we as a nation (and a medical community) have decided that somehow 400+ lawyers actually can devise a system that is efficient, cost effective and deliver quality care. Medicare/Medicaid is a great example. While many laud these programs the fact is they are horribly flawed. They are also completely insolvent.

The only hope we have at this point is that SCOTUS will hear the case from the states and deem it unconstitutional. From there we can have a more targeted approach that will lead to BETTER care and more access without bankrupting the states or the federal government.

At some point though, aren't doctors and hospitals going to have to take a pay cut?

-- Posted by nathan.evans

Well, considering that you liberals think the health insurance companies are evil because they had a miniscule profit margin last year, I'm sure you'll have a whole host of industries that should take a pay cut. Let's list a few:

Drug manufacturing:

Johnson & Johnson: 20.8% profit

GlaxoSmithKline: 17.4%

Pfizer: 16.3%

(Wait, Obama couldn't go after pharmaceutical companies as he received so much in campaign contributions from them. Better find someone else to hound.)

Medical equipment:

Medtronic: 14.9%

Baxter Int'l: 17.5%

Covidien: 12.3%

Biotech:

Amgen: 30.6%

Gilead Sciences: 37.6%

Celgene Corp.: 11.9%

Now let's compare that to the health insurance companies:

Wellpoint: 4%

Unitedhealth Group: 4.1%

Aetna: 3.9%

Yeah, how dare they turn a profit in a capitalist society?

Why don't people start taking care of themselves and their communities rather than mandating that we take care of everyone that doesn't feel like doing for themselves? Personal responsibility has gone the way of the dodo in this country.

At some point though, aren't doctors and hospitals going to have to take a pay cut?

-- Posted by nathan.evans on Tue, Mar 23, 2010, at 11:52 AM

I know of no physicians who wouldn't take a drop in salary to make sure sure care was delivered efficiently and with the highest quality. BUT as a physician when you come to me you are getting my education, experience and expertise. None of those things came cheaply to me.

Hospitals are a completely different beast and should be treated as such. Hospitals are large corporations (even small hospitals). They also run on very thin margins. A drop in reimbursement will result in either the termination of services or closure of the hospital altogether. Shelbyville has a slight advantage in that the company that owns Heritage is a large enough company to leverage buying power to keep costs at a minimum. But if the proposed cuts to hospitals continues don't be shocked to see some very hard decisions being made.

Ok Thom how can United Health have boosted their net income by 35% and only have 4.39% profit? Don't you think that smells a bit fishy

This is where I got my info

http://www.timesfreepress.com/news/2010/...

Which is a Chattanooga newspaper.

Don't you think they are doing this just like the banks and other insurance companies are doing? They are giving millions of dollars to their CEO's in bonuses and salary to cover what they are really making. And quite sure they are tucking away much more than that..

How else could you explain the CEO of Blue Cross Blue Shield of TN getting 1.7 million last year from a not for profit insurance company?

"Not everyone that attends college is doing bong hits and partying late. Not everyone wants to be a doctor. Some of us would rather be teachers, police officers, mathematicians, and computer programmers. That doesn't make us a lesser class of people because we did not aspire to become and MD."

-- Posted by nathan.evans on Tue, Mar 23, 2010, at 7:58 AM

The bong hits were not aimed at you personally. Most of it was meant as humor although my sense of humor is admittedly sardonic. I'm not too good to scrub a floor when it needs it. I respect people that set goals and follow through on them. I also have a great deal of respect for anybody willing to become a Marine. I would never presume to tell you that Marines don't deserve every benefit coming to them. In fact, I would defend their rights to those benefits. I'm not looking to trash any particular degree paths, but I'll say many people I knew in college seemed to have little regard for their employability after their degree was earned. It's a well known fact that people don't need college degrees to be successful productive citizens. I know I'm not better than them. Most people go into medicine for the right reasons, but undeniably there is investment in a career, a business aspect, and a certain amount of personal risk that can't be ignored. It's still a cool profession. Plus when you graduate, you become immediately more attractive to women. Peace nathan.

Now I have to earn enough so that my kids don't take out any federal loans for university. In light of the healthcare takeover, I think many are ignoring this. For me, 2010 will be the year the Democrats subjugated the middle class and got away with it.