5 freedoms you'd lose in health care reform

[Spursmania]

http://money.cnn.com/2009/07/24/news/economy/health_care_reform_obama.fortune/index.htm

This definitely takes away all our individual choices and eventually, we would all be on the government plan as I have been saying for awhile now.:depressed

[boutons_deux]

"The rub is that the plans can't really compete based on what they offer. The reason: The federal government will impose a minimum list of benefits that each plan is required to offer."

Why can't the plans compete on something above the floor set by the govt? The plans can only compete on the minimum offer? GMAFB

"the reason" that this "writer" is a writer? :lol

"gouging the young"

but those young will be thrilled, when they are older and sicker, to
"gouge" the young. The whole point of insurance is to spread actual costs over a wide population of potential claimants. And the fat, lazy, thrill-seeking, helmet-non-wearing, drug-taking, binge-drinking, pre-diabetic "jackass" young aren't exactly non-claimants or "healthy livers".

More scare tactics from a Fortune/anti-consumer/pro-business "writer"

[Spursmania]

This is an insult to our intelligence. Why isn't the President and Congress upfront with the American people?

That's why we have to research and dig up this information to figure out what the hell it is they are trying to pass. Obama keeps saying, "if you like your plan, you can keep it!" Which is not true. It's a blatant lie because if you have any common sense you will see that once your plan changes a little and you don't like it, the only alternative is the public plan. And, you have to be on a private plan prior to the law taking effect or you will automatically be pushed to the public plan.

How can they say with a straight face that this is good for all of America. Where is our choice, our freedom? Why should we all be forced to be on a government plan? I've known this for awhile, but it isn't right that Congress and the President are not up front with the America people. This is so wrong on so many levels.

[Spursmania]

:bang

[DarrinS]

We can all have free health care, with lower costs, higher quality, and more individual choice.

We can also have limitless green energy.

We can also all have pet unicorns.


-Liberal mind

[DarrinS]

-p2vOZJZiLE

[boutons_deux]

Choice? Tell your employer that you'd rather have his cost of your insurance as taxed salary rather than as a tax-free benefit, and see what his says.

Why would you do that? Because as hard-core free marketer, you want the choice of buying your own health insurance that than being FORCED to take the employer's plan (which is where ALL of your raises go).

[ChumpDumper]

-p2vOZJZiLEHave you read any bill before congress completely, Darrin?

Name one.

[DarrinS]

Have you read any bill before congress completely, Darrin?

Name one.


I've probably read as much as they have and I'm not a congressman.

[ChumpDumper]

That wasn't the question.
Have you read any bill before congress completely, Darrin?

Name one.

[Winehole23]

I've probably read as much as they have and I'm not a congressman. In other words, close to nothing.

[DarrinS]

In other words, close to nothing.


:toast


I've read enough to know that I'm worried about it being rushed through.

[ChumpDumper]

:toast


I've read enough to know that I'm worried about it being rushed through.How many pages of this actual bill have you read, Darrin?

[DarrinS]

How many pages of this actual bill have you read, Darrin?


Fewer than your post count and greater than 50.

[ChumpDumper]

Fewer than your post count and greater than 50.Really?

You read more than 50 pages of this bill?

One would think you could actually comment on that part of the bill instead of posting someone's lame Youtube.

Let me know the section and we can discuss it.

[mookie2001]

what if one doesnt have insurance what freedoms will they lose?

[Yonivore]

what if one doesnt have insurance what freedoms will they lose?
The freedom to walk into any emergency room in the country and receive free medical care. They'll have to go on a government plan and use a government doctor...maybe one that isn't as conveniently located or competent as most Emergency Room doctors.

[George Gervin's Afro]

The freedom to walk into any emergency room in the country and receive free medical care. They'll have to go on a government plan and use a government doctor...maybe one that isn't as conveniently located or competent as most Emergency Room doctors.

status quo...

[Yonivore]

status quo...
Further degrading an already poor system isn't the status quo.

[Spursmania]

what if one doesnt have insurance what freedoms will they lose?

They will lose the freedom of choosing not to have insurance.

About 16 million people between the ages 0f 18-34 choose not to pay for insurance because they are pretty healthy at that age. As the article reads, the young will be paying much higher premiums, i.e. 2,500 on insurance because they will be essentially helping to defray the higher cost of premiums the elderly usually pay.

[George Gervin's Afro]

They will lose the freedom of choosing not to have insurance.

About 16 million people between the ages 0f 18-34 choose not to pay for insurance because they are pretty healthy at that age. As the article reads, the young will be paying much higher premiums, i.e. 2,500 on insurance because they will be essentially helping to defray the higher cost of premiums the elderly usually pay.


chances are some of these folks will suffer catostraphic injuries or illnesses..what then? who pays for them?

[ChumpDumper]

The freedom to walk into any emergency room in the country and receive free medical care. They'll have to go on a government plan and use a government doctor...maybe one that isn't as conveniently located or competent as most Emergency Room doctors.What is your measure of the relative competency of most ER doctors?

[Yonivore]

What is your measure of the relative competency of most ER doctors?
Relative to what?

[ChumpDumper]

Relative to what?Relative to other doctors as you just mentioned.

[Spursmania]

chances are some of these folks will suffer catostraphic injuries or illnesses..what then? who pays for them?


Every American-it's called life. No one should be responsible for everyone else's problems. We make our own way in life. I don't expect handouts from anybody. I'm not quite sure why people are expecting free healthcare.
People in this country work for what they want in life.

Besides, you are still treated for a catastrophic illness now even if you don't have insurance, but you will not get cutting edge treatment. I don't think under the rationed plan, you'd be getting cutting edge treatment anyway.

[Yonivore]

Relative to other doctors as you just mentioned.
Well, relative to doctors working in a single-payer system, I rate Emergency Room doctors (on a scale of 1-10) at a 9 to a government doctor's 3 or 4.

Relative to other doctors, it would depend on their speciality. Emergency Room doctors have to be versed in a multitude of medical disciplines to the point they can quickly diagnose and treat whatever comes through the door. I give them high marks. Other doctors have the luxury of choosing their patients and, in fact, the illnesses or specialties they decide to treat.

Even family practitioners don't get much beyond general physicals and routine ailments anymore.

What's your point? In a clutch, I'd put my health in the hands of an Emergency Room doctor over the leading cardiologist -- unless, of course, I was having a heart problem...etc...

People walking into the typical emergency room get better care than veterans walking into the typical V. A. Hospital (And, before we start talking about wounded soldiers, I think their is a distinct difference between the care received by active soldiers injured in combat and retired military members getting standard care.)

[boutons_deux]

"government doctor"

WTF? That's a scare-mongering lie like "govt taking over health care".

[ChumpDumper]

Well, relative to doctors working in a single-payer system, I rate Emergency Room doctors (on a scale of 1-10) at a 9 to a government doctor's 3 or 4.Based on what?

[Yonivore]

Based on what?
My experiences with both; 10 years of emergency medical experience where I routinely witnessed miracles performed in the emergency room and watching the V.A. system kill two of my relatives through misdiagnosis, delay, and neglect.

How do emergency room doctors measure up in your matrix of health care experiences?

[Spursmania]

"government doctor"

WTF? That's a scare-mongering lie like "govt taking over health care".

When my spouse was doing his internship, he had to intern at government run VA hospitals. The level of care there as compared to other hospitals was substandard. We will probably shift to more substandard care if the bill passes given the US have limited resources, limited physicians, etc... so it's inevitable that our care will have to be rationed.

By the way, some VA hospitals are scary. You don't want to get sick there. It's sad. I mean they fought for our country.:depressed

[ChumpDumper]

My experiencesIf that's anything like your knowledge of the law when you were playing Barney Fife, it's safe to say your experiences mean shit.

[Yonivore]

"government doctor"

WTF? That's a scare-mongering lie like "govt taking over health care".
Have you read the bill? I know President Obama hasn't, he so much as said so...therefore, all his rhetoric is meaningless.

The fact is, the bill is written to force commercial insurers out of business and force the insured on the a "PUBLIC PLAN" which is nothing more than government, single-payer insurance where they control the doctors. That makes them government doctors...in the same mold as doctors working at the VA.

[boutons_deux]

good old Yoni, off on a side track.

We're not talking about the quality of healthcare (100K iatrogenic deaths year is a good measure of quality), but cost and access.

[Yonivore]

If that's anything like your knowledge of the law when you were playing Barney Fife, it's safe to say your experiences mean shit.
That's your opinion and you're entitled. Again, whatever makes you comfortable.

[Yonivore]

good old Yoni, off on a side track.

We're not talking about the quality of healthcare (100K iatrogenic deaths year is a good measure of quality), but cost and access.
Chump asked, I answered.

But, as far as cost and access. 100% of the population has access to health care. Actually, more than 100% because, we even treat illegal immigrants too.

Cost is irrelevant when health care providers are prohibited from refusing treatment based on the economic situation of the patients which, by the way, they are.

[ChumpDumper]

Chump asked, I answered.Exactly, and it was as useless a standard as could be expected.

[ChumpDumper]

Cost is irrelevant when health care providers are prohibited from refusing treatment based on the economic situation of the patients which, by the way, they are.There is another complete fail.

Treatments in the ER cost much more than treatments not done in the ER.

[Yonivore]

There is another complete fail.

Treatments in the ER cost much more than treatments not done in the ER.
Costs who, though? Like I said, patients who can't pay don't worry about paying...cost is irrelevant.

[ChumpDumper]

Costs who, though? Like I said, patients who can't pay don't worry about paying...cost is irrelevant.Costs everyone who does pay.

You like paying more than you have to for someone else's care.

[boutons_deux]

"100% of the population has access to health care."

wow, you really are fucking stupid.

About the only humanitarian aspect of US health care is public hospitals being committed to caring for those who can't pay (which includes a large numbe of employed people who are under insured), and Yoni against even that.

Let them suffer and die if they can't pay, is that it, Yoni?

[Yonivore]

Costs everyone who does pay.
And you think the Trillion Dollar Democrat plan is going to make everyone pay proportionately?


You like paying more than you have to for someone else's care.
I'm already doing that. I don't want the government telling me where to get my medical care or which procedures they'll cover.

[SonOfAGun]

Let me know the section and we can discuss it.

lmao sure we will Mr. 20 Questions :wakeup

[Yonivore]

"100% of the population has access to health care."

wow, you really are fucking stupid.

About the only humanitarian aspect of US health care is public hospitals being committed to caring for those who can't pay (which includes a large numbe of employed people who are under insured), and Yoni against even that.

Let them suffer and die if they can't pay, is that it, Yoni?
100% of the U.S. Population has immediate access to health care. Indisputable.
100% of illegal immigrants have immediate access to health care. Also indisputable.

If the government wants to find savings in the Medicare and Medicaid programs to pay for the care, so I don't have to, I'm all for it. It doesn't require an overhaul of the entire industry. Blue Dog Democrats, moderates, and most common-sense Americans realize this.

[Yonivore]

Fortunately, the President's unprecedented act of calling the head of the CBO on the carpet has had the opposite intended effect:

CBO deals new blow to health plan (http://www.politico.com/news/stories/0709/25415.html)

Thank God they work on Saturdays.

[ChumpDumper]

And you think the Trillion Dollar Democrat plan is going to make everyone pay proportionately?You think you pay proportionately now?



I'm already doing that.No shit, I just told you you were.

[Yonivore]

You think you pay proportionately now?
No, I think I pay a disproportionate amount for healthcare. This bill will not make my situation better, it will make it worse.


No shit, I just told you you were.
Yeah, but you don't say how the Trillion Dollar Healthcare Bill will change that for the better. Why? Because it won't.

[ploto]

Choice? Tell your employer that you'd rather have his cost of your insurance as taxed salary rather than as a tax-free benefit, and see what his says.

I know an employer who did just that after employees kept griping about their insurance. He gave them all a raise equal to the cost he was spending on the plan and told them to buy their own.

[ChumpDumper]

No, I think I pay a disproportionate amount for healthcare. This bill will not make my situation better, it will make it worse.So how much more will you personally pay?

[Yonivore]

So how much more will you personally pay?
I don't know...they're not letting us see all the funding mechanisms yet. But, from what we do know; they're going to start taxing me on what my employer pays toward my insurance premium; they're going to start a "public option," to compete with the private insurance companies -- except, of course, it doesn't have to operate at a profit so, that'll drive commercial companies to raise premiums or close shop.

I'm sure I'll see my share of the Trillion Dollar cost. I'm equally sure those who aren't paying anything now, won't be paying anything under this plan.

[Wild Cobra]

I don't know...they're not letting us see all the funding mechanisms yet.
Transparency, my ass.

This administration is less transparent that obsidian.

[TMTTRIO]

My experiences with both; 10 years of emergency medical experience where I routinely witnessed miracles performed in the emergency room and watching the V.A. system kill two of my relatives through misdiagnosis, delay, and neglect.

Yeah I've had horrible VA stories with my Dad. Even though my Dad is still pretty young he took a horrible fall and broke his hip. They never operated on him until 4 or 5 days later. At the time the surgeons never had the right type of screw to put into his hip when it came time to do the surgery that they went ahead and put any kind of screw that was around they could put into the hip socket. After the surgery he never got better at all and instead the screw was tearing his hip up more and even into the femur bone of his leg. It took them months for them to admit their mistakes even though they were forced to admit it . It took them at least a year to redo the surgery and it's still not right and now he's never going to be the same again. He's going to be crippled for the rest of his life. I hope this is not what it's going to come down to.

[jack sommerset]

It is nice to see Obama put in his place but more importantly the non Obama dems take some steps back and not fuck this country up giving away more free shit. On a side note please write ur local politicians about kicking out illegals. It will help our country a great deal.

