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View Diary: Betrayal in Massachusetts (293 comments)

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  •  No different than the private sector though.. (5+ / 0-)
    it does so by just transferring the burden to union members instead of the state.

    That is exactly what is happening all over the US to non-public employees.

    And by transferring to "the state", please say what that really means.. "to the taxpayers".

    Yes, you are right it doesn't address the root problem.  But private sector employees are beginning to wonder why the public employees should be exempt from the realities of health care.  Many voters resent this.  And municipalities will go under without some relief.

    My employer transferred us to a high deductible plan last year.  It hurts!

    I don't like it, but at some point we really need to address the underlying problem of health care costs.  Something the stupid ACA law Congress passed last year does not do at all.

    •  I'm glad you support single payer for all (5+ / 0-)

      Or did you mean a system like we have for the VA, where doctors work for the people?  I'd be even more supportive of that.

      Republicans definitely want to screw me. Democrats also want to screw me, but slower.

      by Nada Lemming on Wed Apr 27, 2011 at 01:35:49 PM PDT

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      •  At some point, doctors have to be public workers (7+ / 0-)

        to make real health universal care effective and affordable.

        However, a single-payer system could effectively do the same thing with private providers through cost controls.  close enough anyway..   In a single-payer system, doctors have nowhere else to turn to.  There's only one payer and they must agree to the reimbursement schedule.

        Single payer is the only obvious choice.. I wish Congress had given it a chance.

        •  It would help to promote generic meds, too (1+ / 0-)
          Recommended by:
          drewfromct

          I don't know the percentages, but prescription costs are a big piece of the cost equation, and the drug companies have way too much clout, keeping out generics while pushing unnecessary and superfluous meds on uninformed patients.

          Yet it is not our part to master all the tides of the world, but to do what is in us for the succour of those years wherein we are set... -- Gandalf

          by dnta on Wed Apr 27, 2011 at 01:52:50 PM PDT

          [ Parent ]

          •  Generics have been proven (3+ / 0-)
            Recommended by:
            dnta, farbuska, Nada Lemming

            time and time again to be just as effective as most newer versions costing tens times as much. (sometimes with much less risk!)  Hefty co-pays should apply on any of those, if even allowed in the formulary at all.

            •  Not necessarily. (4+ / 0-)
              Recommended by:
              dnta, milkbone, neroden, schnecke21

              A lot of psychoactive medications work differently in the generic form than the brand name, at least for some people.

              See here, for example.

              People who have struggled to find medications (or a mix of medications) that work for them to treat depression, anxiety, bipolar disorder, etc., should not be forced to take drugs that do not work for them and renew their symptoms.

              This goes for drugs treating physical issues, as well.

            •  Sometimes generics don't work. (1+ / 0-)
              Recommended by:
              Betty Pinson

              I've never figured out why, but I know people for whom particular psych drugs only work in certain brand names.

              Those things (psych drugs) are really finicky though.

              Read pp. 1-7 of Krugman's _The Great Unraveling_ (available from Google Books). NOW.

              by neroden on Wed Apr 27, 2011 at 08:34:17 PM PDT

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            •  Not always (0+ / 0-)

              USP allows up to a 7% difference in capsule content, and the FDA allows up to a 20% difference in bioavailability for a generic drug. Depending on the drug and what it's being used to treat, that can potentially be huge.

        •  Oligarchs & Trailer Trash But No Country Club GOP? (3+ / 0-)

          Is the upper middle calss GOP doomed for extinction along with the middle class?  I don't see how they can survive without customers, but they are fantasizing that somehow they will be spared.

          It's all so clear to me now. I'm the keeper of the cheese. And you're the lemon merchant. Get it? And he knows it.

          by bernardpliers on Wed Apr 27, 2011 at 02:23:34 PM PDT

          [ Parent ]

          •  They'll be the last non-elite group to be shredded (2+ / 0-)
            Recommended by:
            Betty Pinson, Nada Lemming

            But I strongly doubt they're exempt, however much they may think they're members of "the investor class".  They're not, as they will find out once all the rest of us have been ground down into debt peonage.

            "Power concedes nothing without a demand. It never did and it never will." ~Frederick Douglass

            by ActivistGuy on Wed Apr 27, 2011 at 03:12:24 PM PDT

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        •  To be accurate, only one *significant* payer (1+ / 0-)
          Recommended by:
          Victor Laslo

          In "single-payer" systems and in in VA Hospital-type systems, generally private, fee-for-service medical care is allowed, but it's only used by the superrich or the occasional oddball.  (Private insurance is prohibited, private care isn't.)  

