LJ embed video--hacking

I don't know if you all noticed this, but for a couple of hours last night, embedding of videos did not work on LJ. 

It turns out that LJ turned it off due to some kind of script that was modifying people's LJ entries.

You can find out more here.

After reading about I realized that my LJ was hit.  My 2020 sticky post had those weird boxes at the end of the post added and the tags, location, and mood were removed.  Luckily it was already a public post.  But I'm now concerned about what LJ said about profile email addresses being nabbed.

Honestly, last night I really thought it was just me.  I was having a weird evening and thought I must have had an extreme brain fart and accidently updated my sticky post! 

 

Health Care Reform :: Increased Cost?

Health Reform = Increase Cost


According to Joe Flower of imaginewhatif.com, Health Care Reform will mean higher, not lower costs. His argument cites the fact that the bill he believes will finally pass will not curb what constitutes what he believes are some of the significant drivers of high health care cost.

Flower states that most of what curbs health care insurance cost includes 1) having large enough patient base to enable the insurer to convince providers to provide services for less cost (supply vs. demand, etc.); 2) insurers being effective at limiting what they cover; and 3) (this I raise my eyebrows at) insurers being able to avoid paying the bills that are run up. Huh? Does this refer to "denial of claims?" In other words, insurers being able to find reasons/loopholes as to why a particular high-cost claim is not covered by benefits?

Flower contends that Health Care Reform will curb the insurance payors' ability to do #2 & #3 since there will be regulations in place to require coverage of more and sicker people. He also mentions that reform will do nothing to cap/control executive salary costs. (source)

I agree about needing to cap executive salary cost (who wouldn't? except, of course, perhaps the executives themselves!) Although I do have to relate one personal story about the health insurance company I use to work for. Many people do not realize that particular company is not-for-profit. I actually agree with a lot of the company's healthcare transformation mission. I don't agree with all aspects of how they are going about it. Nor do I agree with the toll some of their operational changes has taken on it's own employees. But I very much agree with and believe that the company is sincere. The company is NOT out for profits. Nor do I believe it's executives are in it for the money either. Recently during some hard financial impacts to it's employees, the CEO also gave up several financial benefits. More than his employees had to give up. So I believe in the company's motivations, if not always their methods.

I also believe that there a large percentage of health care insurers and (crosses fingers against evil) pharmaceutical companies who are in it for the profits. How could they not be? They are corporations. They have shareholders. It's their JOB to make a profit. To me, that's one of the reasons you cannot have health care payors that are required by their structure and ownership to make profits. It just won't work. And perhaps the same should be said about pharmaceuticals as well--but that's more for me to learn.

And of course, if you mandate taking away profit-making corporations as part of health care reform...well then you're talking socialism baby! Big no-no in the States dontchaknow. When you take alway the promise of more and more of the all-mighty dollar, then what is left to motivate people to perform, to do more, to innovate? Where's the competition that ultimately controls cost, increases productivity and innovation, and increases choice?

Well that argument doesn't fly with me because our health care delivery and payor system is so convoluted, complex, and pseudo-bureaucratic--that to me, the basic standard rules of how capitialism can be a force for efficiency and change--just doesn't work anymore. Just as a basic example, there is NOTHING in our current system to motivate a patient to seek a less expensive, yet quality, provider. Nothing. If you are sick, you want the best. Period. And to Americans (unfortunately) the best is frequently associated with "not being cheap." The "best" is certainly not associated with being cost efficient. When you are sick, money does not matter. Therefore capitalistic structure for health care delivery and payor system--just won't work.

(Okay that was me going off on a partial rant... Ahem.)


As for not being able to curb costs through limiting coverage and/or denial of claims payment. That's true. That's what would happen with health care reform. But THAT's the whole point of the reform. Heh--not increase cost of course, but the basic human right (as far as I'm concerned) that EVERYONE should be covered and people should not be financially ruined--thereby having their lives ruined--by medical costs.

Our challenge is that if we want this. If we agree it is a basic human right. Then we have to figure out a way to pay for it. Including how to make it cost less. And including perhaps paying more---even if it means paying for the care of someone not in your family. Hopefully (yea, I'm Pollyanna) over time we can change the delivery system to curb costs to minimize additional taxes.

Of course, this doesn't negate Flower's whole point--that health care reform will therefore cost more. Based on what he's saying, he's likely right. Insurance is all about assessing financial risk. Balancing what the likihood of incurring costs against how much premium they collect from their customers. It's all about the numbers. And yes, when everyone is required to be covered and when insured people have high incidents of claims and medical conditions that will continue to degrade and/or will likely cause additional conditions--yup--more $$$$

Something needs to balance that increased medical care. To me, in my as yet not-completely-informed opinion, that has to be decreasing the cost of delivery of the care. Decreasing the costs of physicians, the clinics, the drugs, the lab tests, the hospital costs, etc. And all those ever-increasing costs are so woven into the DNA of our whole health care delivery process--I shudder to think at how that process can be re-engineered for more efficiency.

Yes, other countries might be able to control their costs more. But how much do their physician's pay for their education? How much do they pay for malpractice insurance? If every piece of the chain of delivery of medical care has to somehow add cents/dollars onto the bottom line to meet the requirements of shareholders... well then...

When I listened to and read up on Obama's statements, Obama claimed that some kind of waste and inefficiency reduction will result in savings which would pay for the additional coverage and payouts. Not that I think Obama is "lying"--but is that really possible without some very drastic delivery changes? And if we make those changes, the impacts to those providers who are caught in the middle of the cycle of change--yeah well those changes would not be uneventful for them.

Just my opinion of course.