[Yonivore]

Yeah I've had horrible VA stories with my Dad. Even though my Dad is still pretty young he took a horrible fall and broke his hip. They never operated on him until 4 or 5 days later. At the time the surgeons never had the right type of screw to put into his hip when it came time to do the surgery that they went ahead and put any kind of screw that was around they could put into the hip socket. After the surgery he never got better at all and instead the screw was tearing his hip up more and even into the femur bone of his leg. It took them months for them to admit their mistakes even though they were forced to admit it . It took them at least a year to redo the surgery and it's still not right and now he's never going to be the same again. He's going to be crippled for the rest of his life. I hope this is not what it's going to come down to.
Pretty much socialized medicine in a nutshell; rationed, inferior care.

[ploto]

I find it interesting that someone is touting ER docs when many of them get paid a salary- as opposed to being paid by insurance reimbursement or by the work they actually do.

[Spursmania]

Yeah I've had horrible VA stories with my Dad. Even though my Dad is still pretty young he took a horrible fall and broke his hip. They never operated on him until 4 or 5 days later. At the time the surgeons never had the right type of screw to put into his hip when it came time to do the surgery that they went ahead and put any kind of screw that was around they could put into the hip socket. After the surgery he never got better at all and instead the screw was tearing his hip up more and even into the femur bone of his leg. It took them months for them to admit their mistakes even though they were forced to admit it . It took them at least a year to redo the surgery and it's still not right and now he's never going to be the same again. He's going to be crippled for the rest of his life. I hope this is not what it's going to come down to.

I am really sorry about you Dad.

[Yonivore]

I find it interesting that someone is touting ER docs when many of them get paid a salary- as opposed to being paid by insurance reimbursement or by the work they actually do.
Why? The Emergency Room Doctors voluntarily seek employment at the hospital. Many of them cut their teeth there before entering private practice. Under the government plan, there would be no option to go into private practice.

[FuzzyLumpkins]

It seems to be the way of the conservatives around here to post an article without quoting it and then making blanket statements that really have nothing to do with the article.

its wonderful bait and switch but its worthless fearmongering at its core.


5 freedoms you'd lose in health care reform
If you read the fine print in the Congressional plans, you'll find that a lot of cherished aspects of the current system would disappear.

NEW YORK (Fortune) -- In promoting his health-care agenda, President Obama has repeatedly reassured Americans that they can keep their existing health plans -- and that the benefits and access they prize will be enhanced through reform.

A close reading of the two main bills, one backed by Democrats in the House and the other issued by Sen. Edward Kennedy's Health committee, contradict the President's assurances. To be sure, it isn't easy to comb through their 2,000 pages of tortured legal language. But page by page, the bills reveal a web of restrictions, fines, and mandates that would radically change your health-care coverage.

If you prize choosing your own cardiologist or urologist under your company's Preferred Provider Organization plan (PPO), if your employer rewards your non-smoking, healthy lifestyle with reduced premiums, if you love the bargain Health Savings Account (HSA) that insures you just for the essentials, or if you simply take comfort in the freedom to spend your own money for a policy that covers the newest drugs and diagnostic tests -- you may be shocked to learn that you could lose all of those good things under the rules proposed in the two bills that herald a health-care revolution.

In short, the Obama platform would mandate extremely full, expensive, and highly subsidized coverage -- including a lot of benefits people would never pay for with their own money -- but deliver it through a highly restrictive, HMO-style plan that will determine what care and tests you can and can't have. It's a revolution, all right, but in the wrong direction.

It seems this lady doesn't understand how insurance works. The entire principle of insurance is that you pool risk and spread the cost around. All insurance companies do it. If someone pays $2000 a year for full coverage on their BMW M5 and you wreck it costing $40k to replace it then is that person going to be ever paying for the benefits he received?

Of course he is not but that is how insurance works. The only issue that the author has is when its government that supposedly does this and not some profit motivated private insurer.


Let's explore the five freedoms that Americans would lose under Obamacare:

Let's


1. Freedom to choose what's in your plan

The bills in both houses require that Americans purchase insurance through "qualified" plans offered by health-care "exchanges" that would be set up in each state. The rub is that the plans can't really compete based on what they offer. The reason: The federal government will impose a minimum list of benefits that each plan is required to offer.

Today, many states require these "standard benefits packages" -- and they're a major cause for the rise in health-care costs. Every group, from chiropractors to alcohol-abuse counselors, do lobbying to get included. Connecticut, for example, requires reimbursement for hair transplants, hearing aids, and in vitro fertilization.

This is fearmongering at its finest. Of course there needs to be a limit on what is actually covered. While I like women with large breasts that does not mean that that augmentation should be covered. Instead of pointing to any place in the bill where these supposed ills are she throws out fear of what can happen. Its bullshit. She can point to oregan all she wants but I can point you to every other wesern nation wheres it not an issue.


The Senate bill would require coverage for prescription drugs, mental-health benefits, and substance-abuse services. It also requires policies to insure "children" until the age of 26. That's just the starting list. The bills would allow the Department of Health and Human Services to add to the list of required benefits, based on recommendations from a committee of experts. Americans, therefore, wouldn't even know what's in their plans and what they're required to pay for, directly or indirectly, until after the bills become law.

This is funny she first lists things that we know will be covered and then says we won't know whats covered until after its done. Its bullshit. Whats going on here is that they have a list of things that they will initially require like prescription drug coverage and then they will allow a committee to cover other things in the future.

I mean really WTF do you expect? Obviously new treatments will come down the pipe and some will be more beneficial and/or inexpensive. Of course new treatments will have to be approved.

Oh and again its not as if private insurers do not do this already. They have a list of items that they insure that they have a board review and adjust ahs time goes by. If any plan passes of course it has to have long term adjustibility but this idea that our current insurance has this great wealth of options as to what they will cover and what they wont is bullshit.


2. Freedom to be rewarded for healthy living, or pay your real costs

As with the previous example, the Obama plan enshrines into federal law one of the worst features of state legislation: community rating. Eleven states, ranging from New York to Oregon, have some form of community rating. In its purest form, community rating requires that all patients pay the same rates for their level of coverage regardless of their age or medical condition.

Americans with pre-existing conditions need subsidies under any plan, but community rating is a dubious way to bring fairness to health care. The reason is twofold: First, it forces young people, who typically have lower incomes than older workers, to pay far more than their actual cost, and gives older workers, who can afford to pay more, a big discount. The state laws gouging the young are a major reason so many of them have joined the ranks of uninsured.

Now this is hilarious. She talks about gouging the young where just before she is talking about how coverage for existing policies would extend to age 26 instead of 18. Now she is saying that young people get fucked. Can't have it both ways bitch.

And lets get one thing clear the one age demographic that has the highest rate of insured is 18-28. Half of all adults under the age of 28 do not have insurance. If we can get coverage I for one would be a happy motherfucker. As it stands now I cannot afford good coverage that doesn't have a large deductible and if I were to get sick the deductible would just kill me. Its pointless for me to get the coverage that I could afford. This idea that I am going to get gouged from a percentage of my paycheck is laughable.

Do not use me and my contemporaries to pimp your cause bitch. Call it what it is which is the wealthier americans who are worried about their pocketbooks. The status quo fucks me as it is.


Under the Senate plan, insurers would be barred from charging any more than twice as much for one patient vs. any other patient with the same coverage. So if a 20-year-old who costs just $800 a year to insure is forced to pay $2,500, a 62-year-old who costs $7,500 would pay no more than $5,000.

You know that HC industry can suck my dick. I know that capitalists have nightmares about price controls but this is about the American people not some rich AETNA exec.

1) HC is a vertical demand slope market. What I mean by that is that consumers will pay whatever price put in front of them. Think of it this way. If youre dying on a gurney or better yet you infant child is dying on a gurney what price will you not pay to save their life? I myself would pay whatever I had to. Any market like that where to suppliers can dictate price at whim cannot self regulate. Price controls are necessary.

Its pretty apparent with the way prices have escalated that the industry is taking full advantage of the way this market operates.

2) All other insurance has price controls anyway as it is. In Texas, all auto and home insurance rates have to be approved by the DoI and if they come back with dramatic increases its sent right back. All states have this.

Furthermore, and this goes to a previous point. All the coverages available like a 50/100 bodily injury limit or a $1m renters liability policy are all mandated by the state. The coverage options that you can get on all other insurance are mandated by the state.

The way this bitch would have us believe, USAA or AllState cannot make money on car insurance.


Second, the bills would ban insurers from charging differing premiums based on the health of their customers. Again, that's understandable for folks with diabetes or cancer. But the bills would bar rewarding people who pursue a healthy lifestyle of exercise or a cholesterol-conscious diet. That's hardly a formula for lower costs. It's as if car insurers had to charge the same rates to safe drivers as to chronic speeders with a history of accidents.

Its necessary becasue if you don't do this then you are going to have people that are excluded. There is one thing I would like to point out on this.

One of the huge myth is all of this good behavior rewardance. Its bullshit. Auto insurers for example will forgive an accident after 8 years of not having one. The thing is though your record clears at least in terms of insurance every 3 years so you have gone over twice that period and supposedly they are doing you a favor.

What they are doing is saying, aren't we great were giving back when thye arent giving as much back on the back end as they are fucking you on the front end. All of the other perks like car alarm or whatnot have no actuarial significance. Its window dressing.

So basically what they are doing here is getting rid of shit that does no real benefit to overall costs yet masks them and forcing the issue.


3. Freedom to choose high-deductible coverage

The bills threaten to eliminate the one part of the market truly driven by consumers spending their own money. That's what makes a market, and health care needs more of it, not less.

Hundreds of companies now offer Health Savings Accounts to about 5 million employees. Those workers deposit tax-free money in the accounts and get a matching contribution from their employer. They can use the funds to buy a high-deductible plan -- say for major medical costs over $12,000. Preventive care is reimbursed, but patients pay all other routine doctor visits and tests with their own money from the HSA account. As a result, HSA users are far more cost-conscious than customers who are reimbursed for the majority of their care.

The bills seriously endanger the trend toward consumer-driven care in general. By requiring minimum packages, they would prevent patients from choosing stripped-down plans that cover only major medical expenses. "The government could set extremely low deductibles that would eliminate HSAs," says John Goodman of the National Center for Policy Analysis, a free-market research group. "And they could do it after the bills are passed."

I love this. High deductible coverages are like toxic variable rate loans. Sure they cost very little up front but they end oup fucking you in the end. High deductible coverages target those with lower incomes. The only issue is that 20% still leaves you in the cold when you are poor and rack up a $50k hospital bill. Thats about 3 days in the hospital BTW.

But no that 20% deductible not only gets a you a $10k bill but it drives costs across the board. The medical industry wants you to pay as an individual and the more via deductibles copays etc that they can push out to individual negotiators the higher overall costs.

The reason for this is simple. The insurance company is liable for $40k of the bill but the thing is they have the backing of the other millions upon millions of dollars they have and will be paying the hospital to negotiate the price down at the end of the day. Make no mistake they do that.

You OTOH are stuck with your bill and no leverage so you eat the proverbial dick. The hospital likes this because they get full price and the insurer loves this because they can justify higher premiums the next year without having to pay the tab.

Fuck those companies and their shitty policies.


4. Freedom to keep your existing plan

This is the freedom that the President keeps emphasizing. Yet the bills appear to say otherwise. It's worth diving into the weeds -- the territory where most pundits and politicians don't seem to have ventured.

The legislation divides the insured into two main groups, and those two groups are treated differently with respect to their current plans. The first are employees covered by the Employee Retirement Security Act of 1974. ERISA regulates companies that are self-insured, meaning they pay claims out of their cash flow, and don't have real insurance. Those are the GEs (GE, Fortune 500) and Time Warners (TWX, Fortune 500) and most other big companies.

The House bill states that employees covered by ERISA plans are "grandfathered." Under ERISA, the plans can do pretty much what they want -- they're exempt from standard packages and community rating and can reward employees for healthy lifestyles even in restrictive states.

But read on.

The bill gives ERISA employers a five-year grace period when they can keep offering plans free from the restrictions of the "qualified" policies offered on the exchanges. But after five years, they would have to offer only approved plans, with the myriad rules we've already discussed. So for Americans in large corporations, "keeping your own plan" has a strict deadline. In five years, like it or not, you'll get dumped into the exchange. As we'll see, it could happen a lot earlier.

The outlook is worse for the second group. It encompasses employees who aren't under ERISA but get actual insurance either on their own or through small businesses. After the legislation passes, all insurers that offer a wide range of plans to these employees will be forced to offer only "qualified" plans to new customers, via the exchanges.

The employees who got their coverage before the law goes into effect can keep their plans, but once again, there's a catch. If the plan changes in any way -- by altering co-pays, deductibles, or even switching coverage for this or that drug -- the employee must drop out and shop through the exchange. Since these plans generally change their policies every year, it's likely that millions of employees will lose their plans in 12 months.

See again with the fearmongering. I will put it this way: I would rather have medicare through SSID than what most of these companies offer. I love this assumption that government coverage will suck when quite frankly the current government coverages from the civil service version through the SSI stuff are pretty damn good. Oh and they pay out less reducing costs for everyone.


5. Freedom to choose your doctors

The Senate bill requires that Americans buying through the exchanges -- and as we've seen, that will soon be most Americans -- must get their care through something called "medical home." Medical home is similar to an HMO. You're assigned a primary care doctor, and the doctor controls your access to specialists. The primary care physicians will decide which services, like MRIs and other diagnostic scans, are best for you, and will decide when you really need to see a cardiologists or orthopedists.

