SINGLE PAYER IS THE ONLY HEALTHY SOLUTION

[cannon_fodder]

Guido, Conan . . . I think we are at a point at which we can agree.

Too many people want to pass their problems off on someone else.  Most doctors are not out to hurt people.  Many med mal cases should be tossed.

But to be fair, when a MSJ is filed on every case the court approaches them as routine and often lacking merit.  Like a list of affirmative defenses.  Hence, when they have merit it is often over looked.  I have no interest in picking up loser cases; it wastes my time, hurts my profession and in the long run costs me money.

/thread hijack

[guido911]

CF:

Agreed.

One other thing. It looks like the tort reform bill that passed has modified the standard for msj, apparently in line with the federal standard set forth in the tripletts. Perhaps this will help get rid of some of the more weaker cases.

/thread thoroughly hijacked.

[nathanm]

Lets see, it costs people a mere .44 cents to send a letter.  The government spends far more than .44 cents to deliver that letter, operating at a net loss.   As of last year, priority mail packages are now flown by FedEx under contract by the postal system for an excess of what the consumer is charged. 

Basically FedEx is receiving an unnecessary subsidy to deliver your package with US postal packaging.  The Post Office has chosen FedEx to deliver packages because they can do it at a far lower base rate than the postal service can provide internally.  Prior to this arrangement the USPS operated at a loss of $5.3 billion dollars for 2007.  After the private agreement, the USPS operated with a surplus of 900 million for 2008.  Privatizing just a small sector of the postal service saved over $4 billion.

The US post office is very good at sorting letters, they have a better mechanism than any private company in the world, but they do it at a loss.  Operating losses are met using federal tax money. In other words, sending a letter costs you far more than .44 cents, you just don't realize it.  Even if you don't send letters, you are paying for letters.  Most of what you are paying for is junk mail.  Billions of trees worth of junk mail.

Very dependable system indeed.

Please provide a citation for the government subsidy.

[FOTD]

That's pretty weak Nate. It's not bias against the govt, it's that the govt cannot do anything right. The postal service is one example.

Medicare is a very well run government program. Just fyi for when your time comes.

[Gaspar]

Please provide a citation for the government subsidy.

Thank you Nathanm,

I appreciate you asking such a question because the way the money is distributed is designed to keep the public unaware of the expenditure.  Otherwise people would be up in arms over the amounts. 

First, lets look at the system itself.

in 2002 the operating debt was around $11 billion for the USPS.
The Bush administration forced USPS  to make changes including downsizing, and outsourcing to private companies dropping their yearly operating debt to just over $5 billion by 2007, and they were able to turn a "profit" (LOL) by 2008. 

So one would think that they are operating a profitable organization now.  All of this info is available on the USPS website.

Now lets look under the hood.  The postal Pension fund was in debt for HALF A TRILLION DOLLARS during the Clinton and Bush administrations and the sum was growing.  Each employee pays 7% of their paycheck to the postal pension fund and of course that money is invested in the typical blend of stupid government crap resulting in dismal returns.  To make up for the shortfall the Bush administration hatched a plan to make treasury payments to the pension fund over a period of 40 years.  In response to this additional government handout, the Postal Union increased demands for benefits, and so the wheel turns, and the debt still grows.

Now lets look at operations and the reasons behind "revenue support" or subsidies.

The Postal Reorganization Act (PRA) of 1970 guarantees governmental appropriations to the USPS.  The way it is structured, it subsidizes the postal service for any parcel not posted at the standard (current $.44) rate or higher.  Currently the appropriation is running at around 25% of the USPS operating budget!

Business rates, educational rates, bulk rates, governmental postage, non-profit rates, services for the blind, newspapers, Second-class mail, agricultural, labor union rates, veterans rates, book rate, media rate, fourth-class mail, library rate, and a host of other discounted postal services support the growing subsidy.  All of your junk mail is paid for by YOU.

You would think that the postal service would operate like any other business and simply raise rates to cover these losses, but a fail safe provision (39 U.S.C.§ 3627) requires them only to raise rates when congress will not appropriate necessary funds to make up for shortfalls.

There are a number of appropriations supporting the operation, and employee benefit programs of the USPS and they are spread over many categories as to make them easier to swallow.  $20-30 million for mail for the blind, $3 billion for retirement funding, and individual appropriations for several of the discounted and free rates, and millions and millions  for "discretionary administrative expenses." 

