When you hear advocates of Universal Health Care...

...think about this:

Who amongst us would:
- take a car back to a mechanic who already screwed up the last service, and made it worse each and every time he messed with it;
- take laundry to a laundry mat where the washers stained the last batches of clothes;
- go eat where the service is lousy and the food tastes worse each time we go?

Am I missing something here?

Yes - I agree the current health insurance system is not working to the best level it could.
But I'd rather be on it than the current Universal Care System for the over 65, called Medicare, or Medicaid, for the under 65.

We sometimes forget, in all the hype that anyone who needs Emergency care can still get it if they go to a hospital.
Note that because of what is happening, this may change in UTAH

People who want Universal Health Care need to be asked to explain why the following is happening with the Government Universal Health Care system we already have.

They should also be reminded that before we do a political biased change to scrap what we have now, and create another Government system, prudence and (un?) common sense would point out that we need to get the current Government systems fixed, first.

If not, Doctors, Nurses and Providers that are not enslaved to the Government have the right to refuse to treat patients. Hospitals that are not federally owned will have the right to refuse all but emergency care to those on Medicare.

Here is the current Universal Health Care system at work:


UT hospitals struggling under Medicaid cuts

By Anne Zieger

Hospitals in Utah are reeling under a 25 percent Medicaid reimbursement cut that was much larger than anticipated, and now are warning that they might be forced to offset costs by increasing fees on insured patients or cutting back on charity care.

Hospital association leaders said the hospitals failed to factor in the effects of using a funding stream to offset the cuts occurring in 2009. Meanwhile, technical changes in the payments to hospitals for "nonphysicians services" such as nursing care also had an impact on such reimbursement. To help address this huge change in funding, the state is looking at increasing its tobacco tax or imposing a tax on hospital stays.

If the state can't come up with a solution, state hospitals could theoretically refuse to treat Medicaid beneficiaries entirely, observers note.

To learn more about Utah's Medicaid situation:
- read this Kaiser Daily Health Policy Review item

Universal Healthcare already in place is failing

Here is a link to a simple summary of what is being looked at by Congress, and it raises interesting issues. http://www.staysmartstayhealthy.com/watch.cfm?v=20

One point it raises, that is not spoken of often, is the issue of "unhealthy" lifestyles. There are many studies and programs going on that screen employees for alcohol, diet and exercise issues and this video implied how that may need to be managed because of the cost impact on all.

In this day's conversation about Health Care coverage, the people should know how well the existing system, which is being offered as the Universal model for the U. S., is working.

Again - those computer savvy should Google "Medicare issues" and "infections in Veteran's Hospitals" and get up to speed on what certain congressmen want us to live under.

In the interest of full disclosure - once that plan is in place, the exodus of people leaving the Universal plan will rival the exodus out of New Orleans pre- Katrina.

Agents like myself stand to make a nice income providing people with plans that do not limit access or care, and allow the affluent access to better care than that offered in the social programs proposed.

The other factor is it will create a class difference and discrimination between those who are on the social program, and those who can afford "real" care.

Having health care providers bid for the right to provide coverage by offering the lowest price per service has it's own issues. This is part of the structure the VA already uses, with the result that Doctors prescribe medication that is not available to patients in the Pharmacy system.

Witnesses: Sam, Heal Yourself

• By ALLISON BELL

Published 4/21/2009

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If the federal government really wants to reform health care, it should start by fixing Medicare.

Witnesses from the insurance industry made that case today at a Senate Finance Committee hearing on reforming the U.S. health care delivery system.

Ronald Williams, chairman of Aetna Inc., Hartford, and Dr. Allan Korn, chief medical officer at the Blue Cross and Blue Shield Association, Chicago, appeared on a panel that also included representatives from think tanks such as the Brookings Institute, Washington; employer groups such as the Pacific Business Group on Health, San Francisco; and provider and consumer organizations.

The round table was convened by Sen. Max Baucus, D-Mont., chairman of the Senate Finance Committee, and Sen. Charles Grassley, R-Iowa, the highest-ranking Republican member on the committee.

Baucus and Sen. Edward Kennedy, D-Mass., chairman of the Senate Committee on Health, Education, Labor and Pensions, wrote Monday in a letter to President Obama that they want their committees to move quickly on passing broad health reform legislation.

“Right now, all of the incentives in our system encourage health care providers to deliver more care, not better care,” Baucus said today at the hearing. “Today’s conversation is about how to lower costs and improve quality in the system for the millions of hard-working Americans that are tired of seeing their health care costs rise faster than inflation.”

Panelists talked about creating incentives in the Medicare program to eliminate waste, using health information technology to improve provider communications, and conducting more research on the comparative effectiveness of various treatments.

Panelists also talked about ways to reduce fraud and abuse in federally financed health care programs.

Williams spoke at length about the importance of health IT efforts and wellness efforts.

The United States has the highest per-capita health care spending in the world, but the quality of care delivered by our health care system falls far short of expectations, Williams said.

“Our seat belt laws and anti-smoking efforts have achieved great results, and we need this same type of commitment in the wellness challenges facing us in the areas of obesity and encouraging healthy behaviors,” he said.

Williams also talked about provider compensation.

“Improving our delivery system starts with reforming our payment system to focus on quality and value,” Williams said. “Aetna supports transforming the payment system into one that aligns provider reimbursement incentives with achieving high quality outcomes for patients.”

Reimbursement changes are especially important for the Medicare and Medicare Advantage programs, Williams said.

The programs must be revised so that the focus of health care services “rests on value and quality rather than volume,” Williams said.

Under Medicare’s current fee-for-service payment structure, providers are paid on the basis of volume rather than value, often with suboptimal results, Williams said.

“Moreover, lower payment rates paid by public programs result in cost shifting to those who are privately insured,” he added.

If Congress wants to reduce the cost of Medicare Advantage as compared to Medicare as part of a down payment for financing a health reform program, Congress also must examine Medicare's operational structure and the Medicare Advantage bidding process, Williams said.

“If we decide to follow a pathway to Competitive Bidding in Medicare Advantage, we should look at the development of a viable structure that includes several guiding principles,” Williams said.

Williams said the principles should include generating meaningful cost savings from the Medicare Advantage program; maintaining access for all beneficiaries and minimizing disruption; and providing incentives to improve quality.

Korn also talked about the importance of wellness and prevention programs, comparative effectiveness research, and health IT.

Like Williams, he called for changes in provider compensation arrangements, especially in the Medicare program.

Korn described a “3-tier” Medicare reform strategy that would start with efforts to pay physicians based on quality, build up to promoting wellness and condition management programs, and eventually work up to encouraging providers to combine to form “virtual” care delivery system.

Eventually, Korn said, Medicare should pay the virtual care delivery groups bundled amounts for treating health care “episodes,” rather than paying individual providers separate fees for each type of service delivered.

Korn criticized the Obama administration proposal to create a new, government-run health insurer that would be open to healthy, working-age U.S. residents with above-average incomes.

“Private plans in general and Blue plans in particular, have been active innovating in these priority areas,” Korn testified. “Creating a new government plan that would compete with the private sector would undermine the ability of the health care sector to implement meaningful delivery system reforms. The private sector has led the way in developing innovative programs (e.g., chronic care management, wellness programs, and Centers of Excellence) that would not be possible under a government plan due to enormous political pressure.”