Under the proposals, the gatekeepers would theoretically guide patients to tests and treatments that have proved most cost-effective. The danger is that doctors will be financially rewarded for denying care, as were HMO physicians more than a decade ago. It was consumer outrage over despotic gatekeepers that made the HMOs so unpopular, and killed what was billed as the solution to America's health-care cost explosion.

The bills do not specifically rule out fee-for-service plans as options to be offered through the exchanges. But remember, those plans -- if they exist -- would be barred from charging sick or elderly patients more than young and healthy ones. So patients would be inclined to game the system, staying in the HMO while they're healthy and switching to fee-for-service when they become seriously ill. "That would kill fee-for-service in a hurry," says Goodman.

In reality, the flexible, employer-based plans that now dominate the landscape, and that Americans so cherish, could disappear far faster than the 5 year "grace period" that's barely being discussed.

Companies would have the option of paying an 8% payroll tax into a fund that pays for coverage for Americans who aren't covered by their employers. It won't happen right away -- large companies must wait a couple of years before they opt out. But it will happen, since it's likely that the tax will rise a lot more slowly than corporate health-care costs, especially since they'll be lobbying Washington to keep the tax under control in the righteous name of job creation.

The best solution is to move to a let-freedom-ring regime of high deductibles, no community rating, no standard benefits, and cross-state shopping for bargains (another market-based reform that's strictly taboo in the bills). I'll propose my own solution in another piece soon on Fortune.com. For now, we suffer with a flawed health-care system, but we still have our Five Freedoms. Call them the Five Endangered Freedoms.

So in other words keep it as it is because its just so wonderful. :rolleyes

What kind of shill is this bitch? First of all she said it was LIKE an HMO. The issue with HMO's is that the primary care doctors are beholden to profit motivated insurance execs. Doctors in HMO's are encouraged to NOT refer and try to keep costs to an arbitrary bottom line. That is not the case here and as such it is NOT like an HMO in the most fundamental way: the decision calculus of how care is administered.

Now even after all of the further fearmongering she kind of glossed over the fact that other types of plans will be available that you are not locked into them. Since its not a product that the public option will offer then it will have no direct competition. From the way it would seem after all her bull shit you wouldnt have a chance.

[FuzzyLumpkins]

Why? The Emergency Room Doctors voluntarily seek employment at the hospital. Many of them cut their teeth there before entering private practice. Under the government plan, there would be no option to go into private practice.

Thats a baldfaced fucking lie.

Cosmetic surgery will be covered under no health insurer. Are you going to say that fake tits are a thing of the past?

[Yonivore]

Thats a baldfaced fucking lie.

Cosmetic surgery will be covered under no health insurer. Are you going to say that fake tits are a thing of the past?
You pose an interesting question. I'm not sure what the legislation says about elective cosmetic procedures.

But, seriously, I think we're talking about the treatment of illnesses and injuries; non-elective medical care.

[FuzzyLumpkins]

Pretty much socialized medicine in a nutshell; rationed, inferior care.

No, the VA is definitely fucked up. Thats because they set up an infrastructure about 30 years ago and instead of scaling funding for inflation to maintain and keep up care standards the DoD systemcially slashed funding so that vets were left ouyt to dry. After all we need funding for F-22's and to prepare for a European land war that will never happen.

[FuzzyLumpkins]

You pose an interesting question. I'm not sure what the legislation says about elective cosmetic procedures.

But, seriously, I think we're talking about the treatment of illnesses and injuries; non-elective medical care.

No, were talking about medical procedures. Plastic surgery has to be approved by the FDA and is beholden to the same oversight as plastic splints for broken arms.

Basically what you're saying is that boob jobs will be available but not noncovered chemotherapies that are also approved by the FDA. Its bullshit.

[Yonivore]

No, the VA is definitely fucked up. Thats because they set up an infrastructure about 30 years ago and instead of scaling funding for inflation to maintain and keep up care standards the DoD systemcially slashed funding so that vets were left ouyt to dry. After all we need funding for F-22's and to prepare for a European land war that will never happen.
So, I say prove you can run a single-payer system by fixing the VA first before you fuck up health care for the rest of us.

[Yonivore]

No, were talking about medical procedures. Plastic surgery has to be approved by the FDA and is beholden to the same oversight as plastic splints for broken arms.

Basically what you're saying is that boob jobs will be available but not noncovered chemotherapies that are also approved by the FDA. Its bullshit.
Okay, maybe your talking about elective procedures, I'm not. I have no idea what the legislation will mean for Dr. 90210.

[Spursmania]

Understanding the Kennedy Healthcare bill

http://keithhennessey.com/2009/06/08/kennedy-health-bill/

I believe the health care reform bill is house bill 320, but I will try to find what I can of the bill and the most updated version, so we can read it ourselves.

http://www.financialsense.com/fsn/presentations/2009/0724.html

I can't seem to find the actual draft of the bill. Maybe it's not posted yet. I'm trying to find just the bill itself, so we can decide for ourselves how good or bad it is. Sorry, I can't find it yet.
(http://www.financialsense.com/fsn/presentations/2009/0724.html)

[FuzzyLumpkins]

So, I say prove you can run a single-payer system by fixing the VA first before you fuck up health care for the rest of us.

Sorry but you have no idea what you're talking about. There is this entity its called the department of defense. Perhaps you've heard of them? Yeah, well the DoD has been slashing VA funding for years. The senate appropriates the DoD less money and they in turn cut VA benefits in favor of F-22's and B-1's. See its not the people that fought for this country that matter its the defense contractors.

They are tow seperate issues.

[ElNono]

Obama keeps saying, "if you like your plan, you can keep it!" Which is not true. It's a blatant lie because if you have any common sense you will see that once your plan changes a little and you don't like it, the only alternative is the public plan.

This is not accurate at all.

[Yonivore]

Sorry but you have no idea what you're talking about. There is this entity its called the department of defense. Perhaps you've heard of them? Yeah, well the DoD has been slashing VA funding for years. The senate appropriates the DoD less money and they in turn cut VA benefits in favor of F-22's and B-1's. See its not the people that fought for this country that matter its the defense contractors.

They are tow seperate issues.
It's government health care. The only difference will be that Robert Byrd will funnel money to a Robert Byrd Memorial Bridge when he funnels money away.

[FuzzyLumpkins]

Okay, maybe your talking about elective procedures, I'm not. I have no idea what the legislation will mean for Dr. 90210.

All medical procedures are elected. Dear god your obtuse. In the eyes of the FDA there are no 'covered' or 'noncovered.' There are just medical treatments and procedures.

You said noncovered care would not existoutside of what was covered by the public plan. All I have to show is one medical procedure that would be and it shows you to be wrong. I did that.

[FuzzyLumpkins]

It's government health care. The only difference will be that Robert Byrd will funnel money to a Robert Byrd Memorial Bridge when he funnels money away.

Whatever if you want to be one of the 'everything the government does is bad crowd' and be intentionally obtuse go right ahead.

[Yonivore]

All medical procedures are elected. Dear god your obtuse. In the eyes of the FDA there are no 'covered' or 'noncovered.' There are just medical treatments and procedures.
There's breast augmentation and then, there's triple, coronary bypass. With or without one, and you continue living. Without the other, you die. That's the difference between elective and non-elective surgery.


You said noncovered care would not exist outside of what was covered by the public plan. All I have to show is one medical procedure that would be and it shows you to be wrong. I did that.
I never said that. I admit to not know what will become of "Plastic" Surgeons, under this plan. I was merely talking about physicians that offer curative, life-extending, medical care. Things we need to live...not look better.

[Yonivore]

Whatever if you want to be one of the 'everything the government does is bad crowd' and be intentionally obtuse go right ahead.
The fight wars real good and they now how to build a road, although, they've farmed much of that out.

Name an industry, other than the two above, where the government out performs and is more efficient than the private sector.

[FuzzyLumpkins]

There's breast augmentation and then, there's triple, coronary bypass. With or without one, and you continue living. Without the other, you die. That's the difference between elective and non-elective surgery.


I never said that. I admit to not know what will become of "Plastic" Surgeons, under this plan. I was merely talking about physicians that offer curative, life-extending, medical care. Things we need to live...not look better.

Lol I can show you reams and reams of doctors that offer noncovered care in every other western nation. What you are purporting is the bald faced lie that is being thrown out which is just not true.

What youa re saying is for example the board approves to cover one type of chemo therapy but not another for cost considerations and that means the more expensive option would not be available. They would both be available. Its just that the national plan wouldn't cover it. That doesn't mean you cannot get it.

I use the breast augmentation as an extreme to prove a point. Look up 'breast augmentation london' and you will see reams and reams of them. I find it absurd that youw ould give any credibility to the idea that they would not allow an alternative FDA approved chemo but they will allow you to get a tit job. Prima facia its stupid.


In fact if you look at other countries like England they have all kinds of insurances and facilities that cover treatments and procedures that handle things that the NHS does not cover.

[TDMVPDPOY]

medical bills etc are tax deductible arent they in america? if not then it really sucks

[FuzzyLumpkins]

The fight wars real good and they now how to build a road, although, they've farmed much of that out.

Name an industry, other than the two above, where the government out performs and is more efficient than the private sector.

As AETNA is fond of pointing out, Medicare and Medicaid provide treatments, procedures and medications for less than what the private insurers do. There is a whole slew of water and power companies that are owned form the municipal level up that are successful. The US postal service is self sufficient. They offer quite a few delivery options that are cheaper than UPS, FedEx, etc.

About the only thing you can point to is that AMTrack doesn't fare well compared to the airlines and thats about it.

But really the one that is most important is that Medicare and Medicaid are more efficient than AETNA and the big 7.

[boutons_deux]

For-profit health industry is SO EFFICIENT that dubya had to subsidize it with locked-in $50B/year so it could compete with Medicare/Medicaid, in addition to making it illegal for the govt to negotiate drug prices with BigPharma.

The inefficiencies of for-profit health-insurance suck $200B-$300B out of Americans' pockets every year.

($200B + $50B) x 10 years = $2.5T

Why did Americans decisively reject dubya's snake oil of privatizing Social Security which would have subsidized the criminal, rigged fraudulent, wealth-destroying financial sector?

"Under the government plan, there would be no option to go into private practice."

which page of the reform bill is that on?

[Spursmania]

Medicare will be bankrupt in ten years! I hardly call that efficient or a model for this health care reform.

http://findarticles.com/p/articles/mi_m1365/is_1_35/ai_n6145432/
http://www.independent.org/newsroom/article.asp?id=1294
http://www.npr.org/templates/story/story.php?storyId=1791298

[Spursmania]

This is not accurate at all.

How so?

[redskinfan]

Yoni where are your partners now to back you up? Darrin, Jack? Fuzzy is tea-bagging the shit out of you and your pathetic partners in crime!

[Bender]

medical bills etc are tax deductible arent they in america? if not then it really suckswell, they aren't "really" deductible anymore, since the IRS raised the deductible level to only what is over 7.5% of your Adjusted Gross Income.

So for someone who makes, say, $50,000 AGI, and has $4,000 of medical expenses, can only deduct $250 on his tax return.
$50,000 x 7.5% = $3,750, so he can only deduct medical expenses above $3750.

The IRS is saying that they consider spending 7.5% of your gross income on medical expenses to be "normal".

[FuzzyLumpkins]

Medicare will be bankrupt in ten years! I hardly call that efficient or a model for this health care reform.

http://findarticles.com/p/articles/mi_m1365/is_1_35/ai_n6145432/
http://www.independent.org/newsroom/article.asp?id=1294
http://www.npr.org/templates/story/story.php?storyId=1791298

Bravo for finding reports based on projections from the Bush budget cuts of 2004. If you cut funding to something its not going to remain soluble.

That doe snot mitigate the fact that medicare and medicaid are more efficient at getting people medical treatment and procedures over private insurers.

[FuzzyLumpkins]

well, they aren't "really" deductible anymore, since the IRS raised the deductible level to only what is over 7.5% of your Adjusted Gross Income.

So for someone who makes, say, $50,000 AGI, and has $4,000 of medical expenses, can only deduct $250 on his tax return.
$50,000 x 7.5% = $3,750, so he can only deduct medical expenses above $3750.

The IRS is saying that they consider spending 7.5% of your gross income on medical expenses to be "normal".

I spent 28 hours in the hospital and it was $13k. Those $6k MRI's are a bitch that I am still fighting today.

Medical costs are so high that $4k isnt shit especially if you have to spend ANY time in the hospital.

[Spursmania]

Bravo for finding reports based on projections from the Bush budget cuts of 2004. If you cut funding to something its not going to remain soluble.

That doe snot mitigate the fact that medicare and medicaid are more efficient at getting people medical treatment and procedures over private insurers.

You can blame whomever you want-it's irrelevant. Different parties take control of the white house and blame can go back and forth forever. I voted for Obama, so any party blaming is just unproductive to me and a waste of time.

Also, medicare had financial problems long before the year 2002. If you read up on it, you would clearly see the medicare mess started quite awhile back.

Some people would prefer to trust the government to run healthcare at all costs despite contrary findings. Most people do not believe the government is an efficient machine. I won't bother finding statistical and imperical data to refute your "efficiency" assertion. You clearly prefer the government health care plan thereby incurring more government control in your medical decisions. I would like to make my own choices regarding medical care.

And, I do not believe the government is an efficient machine that will decrease my medical costs, retain the quality of care I receive now while allowing me free choice to make my own medical decisions.

But I have no intention of attempting to change your mind. You are entitiled to your opinion. As I am of mine.

[FuzzyLumpkins]

You can blame whomever you want-it's irrelevant. Different parties take control of the white house and blame can go back and forth forever. I voted for Obama, so any party blaming is just unproductive to me and a waste of time.

Also, medicare had financial problems long before the year 2002. If you read up on it, you would clearly see the medicare mess started quite awhile back.

