Page 1 of 4 1234 LastLast
Results 1 to 25 of 80

Thread: US Health-Care Reform 2009

  1. #1
    Master OptiBoarder rbaker's Avatar
    Join Date
    May 2000
    Location
    Gold Hill, OR
    Occupation
    Other Optical Manufacturer or Vendor
    Posts
    4,401

    US Health-Care Reform 2009

    The Administration has promised us health-care reform legislation this year. One option on the table is a single payer system, a national program like those in Europe, be adopted. While no one knows what this legislation will require:

    How do you think it will effect your eye care business?

    How do you think that it will effect your personal life?

    The reform is coming and I think it will come at us like a bolt from the blue. We may just wake up one morning, real soon now, and wonder what happened much as the auto industry now finds itself operating under unheard of terms just a few months ago.

    There is an old Chinese curse which states "may you live in interesting times."

    .

  2. #2
    Master OptiBoarder
    Join Date
    Oct 2006
    Location
    Michigan
    Occupation
    Dispensing Optician
    Posts
    2,827
    I doubt there would be any vision insurance under a national health plan, maybe for comprehensive exams. I don't know of any countries that have vision coverage but many that offer supplimental or private plans. So third party insurance for vision might still be around....unfortunately.

    How would national health care affect me? I dread it though I don't see another possible option. I have very good and affordable coverage and would hate to lose it in exchange for some ill-organized, lesser plan run by the same government that came up with the Medicare Rx plans. Genius.

  3. #3
    One of the worst people here
    Join Date
    Jan 2004
    Location
    Canada
    Occupation
    Other Eyecare-Related Field
    Posts
    8,331
    Quote Originally Posted by cocoisland58 View Post
    I doubt there would be any vision insurance under a national health plan, maybe for comprehensive exams. I don't know of any countries that have vision coverage but many that offer supplimental or private plans. So third party insurance for vision might still be around....unfortunately.

    .

    It is interesting that on this site, probably 50 times the idea of vision coverage has been brought up, usually by the same people, and each time the answer has been that Universal Health Care tends to not have vision coverage.

    On another note. Sometimes I read about the state-run medical coverage down there. I am shocked by what I hear, because it is nothing like that here. I am starting to believe that these programs down there are implemented in bad ways on purpose. I am starting to wonder if there are people involved who purposely create bad proposals to make the welfare system and medicare look bad.

  4. #4
    Paper Shuffler GOS_Queen's Avatar
    Join Date
    Dec 2004
    Location
    Portland Metro
    Occupation
    Other Eyecare-Related Field
    Posts
    1,533
    Since I work in the eyewear billing end of things now ... I cringe at the thought of the the same people who handle Medicare & DMERC handling the rest of it

    I mean, seriously, people! Think about billing eyewear to DMERC.

    Why can't they just have one frame code and one lens code for each lens style (sv, bi, tri). It's absurd to have so many lens codes :hammer: It doesn't really matter!


    Also, WHY do I have to break the claim into 2 HCFA's ... it's so stupid!

    No other insurance company needs all this tedious junk!



    Also, for the bigger picture, (not just optical) I think that we will see rationing and waiting for procedures. It's inevitable.

  5. #5
    Master OptiBoarder OptiBoard Silver Supporter Jubilee's Avatar
    Join Date
    May 2001
    Location
    United States
    Occupation
    Dispensing Optician
    Posts
    3,197
    Screw making it like Medicare.. go the route of the VA's.

    The VA medical system has invested in technology, and upgrading its services. They have the power to negotiate pricing on medications (something that Medicare does not and thus its horrendous rx plan) and is an example of "socialized" medicine at its best.

    The main advantage to a single payer system is reducing all the administration necessary to track the money trail. Also, can you imagine how much easier it would be for the physicians to be able to submit to one clearing house.. fill out the forms one way (electronically) .. and reconcile it? Currently we have at least 6 admistrators for every provider. All that overhead is a huge contributing factor in why our health care costs so much.

    As far as rationing is concerned.. we already have that with private pay systems. Its called the pre-approval process. The doctors have to justify why the want an MRI, surgery, or some other service and the ins company will say yeah, or nay.. Many are already cracking down on this by implementing Imaging review boards, etc.