          It's too small a clientele to make a meaningful difference to most doctors, but a few doctors can continue with the model of providing private service to the superrich.  So technically doctors have somewhere else to turn to, but only a very few doctors and only the ones who can advertise themselves to billionaires.  The costs for the population in general are still controlled.

          Read pp. 1-7 of Krugman's _The Great Unraveling_ (available from Google Books). NOW.

          by neroden on Wed Apr 27, 2011 at 08:33:34 PM PDT

          [ Parent ]

        •  Not necessarily public (0+ / 0-)

          but at the end of the day, everyone working in health care will be making less money.  Often, a lot less.  

    •  The ACA does indeed (2+ / 0-)
      Recommended by:
      dnta, Betty Pinson

      lay out several proposals for cutting the costs associated with health care delivery.  You may not like some parts of the ACA, or most parts of the ACA, but you can not legitimately claim that it does not address health care costs at all.

      "In this world of sin and sorrow there is always something to be thankful for; as for me, I rejoice that I am not a Republican." - H. L. Mencken

      by SueDe on Wed Apr 27, 2011 at 01:52:56 PM PDT

      [ Parent ]

      •  B.S. Our premiums are getting jacked to pay for it (2+ / 0-)
        Recommended by:
        drewfromct, Sparhawk

        The government might see some slight savings.  But Americans as a whole are seeing both our premiums and cost of delivery continue to rise.

        So, big effin deal, the government prohibits insurers from charging a co-pay for a mammogram or office visit.  It's the bottom line that counts.  We end up paying for it one way or another.

        Can you cite one of those "cost cutting proposals" that made it into ACA that will actually save me money?  Please?

        •  There are more cost control items (1+ / 0-)
          Recommended by:
          dnta

          in PPACA.   Two others are the restrictions on medical loss ratios and comparative effectiveness standards.

          The first requires insurance companies to spend 75% or more of premium dollars on paying medical claims. The second uses the latest scientific evidence to evaluate and set standards to ensure health care interventions actually result in reducing mortality and effectively treating illness and injury.  No more paying for expensive drugs, treatments and tests that are unnecessary, wasteful and don't help the patient.

          To some degree, health information technology, or computerized medical records, will also reduce mistakes and eliminate unnecessary testing and treatments.  These systems will both improve the quality of care and reduce errors and fraud.

          It is the mark of an educated mind to be able to entertain a thought without accepting it. ~ Aristotle

          by Betty Pinson on Wed Apr 27, 2011 at 02:17:13 PM PDT

          [ Parent ]

          •  That doesn't apply to private insurance (1+ / 0-)
            Recommended by:
            neroden

            Those standards only apply to Medicare/Medicaid.

            Where do you get your information????

            No more paying for expensive drugs, treatments and tests that are unnecessary, wasteful and don't help the patient.

            Betty - You insert yourself into any discussion of healthcare reform as if you are some sort of expert, but you constantly spew incorrect information.

            Medicare/Medicaid is NOT healthcare!  85% of Americans g
            et their health insurance through employers.  Private plans are not subject to those standards.  Please stop interjecting yourself with false "facts".

    •  Anyone who believes the (3+ / 0-)
      Recommended by:
      dnta, We Won, Nada Lemming

      right wing propaganda on this issue should reconsider whether they're smart enough to vote.

      There are many ways to deal with cost sharing on health care plans without complete revocation of the right to organize.  The health care cost argument is a red herring.

      The ultimate purpose in destroying collective bargaining is to kill off a major source of political support for Dem candidates.  

      The GOP wants to remove organized labor as a source for funding and assisting Dem political campaigns.  

      It is the mark of an educated mind to be able to entertain a thought without accepting it. ~ Aristotle

      by Betty Pinson on Wed Apr 27, 2011 at 02:10:06 PM PDT

      [ Parent ]

    •  OK, this needs to stop (8+ / 0-)

      In all honesty, people who complain about public employees being exempt form "the realities of health care" need to educate themselves about how much public sector employees actually get from the government, particularly in Mass.

      When I worked in the private sector, my health insurance was far superior to what my husband, a public sector employee, gets.  We had higher percentage of our premiums covered, had better coverage, and better choices in health care.  My husband's insurance, as  state employee, is crappy - higher premiums for us with less coverage.  

    •  Victor, I know that when times (4+ / 0-)

      were flush for private industries you were busy advocating that Public Employees got their share of profit-sharing and bonuses, right?  Or were you fine with private company employees doing better than those in the public sector while times were good?

      I Know a place where a Royal Flush never beat a Pair" T. Waits

      by NearlyNormal on Wed Apr 27, 2011 at 02:54:38 PM PDT

      [ Parent ]

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