Some people would prefer to trust the government to run healthcare at all costs despite contrary findings. Most people do not believe the government is an efficient machine. I won't bother finding statistical and imperical data to refute your "efficiency" assertion. You clearly prefer the government health care plan thereby incurring more government control in your medical decisions. I would like to make my own choices regarding medical care.

And, I do not believe the government is an efficient machine that will decrease my medical costs, retain the quality of care I receive now while allowing me free choice to make my own medical decisions.

But I have no intention of attempting to change your mind. You are entitiled to your opinion. As I am of mine.

I really don't give a shit for what you 'believe.' The numbers speak for themselves. The government pays less for a doctor's visit or hospital stay etc over AETNA etc. They get more out of a dollar then your precious AETNA and BlueCross. Thats more efficient no matter how much you put your hands over your ears and try to ignore it. Sorry if the truth doesn't jive with your bias.

You don't know how federal budgeting works. Its not like a business where a customer comes in and makes a payment and that is budgeted over time. A program is given large annual allotment and that serves as payment. Well when Bush in essence cut that payment in half it fucked everything up. In essence it was the same as an exec taking half of the premiums coming in and then diverting it to building a new office or something. The fact that it was still expected to last for 11 more years is a testament to just how efficient it is. You do that to AETNA and I guarantee they wont last 11 years.

Thats what I love about conservatives. The GOP and Reagan started doing this shit back in the 80s. They would make sweeping tax cuts and then try and make up for the shortfall by cutting funding to social security and medical care and selling bonds. Yay lower taxes!!!

The sweetest part is they would then turn to the programs that their fucking asses underfunded and then try to point to it as a failure. They fucking sabotaged it.

Here's a hint: the money that you pay on your taxes thats supposedly earmarked for SS doesn't go to SS.

Your medicare crisis is a direct result of Reagan and then Bush cutting funding to it. Its not because they aren't run well. Its because they were sabotaged.

[Wild Cobra]

This is not accurate at all.
You can keep your plan until it is no longer available, which will wither away under Obamacare.

[Wild Cobra]

medical bills etc are tax deductible arent they in america? if not then it really sucks
Look at a tax form sometime and see just how little you can deduct.

I spent 28 hours in the hospital and it was $13k. Those $6k MRI's are a bitch that I am still fighting today.

Medical costs are so high that $4k isnt shit especially if you have to spend ANY time in the hospital.
Did you ask for the MRI's or did they do it without your permission? They might have performed unnecessary procedures just so you couldn't sue them on the off chance it would discover something cheaper methods wouldn't discover. It would help to know what was wrong. Also consider how expensive those are, and technicians like me probably make $45 + per hour to calibrate them. They have to charge big money for the procedure to pay for the equipment. If it costs $250,000, then they have to do more than 41,000 of them just to pay for the equipment.

Did you really need a MRI?

[ElNono]

How so?

The supposed exchange will offer both the public option and as many private options as the private companies want to offer.
Right now, your plan changes annually or bi-annually, so you're never really 'keeping the same plan'. What are you keeping is a plan somewhat similar that gives you certain coverage and deductibles that's important to you.
You can still pick up that program from an exchange. It will be different in that it will be mandated to cover certain baseline procedures. But any of these private plans will have to differentiate themselves enough from the public plan as to providing added value so people are willing to pay more for them.

[ElNono]

You can keep your plan until it is no longer available, which will wither away under Obamacare.

You can still go with a private plan afterwards. It's really your choice.

[FuzzyLumpkins]

Look at a tax form sometime and see just how little you can deduct.

Did you ask for the MRI's or did they do it without your permission? They might have performed unnecessary procedures just so you couldn't sue them on the off chance it would discover something cheaper methods wouldn't discover. It would help to know what was wrong. Also consider how expensive those are, and technicians like me probably make $45 + per hour to calibrate them. They have to charge big money for the procedure to pay for the equipment. If it costs $250,000, then they have to do more than 41,000 of them just to pay for the equipment.

Did you really need a MRI?

I was unconscious from a head injury. The X-rays were negative and they took MRI's on my arms and legs anyway. I can understand the head, neck and back but its the extremities that I absolutely refuse to pay.

A 3 tesla machine costs $3 million. How many scans do you do a day?

[Wild Cobra]

You can still go with a private plan afterwards. It's really your choice.
Are you sure? I heard the way the legislation is in the current form, you cannot change plans. You must buy the government version if you leave the plan you have.

[FuzzyLumpkins]

You can still go with a private plan afterwards. It's really your choice.

What he is talking about is how the plans for major businesses that do not meet the new minimum coverage requirements will no longer be available. Why anyone thinks its a good idea to pay a 20% deductible is beyond me.

But what I really think is funny is do people really think that say Blue Cross/Blue Shield is not going to offer a package that does meet the minimum requirements that will be available on the exchange? As it is right now, private insurers will change the plans that are available to your company and you're old plan won't be available. Its not like they dont have a new one. I don't see how this would be any different.

If your current policy meets those minimum requirements you will be able to keep your coverage. If it has one of those stupid deductibles or doesn't cover prescriptions and the like then its out.

The high deductible policies ABSOLUTELY have to go.

[ElNono]

Are you sure? I heard the way the legislation is in the current form, you cannot change plans. You must buy the government version if you leave the plan you have.

You don't. You drop into the exchanges. Now, programs offered through there have to have the baseline coverage that the public option has. But that's the floor. You're free to purchase insurance from a private insurer that offer added value (probably for more money) if you so desire.

[ElNono]

What he is talking about is how the plans for major businesses that do not meet the new minimum coverage requirements will no longer be available. Why anyone thinks its a good idea to pay a 20% deductible is beyond me.

Well, no, most people here claim you have to fall into the public option and you have no choice. That's simply not accurate.
They automatically assume that companies cannot provide anything of added value, and they will die away. I don't think that's accurate at all either.
I think most insurance companies will probably move to a system like AARP, where they offer additional value to complement the public option.

[FuzzyLumpkins]

You don't. You drop into the exchanges. Now, programs offered through there have to have the baseline coverage that the public option has. But that's the floor. You're free to purchase insurance from a private insurer that offer added value (probably for more money) if you so desire.

That nad companies have to pay additional tax if they don't offer their employees an insurance plans. Its in their best interest to provide coverage and you bet your ass that the previous proveder is going to do everything within their power to keep that contract.

[FuzzyLumpkins]

Well, no, most people here claim you have to fall into the public option and you have no choice. That's simply not accurate.
They automatically assume that companies cannot provide anything of added value, and they will die away. I don't think that's accurate at all either.
I think most insurance companies will probably move to a system like AARP, where you offer additional value to complement the public option.

Yeah I was just saying that that is the phenomenon that he is attributing the 'have to go to the state plan' to.

[ElNono]

That nad companies have to pay additional tax if they don't offer their employees an insurance plans. Its in their best interest to provide coverage and you bet your ass that the previous proveder is going to do everything within their power to keep that contract.

Depends on the tax amount. If they're taxed 8%, and they're currently paying 15-18% to provide coverage, then it might be more economical for them to simply pay the tax. I think the government is actually counting on some of this happening in order to fund part of the program.

[FuzzyLumpkins]

Depends on the tax amount. If they're taxed 8%, and they're currently paying 15-18% to provide coverage, then it might be more economical for them to simply pay the tax. I think the government is actually counting on some of this happening in order to fund part of the program.

Yeah thats true. I also think though that private insurers are actually going to legitimately attempt to negotiate prices down to what medicare and medicaid pay to try and bring those premiums down to compete.

I have no sympathy for them. For years they have negotiated in bad faith to spiral costs up and thus garner larger profits. People will pay whatever they have to when they or their loved ones are sick or hurt and they have preyed upon it the entire time.

[Spursmania]

The supposed exchange will offer both the public option and as many private options as the private companies want to offer.
Right now, your plan changes annually or bi-annually, so you're never really 'keeping the same plan'. What are you keeping is a plan somewhat similar that gives you certain coverage and deductibles that's important to you.
You can still pick up that program from an exchange. It will be different in that it will be mandated to cover certain baseline procedures. But any of these private plans will have to differentiate themselves enough from the public plan as to providing added value so people are willing to pay more for them.

These are excepts from the article "5 freedoms you'll lose in health care reform" they are in quotations or bold:

"The bills in both houses require that Americans purchase insurance through "qualified" plans offered by health-care "exchanges" that would be set up in each state. The rub is that the plans can't really compete based on what they offer. The reason: The federal government will impose a minimum list of benefits that each plan is required to offer. "

"Obama platform would mandate extremely full, expensive, and highly subsidized coverage -- including a lot of benefits people would never pay for with their own money -- but deliver it through a highly restrictive, HMO-style plan that will determine what care and tests you can and can't have."


We don't want full maximum coverage. What if we want what we already have? Why should the government choose what we need and don't need. Most people want choice and to be able to fit a plan according to their needs. Do they know our health more than we do? Mandating full coverage, makes it more expensive to keep my private insurance because the insurer is competing with the highly subsidized government mandated plan. Government Subsidies make it impossible to compete.


"The Senate bill would require coverage for prescription drugs,mental-health benefits, and substance-abuse services."

"The bills seriously endanger the trend toward consumer-driven care in general. By requiring minimum packages, they would prevent patients from choosing stripped-down plans that cover only major medical expenses."

I would not have a choice to decline substance and mental health coverage. Yet, it's requiring all of us to pay for that. Also, young healthy people shouldn't be forced to have maximum insurance.

"Hundreds of companies now offer Health Savings Accounts to about 5 million employees. Those workers deposit tax-free money in the accounts and get a matching contribution from their employer. They can use the funds to buy a high-deductible plan -- say for major medical costs over $12,000. Preventive care is reimbursed, but patients pay all other routine doctor visits and tests with their own money from the HSA account. As a result, HSA users are far more cost-conscious than customers who are reimbursed for the majority of their care."

We use HSA together with our insurance, and it's a good combination. It certainly makes us more cost conscious. It seems this plan may be eliminated.

"The employees who got their coverage before the law goes into effect can keep their plans, but once again, there's a catch. If the plan changes in any way -- by altering co-pays, deductibles, or even switching coverage for this or that drug -- the employee must drop out and shop through the exchange. Since these plans generally change their policies every year, it's likely that millions of employees will lose their plans in 12 months."

It's just as I thought. If I don't like my current private plan, and want to change it, I would be forced into the exchange which only has the mandated maximized health care coverage plans to pick from. So, this exchange will not allow us to pick a similar private plan.

Rather, we would be forced into the exchange where the minimum coverage is mandated by the government and is different from my original private plan.

[Spursmania]

Are you sure? I heard the way the legislation is in the current form, you cannot change plans. You must buy the government version if you leave the plan you have.

Sine the government will mandate the minimum coverage allowed, like substance abuse or mental disorder coverages, all insurers in the exchange would have to carry that minimum policy. So, yes, everybody will have at least the government version policy -they have too.

So, if you don't carry any of the coverages that are mandated by the government, and you leave your private plan for whatever reason, you will be forced into the exchange. So, whether you like it or not, you will have to carry the minimum mandated government coverage plus whatever else you would like to add.

The bill in its current stage is mandating the mental and substance abuse coverage. No one knows yet how much more or less will be mandated until the final version is adopted.

[FuzzyLumpkins]

LOL I am a young healthy American and I say you're full of shit. The only coverage I can afford right now is that bullshit with the 20% deductible and those policies are complete bullshit and even they won't give me those anyway.

Regardless medicaid/care already covers that shit and is cheaper than those plans anyway without any deductible.

[Spursmania]

Health Reforms hidden victims

Young people and seniors would pay a high price for ObamaCare.


http://online.wsj.com/article/SB10001424052970203517304574306303720472842.html

[FuzzyLumpkins]

Health Reforms hidden victims

Young people and seniors would pay a high price for ObamaCare.


http://online.wsj.com/article/SB10001424052970203517304574306303720472842.html


1) REad the article thats not what it says.
2) The issue with 2:1 is in the house plan which i agree sucks.

[ElNono]

These are excepts from the article "5 freedoms you'll lose in health care reform" they are in quotations or bold:

"The bills in both houses require that Americans purchase insurance through "qualified" plans offered by health-care "exchanges" that would be set up in each state. The rub is that the plans can't really compete based on what they offer. The reason: The federal government will impose a minimum list of benefits that each plan is required to offer. "

"Obama platform would mandate extremely full, expensive, and highly subsidized coverage -- including a lot of benefits people would never pay for with their own money -- but deliver it through a highly restrictive, HMO-style plan that will determine what care and tests you can and can't have."


We don't want full maximum coverage. What if we want what we already have? Why should the government choose what we need and don't need. Most people want choice and to be able to fit a plan according to their needs. Do they know our health more than we do? Mandating full coverage, makes it more expensive to keep my private insurance because the insurer is competing with the highly subsidized government mandated plan. Government Subsidies make it impossible to compete.


Who are we? You and the insurance companies?
Plus, from the sole basis that we still don't know the full extent of the minimum required coverages, you're basically complaining of hypotheticals. My understanding is that it won't be maximum coverage, but a set of minimums required. Once the minimum required covered procedures/treatments information is released, then we can attend to your incessant bitching.



"The Senate bill would require coverage for prescription drugs,mental-health benefits, and substance-abuse services."

"The bills seriously endanger the trend toward consumer-driven care in general. By requiring minimum packages, they would prevent patients from choosing stripped-down plans that cover only major medical expenses."

I would not have a choice to decline substance and mental health coverage. Yet, it's requiring all of us to pay for that. Also, young healthy people shouldn't be forced to have maximum insurance.