The system is so clouded that for the most part the public remains unaware of any total number spent on a yearly basis for postal operations.  In the USPS annual report, numbers are calculated based on postal rate collections without a line item for any of the government subsidies, so when we see that the post office was profitable to a tune of 900 million last year we don't see that tens of billions of dollars were provided by appropriations, and long term congressional funding extending over decades.

In our recient Omnibus 2009 (H.R.1105) the USPS was provided:
$111,831,000 for free and discounted mail for 2009.
$239,356,000 for salaries for 2009.
$48,463,000 for expenses for 2009.

. . .And then of course there is the billions spend on construction and upgrades of new postal facilities, but we won't even cover that.

Basically you don't have to look very far to find the subsidies, you just have to look in many places.  It's the definition of a "cluster-F."

Yes the mail arrives on time.  It should for the price we pay.

I hope that answers your question.  Consult the Library of congress website and do a search on "Postal Appropriations."  It will take you the better part of a day with a good calculator, and is quite shocking.

[Cats Cats Cats]

The whole system is jacked..

I go to the dr. and get an antibiotic shot.  They charged me $87 (I have catastrophic coverage so I pay 100% up to $2300).  The insurance company's "negotiated" rate for that shot was under $1.  So I only had to pay like 87 cents instead of $87.  The insurance company wasn't on the hook for any of it.  For somebody without insurance who makes minimum wage that would be probably 1/3 to 1/4 of their rent money.  Because they don't buy into the system.  Uninsured go to the emergency room and clog it up.  My wife had appendicitis and she couldn't get in for like 3 hours.  Then with her insurance at the time she still had to pay 14% of her salary (before taxes) for the operation/hospital stay.  Hell. They charge $50 for a bag of salt water..  60% of all bankruptcies are for medical reasons.  Then most of those 60% are insured.

[FOTD]

Blowing Our Chance for Real Health Care Reform
by Dave Lindorff


"Simply put, you cannot solve either of these problems by leaving the payment system for medical care in the hands of the private insurance industry, since the whole paradigm of insurance is to make money by keeping high-risk people out of the insured pool, and by keeping reimbursements and coverage for premium payers as low as possible.

If President Obama had any political courage at all, he'd simply get on TV and say this: I will create a plan that will cover everyone, lift the burden of paying for health care from individuals and employers, and have the government pay for it all. You the taxpayer will pay for this plan with higher taxes, but you will no longer have any significant medical bills, you will no longer have health insurance premiums deducted from your paycheck, your employer will no longer be paying for employee medical coverage, and you will never have to worry about losing health benefits again, even if you are laid off. (Incidentally, eliminating employer-funded health insurance would go a long way towards allowing workers to fight to have unions, and to strike for contracts, by ending the threat that they would lose their benefits.)

Right now, with half of all Americans reportedly fearing that they could lose their jobs, and with one in five Americans reportedly either unemployed, or involuntarily working part-time, we have a situation where a majority of Americans either have no health insurance, have lost their health insurance, or are in danger of losing their employer-funded health insurance. It is a unique moment when a bold president and Congress could act to end private health insurance and establish a public single-payer insurance plan to insure and provide access to affordable medical care to all Americans.

Instead of this, we are being offered half measures or no measures at all by leaders who are shamelessly in hock to the health care industry or who are afraid of its power.


It doesn't have to be this way, but only if Americans rip their eyes away from their crisp new digital-image TV screens and start demanding real health care reform will we get honest reform. A good place to begin would be to start writing and phoning your local media outlets to ask why they are not reporting on single-payer, and in particular on the single-payer bill sponsored by Rep. John Conyers (D-MI), which is being silently blocked and killed by his colleagues in the Democratic congressional leadership and by the White House. A good place to begin would also be to start calling your elected representatives to demand that they support Rep. Conyers' single-payer bill."
http://www.commondreams.org/view/2009/06/16-3



Blowing it? we don't even have a seat at the table.

[Conan71]

And federal and state programs provide coverage to those typically excluded from the insurance pools. 

http://okhrp.org/

The Oklahoma High Risk Pool provides health insurance to Oklahoma residents who have been denied coverage. We've redesigned our website to give our members better tools and service. If you are currently a member of OHRP, please register to use this site now. If you aren't a member, find out if you are eligible.

Soonercare:

http://www.ohca.state.ok.us/individuals.aspx?id=548

[nathanm]

My understanding was that the lion's share of the "subsidy" is actually repayment for franking privileges that members of congress and others receive.

