Os Americanos estão loucos

Fonte: aqui.

The First Victims of Health Care Reform

As Democrats on the campaign trail do their best to drum up support for health care reform by touting the benefits that take effect this year, it's easy to forget that the full thrust of the Patient Protection and Affordable Care Act doesn't kick in until 2014. But by then, a few major players in the health care industry might have already experienced a real downside of the massive overhaul, so much so that they may no longer exist. Insurance agents and brokers and small insurance companies are among those who may have to scramble to stay afloat over the next few years. This is partly by design and partly an unintended consequence of a new law that is so sweeping, it will affect nearly every corner of an industry that accounts for one-sixth of the U.S. economy. Under the Affordable Care Act, beginning in January, plans sold to individuals and small groups must spend 80% of premiums on actual medical care (as opposed to administrative costs); the figure is 85% for large group plans. Plans that spend less will be required to send rebates to customers. The NAIC counted agent and broker commissions, which can make up 5% to 20% of premiums, in the administrative category. Most experts, therefore, predict these commissions will be on the chopping block as insurers scale back administrative expenses to comply with the new rules.

ObamaCare II

As Mr. Obama finished signing the bill, the first hand he shook was that of Marcelas Owens, an 11-year-old who has helped Democrats put a human face on the health care debate by talking about the death of his mother.

Mr. Obama is now speaking. “Today after all the votes are tallied, health insurance reform becomes law.”

Post Scriptum: The passage of the health care law shows that the US empire is declining because it illustrates the fact that people expect the state to take care of them. In their expansionary phase, empires force people to go out, seek risks and fend for themselves, Murrin said, reminding of the dismantling of the British empire after the war, when the National Health Service, which ensures universal health coverage in Britain, was created.

Obamacare

Rival senators who were once happy to set aside political differences over bowls of mushroom soup are now at each other’s throats. After last week’s crucial procedural vote on a sweeping $871 billion (£546 billion) reform package, Obama may pay a steep price for his advance on a longstymied Democratic dream of extending health insurance to more than 30m Americans previously unable to afford it.

Yet it was clear last week, as the president flew off to Hawaii for his Christmas break, that while the Clintons put defeat behind them and cruised to two full terms in the White House, Obama may never recover from a victory that has demolished his bipartisan aspirations and which his critics have already judged pyrrhic.

It was a bizarre feature of the US healthcare debate that the longer it went on and the closer it came to a successful outcome, the lower Obama sank in opinion polls. By the time the last $100m incentives had been dished out to wavering Democratic senators last week, Obama was languishing at his lowest approval ratings of the year, with one poll showing that only 32% of Americans still think the healthcare plan is a “good” idea.

Obama's ex-doctor: Insurers 'screwing it up'

President Obama's former personal physician of 22 years, Dr. David Scheiner, has been very vocal on the issue of health insurance, particularly with his criticism of commercial insurers and how he feels they are meddling with the doctor-patient relationship.

You've said in interviews that insurers are making it increasingly difficult for doctors to do their jobs. Can you give some examples? I'll give you two. I have a patient with bipolar disorder whose psychiatrist is no longer in her insurance company's panel. She is heartbroken that the insurance company won't pay to let her see the doctor. I have another patient with obvious sleep apnea. I ordered a sleep study on him. The insurance company knows he needs it but has made life miserable for him. They are making him wait to get their approval, hoping he won't bother with it. Insurance companies are making it more difficult for doctors to get preauthorization for treatments because they are hoping it will discourage people from getting expensive treatments. Insurers also tell us what hospitals we can admit patients to and what subspecialists we can refer our patients to. They are telling me how to do my job.

You Have No Idea What Health Costs

The average health-care coverage for the average family now costs $13,375, according to Kaiser. Over the past decade, premiums have increased by 138 percent. And if the trend continues, by 2019 the average family plan will cost $30,083.

About 160 million Americans receive health coverage through their employers. In general, the employer picks up 73 percent of the tab. This seems like a good deal. In reality, that money comes out of wages.

Another 80 million Americans are on public plans, mainly Medicare and Medicaid. Those costs are paid by taxpayers. And about 46 million Americans are uninsured.

That's the dilemma for Washington wonks trying to fix this mess: They look at the numbers and see health-care costs crushing our economy, overwhelming our government, swallowing our wages. But the public isn't feeling it. Virtually no one cuts a $13,375 check for health care. Most pay 27 percent of it, or even less. The surest way to cut health-care spending would be to make people shoulder more of the burden directly, as opposed to hiding it in taxes and lost wages. But that's about as popular as a puppy pot roast.

ObamaCare

Fonte: aqui.

Obama universal healthcare

Fonte: aqui.

Obama e o universal healthcare II

O Presidente Obama trouxe muita esperança. O Presidente Obama está em estado de graça. Aguardemos.

Uma das principais esperanças que Obama trazia, tinha que ver com os cerca de 45 milhões de Americanos excluídos de um serviço de saúde universal. Ainda assim, os EUA gastam cerca de 17% do seu PIB em saúde. Ou seja, Obama prometeu trazer serviços de saúde a quem não os tinha.

Vejamos, o que nos dizem as últimas notícias:

• President Barack Obama will ask Congress to set aside $634 billion over 10 years to help pay for an overhaul of the nation’s health-care system.
• About half the money will come from cost cuts in the Medicare and Medicaid programs and the other half from tax provisions.
• The tax changes would limit deductions for wealthy tax payers.
• “The cost of our health care has weighed down our economy and the conscience of our nation long enough,” Obama told a joint session of Congress.
• Obama has set a goal of reducing the nation’s spending on health care and getting more of the nation’s uninsured covered.

Disse o Poeta, que "o sonho comanda a vida". Contudo, não acreditamos em milagres, sejam de que tipo forem. No país em que se gasta mais em serviços de saúde, o Presidente Obama quer aumentar o nível de serviços aos que não os têm, e simultaneamente reduzir os custos globais de saúde.

A quadratura do círculo!

Os orçamentos da saúde

A despesa em saúde representa cerca de 10% do PIB da generalidade dos países desenvolvidos (nos EUA, já representa quase 18% do PIB). É muito? É pouco? Há pessoas que dizem que a saúde não tem preço! Será que não tem? Será que não tem que se impor um limite aos gastos com a saúde?

Vejamos o que por aqui se escreve:

• The American hospital is a 19th-century cottage industry in the postmodern world. The problem is not medical or technological.
• The first problem is correcting wasteful and dangerous management practices before extending coverage to more patients. Knowledge exists to transform every hospital in the country to deliver higher quality care and in so doing substantially reduce costs and save lives.
• Extending health care to more people without correcting the antiquated delivery system doesn’t make sense.
• In fact, two large hospitals systems — in Pittsburgh and across the Midwest — cut costs in half and significantly reduced hospital-acquired infections and medical and medication errors.
• This solution of continually improving patient care was based on the Toyota management system. The hospital managements created an environment — without blame — where their employees could learn and practice continual improvement of their processes, systems and themselves in pursuit of “perfect patient care.”

O próximo Presidente dos EUA, Barack Obama, prometeu uma cobertura de saúde alargada, tendo em vista dar mais saúde àqueles que não têm dinheiro para comprar uma apólice de seguro de saúde. Mas, como se diz acima, se alargar a cobertura de saúde, sem racionalizar custos, vai apenas transformar um grande problema, na falência do Estado Americano!