This is no different than your run of the mill group coverage plan. You are offered a package and then you're either happy and take it, or if you're not happy then you decline it in it's entirety. There are things covered there that you pay for and you probably won't use.
If you don't like any plan, you're always free to pay the penalty of not carrying a plan (which is cheaper than paying for a plan) and then pay out of pocket for just want you want.


"Hundreds of companies now offer Health Savings Accounts to about 5 million employees. Those workers deposit tax-free money in the accounts and get a matching contribution from their employer. They can use the funds to buy a high-deductible plan -- say for major medical costs over $12,000. Preventive care is reimbursed, but patients pay all other routine doctor visits and tests with their own money from the HSA account. As a result, HSA users are far more cost-conscious than customers who are reimbursed for the majority of their care."

We use HSA together with our insurance, and it's a good combination. It certainly makes us more cost conscious. It seems this plan may be eliminated.


Nothing more cost conscious than running a $20K bill when your insurance company gave you the middle finger.



"The employees who got their coverage before the law goes into effect can keep their plans, but once again, there's a catch. If the plan changes in any way -- by altering co-pays, deductibles, or even switching coverage for this or that drug -- the employee must drop out and shop through the exchange. Since these plans generally change their policies every year, it's likely that millions of employees will lose their plans in 12 months."

It's just as I thought. If I don't like my current private plan, and want to change it, I would be forced into the exchange which only has the mandated maximized health care coverage plans to pick from. So, this exchange will not allow us to pick a similar private plan.

Rather, we would be forced into the exchange where the minimum coverage is mandated by the government and is different from my original private plan.

Again, you can't claim it's maximized simply because we still don't know what that baseline coverage is. And you always have the choice not to have a plan and pay out of pocket.

[ElNono]

Sine the government will mandate the minimum coverage allowed, like substance abuse or mental disorder coverages, all insurers in the exchange would have to carry that minimum policy. So, yes, everybody will have at least the government version policy -they have too.

So, if you don't carry any of the coverages that are mandated by the government, and you leave your private plan for whatever reason, you will be forced into the exchange. So, whether you like it or not, you will have to carry the minimum mandated government coverage plus whatever else you would like to add.

The bill in its current stage is mandating the mental and substance abuse coverage. No one knows yet how much more or less will be mandated until the final version is adopted.

So what you're against is a minimum mandated coverage... that's a different story. Don't go saying your only choice is the public option, because that's simply not accurate at all.

[Spursmania]

So what you're against is a minimum mandated coverage... that's a different story. Don't go saying your only choice is the public option, because that's simply not accurate at all.

No, what you're saying is not accurate. People will no longer have the choice of choosing their own coverage and their own plan. You're misleading by assuming people don't think it's a change because they have to carry a minimum. That in and of itself already is a different policy set by bureaucrats in Congress.

I am against the government mandating my insurance options, period. That is what this plan does. It takes away our choice to choose what type of coverage we want, to say otherwise is misleading. When the government forces you to buy a certain policy how can that be choice?

[Spursmania]

Who are we? You and the insurance companies?
Plus, from the sole basis that we still don't know the full extent of the minimum required coverages, you're basically complaining of hypotheticals. My understanding is that it won't be maximum coverage, but a set of minimums required. Once the minimum required covered procedures/treatments information is released, then we can attend to your incessant bitching.

"We" is every American who may not want government mandated minimum coverage. The analysis is based on the most current version out there. By your logic, however, any arguments you make or your "incessant bitching" as you like to refer to it would also be based on complete hypotheticals and hogwash since nothing has indeed passed.

If your understanding is different on the Max coverage-then please refer me to your information.


This is no different than your run of the mill group coverage plan. You are offered a package and then you're either happy and take it, or if you're not happy then you decline it in it's entirety. There are things covered there that you pay for and you probably won't use.
If you don't like any plan, you're always free to pay the penalty of not carrying a plan (which is cheaper than paying for a plan) and then pay out of pocket for just want you want.


What? Of course, this is different. The government will be mandating a required minimum even though we may never need substance or mental disorder coverage, etc... So, Americans are forced to pay for items they don't want in their coverage. How is that cost efficient? Americans don't like paying extra for things they don't use or need.

Free to pay the penalty? :lol This is different, as well. We will be forced to carry insurance the government wants us to carry or be forced to pay a penalty. Neither of which many people find appealing. This is not free choice.


Nothing more cost conscious than running a $20K bill when your insurance company gave you the middle finger.

It's clear you don't know how the HSA's work.



Again, you can't claim it's maximized simply because we still don't know what that baseline coverage is. And you always have the choice not to have a plan and pay out of pocket.

Again, you can't claim I'm wrong either, because this analysis is based on the current version. So, based on your logic, you too would have no business refuting this analysis since you have no idea what will pass.

Everybody, knows this Bill may not be the final version, but parts of it might very well be. You think forcing Americans to pay a penalty for declining insurance is a choice? :lol

No one knows the final version yet. However, it's useful to analyze what the bill would require us to do in it's current form.

[ElNono]

"We" is every American who may not want government mandated minimum coverage. The analysis is based on the most current version out there. By your logic, however, any arguments you make or your "incessant bitching" as you like to refer to it would also be based on complete hypotheticals and hogwash since nothing has indeed passed.

I'm not bitching about it, you are.


If your understanding is different on the Max coverage-then please refer me to your information.

I've seen them called 'essential benefits', but again, they're yet to be determined. Here (http://www.nytimes.com/2009/07/26/opinion/26sun1.html?pagewanted=1&_r=1) is an article I pointed to in another thread.


What? Of course, this is different. The government will be mandating a required minimum even though we may never need substance or mental disorder coverage, etc... So, Americans are forced to pay for items they don't want in their coverage. How is that cost efficient? Americans don't like paying extra for things they don't use or need.

Your current employee provided insurance plan might cover cancer treatment that you might never end up using. You're still paying for it. Now I'll ask you the same questions that you're asking me: How is that cost efficient? Americans don't like paying extra for things they don't use or need. (But they do anyways).


Free to pay the penalty? :lol This is different, as well. We will be forced to carry insurance the government wants us to carry or be forced to pay a penalty. Neither of which many people find appealing. This is not free choice.

Do you have a choice not to pay taxes on your income? How about your car insurance? In this case, you essentially DO have an option.


It's clear you don't know how the HSA's work.

I do, but it's not the point. HSA might work for people of certain income and age, but overall make it more expensive for everyone else. It basically goes against the social redistributive idea of insurance. Furthermore, they're subject to market risk, just like any other investment, making the entire proposition a risky gamble. And I'm not even going into the bait and switch of selling reduced priced premiums with high deductibles to people that can ill afford to fund the HSA account.
If you're looking to reduce cost in healthcare, HSA is one of the very first things that need to go.


Again, you can't claim I'm wrong either, because this analysis is based on the current version. So, based on your logic, you too would have no business refuting this analysis since you have no idea what will pass.

Everybody, knows this Bill may not be the final version, but parts of it might very well be. You think forcing Americans to pay a penalty for declining insurance is a choice? :lol

No one knows the final version yet. However, it's useful to analyze what the bill would require us to do in it's current form.

I don't have a choice not to have car insurance if I want to drive. At least this gives me a choice if I'm willing to pay for the penalty. So yeah, it is a choice after all. You might not like it, but that's a different story altogether.

[Spursmania]

Sorry, but none of your replies are convincing nor does it controvert the fact that our choices will be limited and will come from the government. Our private plans will never be the same and eventually we will all be on government plans. You can buy basic stripped down packages now which you won't be able to do once the government is involved.

We should be focusing on national tort reform. Doctors order extra tests to cover their ass and practice defensive medicine because if they don't there's always blood hungry attorneys who will abuse the legal system. As a result, Doctors are required to pay several thousands of dollars in medical malpractice insurance. These costs spill over to patient's fees. We all suffer because of this huge national problem. This reform doesn't even begin to address that. Why?

Obama is a lawyer and most members of Congress are lawyers. The Trial Lawyer's asscoiation feeds millions of dollars into congress' members to avoid any type of reform. They are all one big happy family. Meanwhile, we are all left with a problem, Congress isn't even bothering to address tort reform. It's really an insult to the whole idea of reform when it's not even considered. We should concentrate on kicking insurance companies' asses and tort reform first before we start overhauling the whole industry.

[101A]

It seems this lady doesn't understand how insurance works. The entire principle of insurance is that you pool risk and spread the cost around. All insurance companies do it. If someone pays $2000 a year for full coverage on their BMW M5 and you wreck it costing $40k to replace it then is that person going to be ever paying for the benefits he received?



You don't know a whole lot about insurance.

If you are MUCH MORE LIKELY to wreck your M5, then the insurance company will charge you a great deal more. If they KNOW you are going to wreck your M5, and total it, they will charge you replacement cost, plus administrative fees, plus reserve funding, commissions and taxes.

An underwriter's job is to KNOW what normal expenses are going to be, and then charge for the risk the insurance company is taking for things beyond "normal". They add premium loads to that to cover administrative costs.

An older person should pay more because they have: 1. Higher Normal, everyday costs (maintenance drugs, more doctors visits, etc.),; 2. Higher risk - MUCH more likely to get a seriously expensive disease; 3. Higher administrative costs because the insurance company is going to be spending a great deal more resources on them, than the 22 year old, who may, or may not have a single claim all year.

Yes, insurance exists to spread the cost around, but that is mainly related to the risk piece; the unknowable; the rest is known.

Which brings us to WHY healthcare WAS so cheap and has been rising SO fast.

As with most other issues in this country, it's the baby boomers fault. In the 70's, the bulge was with young, healthy types; lots of them paying premium, with relatively few elderly; and nobody gave much of a crap about the elderly - the market and focus was on the boomers. As they've aged; so has the cost of healthcare risen; and NOBODY thought for the boomers to be putting money away to cover their future healthcare costs; so that burden falls on all of us. Wouldn't want to duly stress the boomers, would we? Pile on top of that the rush to develop new drugs to sell to the boomers (nobody heard of VIAGRA until a 'boomer couln't get it up), and you have a perfect storm of increasing prices.

And the kicker?

There's no solution.

The Boomers ARE getting older, and sicker - the cost is going to continue to go up, unless we decide to NOT spend a great deal of money on them when they get catastrophically ill.............the only real solution.

Frankly, I think Obama gets this, but he just can't say it.

[ElNono]

Sorry, but none of your replies are convincing nor does it controvert the fact that our choices will be limited and will come from the government. Our private plans will never be the same and eventually we will all be on government plans. You can buy basic stripped down packages now which you won't be able to do once the government is involved.

On the same note, what you want is utopian. It doesn't exist. That's why you can't come up with a proposition. You want:
1) Lower premiums
2) Higher quality of care
3) Lower care costs
4) Minimum or no government intervention

There's simply no incentive for insurers or pharmas to lower any costs. Actually, the opposite is true. Even the cost whining on this plan is a red herring, because 5 years from now, with the status quo, we will be on the hook for $1 trillion to fund medicare and medicaid alone, and you bet it's gonna come from taxes. Furthermore, we will keep on reducing access to care, as premiums keep on growing a disproportionate amount compared to salaries.

Now, this might not be the best plan your money can buy, and we can debate that to eternity, but it's an attempt to move in another direction. Something that's long overdue.


We should be focusing on national tort reform. Doctors order extra tests to cover their ass and practice defensive medicine because if they don't there's always blood hungry attorneys who will abuse the legal system. As a result, Doctors are required to pay several thousands of dollars in medical malpractice insurance. These costs spill over to patient's fees. We all suffer because of this huge national problem. This reform doesn't even begin to address that. Why?

I agree this is something that should have been included, but I also can't fault the entire plan for not containing a provision to deal with that topic. Like I said in another post, there's just so many battles you can fight at one time. Plus it's not like you can't do tort reform on a separate bill.


Obama is a lawyer and most members of Congress are lawyers. The Trial Lawyer's asscoiation feeds millions of dollars into congress' members to avoid any type of reform. They are all one big happy family. Meanwhile, we are all left with a problem, Congress isn't even bothering to address tort reform. It's really an insult to the whole idea of reform when it's not even considered. We should concentrate on kicking insurance companies' asses and tort reform first before we start overhauling the whole industry.

You need to make a point that the entire plan is inviable if tort reform is not included. I haven't seen that yet.

[ElNono]

Which brings us to WHY healthcare WAS so cheap and has been rising SO fast.

I don't necessarily disagree with your view, but I don't think it really encompasses the entire spectrum. The better question to me is: Why does premiums and profits keep going up when some of these companies actually insure LESS people?

[Wild Cobra]

Anyone care for CBO numbers?

I find them generally to be way off on expected costs. The costs are generally way higher than they estimate. Anyway:

CBO preliminary analysis of H.R. 3200 (http://www.cbo.gov/ftpdocs/104xx/doc10464/hr3200.pdf) 7/17/09

Text of HR 3200 (http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=111_cong_bills&docid=f:h3200ih.txt.pdf)

[101A]

I don't necessarily disagree with your view, but I don't think it really encompasses the entire spectrum. The better question to me is: Why does premiums and profits keep going up when some of these companies actually insure LESS people?

Depends on the company.

Insurance companies often run in cycles; we talk about it as either the marketers or the accountants running things. When the salespeople are dominant; they write a lot of paper; drive up revenue - but it's not good for profit; which leads to the accountants taking over, and tightening up underwriting guidelines (charging more when people get sick, etc.); which increases profit, and often sends those less attractive cases to another company which is looking to add policy-holders, and with more loose underwriting criteria. People, and groups, move from carrier to carrier all the time.