And it is true the USPS has been losing money hand over fist for the last year (as opposed to last year when the losses were more manageable), but that's mostly due to the drastic decrease in mailing volume.

And as far as the USPS' retirement contributions, they actually contribute more than their fair share to the civil service retirement fund. Something like $5 billion a year in overpayments first due to a miscalculation, then due to Congress requiring them to pay more than other departments so the newfound shortfall wouldn't have to be made up on the books. Of course, when the USPS loses money it borrows from the Treasury to make up for it, so I'm not really sure who thought that was a good idea.

Like any other corporation, the fortunes of the USPS ebb and flow. In these difficult economic times, there's much more ebb than flow.

And FWIW, given that postal service is guaranteed in our Constitution, I don't really have a problem with it receiving government subsidies. You think that government compensating the USPS for being required to provide a significant discount to the blind is a problem?

Thank you Nathanm,

I appreciate you asking such a question because the way the money is distributed is designed to keep the public unaware of the expenditure.  Otherwise people would be up in arms over the amounts. 

First, lets look at the system itself.

in 2002 the operating debt was around $11 billion for the USPS.
The Bush administration forced USPS  to make changes including downsizing, and outsourcing to private companies dropping their yearly operating debt to just over $5 billion by 2007, and they were able to turn a "profit" (LOL) by 2008. 

So one would think that they are operating a profitable organization now.  All of this info is available on the USPS website.

Now lets look under the hood.  The postal Pension fund was in debt for HALF A TRILLION DOLLARS during the Clinton and Bush administrations and the sum was growing.  Each employee pays 7% of their paycheck to the postal pension fund and of course that money is invested in the typical blend of stupid government crap resulting in dismal returns.  To make up for the shortfall the Bush administration hatched a plan to make treasury payments to the pension fund over a period of 40 years.  In response to this additional government handout, the Postal Union increased demands for benefits, and so the wheel turns, and the debt still grows.

Now lets look at operations and the reasons behind "revenue support" or subsidies.

The Postal Reorganization Act (PRA) of 1970 guarantees governmental appropriations to the USPS.  The way it is structured, it subsidizes the postal service for any parcel not posted at the standard (current $.44) rate or higher.  Currently the appropriation is running at around 25% of the USPS operating budget!

Business rates, educational rates, bulk rates, governmental postage, non-profit rates, services for the blind, newspapers, Second-class mail, agricultural, labor union rates, veterans rates, book rate, media rate, fourth-class mail, library rate, and a host of other discounted postal services support the growing subsidy.  All of your junk mail is paid for by YOU.

You would think that the postal service would operate like any other business and simply raise rates to cover these losses, but a fail safe provision (39 U.S.C.§ 3627) requires them only to raise rates when congress will not appropriate necessary funds to make up for shortfalls.

There are a number of appropriations supporting the operation, and employee benefit programs of the USPS and they are spread over many categories as to make them easier to swallow.  $20-30 million for mail for the blind, $3 billion for retirement funding, and individual appropriations for several of the discounted and free rates, and millions and millions  for "discretionary administrative expenses." 

The system is so clouded that for the most part the public remains unaware of any total number spent on a yearly basis for postal operations.  In the USPS annual report, numbers are calculated based on postal rate collections without a line item for any of the government subsidies, so when we see that the post office was profitable to a tune of 900 million last year we don't see that tens of billions of dollars were provided by appropriations, and long term congressional funding extending over decades.

In our recient Omnibus 2009 (H.R.1105) the USPS was provided:
$111,831,000 for free and discounted mail for 2009.
$239,356,000 for salaries for 2009.
$48,463,000 for expenses for 2009.

. . .And then of course there is the billions spend on construction and upgrades of new postal facilities, but we won't even cover that.

Basically you don't have to look very far to find the subsidies, you just have to look in many places.  It's the definition of a "cluster-F."

Yes the mail arrives on time.  It should for the price we pay.

I hope that answers your question.  Consult the Library of congress website and do a search on "Postal Appropriations."  It will take you the better part of a day with a good calculator, and is quite shocking.

[FOTD]

Warning: Health Care Lobbyists Are Winning the Battle to Screw All of Us

http://www.alternet.org/healthwellness/140732/warning:_health_care_lobbyists_are_winning_the_battle_to_screw_all_of_us_/

Democrats have all but abandoned the idea that everyone be covered without exception. They've so far avoided endorsing clear cost-containment measures that would pass the budget-scorers' test of legitimacy. The wished-for savings that Obama says he wants the private insurance industry to achieve are exactly that -- wishes. The winners so far are health-industry lobbyists. They sense that their chances of protecting the interests of big insurers, drug companies, medical specialties, technology companies and the like are improving every day. They're probably right.