    Most nations with a single payor system do allow for you to take private coverage at your expense. Some even will give you tax credits for doing so! Not all physicians have to participate either. Those that do may receive a guaranteed base salary and gain extra benefits for quality of care. Some countries...like France even pay for education/training of their MDs. Imagine coming out of Med School w/o dedt.. instead of 100K plus many are finding themselves in when they start out.

    Cassandra
    "Some believe in destiny, and some believe in fate. But I believe that happiness is something we create."-Something More by Sugarland

  6. #6
    Cape Codger OptiBoard Gold Supporter hcjilson's Avatar
    Join Date
    May 2000
    Location
    Cape Cod, Hyannis, MA. USA
    Occupation
    Dispensing Optician
    Posts
    7,437

    Your timing is perfect.....

    Just last night I went to a health care reform meeting held by an Organizing for America volunteer. I went because I think it is the birthright of every American to have access to quality affordable health care and that simply is NOT the way the health system operates today. It needs reform but it needs a groundswell effort from the citizens in order for that to happen.

    What form the health system takes will be essentially be what we decide it should be. There are many options, single payer being one of them.What you will see well may be a system with different options, such as other countries have now.
    "Always laugh when you can. It is a cheap medicine"
    Lord Byron

    Take a photo tour of Cape Cod and the Islands!
    www.capecodphotoalbum.com

  7. #7
    Master OptiBoarder
    Join Date
    Oct 2006
    Location
    Michigan
    Occupation
    Dispensing Optician
    Posts
    2,827
    Quote Originally Posted by For-Life View Post
    On another note. Sometimes I read about the state-run medical coverage down there. I am shocked by what I hear, because it is nothing like that here. I am starting to believe that these programs down there are implemented in bad ways on purpose. I am starting to wonder if there are people involved who purposely create bad proposals to make the welfare system and medicare look bad.

    That would be my guess also otherwise it would be made much simpler by reason of common sense. I agree that we need universal medical coverage down here but my fear is that our government will think they have a better way instead of copying programs that work in other countries. No country has a perfect program but my friends in Canada don't complain too much and my friend in Australia finds hers acceptable. I have heard that Israel has an excellent program. If we don't rush into this we might be able to make it work but our president seems to be on the fast track to turn the country upside down. JMO;)

  8. #8
    Bad address email on file
    Join Date
    Aug 2007
    Location
    minnesota
    Occupation
    Dispensing Optician
    Posts
    146

    Wave

    The followings are just my thoughts. I am not against any other.
    Unlike U.S., Australia, most countries don't have national vision insurance
    system. In those countries, there is no vision check premium. Refraction error is regarded as one of usual abnormality rather than disease. Any customer drops by any optical shop and can get any glasses or CL by simple vision check (usually done by optician) without asking the cost of vision check.
    Heath system usually depends on each country's policy, interest relationship among heath providers, patients' need as well as the technological advancement.
    Thus, why should new health reform include vision insurance if we consider the
    above factors? Instead, We may need a reform of eye health system for patient's cost and convenience, don't we? :cheers:

  9. #9
    Bad address email on file k12311997's Avatar
    Join Date
    Feb 2005
    Location
    PA
    Occupation
    Dispensing Optician
    Posts
    1,921
    Quote Originally Posted by hcjilson View Post
    .... it is the birthright of every American to have access to quality affordable health care ...
    and I believe it is the birthright of every American to take the opportunities of living in a free country and make the most out of them , nothing more.

    the easiest and most economical solution is abolish all insurance and create a competitive market in health care.

  10. #10
    One of the worst people here
    Join Date
    Jan 2004
    Location
    Canada
    Occupation
    Other Eyecare-Related Field
    Posts
    8,331
    Quote Originally Posted by cocoisland58 View Post
    That would be my guess also otherwise it would be made much simpler by reason of common sense. I agree that we need universal medical coverage down here but my fear is that our government will think they have a better way instead of copying programs that work in other countries. No country has a perfect program but my friends in Canada don't complain too much and my friend in Australia finds hers acceptable. I have heard that Israel has an excellent program. If we don't rush into this we might be able to make it work but our president seems to be on the fast track to turn the country upside down. JMO;)
    Yes, I agree. One of the biggest problem is no one looks at the successes of other programs. It is probably the best way to start.