Profit could also go up becuse bonuses went down, they stopped buying or building new offices; anything - and the company is trying to build cash. Profit is simply what is left over after ALL expenses are covered - including salaries, bonuses AND dividends. It's kind of funny, but in my own business, "profit" is not a good indicator of how we are doing. The company made more profit in the past fiscal year, but I made less money. Our profit went up considerably, simply because we stopped depreciating an expensive software package we bought 5 years ago; had nothing to do with cash on hand - but it appears as if something significant happened. I assume the same kinds of things apply to large companies; but on a much different scale.

[101A]

There's simply no incentive for insurers or pharmas to lower any costs.

Why do you lump insurers with pharamceuticals?

Pharmaceuticals are providers, like doctors and hospitals and drug stores; insurance carriers are payors.

[Wild Cobra]

In a thread on 10/17/08, I stated the following after the first bailout:
Watch the future. My senator Gordon Smith (R) in a blue state will lose this November now. I'm sure this hurts him enough with conservatives that he will be replaced by the more liberal democrat running against him!Merkley won the 2008 election 49% to 46%. Smith won the 2002 election 56% to 40%! He was on the wrong side of two issues that pissed off his base. Amnesty for illegals, and the bailout.

Remind your republicans that this will likely happen to them if they vote for HR 3200. Doesn't hurt to tell your democrats that also.

[Bender]

Our profit went up considerably, simply because we stopped depreciating an expensive software package we bought 5 years ago; had nothing to do with cash on hand - but it appears as if something significant happened. I assume the same kinds of things apply to large companies; but on a much different scale.

true. That's why a Cash Flow statement is a truer indicator of how a company is doing, rather than a P&L statement. CF statements remove such "non-cash" items such as depreciation & amortization.

[ElNono]

Depends on the company.

Insurance companies often run in cycles; we talk about it as either the marketers or the accountants running things. When the salespeople are dominant; they write a lot of paper; drive up revenue - but it's not good for profit; which leads to the accountants taking over, and tightening up underwriting guidelines (charging more when people get sick, etc.); which increases profit, and often sends those less attractive cases to another company which is looking to add policy-holders, and with more loose underwriting criteria. People, and groups, move from carrier to carrier all the time.

Sure they do. Until they can't find coverage they can afford anymore. Then you get more and more people uninsured and underinsured. Regardless of profits, premiums keep on growing at a pace that salaries can't match.


Profit could also go up becuse bonuses went down, they stopped buying or building new offices; anything - and the company is trying to build cash. Profit is simply what is left over after ALL expenses are covered - including salaries, bonuses AND dividends. It's kind of funny, but in my own business, "profit" is not a good indicator of how we are doing. The company made more profit in the past fiscal year, but I made less money. Our profit went up considerably, simply because we stopped depreciating an expensive software package we bought 5 years ago; had nothing to do with cash on hand - but it appears as if something significant happened. I assume the same kinds of things apply to large companies; but on a much different scale.

There's so much you can attribute to external or one-time factors. This is not a one time occurrence, but a trend that has been happening over the course of years. At the end of the day, the bread and butter of these companies are low-risk people. There's simply no incentive for them to charge less or take on more risky users. Sooner or later the only people they need to respond to are stockholders.

[ElNono]

Why do you lump insurers with pharamceuticals?

Pharmaceuticals are providers, like doctors and hospitals and drug stores; insurance carriers are payors.

They both contribute, in different ways, to the cost of care, which is what I was answering to.

[101A]

There's so much you can attribute to external or one-time factors. This is not a one time occurrence, but a trend that has been happening over the course of years. At the end of the day, the bread and butter of these companies are low-risk people. There's simply no incentive for them to charge less or take on more risky users. Sooner or later the only people they need to respond to are stockholders.


You are aware that in the state of Texas, NO insurance company doing business here can decline an employer group of at least 2 coverage?

You are aware that they cannot load their rates more than 67% over "book", or normal rates?

So you see, if insurance companies do business in Texas, they DO NOT just get the healthy? They get the sick; in droves.

[ElNono]

You are aware that in the state of Texas, NO insurance company doing business here can decline an employer group of at least 2 coverage?

Not in all cases. As you're well aware, that only applies if at least 75% of them are eligible (with the rounding favoring the company). That's for the small employer case. Actually, in your 2 employer case (say husband and wife), the law requires 100% participation, or the insurer can simply decline.


You are aware that they cannot load their rates more than 67% over "book", or normal rates?

Only for businesses classified under 'Small employer'. Why do you think these protections were put in place?


So you see, if insurance companies do business in Texas, they DO NOT just get the healthy? They get the sick; in droves.

There's 300,000 more uninsured just from the period 1995 to 2001. (source (http://www.hhsc.state.tx.us/research/dssi.htm#ins))
I wish they had more recent numbers, and specially underinsured numbers.
This is a system that's simply not viable on the long term.

I'm also wondering, do you believe we would have less costs and more insured if all these state and federal regulations were not in place?

[101A]

I'm also wondering, do you believe we would have less costs and more insured if all these state and federal regulations were not in place?

Generally regulations raise the cost of insurance, but not the cost of healthcare.

Ultimately, our healthcare is expensive because people get very sick, and it costs a lot of money to try to save their lives. No matter how you choose to pay for it, that is a truism.

I don't understand why people ascribe rules for health care that are different than for everything else. If your house burns down, it costs the same to build it again, regardless of how much premium you paid to insure it, or even if it was not insured at all.

That's not to say that in individual cases, the cost of healthcare is different depending on who's paying; but it macro, on a nationwide level; there are going to be X number of claims, and those claims are going to cost Y number of dollars. The majority of those claims dollars are going to be spent on very sick people either dying, or coming damn close to it; cancer/heart disease/dialysis/premature births.

Anecdote: My company's health plan spends about $12,000 per month - coerage for 25 employees; several spouses, and some children. $144,000 per year, for ALL of their healthcare. An employee in 2004 got Pancreatic cancer; was sick for 6 weeks, and died. Cost for that single episode? $620,000. Nearly six years of coverage for 25 families spent in 6 weeks on a single individual. The case is not unique.

Now, unless we limit what doctors are paid, or hospitals can charge OR don't pay for some of those "heroic" treatments; the costs are there - they are going to be incurred. The question is: What is the most effective, efficient way to pay for it? Obviously, we can eliminate paper work and inefficiencies in the system; and save dollars. But, remember, paperwork and inefficincies = clerical jobs for many Americans. Reducing those $$$$ reduces jobs.

How about this; We put Uncle Sam in a position to do the most good; while not being able to do the most damage (day to day operation and control of people's healthcare). Make the fed the ultimate stop-loss; they pay claims on individuals over $100,000 - to $250,000 (and index it to healthcare inflation biannually); private entities cover everything up to that point - with subsidies for people who cannot afford that lower coverage. The payor's file claims with the govt. for claims over the stop/loss - the govt. reimburses the claim; but doesn't have to get involved directly with the processing - although, obviously, they must have an ability to audit. Pass a regulation, not controlling prices; but making pricing by providers transparent (doctors/hospitals/labs); they must post their charges publicly; and must charge everyone the same price - whatever that might be (I cringe at this suggestion; but for reasons that are more complex than I want to explain - there are a lot of shenanigans that go on in contractual pricing that should be stopped).

[Spursmania]

I'm all for healthy debates guys. It's nice to hear different perspectives without the insults. :toast

[ElNono]

(I skipped over the parts I mostly agree with)


That's not to say that in individual cases, the cost of healthcare is different depending on who's paying; but it macro, on a nationwide level; there are going to be X number of claims, and those claims are going to cost Y number of dollars. The majority of those claims dollars are going to be spent on very sick people either dying, or coming damn close to it; cancer/heart disease/dialysis/premature births.

Anecdote: My company's health plan spends about $12,000 per month - coerage for 25 employees; several spouses, and some children. $144,000 per year, for ALL of their healthcare. An employee in 2004 got Pancreatic cancer; was sick for 6 weeks, and died. Cost for that single episode? $620,000. Nearly six years of coverage for 25 families spent in 6 weeks on a single individual. The case is not unique.

Now, unless we limit what doctors are paid, or hospitals can charge OR don't pay for some of those "heroic" treatments; the costs are there - they are going to be incurred.


I think it's really, really hard to really tell what are the actual costs under the current system. The doctor will bill one thing (is that the actual cost?), then insurance will pay another thing (is that the actual cost?), if you offer to pay out of pocket, you might get quoted a different amount (is that the actual cost?) and lastly, if you compare how much the same procedure costs somewhere else, adjusted for differing standards of living, liability, etc you get yet another sum (is that the actual cost?).

For the most part, I think costs are inflated. I think the doctor charges 'X' to the insurance, because he already knows that the insurance, if it approves it, will only pay 'X/4'.
Then there's other legitimate factors, such as overuse. We've argued extensively about the CYA angle which encompasses tort reform. Then there's physician owned hospitals, and their abuse of testing.

So, I really think we need a whole lot more of transparency when it comes to really determining where this 1/6 of our entire economy is being spent on.

At the end of the day, you can't really reduce this to a 'baby boomers only' or 'we have more sick now' issue. Other countries have their own generations of elders to care for, and they do it with relatively the same outcome for a fraction of what costs us. Furthermore, their systems have sustainability, something our current system does not have. So there's something we're not doing quite right. The thing is to identify what exactly that is.


How about this; We put Uncle Sam in a position to do the most good; while not being able to do the most damage (day to day operation and control of people's healthcare). Make the fed the ultimate stop-loss; they pay claims on individuals over $100,000 - to $250,000 (and index it to healthcare inflation biannually); private entities cover everything up to that point - with subsidies for people who cannot afford that lower coverage. The payor's file claims with the govt. for claims over the stop/loss - the govt. reimburses the claim; but doesn't have to get involved directly with the processing - although, obviously, they must have an ability to audit. Pass a regulation, not controlling prices; but making pricing by providers transparent (doctors/hospitals/labs); they must post their charges publicly; and must charge everyone the same price - whatever that might be (I cringe at this suggestion; but for reasons that are more complex than I want to explain - there are a lot of shenanigans that go on in contractual pricing that should be stopped).

It's not an unreasonable proposition. However, I think you automatically assume that by removing risk, insurance companies will pass the savings directly to the consumers, and I don't see it anywhere near as clear cut.
I would add a rule to restrict companies from having over 50% of market concentration in a single area, as a way of fomenting actual competition. As far as pricing being public and transparent, I agree (see my comment above), but I'm also skeptical it's enough. Whoever dictates those prices are going to end up being a new big lobbying group, just like pharma, fighting against any kind of check and balances to determine the methodology of their price scale. I'm sorry if I sound somewhat pessimistic, but I trust corporations to regulate themselves as much as I trust government to control it's own spending... that is, not much at all.

Thanks for taking the time to put together a proposition. You've succeeded where others have failed!

[FuzzyLumpkins]

You don't know a whole lot about insurance.

If you are MUCH MORE LIKELY to wreck your M5, then the insurance company will charge you a great deal more. If they KNOW you are going to wreck your M5, and total it, they will charge you replacement cost, plus administrative fees, plus reserve funding, commissions and taxes.

An underwriter's job is to KNOW what normal expenses are going to be, and then charge for the risk the insurance company is taking for things beyond "normal". They add premium loads to that to cover administrative costs.

An older person should pay more because they have: 1. Higher Normal, everyday costs (maintenance drugs, more doctors visits, etc.),; 2. Higher risk - MUCH more likely to get a seriously expensive disease; 3. Higher administrative costs because the insurance company is going to be spending a great deal more resources on them, than the 22 year old, who may, or may not have a single claim all year.

Yes, insurance exists to spread the cost around, but that is mainly related to the risk piece; the unknowable; the rest is known.

Which brings us to WHY healthcare WAS so cheap and has been rising SO fast.

As with most other issues in this country, it's the baby boomers fault. In the 70's, the bulge was with young, healthy types; lots of them paying premium, with relatively few elderly; and nobody gave much of a crap about the elderly - the market and focus was on the boomers. As they've aged; so has the cost of healthcare risen; and NOBODY thought for the boomers to be putting money away to cover their future healthcare costs; so that burden falls on all of us. Wouldn't want to duly stress the boomers, would we? Pile on top of that the rush to develop new drugs to sell to the boomers (nobody heard of VIAGRA until a 'boomer couln't get it up), and you have a perfect storm of increasing prices.

And the kicker?

There's no solution.

The Boomers ARE getting older, and sicker - the cost is going to continue to go up, unless we decide to NOT spend a great deal of money on them when they get catastrophically ill.............the only real solution.

Frankly, I think Obama gets this, but he just can't say it.

Dude I sold it for 4 years so blow me.

The entire idea was that there would be payouts that the people involved would never be able to repay. I am aware for how risk rating works.

Oh and BTW a 16 year old male driving a brand new M5 with full coverage would cost about 2.5 times as much as a 36 year old married female. Thats about as extreme of a risk rating difference as you can get. Thats not 5x as much.

At the end of the day though using current medical insurance price structures as an attempt to show what is wrong in the state plan is pretty dumb. I know that the very worst for property and casualty its not 5 times as much. What AETNA et al has been doing for years now is pricing things so that people are excluded.

We are not privy to the actuarial data so the point at the end of the day as to what a good ratio is is moot anyway.

And I am sorry I am not down with the whole 'lets just let the older generation suffer hurt and die' idea even though they are the reason why were in this pickle today.

[boutons_deux]

There is obviously population(medical treatment) bump as boomers (an innocent result of Hitler's war) hit retirement. But then there is also a bump in the govt income from the population bump from the boomer's children.

To say that boomers are THE reason for the health care fiasco is nothing but the wrongies shifting the blame away from corrupt, predatory institutions they love to absolve and protect onto the individuals.

Most people of ALL ages simply do not have any clue how to take care of their health. No exercise and overeating industrial food-like dead substances are two main reasons that all ages have diabetes or pre-diabetes, CVD or showing signs of it in teen years, etc, etc. So it's just not boomers who are sick.