Americans want, need, and deserve Single Payer. Nothing less. This WILL happen. The insurance industry WILL win. Make no mistake about this.

Report: Health care costs to rise 9 pct in 2010
http://www.google.com/hostednews/ap/article/ALeqM5hZuemSJ4pbgjxRDMzsbINv6ImpuwD98T1IB80

"If the underlying costs go up by 9 percent, employees' costs actually go up by double digits," he said, noting that will have a "major, major impact" when many employers also are freezing or cutting pay.

[Conan71]

Warning: Health Care Lobbyists Are Winning the Battle to Screw All of Us

Shocker, didn't see that one coming. 

[FOTD]

Single Payer and the Duplicitous Rahm Emanuel
by Russell Mokhiber


Earlier this year, Dr. Marcia Angell, the former editor of the New England Journal of Medicine, warned about what she called "the futility of piecemeal tinkering." Obama and the Democrats did not heed her warning. -- Earlier this week, the most liberal of the Democrats tinkering plans - Senator Kennedy's - went up in smoke when the "Congressional Budget Office (CBO) estimated that the Kennedy plan would cost $1 trillion over ten years and still leave 37 million Americans uninsured. Three months ago, House Majority Leader Steny Hoyer (D-Maryland) told single payer supporters that he would seek to get the CBO to score single payer legislation (HR 676). But Steny Hoyer backed off his pledge. He never did get the CBO to score single payer. Why? -- Because it would show that under single payer, we'd pay what we are paying now - or less - and it would cover everyone. Zero People Left Uninsured. Zero People Dead From Lack of Health Insurance. No More Medical Bankruptcies. -- But at the same time, single payer would eliminate the more than 1,000 health insurance corporations. That's how you save $400 billion a year to cover everyone - replace the 1,300 payers with one single payer. -- So the corporate Democrats and Obama are now engaged in a Protection Racket - Protecting the Bloated, Wasteful Health Insurance Industry from sure extinction if single payer becomes law."


http://www.commondreams.org/view/2009/06/18-2

[nathanm]

As long as employers have anything to do with the health care system, the system is broken. Yet nobody seems willing to do what needs to be done.

FWIW, single payer does not at all mean an elimination of private health insurance, although it does relegate private health insurance to providing supplemental insurance for experimental procedures or drugs a public single payer plan would not cover.

Mandating that people buy coverage is worse than what we have now unless that mandate comes with strict limits on the health insurance companies as to limitations of coverage and what they charge. Even so, having multiple risk pools run by private insurers defeats the purpose. Private insurers will do whatever they can to make sure their risk pool has only the healthiest. One single pool encompassing the entire nation is the only way to go.

If getting it done means that the single payer government plan is a wholesaler to private insurers who profit on the markup, so be it. Anything short of a single risk pool with universal coverage is no real progress at all.

Once again the Congressional Democrats are kowtowing to the Congressional Republicans in an effort to get them to vote for a bill they will never vote for. They obviously learned nothing from the stimulus vote. Idiots. Oh well, at least they aren't also malicious.

[Gaspar]

Like any other corporation, the fortunes of the USPS ebb and flow. In these difficult economic times, there's much more ebb than flow.

That quote made my day. 

Nathanm, My point was to respond first to the assertion that the USPS is an example of a profitable government run industry, and then second was to respond to the strange idea that the USPS was somehow not subsidized.

I have done both, and am still waiting for an example of ANY industry run by the federal government that is functional under normal market circumstances.  If anyone can provide an example then perhaps we can look at the model and apply it to how the government might treat healthcare.

But then again, I think that the exercise is probably pointless, people don't care if the system produces poor medicine, wrecks the economy, or fails economically.  The people want a pony damn it!. . .and they want that pony now!

[nathanm]

But then again, I think that the exercise is probably pointless, people don't care if the system produces poor medicine, wrecks the economy, or fails economically.  The people want a pony damn it!. . .and they want that pony now!

What you seem not to understand is that health care is already subsidized. (As are FedEx and UPS)

And you have yet to explain how exactly single payer would result in poor medicine, or how it's possible to be a larger economic failure than the current system which is bankrupting employers. And how it could wreck the economy by reducing the overhead expenses of healthcare, which would actually be good for the economy, again, by reducing the costs of businesses here in the US.