    I always wanted to say something that people may find shocking, but here it is: Government run Health Care is competitive!!!
    :drop:

    Absolutely. When patients look at their health care, they compare it to other places. So in Ontario, we compare it to other provinces and we compare it to other nations (including the US). If it is sub par, there are major pressures to fix it.

  11. #11
    One of the worst people here
    Join Date
    Jan 2004
    Location
    Canada
    Occupation
    Other Eyecare-Related Field
    Posts
    8,331
    Quote Originally Posted by k12311997 View Post
    and I believe it is the birthright of every American to take the opportunities of living in a free country and make the most out of them , nothing more.

    the easiest and most economical solution is abolish all insurance and create a competitive market in health care.
    How competitive can it be if there is only room for one hospital within 100kms?

  12. #12
    Banned
    Join Date
    Jun 2000
    Location
    Only City in the World built over a Volcano
    Occupation
    Dispensing Optician
    Posts
    12,996
    Where in the U.S. Constitution is this a right? Where is it written that all other citizens are obligated to provide this? Do you interpret the words: "Provide for the common defense" to mean defense against germs or injury, or birth defects and the like?

    All men are not required to provide for the needs of all other men. Perhaps if this were actually a Christian nation, but now that the president says we aren't where do you get this from?

    Where does one's obligation to provide for his own needs begin and end?

    Chip

  13. #13
    One of the worst people here
    Join Date
    Jan 2004
    Location
    Canada
    Occupation
    Other Eyecare-Related Field
    Posts
    8,331

    Blue Jumper

    Quote Originally Posted by chip anderson View Post
    Where in the U.S. Constitution is this a right? Where is it written that all other citizens are obligated to provide this? Do you interpret the words: "Provide for the common defense" to mean defense against germs or injury, or birth defects and the like?

    All men are not required to provide for the needs of all other men. Perhaps if this were actually a Christian nation, but now that the president says we aren't where do you get this from?

    Where does one's obligation to provide for his own needs begin and end?

    Chip
    Good question Chip. Very good question. Where does it begin and where does it end?

    If we take the view that it begins but does not end, then we can say that it should be total communism where no one owns anything. I am sure no one here wants that.

    If we take the view that it should not begin at all, then our military, police force, all roads, waterways, sewage, and so forth is privatize. You cannot gain protection unless you pay for it out of your own money and you cannot move unless you do the same either. I doubt anyone wants that either.

    So here I can establish through that argument that there should definitely be a beginning and an ending. In my opinion, I believe it should be up to at least secondary education with some support for post-secondary education, health care, some welfare assistance, roads, sewage, waterways, military, and policing (may have left something out), and after that, it is free market.

  14. #14
    Bad address email on file k12311997's Avatar
    Join Date
    Feb 2005
    Location
    PA
    Occupation
    Dispensing Optician
    Posts
    1,921
    Quote Originally Posted by For-Life View Post
    How competitive can it be if there is only room for one hospital within 100kms?

    hospitals would cease to be the health care portal for the under served you would be able to afford the doctor for the little things before they became big things. Costs would go down. No more waiting(hoping) for payment no more time wasted resubmiting claims. no more having a staff of insurance billers. Hospitals would have to court the elective surgerys surgery by the hour would be the same elective or emergency.

    Pittsburgh is looked at as a minor city (just ask Pete Hanlin:bbg:) there are at least 5 hospitals within 60 miles (is that a close conversion of 100 kms?) of my house (east suburbs)

  15. #15
    One of the worst people here
    Join Date
    Jan 2004
    Location
    Canada
    Occupation
    Other Eyecare-Related Field
    Posts
    8,331
    Quote Originally Posted by k12311997 View Post
    hospitals would cease to be the health care portal for the under served you would be able to afford the doctor for the little things before they became big things. Costs would go down. No more waiting(hoping) for payment no more time wasted resubmiting claims. no more having a staff of insurance billers. Hospitals would have to court the elective surgerys surgery by the hour would be the same elective or emergency.