BigPharma is simply a criminal exercise. "pop-a-pill" is hypnotically ingrained into every American as the only solution to everything that ills ya.

Then there is BigPharma's pervasive, sinister $60B/year marketing that convinces healthy people that there is something somewhere wrong with them (you're missing out on The American Dream of perfection and perfectibility), and convinces sick people they are really much sicker than they are.

Fee-for-service causes doctors and hospitals to go for volume of treatments and flipping through patients to run up their volume services, separate from results. Treatment often causes more disease and dysfunction, but that's OK, that means more treatment.

And as if performing unnecessary services wasn't enough, there is the widespread fraud of (over)charging (Medicare/Medicaid) for services not performed. Something like $2.5b+/year in CA alone.

But let's forget about all that. THE problem is boomers. GMAFB

[101A]

We are not privy to the actuarial data so the point at the end of the day as to what a good ratio is is moot anyway.


Speak for yourself.

[RandomGuy]

So, Americans are forced to pay for items they don't want in their coverage. How is that cost efficient? Americans don't like paying extra for things they don't use or need.

I may never use my fire insurance coverage on my house, but I will still pay for it.

You cannot know you will never need something ahead of time, because the future is unknowable. You can estimate probabilities, and that is about it.

That is what insurance does.

It is more cost efficient for us as a society to spread that risk very widely, than it is for no-one to have the coverage, and for us to bear the time and expense of dealing with bankrupcies, legal actions, and collections involved.

We all bear the costs of uninsured in one way or another, it is just out of sight, and buried in the cost of everything else.

For example, if I have no mental health coverage, become insane, do things like vote Republican, then start talking to Ronald Reagan as if he is in the room with me, and my delusions about socialists under every rock become so bad as to impair my ability to work and pay off my debts, then the people I have borrowed money from will pass the costs of that bad debt ont you anyways through higher borrowing costs.

The thing conservatives never fail to fail when it comes to understanding is that we all bear the costs of the uninsured right now.

Getting everybody onto insurance will simply shift costs into the open. Right now, you are paying higher prices in goods to cover the costs of debt defaults caused by medical bill bankruptcies.

Why are you not complaining about THAT inefficiency?

[DarrinS]

I may never use my fire insurance coverage on my house, but I will still pay for it.

You cannot know you will never need something ahead of time, because the future is unknowable. You can estimate probabilities, and that is about it.

That is what insurance does.

It is more cost efficient for us as a society to spread that risk very widely, than it is for no-one to have the coverage, and for us to bear the time and expense of dealing with bankrupcies, legal actions, and collections involved.

We all bear the costs of uninsured in one way or another, it is just out of sight, and buried in the cost of everything else.

For example, if I have no mental health coverage, become insane, do things like vote Republican, then start talking to Ronald Reagan as if he is in the room with me, and my delusions about socialists under every rock become so bad as to impair my ability to work and pay off my debts, then the people I have borrowed money from will pass the costs of that bad debt ont you anyways through higher borrowing costs.

The thing conservatives never fail to fail when it comes to understanding is that we all bear the costs of the uninsured right now.

Getting everybody onto insurance will simply shift costs into the open. Right now, you are paying higher prices in goods to cover the costs of debt defaults caused by medical bill bankruptcies.

Why are you not complaining about THAT inefficiency?



You bring up a very good point. NO ONE is being denied heath care -- even non-citizens.

I just don't want the govt to take over the system. There are too many ACTUAL EXAMPLES of how this reduces quality and creates rationing.

[RandomGuy]

You bring up a very good point. NO ONE is being denied heath care -- even non-citizens.

I just don't want the govt to take over the system. There are too many ACTUAL EXAMPLES of how this reduces quality and creates rationing.

People are being denied health care.

Please walk into a doctor's office, tell them you can't/won't pay them, and see if you get a physical, or a blood draw for testing.

[Wild Cobra]

I may never use my fire insurance coverage on my house, but I will still pay for it.That's by choice. You don't have to carry it unless it's a condition for a loan. To require a person to buy coverage as a condition of freedom? Do you realize what you are saying?
You cannot know you will never need something ahead of time, because the future is unknowable. You can estimate probabilities, and that is about it.This is true, but that's where taking responsibility for your own actions come in. I have never bough health insurance for the times I didn't have it employer subsidized. Hell, I would prefer they gave me the money it costs, then I would buy only insurance for catastrophic incidents. I'll pay for regular care out of pocket. To deny me that right is un-American.
It is more cost efficient for us as a society to spread that risk very widely, than it is for no-one to have the coverage, and for us to bear the time and expense of dealing with bankrupcies, legal actions, and collections involved.I disagree with doing that unless those who are paying the bulk can mandate the lifestyle of those who benefit from the fruits of our labor. To give something for free releases a person from responsibility for their actions. If they don't have a financial stake, they will abuse it.
We all bear the costs of uninsured in one way or another, it is just out of sight, and buried in the cost of everything else.And you want to make it easier for abuse of the system. I have an explaination, but it's long. Just take the concept of my last answer. Without a financial stake, the system will get abused. I see it on The Oregon Health plan where the poor have a ZERO copay. They go in for any little reason, just to get out of something like a Work Program class required for them to stay on wealfare.
For example, if I have no mental health coverage, become insane, do things like vote Republican, then start talking to Ronald Reagan as if he is in the room with me, and my delusions about socialists under every rock become so bad as to impair my ability to work and pay off my debts, then the people I have borrowed money from will pass the costs of that bad debt ont you anyways through higher borrowing costs.
It's still less that the abuses of free care has.

The thing conservatives never fail to fail when it comes to understanding is that we all bear the costs of the uninsured right now.
No, we understand it. That's one reason we want the illegal aliens to go home.

Getting everybody onto insurance will simply shift costs into the open. Right now, you are paying higher prices in goods to cover the costs of debt defaults caused by medical bill bankruptcies.
I'll tell you want. Make a donation to hospitals that offer indigent care. Keep your filthy hands off my wallet. Have your socialist friends do the same. Donate your money, not mine. I already have payroll deductions to a hospital charity for $875 this year. If you aren't doing something similar, then STFU.

[RandomGuy]

Generally regulations raise the cost of insurance, but not the cost of healthcare.

Ultimately, our healthcare is expensive because people get very sick, and it costs a lot of money to try to save their lives. No matter how you choose to pay for it, that is a truism.

I don't understand why people ascribe rules for health care that are different than for everything else. If your house burns down, it costs the same to build it again, regardless of how much premium you paid to insure it, or even if it was not insured at all.

That's not to say that in individual cases, the cost of healthcare is different depending on who's paying; but it macro, on a nationwide level; there are going to be X number of claims, and those claims are going to cost Y number of dollars. The majority of those claims dollars are going to be spent on very sick people either dying, or coming damn close to it; cancer/heart disease/dialysis/premature births.

Anecdote: My company's health plan spends about $12,000 per month - coerage for 25 employees; several spouses, and some children. $144,000 per year, for ALL of their healthcare. An employee in 2004 got Pancreatic cancer; was sick for 6 weeks, and died. Cost for that single episode? $620,000. Nearly six years of coverage for 25 families spent in 6 weeks on a single individual. The case is not unique.

Now, unless we limit what doctors are paid, or hospitals can charge OR don't pay for some of those "heroic" treatments; the costs are there - they are going to be incurred. The question is: What is the most effective, efficient way to pay for it? Obviously, we can eliminate paper work and inefficiencies in the system; and save dollars. But, remember, paperwork and inefficincies = clerical jobs for many Americans. Reducing those $$$$ reduces jobs.

How about this; We put Uncle Sam in a position to do the most good; while not being able to do the most damage (day to day operation and control of people's healthcare). Make the fed the ultimate stop-loss; they pay claims on individuals over $100,000 - to $250,000 (and index it to healthcare inflation biannually); private entities cover everything up to that point - with subsidies for people who cannot afford that lower coverage. The payor's file claims with the govt. for claims over the stop/loss - the govt. reimburses the claim; but doesn't have to get involved directly with the processing - although, obviously, they must have an ability to audit. Pass a regulation, not controlling prices; but making pricing by providers transparent (doctors/hospitals/labs); they must post their charges publicly; and must charge everyone the same price - whatever that might be (I cringe at this suggestion; but for reasons that are more complex than I want to explain - there are a lot of shenanigans that go on in contractual pricing that should be stopped).

That actually isn't a bad idea.

Most HMO's buy stop-loss reinsurance anyway.

[RandomGuy]

Hell, I would prefer they gave me the money it costs, then I would buy only insurance for catastrophic incidents. I'll pay for regular care out of pocket.


I would posit this would be the best way to go for us as a society, as this would reduce the massive overhead involved in paying large numbers of small claims by HMO's.

That would bring down the overall costs for health insurance markedly.

[DarrinS]

People are being denied health care.

Please walk into a doctor's office, tell them you can't/won't pay them, and see if you get a physical, or a blood draw for testing.


This is what you want univeral health care for? Really? This is nickles and dimes shit compared to having a bad accident or disease.

[RandomGuy]

Keep your filthy hands off my wallet. Have your socialist friends do the same. Donate your money, not mine. I already have payroll deductions to a hospital charity for $875 this year. If you aren't doing something similar, then STFU.


Bla bla bla.

You want to borrow money, you WILL pay for it the capitalist way through higher borrowing costs.

You want to buy a washingmachine, or a new camera, you pay for it through higher costs for those items as well.

Do you not understand that you pay for the uninsured RIGHT NOW IN EVERYTHING YOU BUY, AND EVERY SERVICE YOU PURCHASE?

Was I not clear on this?

If it costs you an extra $5,000 per year on all the goods and services you buy, how is that any different economically, or even morally than paying a tax of $5,000?

You still are forced to pay for the price of the uninsured either way. You have no choice in the matter unless you literally live in a mud hut of your own making on public land.

[jack sommerset]

Write your representive. https://writerep.house.gov/writerep/welcome.shtml

For those who don't know who you should write.

Lets hope they don't pass this before Friday.

[sabar]

Make a donation to hospitals that offer indigent care. Keep your filthy hands off my wallet. Have your socialist friends do the same. Donate your money, not mine. I already have payroll deductions to a hospital charity for $875 this year. If you aren't doing something similar, then STFU.

People won't be content until the government decides what is best for everyone. Of course nearly everyone that wants the general populace to feed/clothe/bath/educate/cure/asswipe the poor through taxation doesn't give them any of their own money through volunteer choice.

However, we are at a crossroads that people always mix up in their conversations and debates. People are denied health care. Which kind is society obligated to fix?

1. Cannot afford insurance
2. Cannot afford out-of-pocket costs
3. Denied insurance due to pre-existing condition

In my opinion, we are obligated to fixing none of these issues since they all stem from being poor. Unfortunately the greater part of society lives in la-la land where they think we can bring people out of poverty while retaining an affluent lifestyle.

The real issues that should be discussed are things like

1. Unnecessary treatments that drive up costs
2. Unnecessary tests that drive up costs
3. Malpractice scams killing off an already low doctor population
4. Legitimate malpractice issues earning the victim proportionate millions in compensation and loss of work for the doctor
5. Destroying the pharmaceutical oligopoly
6. Removing guaranteed monopolies/patent/copyright on all medical breakthroughs

But as usual, the solution to everything is to get the government that can't run a postal service monopoly that produces profit to take over everything. :wakeup

Then when the whole thing fails the bureaucracy is in place and can never be removed, forever a part of our every growing government.

[RandomGuy]

This is what you want univeral health care for? Really? This is nickles and dimes shit compared to having a bad accident or disease.

Access to decent preventive health care can prevent diabetes and heart disease, two things that are VERY expensive to treat.

Should we not get people pointed towards losing weight and exercising?

I am all for incentives for healthy behavior becuase it costs me less money anyway.

[Holt's Cat]

The reason we pay for routine health care costs through 3rd party payers is the tax exclusion of employer provided health care benefits. People would have a much greater reason to economize on routine health care costs if they had to pay out of pocket, instead of paying a portion of the true cost of their care through insurance. They'd also have a reason to buy high deductible catastrophic insurance...and perhaps another reason to save instead of blowing their income on mass produced bullshit and expecting someone else to take care of them when they haven't been responsible financially.

Health care costs a lot because for the most part, there are much better treatments available today than in the past. A lot of that is the result of investment in R&D due to companies chasing returns made possible by increasing health care expenditures.

Anyways, the real reason for increasing health care costs is not fraud, lawsuit abuse, executive compensation, or whatever tripe which is spewed by various partisans.

[ChumpDumper]

People won't be content until the government decides what is best for everyone. Of course nearly everyone that wants the general populace to feed/clothe/bath/educate/cure/asswipe the poor through taxation doesn't give them any of their own money through volunteer choice.

However, we are at a crossroads that people always mix up in their conversations and debates. People are denied health care. Which kind is society obligated to fix?

1. Cannot afford insurance
2. Cannot afford out-of-pocket costs
3. Denied insurance due to pre-existing condition

In my opinion, we are obligated to fixing none of these issues since they all stem from being poor. Unfortunately the greater part of society lives in la-la land where they think we can bring people out of poverty while retaining an affluent lifestyle.

The real issues that should be discussed are things like

1. Unnecessary treatments that drive up costs
2. Unnecessary tests that drive up costs
3. Malpractice scams killing off an already low doctor population
4. Legitimate malpractice issues earning the victim proportionate millions in compensation and loss of work for the doctor
5. Destroying the pharmaceutical oligopoly
6. Removing guaranteed monopolies/patent/copyright on all medical breakthroughs

But as usual, the solution to everything is to get the government that can't run a postal service monopoly that produces profit to take over everything. :wakeup

Then when the whole thing fails the bureaucracy is in place and can never be removed, forever a part of our every growing government.Why are we under an obligation to fix your six issues and not the other three?