    Pittsburgh is looked at as a minor city (just ask Pete Hanlin:bbg:) there are at least 5 hospitals within 60 miles (is that a close conversion of 100 kms?) of my house (east suburbs)
    Yes, good conversion.

    Pittsburgh is not small. Not compared to here. Winnipeg is 8 hours West. Sault Ste. Marie is 8 hours east. Thunder Bay (where I am) has 100,000 people. No city even close until you hit those two. On the way, we have west, we have Kenora with a hospital, which is 2 hours from Winnipeg. We then have Dryden and Fort Frances, which both are 2 hours from Kenora, and four hours from Thunder Bay and Winnipeg. We have Sioux Lookout and Red Lake that serve the First Nations up North. East of Thunder Bay, we have Nipigon, Terrace Bay, Marathon, and Manitouwadge, all one hour from each other (as you go down the line) with small hospitals. Most of those municipalities have less than 3,000 people. Three of them have 5,000-10,000 people.

    So really, you have no choice where you go, unless it is a planned procedure. There would be no competition if it were private.

    Now, working for the Ministry of Health, I can tell you that hospitals are not the only way to go. We have home care, aging at home, community support services, community programs, ect. But even those are not sustainable for more than one provider per town.

    So we, as the government, ensure that they are competitive against each other for the funding dollars we provide to them (keep in mind, all of them have their own administrators and planning. We do not do their planning for them. So they are still essentially separate from the government).

  16. #16
    Objection! OptiBoard Gold Supporter shanbaum's Avatar
    Join Date
    May 2000
    Location
    Manchester, CT USA
    Occupation
    Other Optical Manufacturer or Vendor
    Posts
    2,976
    Quote Originally Posted by chip anderson View Post
    Where in the U.S. Constitution is this a right? Where is it written that all other citizens are obligated to provide this? Do you interpret the words: "Provide for the common defense" to mean defense against germs or injury, or birth defects and the like?

    All men are not required to provide for the needs of all other men. Perhaps if this were actually a Christian nation, but now that the president says we aren't where do you get this from?

    Where does one's obligation to provide for his own needs begin and end?

    Chip
    You need to keep reading, Chip; Article I, Section 8 begins:

    "The Congress shall have Power To lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defence and general Welfare of the United States..." (emphasis added).

    This also answers your second and third questions, that is, it is up to us, acting through our elected representatives, to decide in what ways Congress shall tax and spend for the "general welfare." That the Constitution affords this power to Congress is indisputable, and I cannot imagine an argument that could categorically exclude health care from the "general welfare."

  17. #17
    Master OptiBoarder rbaker's Avatar
    Join Date
    May 2000
    Location
    Gold Hill, OR
    Occupation
    Other Optical Manufacturer or Vendor
    Posts
    4,401
    Quote Originally Posted by shanbaum View Post
    You need to keep reading, Chip; Article I, Section 8 begins:

    "The Congress shall have Power To lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defence and general Welfare of the United States..." (emphasis added).

    This also answers your second and third questions, that is, it is up to us, acting through our elected representatives, to decide in what ways Congress shall tax and spend for the "general welfare." That the Constitution affords this power to Congress is indisputable, and I cannot imagine an argument that could categorically exclude health care from the "general welfare."
    The interpretation of the term "general welfare" has been at the heart of debate and case law since before the ink was dry. Our personal interpretation pretty much defines in a political sense, who we are, liberal, conservative, libertarian or whatever.

    The application of
    "general welfare" to the issue of government supported and financed healt insurance was a moot point until as late as the 1930's. Prior to that date there was no such a thing as health insurance - private or government. Historically, we could all afford to pay for our own health care out of pocket.
    Last edited by rbaker; 06-07-2009 at 05:33 PM. Reason: Added last paragraph.

  18. #18
    ABO-AC, NCLE-AC, LDO-NV bob_f_aboc's Avatar
    Join Date
    Dec 2007
    Location
    Round Rock, Texas, United States
    Occupation
    Dispensing Optician
    Posts
    1,830
    Quote Originally Posted by shanbaum View Post
    Article I, Section 8 begins:

    "The Congress shall have Power To lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defence and general Welfare of the United States..." (emphasis added).
    I think that means Common Defense of the United States of America and the General Welfare of the United States of America.

    Whether or not I get to go to the doctor when I have the sniffles or cancer or whatever has absolutely nothing to do with it. My personal welfare does not affect the welfare of the United States of America and is not guaranteed by anyone.

    There are probably around a dozen people in this country to whom this does not apply. It starts with the President and works down from there.
    A lack of planning on your part DOES NOT constitute an emergency on mine!

  19. #19
    Objection! OptiBoard Gold Supporter shanbaum's Avatar
    Join Date
    May 2000
    Location
    Manchester, CT USA
    Occupation
    Other Optical Manufacturer or Vendor
    Posts
    2,976
    Quote Originally Posted by rbaker View Post
    The interpretation of the term "general welfare" has been at the heart of debate and case law since before the ink was dry. Our personal interpretation pretty much defines in a political sense, who we are, liberal, conservative, libertarian or whatever.

    The application of "general welfare" to the issue of government supported and financed healt insurance was a moot point until as late as the 1930's. Prior to that date there was no such a thing as health insurance - private or government. Historically, we could all afford to pay for our own health care out of pocket.
    While it is true that health insurance only came into being in the late 1920's (although it began in the form of prepaid hospital plans, as opposed to the indemnifiaction plans we think of today), the Public Health Service of the United States traces its history to the 18th century. And of course, it was much easier for everyone to pay for his own health care when there were few treatments of any kind, and no extraordinarily expensive ones.

    Historically, there has been very little debate about the boundaries of the spending power per se; at this point, the only limit that Congress would be likely to bump up against would be if it were to try to spend on some impartial basis - for example, were it to propose to build a network of educational institutions limited to enrolling, say, rednecks. But even that might pass Constitutional muster. A legal challenge to the Constitutionality of a national health care system based solely on Congress having exceeded the boundaries of the spending power in establishing such a system would fail.

    The debate, instead, is as I put it: do we want to do this, or not? There is no doubt that our predecessors empowered the federal government to do it. You are confusing "should we?" with "can we?". There is plenty of room for debate about the former, and that's sufficient to "define who we are."

  20. #20
    Objection! OptiBoard Gold Supporter shanbaum's Avatar
    Join Date
    May 2000
    Location
    Manchester, CT USA
    Occupation
    Other Optical Manufacturer or Vendor
    Posts
    2,976
    Quote Originally Posted by bob_f_aboc View Post
    I think that means Common Defense of the United States of America and the General Welfare of the United States of America.

    Whether or not I get to go to the doctor when I have the sniffles or cancer or whatever has absolutely nothing to do with it. My personal welfare does not affect the welfare of the United States of America and is not guaranteed by anyone.

    There are probably around a dozen people in this country to whom this does not apply. It starts with the President and works down from there.
    I see... so, the general welfare of the United States would not be impacted if, say, all U.S. citizens were to contract scurvy? The federal government couldn't buy oranges?

  21. #21
    Banned
    Join Date
    Jun 2000
    Location
    Only City in the World built over a Volcano
    Occupation
    Dispensing Optician
    Posts
    12,996

    Welfare definition

    Main Entry:1wel·fare Pronunciation:\ˈwel-ˌfer\ Function:noun Etymology:Middle English, from the phrase wel faren to fare wellDate:14th century1: the state of doing well especially in respect to good fortune, happiness, well-being, or prosperity <must look out for your own welfare>2 a: aid in the form of money or necessities for those in need b: an agency or program through which such aid is distributed


    Now are we to assume that we are all "those in need?" Or are we to take this as only the poor are in need? Are should we just assume that medicine has become entirely too over priced (or overly technical, or overly regulated, or overly harrassed by the legal profession) and needs reform? Need this reform take the nature of government provided medicine or just a general clean up of the profession?