[RandomGuy]

People won't be content until the government decides what is best for everyone.

Ah an interesting point.

We have put in place a government that has decided that punishing murder is best for everyone.

Perhaps the big bad government should stop telling me not to murder people. I don't need a bureaucracy stopping me from doing what I want to... right? :stirpot:

Not raggin on ya, just playing with an idea.

[DarrinS]

Access to decent preventive health care can prevent diabetes and heart disease, two things that are VERY expensive to treat.

Should we not get people pointed towards losing weight and exercising?


I am all for incentives for healthy behavior becuase it costs me less money anyway.



Absolutely, and a civil servant should come to every American home to enforce this healthy lifestyle. The govt should tax the hell out of (or ban completely): alcohol, tobacco, red meat, soft drinks, sugar, and homosexuality.

[RandomGuy]

Originally Posted by RandomGuy

For example, if I have no mental health coverage, become insane, do things like vote Republican, then start talking to Ronald Reagan as if he is in the room with me, and my delusions about socialists under every rock become so bad as to impair my ability to work and pay off my debts, then the people I have borrowed money from will pass the costs of that bad debt ont you anyways through higher borrowing costs.


It's still less that the abuses of free care has.


Source?
















Didn't think so. The way you consistantly pull things out of your ass, and then try to pretend they don't stink... jesus.

I call bullshit. Back this statement up or withdraw it.

[Holt's Cat]

Between the mass availability of credit and paying for routine health care costs through insurance, which has enabled many to pay a fraction of the true cost of their health care, the American consumer has lived well beyond their means. Naturally we then expect the government to bail us out. Which isn't an unreasonable expectation, given that the government has bailed out irresponsible business executives who lived well on easily available credit.

[Wild Cobra]

I would posit this would be the best way to go for us as a society, as this would reduce the massive overhead involved in paying large numbers of small claims by HMO's.

That would bring down the overall costs for health insurance markedly.
Agreed. Every time I payed cash for visits when I had no insurance, I was able to get a good price. They had no time involved dealing with redundant paperwork and insurance companies.

[Holt's Cat]

Nobody wants to be responsible financially. We look for the quick fix, be it through maxing out credit cards beyond our ability to pay, or from politicians who offer something for nothing. Everyone feels entitled to consume more and more, to realize the fruits of the American Dream before actually earning it. It's no surprising that the federal government's fiscal house is in such disarray because the American people live that way too. We are not going to fix this. We need someone else to cut us off. But that probably won't be our creditors such as the Chinese because they need us to continue to spend ourselves into oblivion so they can continue to make $.

Of course, nobody wants to hear this. Deferred gratification, thrift, hard work, and responsibility goes directly against the American character circa 2009.

[Spursmania]

I may never use my fire insurance coverage on my house, but I will still pay for it.

Fire insurance is called catastrophic coverage and is required by your lender. This is completely different from health care insurance. In your example, only actual homeowners who are getting a loan need it, and it is based on the value of your home. Not everybody is required to purchase homeowner's insurance. Plus insurers base your coverage according to what part of the country you live in. For example, wind coverage is not required here in San Antonio,Texas whereas it is in Kansas. This is based on risk.


You cannot know you will never need something ahead of time, because the future is unknowable. You can estimate probabilities, and that is about it.

Bullshit. I can tell you for a fact, I would not need substance abuse coverage. I can tell you for a fact, I would not need mental disorder coverage. This is for mental disorders like bi-polar, schizophrenia, etc..

When one is not a drug addict or doesn't take drugs, why in the fuck would they need it? If your argument about "you may never know" was worthy, then we should all get coverage for every possible disease known to mankind because "you may never now."
Forcing all of us to pay for this type of coverage and who knows what else is just part of the inefficiencies of a bureaucratic government.



It is more cost efficient for us as a society to spread that risk very widely, than it is for no-one to have the coverage, and for us to bear the time and expense of dealing with bankrupcies, legal actions, and collections involved.

The only coverage I believe we should all be required to pay for is catastrophic coverage. But everybody should have to pay their fair share for the coverage. Coverage should not be borne by a small percentage of the population. Unless you're volunteering to pay 5.4% of your AGI for heath care, then I could understand that you're just a true altruistic person, but I doubt it.



For example, if I have no mental health coverage, become insane, do things like vote Republican, then start talking to Ronald Reagan as if he is in the room with me, and my delusions about socialists under every rock become so bad as to impair my ability to work and pay off my debts, then the people I have borrowed money from will pass the costs of that bad debt ont you anyways through higher borrowing costs.

That's your problem not mine. And, I shouldn't have to pay for that coverage to cover your problems. Just like a business that opens, it hits a dry spell and has to close down. Well, someone is in the hole 50,000 dollars. We shouldn't have to bail them out. That's life.


The thing conservatives never fail to fail when it comes to understanding is that we all bear the costs of the uninsured right now.

Don't be such a dolt. I could give a shit less about idealogy. Waste of time. I decide things as they come unlike yourself. If health care is passed with a public option, it will be a nightmare. But I don't think there will be a public option, and by the time it passes the senate, the bill won't be as liberal as Pelosi's. All signs are indicating that is happening.


Getting everybody onto insurance will simply shift costs into the open. Right now, you are paying higher prices in goods to cover the costs of debt defaults caused by medical bill bankruptcies.

Like I said above, having everybody carry catastrophic insurance would be a good idea only if it is paid by each and every individual. The 5.4 health surtax is ludicrous and class warfare. People talk real big and happy about heath care for all, but if they were asked if they would be willing to pay 5.4% of their AGI before any deductions are allocated most people would say GTFO. So, don't pretend that you're all for healthcare just for the sake of healthcare. It's just that since you won't be sacrificing a dime out of your pocket, it's easy to cheerlead.


Why are you not complaining about THAT inefficiency?

Plain and simple. You want the government to take over your heath care and be your daddy. I am self sufficient and don't need a Daddy, thank you.
If you believe the government is efficient, you are insane and just a bleeding liberal who wants someone else to pay for your free ride. Medicare will be bankrupt in 10 years--Yeah, the government is so goddamn efficient. Please stfu.

Healthcare is a commodity with limited resources. Health care is not a right, in case you didn't know. Oh wait, you probably think it is.

[ChumpDumper]

Agreed. Every time I payed cash for visits when I had no insurance, I was able to get a good price. They had no time involved dealing with redundant paperwork and insurance companies.Was it lower than the price they charge to insurance companies? If it was, then someone else's hard earned money went to subsidizing your care. If nothing else comes from health care reform, I would like to see the shell game being played to pay for deadbeats like you apparently were to be a bit more normalized.

[George Gervin's Afro]

Fire insurance is called catastrophic coverage and is required by your lender. This is completely different from health care insurance. In your example, only actual homeowners who are getting a loan need it, and it is based on the value of your home. Not everybody is required to purchase homeowner's insurance. Plus insurers base your coverage according to what part of the country you live in. For example, wind coverage is not required here in San Antonio,Texas whereas it is in Kansas. This is based on risk.



Bullshit. I can tell you for a fact, I would not need substance abuse coverage. I can tell you for a fact, I would not need mental disorder coverage. This is for mental disorders like bi-polar, schizophrenia, etc..

When one is not a drug addict or doesn't take drugs, why in the fuck would they need it? If your argument about "you may never know" was worthy, then we should all get coverage for every possible disease known to mankind because "you may never now."
Forcing all of us to pay for this type of coverage and who knows what else is just part of the inefficiencies of a bureaucratic government.




The only coverage I believe we should all be required to pay for is catastrophic coverage. But everybody should have to pay their fair share for the coverage. Coverage should not be borne by a small percentage of the population. Unless you're volunteering to pay 5.4% of your AGI for heath care, then I could understand that you're just a true altruistic person, but I doubt it.




That's your problem not mine. And, I shouldn't have to pay for that coverage to cover your problems. Just like a business that opens, it hits a dry spell and has to close down. Well, someone is in the hole 50,000 dollars. We shouldn't have to bail them out. That's life.



Don't be such a dolt. I could give a shit less about idealogy. Waste of time. I decide things as they come unlike yourself. If health care is passed with a public option, it will be a nightmare. But I don't think there will be a public option, and by the time it passes the senate, the bill won't be as liberal as Pelosi's. All signs are indicating that is happening.



Like I said above, having everybody carry catastrophic insurance would be a good idea only if it is paid by each and every individual. The 5.4 health surtax is ludicrous and class warfare. People talk real big and happy about heath care for all, but if they were asked if they would be willing to pay 5.4% of their AGI before any deductions are allocated most people would say GTFO. So, don't pretend that you're all for healthcare just for the sake of healthcare. It's just that since you won't be sacrificing a dime out of your pocket, it's easy to cheerlead.



Plain and simple. You want the government to take over your heath care and be your daddy. I am self sufficient and don't need a Daddy, thank you.
If you believe the government is efficient, you are insane and just a bleeding liberal who wants someone else to pay for your free ride. Medicare will be bankrupt in 10 years--Yeah, the government is so goddamn efficient. Please stfu.

Healthcare is a commodity with limited resources. Health care is not a right, in case you didn't know. Oh wait, you probably think it is.

So using your logic water is a commodity. Should we exlude water from those people who can't affrod it?

[Spursmania]

So using your logic water is a commodity. Should we exlude water from those people who can't affrod it?

Yes.

[Holt's Cat]

How many could afford it if they lived within their means? We don't seem to be asking that question. I guess it would be too much to expect individuals to be financially responsible. It's much easier to proclaim them victims of something else.

[Wild Cobra]

People won't be content until the government decides what is best for everyone. Of course nearly everyone that wants the general populace to feed/clothe/bath/educate/cure/asswipe the poor through taxation doesn't give them any of their own money through volunteer choice.I think it's sad that so many people want a nanny. I think they should just move back in with their mommy.

However, we are at a crossroads that people always mix up in their conversations and debates. People are denied health care. Which kind is society obligated to fix?

1. Cannot afford insurance
2. Cannot afford out-of-pocket costs
3. Denied insurance due to pre-existing condition
I don't have the answers, but then I'm not foolish enough to think world peace will happen in my lifetime either. We simply cannot fix all problems. Life's a bitch at times. Why doesn't government "Promote the General Welfare" by real leadership style messages. Tell people if you want something, you have to take the pride and effort and do it yourself. I've worked long and hard for what I have, and I thing the lazy people who complain are pathetic. I sympathize with those who try and have bad luck, and they are the ones that get a C note or more from me on occasion.


In my opinion, we are obligated to fixing none of these issues since they all stem from being poor. Unfortunately the greater part of society lives in la-la land where they think we can bring people out of poverty while retaining an affluent lifestyle.
I agree. Obligated, no. That's what charity is for. I am tired of those who have money and complain about this rarely actually give their own money to the cause.


The real issues that should be discussed are things like

1. Unnecessary treatments that drive up costs
2. Unnecessary tests that drive up costs
3. Malpractice scams killing off an already low doctor population
4. Legitimate malpractice issues earning the victim proportionate millions in compensation and loss of work for the doctor
5. Destroying the pharmaceutical oligopoly
6. Removing guaranteed monopolies/patent/copyright on all medical breakthroughs
I agree with the first 4. #5 maybe, but they still meed to profit from their works. I disagree with #6. Why should medical care be required to have the latest and greatest medicines at rock bottom pricing?


But as usual, the solution to everything is to get the government that can't run a postal service monopoly that produces profit to take over everything. :wakeup
I have no complaints about my mail delivery. Seems to me they are one of the few government run things that actually work.


Then when the whole thing fails the bureaucracy is in place and can never be removed, forever a part of our every growing government.
That's my biggest fear. That it will be implemented, and then be permanent, no matter how bad it gets. I keep saying this. I insist on serious tort reform before talking about government run health care. Afterall, that is part of the savings that will occur. We will completely lose the right to sue if it's nationalized!

Access to decent preventive health care can prevent diabetes and heart disease, two things that are VERY expensive to treat.Well, that's a new one. I guess that's something new I learned today.

I thought that proper diet and a healthy lifestyle prevented these. I though doctors could only tell you if you had it or not, or could get it.

My bad. Here I thought that the individual could keep themselves from getting these. I didn't know it required a doctor.

Should we not get people pointed towards losing weight and exercising?If we get universal health care, I'm going to demand that those riding the system pass a military style physical fitness and demand they get in shape.

I am all for incentives for healthy behavior becuase it costs me less money anyway.

Incentive may ass. Require. If my hard earned money will be mandated to pay for others, I will do all I can to mandate they stay fit.

[Holt's Cat]

We want politicians who promise us something for nothing. We want tax cuts and spending increases. We believe someone else will pay for all the crap we want and we believe we are unfairly taxed. We believe it's someone else who is freeloading off the government.

[SonOfAGun]

Go Leach Yourselves.

[Holt's Cat]

We want to blame everyone else except ourselves.

[George Gervin's Afro]

Yes.

What about the children of parents who are irresonsible? DO they get water when they can't afford it?

[Spursmania]

What about the children of parents who are irresonsible? DO they get water when they can't afford it?

Yes, there are child protective laws. I'm sure CPS, the state, foster homes will take care of them since their parents can't.

[Spursmania]

http://www.investmentpostcards.com/wp-content/uploads/2009/07/26-07-09-14.jpg (http://www.investmentpostcards.com/wp-content/uploads/2009/07/26-07-09-14.jpg)

[Wild Cobra]

http://www.investmentpostcards.com/wp-content/uploads/2009/07/26-07-09-14.jpg (http://www.investmentpostcards.com/wp-content/uploads/2009/07/26-07-09-14.jpg)
Not Hope and Change?