    Chip

  22. #22
    Objection! OptiBoard Gold Supporter shanbaum's Avatar
    Join Date
    May 2000
    Location
    Manchester, CT USA
    Occupation
    Other Optical Manufacturer or Vendor
    Posts
    2,976
    Quote Originally Posted by chip anderson View Post

    Now are we to assume that we are all "those in need?" Or are we to take this as only the poor are in need? Are should we just assume that medicine has become entirely too over priced (or overly technical, or overly regulated, or overly harrassed by the legal profession) and needs reform? Need this reform take the nature of government provided medicine or just a general clean up of the profession?

    Chip
    The term "welfare" in the Constitution should not be confused by the modern use of the term to refer to aid to the poor. That second meaning has no place in Constitutional jurisprudence (I should limit that to, "regarding the spending clause").

    There is no shortage of websites where you can read up on the Constitution, for example, http://www.findlaw.com/casecode/constitution/. Dictionaries are not particularly useful in trying to understand the way the words used in the Constitution have been interpreted by the courts.

    You might want to further describe what you mean by a "general clean up of the profession" - including who you think is going to do the cleaning up, if not the government.
    Last edited by shanbaum; 06-08-2009 at 06:08 AM.

  23. #23
    One of the worst people here
    Join Date
    Jan 2004
    Location
    Canada
    Occupation
    Other Eyecare-Related Field
    Posts
    8,331
    Quote Originally Posted by bob_f_aboc View Post
    I think that means Common Defense of the United States of America and the General Welfare of the United States of America.

    Whether or not I get to go to the doctor when I have the sniffles or cancer or whatever has absolutely nothing to do with it. My personal welfare does not affect the welfare of the United States of America and is not guaranteed by anyone.

    There are probably around a dozen people in this country to whom this does not apply. It starts with the President and works down from there.
    Actually, your personal welfare does affect others in the United States of America. If you have poor personal welfare, it will have a negative economic effect. If you have poor health, it can have a poor negative economic effect, and even potential health effects, as your health problems can create diseases seen in many of our poorer nations.

  24. #24
    ABO-AC, NCLE-AC, LDO-NV bob_f_aboc's Avatar
    Join Date
    Dec 2007
    Location
    Round Rock, Texas, United States
    Occupation
    Dispensing Optician
    Posts
    1,830
    Quote Originally Posted by For-Life View Post
    Actually, your personal welfare does affect others in the United States of America. If you have poor personal welfare, it will have a negative economic effect. If you have poor health, it can have a poor negative economic effect, and even potential health effects, as your health problems can create diseases seen in many of our poorer nations.
    As can be witnessed by the 'refugees' of Hurricane Katrina. The government is so concerned about the welfare of those folks that they are still receiving assistance and housing from the government 4 years after the fact. I have had the pleasure of meeting several hundred of these people over the past few years and have found that many of them are making more money not working than I am working 40-50 hours per week.

    The office that I worked for in Houston at the time is still waiting to get paid on any of the Louisiana Medicaid patients we were required to see while they were displaced. The government doesn't seem to be too worried with the welfare of the doctor or his staff that are working for free.

    I will stop paying rent and my car payment and my power bill and my phone bill and my insurance and then we will see how much the government is concerned about my welfare.
    A lack of planning on your part DOES NOT constitute an emergency on mine!

  25. #25
    Master OptiBoarder
    Join Date
    Mar 2008
    Location
    Oakland, California
    Occupation
    Dispensing Optician
    Posts
    1,573
    the easiest and most economical solution is abolish all insurance and create a competitive market in health care.[/QUOTE]
    Until that day when you need a lap coli or a cleanout of your vena cava and find that your total bill is 6 figures, and the first number isn't a 1. Can you spare that from the retirement savings of an Optician? Many can't. So it's starve or just lie down and die. I like what insurance can do. If the corporate medical providers were removed from the equation, would costs go down? Some, maybe, but modern medicine is still expensive. Should we not access that technology? Or is it only for those who have real wealth?

Thread Information

Users Browsing this Thread

There are currently 1 users browsing this thread. (0 members and 1 guests)

Bookmarks

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •