Does insurance make health care more expensive?

[DarrinS]

3WnS96NVlMI

[Yonivore]

6V_kSMKKZFw

[George Gervin's Afro]

You guys are right. I mean if the cost of a liver transplant was open to the free market it wouldn't cost the 700,000 dollars it costs today. It would only cost 250,000 dollars.:rolleyes

[Yonivore]

You guys are right. I mean if the cost of a liver transplant was open to the free market it wouldn't cost the 700,000 dollars it costs today. It would only cost 250,000 dollars.:rolleyes
Your point?

Do you know of anyone that was denied placement on a transplant list or denied a transplant because of their inability to pay?

This debate isn't about the provision of health care, it's about who's going to pay for the health care people are already getting.

I don't know about you but, $450,000 is quite a savings.

[DarrinS]

You guys are right. I mean if the cost of a liver transplant was open to the free market it wouldn't cost the 700,000 dollars it costs today. It would only cost 250,000 dollars.:rolleyes


Hey dummy, that's the kind of thing for which insurance was originally intended. Are you really equating a transplant with routine heath care like a physical or a flu shot?

[George Gervin's Afro]

Hey dummy, that's the kind of thing for which insurance was originally intended. Are you really equating a transplant with routine heath care like a physical or a flu shot?

So this won't happen then?

[101A]

You guys are right. I mean if the cost of a liver transplant was open to the free market it wouldn't cost the 700,000 dollars it costs today. It would only cost 250,000 dollars.:rolleyes

I can get liver's transplanted all day long for $70K.

I shopped around.

[101A]

BTW; Good piece. Stossel's genius - he agrees with me:


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

[TeyshaBlue]

You guys are right. I mean if the cost of a liver transplant was open to the free market it wouldn't cost the 700,000 dollars it costs today. It would only cost 250,000 dollars.:rolleyes

That's irrelevant to the discussion regarding insurance's role. Prices would likely fall, but still be in the zone where insurance was originally designed to function...as...ummm...insurance against catastrophic circumstances.

[jacobdrj]

That is why doctors and other health care professionals should be forced to disclose all prices and costs in the same way a grocery store is forced to show their prices...

Again, the country needs reform. Badly. Any system where someone pays for a service and does not get what they paid for is a broken system.

At the very least, if an insurance company cuts someone ex post facto on a preexisting condition, they should be forced to refund the payments to that insurance customer, with interest, lump sum, tax free...

I would have no problem pay 50% of my income on insurance if I could guarantee the company I am shelling out that income will give me my coverage when I need it. But since I can't guarantee that, I am not going to waste my money on it.

[TDMVPDPOY]

why waste ur time on that shit, when u can get it cheaper done in a foreign country

[Duff McCartney]

http://www.pbs.org/wgbh/pages/frontline/sickaroundamerica/

[nkdlunch]

holy shit how stupid some ppl are. it's scary

[DarrinS]

holy shit how stupid some ppl are. it's scary

[nkdlunch]

exhibit A ^

[boutons_deux]

There's NO incentive for commercial insurers to worry about costs of treatment.

1) if they don't like the price, they tell the client, "we pay what we want to "allow" for this treatment/device/drug, fuck you, you pay the rest."

2) at the end of the year, the insurer will always markup his treatment payouts to cover overheads, so the higher his payouts, the higher his markups, the higher his profits.

Other advanced countries with national health systems have controlled costs to 50% of US's by taking commercialism out of the insurance market. The US has to do the same.

Public option & single payer is the best (proven) way to control costs.

Anything less, eg the current health reform bill, will not "bend the curve down" of health care costs.

[RandomGuy]

Hmmm...

Unsupported claim #1:

"Prices drop [for Lasik eye surgery] because, without insurance payments, patients shop around to get the best deal." (claim at 3:00 or so)

This is a good example of over-simplification.

Let's add some perspective:

This is a rather high-dollar procedure, where it is worth your time to shop around. Would the same hold true for a quick office visits where the differences in price would be much less drastic? How much time/effort would you spend to save $10 bucks on an office visit that you might only use once or twice a year?

Collective bargaining is something the insurance companies do with provider pools. They do the shopping around already, so I kind of doubt the savings that Stossel implies in having everybody instantly drop insurance would mean that we would get our savings from this avenue. There is savings to be had, but not in the way he seems to think.

Lasik is not a life-preserving measure. You cannot go to a hospital emergency room and get this done.

Lasik procedures do not suffer from the same cost-shifting that other procedures do. Lasik providers do not have to worry about every 3rd or 4th patient not paying, so they do not have to raise prices to cover the indigent.

Any economist will tell you that Lasik prices have dropped because both the people who manufacture the equipment, and the doctors that provide them have met their fixed costs through sheer sales volume and can offer the procedure/machines at lower unit prices.

Example:
fixed costs = costs that must be paid no matter how many things you sell, i.e. rent.
activity costs = costs that vary directly per unit produced, i.e. materials, electricity, etc.

Fixed costs of producer = 100
per unit activity costs = 10

If producer only sells one item, to break even he/she must sell at $100 + $10 = $110
If producer sells two units, the price instantly comes down.
100 + (2*10) = 120
120/2 = $60

The benefits of each new sale get smaller and smaller, so selling 100 units:
100 + (100*10) = 1100
1100/100 = $11

In this example, prices have come down 90% compared to the initial cost.

This is basic micro-economics, and the most, if not all, of reduced prices for Lasik would be easily be explained by this well-understood mechanism.

[RandomGuy]

There's NO incentive for commercial insurers to worry about costs of treatment.

False.

Profit motive encourages insurers to shop around. If they can get a procedure cheaper, they get to keep more of each premium dollar.

[RandomGuy]

1) if they don't like the price, they tell the client, "we pay what we want to "allow" for this treatment/device/drug, fuck you, you pay the rest."

True.

Although generally this is told to the doctor submitting the claim, who then must decide how much to attempt to recover from the patient.

[RandomGuy]

2) at the end of the year, the insurer will always markup his treatment payouts to cover overheads

DING DING DING DING!!

True

Boutons wins a prize for zeroing in on the one of the biggest costs of health care/insurance, also touched on in the piece in the OP.

I gotta get to work, but more on this later.

[101A]

Hmmm...

Unsupported claim #1:

"Prices drop [for Lasik eye surgery] because, without insurance payments, patients shop around to get the best deal." (claim at 3:00 or so)

This is a good example of over-simplification.

Let's add some perspective:

This is a rather high-dollar procedure, where it is worth your time to shop around. Would the same hold true for a quick office visits where the differences in price would be much less drastic? How much time/effort would you spend to save $10 bucks on an office visit that you might only use once or twice a year?

Collective bargaining is something the insurance companies do with provider pools. They do the shopping around already, so I kind of doubt the savings that Stossel implies in having everybody instantly drop insurance would mean that we would get our savings from this avenue. There is savings to be had, but not in the way he seems to think.

Lasik is not a life-preserving measure. You cannot go to a hospital emergency room and get this done.

Lasik procedures do not suffer from the same cost-shifting that other procedures do. Lasik providers do not have to worry about every 3rd or 4th patient not paying, so they do not have to raise prices to cover the indigent.

Any economist will tell you that Lasik prices have dropped because both the people who manufacture the equipment, and the doctors that provide them have met their fixed costs through sheer sales volume and can offer the procedure/machines at lower unit prices.

Example:
fixed costs = costs that must be paid no matter how many things you sell, i.e. rent.
activity costs = costs that vary directly per unit produced, i.e. materials, electricity, etc.

Fixed costs of producer = 100
per unit activity costs = 10

If producer only sells one item, to break even he/she must sell at $100 + $10 = $110
If producer sells two units, the price instantly comes down.
100 + (2*10) = 120
120/2 = $60

The benefits of each new sale get smaller and smaller, so selling 100 units:
100 + (100*10) = 1100
1100/100 = $11

In this example, prices have come down 90% compared to the initial cost.

This is basic micro-economics, and the most, if not all, of reduced prices for Lasik would be easily be explained by this well-understood mechanism.

Even if prices per unit don't drop significantly; utilization would.

HSA's are a perfect example of this.

HSA's are illegal in Obama's legislation.

[101A]

True.

Although generally this is told to the doctor submitting the claim, who then must decide how much to attempt to recover from the patient.


What an insurance company will pay is based on contracts:

1. With providers.

2. With insured; and defined in the Contract.

If you stay in-network, and receive non-experimental treatment, 100% of the cost is allowed within the coverage as defined in the schedule of benefits.

If you choose to see an out of network provider, then the insurance company will pay up to a certain threshold of "usual and customary" charges in a given geographical area (zip code). Most plans cover at the 85% - 95% threshold per procedure, meaning they will pay up to what 85 - 95% of the provider in your area charge for that procedure this year.

Yes, there are companies that compile that data. That data costs me $10 K per year.

[DarrinS]

Hmmm...

Unsupported claim #1:

"Prices drop [for Lasik eye surgery] because, without insurance payments, patients shop around to get the best deal." (claim at 3:00 or so)

This is a good example of over-simplification.

Let's add some perspective:

This is a rather high-dollar procedure, where it is worth your time to shop around. Would the same hold true for a quick office visits where the differences in price would be much less drastic? How much time/effort would you spend to save $10 bucks on an office visit that you might only use once or twice a year?

Collective bargaining is something the insurance companies do with provider pools. They do the shopping around already, so I kind of doubt the savings that Stossel implies in having everybody instantly drop insurance would mean that we would get our savings from this avenue. There is savings to be had, but not in the way he seems to think.

Lasik is not a life-preserving measure. You cannot go to a hospital emergency room and get this done.

Lasik procedures do not suffer from the same cost-shifting that other procedures do. Lasik providers do not have to worry about every 3rd or 4th patient not paying, so they do not have to raise prices to cover the indigent.

Any economist will tell you that Lasik prices have dropped because both the people who manufacture the equipment, and the doctors that provide them have met their fixed costs through sheer sales volume and can offer the procedure/machines at lower unit prices.

Example:
fixed costs = costs that must be paid no matter how many things you sell, i.e. rent.
activity costs = costs that vary directly per unit produced, i.e. materials, electricity, etc.

Fixed costs of producer = 100
per unit activity costs = 10

If producer only sells one item, to break even he/she must sell at $100 + $10 = $110
If producer sells two units, the price instantly comes down.
100 + (2*10) = 120
120/2 = $60

The benefits of each new sale get smaller and smaller, so selling 100 units:
100 + (100*10) = 1100
1100/100 = $11

In this example, prices have come down 90% compared to the initial cost.

This is basic micro-economics, and the most, if not all, of reduced prices for Lasik would be easily be explained by this well-understood mechanism.



My sister is an opthamologist. I'll ask her if you are correct.

She's a big Obama-bot, so she may agree with you just to spite me.

[ElNono]

Even if prices per unit don't drop significantly; utilization would.
HSA's are a perfect example of this.
HSA's are illegal in Obama's legislation.

I can't wait until HSA's are outlawed. High deductible plans should follow the same route.

[Wild Cobra]

I can't wait until HSA's are outlawed. High deductible plans should follow the same route.
Authoritarian much?

What's next? You going to advocate Marxism, or Fascism?

[DarrinS]

I can't wait until HSA's are outlawed. High deductible plans should follow the same route.



Why?

[SAGambler]

That is why doctors and other health care professionals should be forced to disclose all prices and costs in the same way a grocery store is forced to show their prices...

Again, the country needs reform. Badly. Any system where someone pays for a service and does not get what they paid for is a broken system.

At the very least, if an insurance company cuts someone ex post facto on a preexisting condition, they should be forced to refund the payments to that insurance customer, with interest, lump sum, tax free...

I would have no problem pay 50% of my income on insurance if I could guarantee the company I am shelling out that income will give me my coverage when I need it. But since I can't guarantee that, I am not going to waste my money on it.

Then our system is without a doubt broken. Ever been to a mechanic lately? All they want is their money and get the job half assed done and get you out of their hair. How about dry cleaners? Ever find one that actually gets your clothes clean.
Every service I try to get performed, it's wham bam and I'm outta here. Who gives a shit if I do a shitty job.

That has become the norm in our society.

[ElNono]

Authoritarian much?
What's next? You going to advocate Marxism, or Fascism?

I'm not asking you to agree with me.
There's nothing authoritarian in expressing my opinion.
Eventually, it's not me who outlaws or not, but our democratically elected representatives.

And you wouldn't know what Marxism or Fascism are even if they poked you with a stick and called you Marta, so please, spare me.


Why?

See, this is the right question. Thanks DarrinS.
There's plenty of reasons why:
- HSA's go straight against the social redistributive spirit of insurance. Insurance is a big pool of money, that includes people with more risk and people with less risk. The people with more risk use more of the insurance and the people with less risk help cover some of those costs. At some point, the people with less risk will gradually become the people with more risk, and will use the assistance of a new generation of low risk people. Rinse and repeat. Now, HSA's are obviously most attractive to young, healthy people. The low-risk people. If you take them out of the equation, you end up with a much more expensive insurance for everyone else.
- HSA's tax benefits are basically negligible to the poor, which also turn out to be most likely the uninsured persons. They just don't make enough to benefit from the tax breaks.
- HSA's are no different than other investment and are subject to market risk. Market crash? There goes your healthcare savings, just when you needed them to help you pay for that hearth attack.
- HSA's don't really control costs. They just shift the cost from the insurer to the patient.
- HSA's do absolutely zero to increase access or reduce the number of uninsured.
- HSA's actually induce people to delay or avoid getting needed care, or to skip medications, because of the cost.

[Wild Cobra]

I'm not asking you to agree with me.
There's nothing authoritarian in expressing my opinion.
Eventually, it's not me who outlaws or not, but our democratically elected representatives.

And you wouldn't know what Marxism or Fascism are even if they poked you with a stick and called you Marta, so please, spare me.



See, this is the right question. Thanks DarrinS.
There's plenty of reasons why:
- HSA's go straight against the social redistributive spirit of insurance. Insurance is a big pool of money, that includes people with more risk and people with less risk. The people with more risk use more of the insurance and the people with less risk help cover some of those costs. At some point, the people with less risk will gradually become the people with more risk, and will use the assistance of a new generation of low risk people. Rinse and repeat. Now, HSA's are obviously most attractive to young, healthy people. The low-risk people. If you take them out of the equation, you end up with a much more expensive insurance for everyone else.
- HSA's tax benefits are basically negligible to the poor, which also turn out to be most likely the uninsured persons. They just don't make enough to benefit from the tax breaks.
- HSA's are no different than other investment and are subject to market risk. Market crash? There goes your healthcare savings, just when you needed them to help you pay for that hearth attack.
- HSA's don't really control costs. They just shift the cost from the insurer to the patient.
- HSA's do absolutely zero to increase access or reduce the number of uninsured.
- HSA's actually induce people to delay or avoid getting needed care, or to skip medications, because of the cost.
Yep, you are an Authoritarian Socialist/Marxist. You believe those who can spend more than their requirement should pay for those who cannot pay for themselves.

[boutons_deux]

Another way for-profit health insurance companies make health insurance more expensive is by raising the prices, pricing people out of the market, thereby reducing their insurer's pool, spreading the (even stable) health costs over smaller number of clients. This exactly why so many insurer's are raising their rates now 20% - 40% in one year.

Since people pay for health insurance so they don't have to pay (all of) health care costs (cost sharing among the client pool), for-profit insurance companies raise the cost of health care.

A huge advantage of the public option is pool of 100M clients sharing costs and overheads, then no $25M salaries, no stock options, no profits, no dividends, thereby reducing insurance costs.

[DarrinS]

Another way for-profit health insurance companies make health insurance more expensive is by raising the prices, pricing people out of the market, thereby reducing their insurer's pool, spreading the (even stable) health costs over smaller number of clients.





Or, perhaps "for-profit" insurance companies have to raise their rates when a large number of people leave the pool?


It would make no sense the way you've described it. Why would they want to price people out of their own market???

[Wild Cobra]

Or, perhaps "for-profit" insurance companies have to raise their rates when a large number of people leave the pool?


It would make no sense the way you've described it. Why would they want to price people out of their own market???
You forget. Libtards have no concept of economics.

[boutons_deux]

"Why would they want to price people out of their own market?"

These price increases are mainly for individual plans, which are already 18% on avg above the same coverage for a group plan member.

Why? each individual must be given a separate contract, and must be paid for/collected from individually, so the transaction costs for individual plans is much higher than when a single group plan contract signs up 1K or 10K clients in a single group plan, and the company skims the group members' salaries on behalf of the insurance company.

So pricing these "high transaction cost" individual buyers out of the market is very much in the insurer's interests. Basic economics, you make more margin by selling big ticket products than low ticket products, esp when the products are complex (not bubble gum or golf balls).

The reason Repugs and assholes here want insurance sold across state lines is so that for-profit insurers could cherry pick the state, eg South Dakota, with the most lax, least demanding insurance regs, and all setup business there, undercutting other states regulations. iow, Repugs love national/centralized operations (ie, no states rights) when it's business friendly and anti-consumer.

This is exactly why cc companies have setup in SD, in a deal with the SD legislature, and charge usurious rates because they are legal in SD (but not in other states).

WC, for the 1000th time, GFY. You must be pretty good at it by now.

[ElNono]

Yep, you are an Authoritarian Socialist/Marxist. You believe those who can spend more than their requirement should pay for those who cannot pay for themselves.

- Do you know how insurance companies work?
- Are they authoritarian socialist and marxists corporations?
- Why do you hate the insurance industry?

[ElNono]

Or, perhaps "for-profit" insurance companies have to raise their rates when a large number of people leave the pool?

Depends who leaves the pool. If they're low risk people, absolutely agree.
If it's high risk people leaving (like when seniors move to Medicare) then it's actually a big advantage to the insurance co.


Why would they want to price people out of their own market???

Well, if it's high risk people coming in, then I can see why they would want to do that. Eventually, an insurance company wants to have as low a risk as possible when it comes to it's customers.

[FuzzyLumpkins]

Authoritarian much?

What's next? You going to advocate Marxism, or Fascism?

Then every state in the union is a facist marxist state. Property and casualty insurance has had these types of restrictions for a century.

[boutons_deux]

"Depends who leaves the pool. If they're low risk people, absolutely agree."

"Studies have shown" that poorer people (those who get priced out of the insurance pool) are sicker and die younger. Of course, the other way to get them out is for the insurance company to cancel them because of their diseases.

So on average, the people who can afford to get screwed by higher rates are also less diseased/costly to treat.

Great game, huh? So go ahead and raise your rates, purging the poor sickos, while retaining/raping the healthy ones.

[coyotes_geek]

"Depends who leaves the pool. If they're low risk people, absolutely agree."

"Studies have shown" that poorer people (those who get priced out of the insurance pool) are sicker and die younger. Of course, the other way to get them out is for the insurance company to cancel them because of their diseases.

So on average, the people who can afford to get screwed by higher rates are also less diseased/costly to treat.

Great game, huh? So go ahead and raise your rates, purging the poor sickos, while retaining/raping the healthy ones.

Don't worry. The United States government is here to help!

For a small fee of course..............

[ElNono]

Don't worry. The United States government is here to help!

For a small fee of course..............

The fact that the insurance industry and big pharma are just cozy with the legislation being proposed is really alarming.
Not only we're keeping the status quo, we're ensuring it's survival.

It's terrible.

[TeyshaBlue]

The fact that the insurance industry and big pharma are just cozy with the legislation being proposed is really alarming.
Not only we're keeping the status quo, we're ensuring it's survival.

It's terrible.

Exactly. We'll be fucking enabling the very practice we wish to discourage. But we must pass something! Now! Change!

[ElNono]

And BTW, back to the thread topic, premiums are just part of the equation. I don't think anybody here denies that's there's an administrative overhead to run a for-profit enterprise.
I actually don't have a problem with the concept of insurance, and I also don't find a problem with protecting the money pool. However, when you insert the for-profit part and that becomes just as much as a priority or more than protecting the money pool, it really becomes a conflict of interests.
That's why I thought the Republican (I think it was a GOP idea) proposal that included non-profit Cooperatives was very interesting.

[coyotes_geek]

The fact that the insurance industry and big pharma are just cozy with the legislation being proposed is really alarming.
Not only we're keeping the status quo, we're ensuring it's survival.

It's terrible.

It's very terrible. IMHO it's also a perfect illustration as to why no matter how bad the current system is, we're still better off with it than with anything the government is going to come up with.

[Nbadan]

The fact that the insurance industry and big pharma are just cozy with the legislation being proposed is really alarming.
Not only we're keeping the status quo, we're ensuring it's survival.

It's terrible.

That's because there is no public or govt option in the current legislation..they get to keep their health-care monopolies and reap millions in 'profit' thanks to the GOP...

[Nbadan]

It's very terrible. IMHO it's also a perfect illustration as to why no matter how bad the current system is, we're still better off with it than with anything the government is going to come up with.

....that's what you get when you let business lobbyist write their own regulations....it's not govt. in itself which is incompetent, it's the lobbyists money which has such a stranglehold on govt. that it keeps it incompetent..

[ElNono]

That's because there is no public or govt option in the current legislation..they get to keep their health-care monopolies and reap millions in 'profit' thanks to the GOP...

Whatever the Dems are passing is without GOP support or votes... so if they wanted a public option, they could easily have one there... this one is on them and nobody else...

[boutons_deux]

There is a group of Dems refusing to sign onto the bill if no public option.

I'm torn. Poor people need health care, which this dog's lunch of bill provides without a public option, but getting it to them via a Medicare-for-all public option would be much better, and cheaper.

Magic Negro campaigned on a public option, and 10s of Ms, over 100M IIRC, polled as supporting it. Then MN drops it, while forcing people into for-profit insurers. Fuck him.

[Nbadan]

Whatever the Dems are passing is without GOP support or votes... so if they wanted a public option, they could easily have one there... this one is on them and nobody else...

... if it wasn't for the filibuster rules and the GOP, we would have a public option...

[Yonivore]

... if it wasn't for the filibuster rules and the GOP, we would have a public option...
Thank God for the filibuster rules and the GOP, then.

[Nbadan]

...that's not to say that Democrats aren't completely free of blame...but there are basically a handful of blue-dog democrats keeping us away from any real reform on anything, as opposed to the GOP which is completely corrupt...

[Yonivore]

...that's not to say that Democrats aren't completely free of blame...but there are basically a handful of blue-dog democrats keeping us away from any real reform on anything, as opposed to the GOP which is completely corrupt...
Thank God for those Blue Dogs, too!

[ElNono]

... if it wasn't for the filibuster rules and the GOP, we would have a public option...

Not really, I mean, reconciliation is what's going to be used, and for that you don't need the GOP and there's no filibuster...


...that's not to say that Democrats aren't completely free of blame...but there are basically a handful of blue-dog democrats keeping us away from any real reform on anything, as opposed to the GOP which is completely corrupt...

blue-dog democrats are, well, democrats... exactly what I mean by this being solely on the Dems...

[Nbadan]

Not really, I mean, reconciliation is what's going to be used, and for that you don't need the GOP and there's no filibuster...

Your not gonna get the public option through reconciliation...the Byrd rule would kill that..

[Yonivore]

Your not gonna get the public option through reconciliation...the Byrd rule would kill that..
Thank God for the Byrd Rule!

I think the Democrats are screwed this November.

Either they so corrupt the legislative process to shoehorn something through so Obama can finally claim a legislative and campaign victory -- thus pissing off a vast majority of the electorate, or;

They fail miserably, showing the electorate what ineffectual piss ants they are that they had a veto-proof majority and yet, couldn't get anything substantial done.

:corn:

[ElNono]

Your not gonna get the public option through reconciliation...the Byrd rule would kill that..

Biden can overrule Frumin... granted, it hasn't been used since Hubert Humphrey was a VP, but it's an entirely legal strategy and one that we'll see as the GOP starts calling out the rule to scratch off stuff from the bill...

An actual real problem is the budget challenge:

Democrats have to show $2 billion in savings in their reconciliation bill over FIVE years and cannot create any deficits thereafter, or Republicans can pounce with a budget challenge. Their bill cannot create any unfunded mandates of more than $69 million, according to Budget Committee staffers, or there's another budget challenge.

[Yonivore]

http://www.barking-moonbat.com/images/uploads/bagdad_bob_large.gif

Pelosi: Dems not in crisis (http://firstread.msnbc.msn.com/archive/2010/03/04/2219194.aspx)

[Yonivore]

Howard Dean: Health bill hangs Dem incumbents and Obama out to dry in elections (http://thehill.com/blogs/blog-briefing-room/news/84969-howard-dean-health-bill-hangs-dem-incumbents-and-obama-out-to-dry-in-elections)

Isn't he the former head of the DNC and, a doctor, to boot?

[ElNono]

Howard Dean: Health bill hangs Dem incumbents and Obama out to dry in elections (http://thehill.com/blogs/blog-briefing-room/news/84969-howard-dean-health-bill-hangs-dem-incumbents-and-obama-out-to-dry-in-elections)

Isn't he the former head of the DNC and, a doctor, to boot?

Putting aside the fact that the proposed healthcare legislation is shit, I would actually be glad if they start to get shit done without second guessing if it's good for elections or not...

I thought governing based on polls was a bad thing?

[Yonivore]

Putting aside the fact that the proposed healthcare legislation is shit, I would actually be glad if they start to get shit done without second guessing if it's good for elections or not...

I thought governing based on polls was a bad thing?
So, you'd accept shit just because it was an accomplishment?

[ElNono]

So, you'd accept shit just because it was an accomplishment?

No, I accept that governing is not a popularity contest.

[Yonivore]

No, I accept that governing is not a popularity contest.
Nor should passing legislation for the sake of accomplishment be an objective.

[ElNono]

Nor should passing legislation for the sake of accomplishment be an objective.

You REALLY don't know why he's so adamant to passing this legislation?

[Yonivore]

You REALLY don't know why he's so adamant to passing this legislation?
Yes. Because the success of his presidency is dependent on him passing something, anything.

Why do you think he's so adamant?

[Yonivore]

But, I think no matter what happens, Obama and the Democrats lose in November...they've pretty much sealed their fate already.

Every time Obama opens his mouth on the subject from here on out is just icing on the cake.

tmGiBu-u45I

[ElNono]

Yes. Because the success of his presidency is dependent on him passing something, anything.

Why do you think he's so adamant?

Because if he manages to get re-elected, the status quo indicates that Medicare would be exploding in his face midway through his second term.
Obviously, passing a simple legislation that just cuts Medicare benefits is not going to fly, so the cuts are getting passed along with some populist measures such as mandating private insurance to accept customers with pre-existing conditions.

[Yonivore]

Because if he manages to get re-elected, the status quo indicates that Medicare would be exploding in his face midway through his second term.
Obviously, passing a simple legislation that just cuts Medicare benefits is not going to fly, so the cuts are getting passed along with some populist measures such as mandating private insurance to accept customers with pre-existing conditions.
:lmao Seriously, you believe that's why he's so adamant about passing this piece of shit?

Why not just pass Medicare reform?

[ElNono]

:lmao Seriously, you believe that's why he's so adamant about passing this piece of shit?
Why not just pass Medicare reform?

Because it's political suicide to do that. Neither the GOP or the Dems want to do that.

[ElNono]

Let me rephrase that: Neither the GOP or the Dems want to be labeled as the party that did that.

[Yonivore]

Because it's political suicide to do that. Neither the GOP or the Dems want to do that.
But being labeled as the President that fucked up 17% of our economy -- on top of an already critical economic situation -- is just fine with Obama?

Listen, I hope Obamacare doesn't pass even though there's a chance it might. Either way, I think the Democrats are screwed this November and if you thought Obama had trouble getting stuff done his first two years... :lmao with a Opposition Congress, he's really screwed.

[ElNono]

But being labeled as the President that fucked up 17% of our economy -- on top of an already critical economic situation -- is just fine with Obama?

Listen, I hope Obamacare doesn't pass even though there's a chance it might. Either way, I think the Democrats are screwed this November and if you thought Obama had trouble getting stuff done his first two years... :lmao with a Opposition Congress, he's really screwed.

Obamacare will pass. And I don't like this legislation any more than you do.
And I can't wait until Pelosi and Reid are gone. But I actually think he'll get more done if he already knows he can't force things through and goes straight to wheeling and dealing with the GOP. It might not be 100% of what he wants to do, but it will get things moving. Don't forget that those GOP guys made campaign promises to get there.

[RandomGuy]

Yep, you are an Authoritarian Socialist/Marxist. You believe those who can spend more than their requirement should pay for those who cannot pay for themselves.

Insurance is about nothing more than pooling risk. This does, in effect, "socialize" everybody's risk.

If you buy insurance, you are then a socialist.

Live with that, know it, love it.

This is considered beneficial because the problem with such things is that true costs CANNOT be known before hand. You could be the healthiest, sprout-eating, jogging mother-fucker in your state, but still get hit by a car and require $100,000's of expensive operations.

The best ANYONE can do is get a rough guess as to individual risk, and let the law of large numbers do its thing.

The ultimate costs are less to everybody because it minimizes the disruption and costs caused by getting sick/injured and not being able to pay for it.

Those costs would get shifted to you anyways, through a variety of market-mechanisms. Either you can pay for it up front at a total lower cost for society, or you can go the more expensive route, keep all the cost-shifting/sharing hidden, and end up paying more in the long run.

Yeah, that's right, I just said that a form of socialism is better for economic growth.

[RandomGuy]

.. I don't like this legislation any more than you do...

what specific part of what is proposed do you dislike?

[101A]

No, I accept that governing is not a popularity contest.




You live in a Democracy.

Get used to it.

Or move to Venezuela.

[101A]

Insurance is about nothing more than pooling risk. This does, in effect, "socialize" everybody's risk.

If you buy insurance, you are then a socialist.

Socialism != "Pooling"

Socialism = Public (State) Ownership

You are categorically, completely, wrong.

[ElNono]

what specific part of what is proposed do you dislike?

The part where there's no public option?. Or the part where you're under obligation by the government to contract services with a private company or you can be penalized.

[ElNono]

You live in a Democracy.
Get used to it.
Or move to Venezuela.

Governing happens AFTER the popularity contest... you get elected, and then there will be times where you have to make tough choices.
Does none of these guys have convictions anymore? Do they really need to look at a poll before they raise their hand or keep it down?
Is everything dictated by the impact it will have on their next election?

That's just some chickenshit way to exercise power, and the reason pretty much almost nothing got done in the first two years of this government.

They won the popularity contest, and they were handed power and a responsibility. None of these people are stepping up to the plate.

[coyotes_geek]

....that's what you get when you let business lobbyist write their own regulations....it's not govt. in itself which is incompetent, it's the lobbyists money which has such a stranglehold on govt. that it keeps it incompetent..

What difference does it make whether or not our government is incompetent on it's own, or just that way because they're unable to resist lobbyists who make them incompetent? The end result is the same.

[LnGrrrR]

What difference does it make whether or not our government is incompetent on it's own, or just that way because they're unable to resist lobbyists who make them incompetent? The end result is the same.

If they're incompetent on their own they usually spend less money, at least. :D

[101A]

Governing happens AFTER the popularity contest... you get elected, and then there will be times where you have to make tough choices.
Does none of these guys have convictions anymore? Do they really need to look at a poll before they raise their hand or keep it down?
Is everything dictated by the impact it will have on their next election?

That's just some chickenshit way to exercise power, and the reason pretty much almost nothing got done in the first two years of this government.

They won the popularity contest, and they were handed power and a responsibility. None of these people are stepping up to the plate.


Again, it's a Democracy; these are professional politicians. They don't know anything but running for and winning elections. THAT is what they see as their job. "Governing" is just a means to an end.

It is insanity that we give so much of our productivity and riches (and the riches of generations to come) to people like this; but we do - more and more. They are not enlightened; a very small number are anything but selfish and self-interested - the "ideologues" are that way because that is what their constituents want them to be; otherwise they would change.

I don't see why you are at all concerned about, or alarmed by the revelation you are apparently having now.

[ElNono]

Again, it's a Democracy; these are professional politicians. They don't know anything but running for and winning elections. THAT is what they see as their job. "Governing" is just a means to an end.

I completely agree. That doesn't mean it's the right way to proceed.


It is insanity that we give so much of our productivity and riches (and the riches of generations to come) to people like this; but we do - more and more. They are not enlightened; a very small number are anything but selfish and self-interested - the "ideologues" are that way because that is what their constituents want them to be; otherwise they would change.

So you agree with me that this has nothing to do with convictions, but merely polls and special interests. Basically you deem it an aberration as much as I do. And I agree.


I don't see why you are at all concerned about, or alarmed by the revelation you are apparently having now.

This is far from a 'new revelation'. If you follow what I was answering to, you'll notice this stems from the fact that somebody here wants these people to govern by polls.

This same Congress under a different executive passed fairly unpopular legislation in the past. The TARP comes to mind. Obviously that appealed to special interests, which these days rank higher than polls in a politician's preference.

That their priorities are aligned like that is neither new or surprising. But it is and has always been alarming. I think it needs to be pointed out that it's wrong, specially when somebody condones the practice.

Last, but not least, democracy is not populism. Some people don't seem to know the distinction these days.

[coyotes_geek]

If they're incompetent on their own they usually spend less money, at least. :D

Fair point. If we're going to be stuck paying for an incompetent government we might as well use a coupon. :)

[Wild Cobra]

- Do you know how insurance companies work?
- Are they authoritarian socialist and marxists corporations?
- Why do you hate the insurance industry?
I hate those who are imposing their authoritarian views on others.

The free market works when you let it.

[ElNono]

I hate those who are imposing their authoritarian views on others.

The free market works when you let it.

Why did you quote my questions? You didn't answer any of them.

[Wild Cobra]

Because if he manages to get re-elected, the status quo indicates that Medicare would be exploding in his face midway through his second term.
Obviously, passing a simple legislation that just cuts Medicare benefits is not going to fly, so the cuts are getting passed along with some populist measures such as mandating private insurance to accept customers with pre-existing conditions.
This will not fix medicare. It will make it harder on the states.

If he wants to reduce costs, then he needs to make changes that work. Root problem analysis. Attacking the symptoms just exasperate the problem.

[ElNono]

This will not fix medicare. It will make it harder on the states.

If he wants to reduce costs, then he needs to make changes that work. Root problem analysis. Attacking the symptoms just exasperate the problem.

Exactly, but it deflects the blame from the executive. And I agree this is just a palliative on Medicare that screws you on many other fronts.

[Wild Cobra]

- Do you know how insurance companies work?

Pretty much.


- Are they authoritarian socialist and marxists corporations?

Neither.


- Why do you hate the insurance industry?

I don't.

Why do you?

[Wild Cobra]

Insurance is about nothing more than pooling risk. This does, in effect, "socialize" everybody's risk.

If you buy insurance, you are then a socialist.

Live with that, know it, love it.

Hmm.... I guess by your definition, stock holders of major capitolist corporations are socialists. I never thought of WalMart, Exxon, etc. to be socialist endeavors.


This is considered beneficial because the problem with such things is that true costs CANNOT be known before hand. You could be the healthiest, sprout-eating, jogging mother-fucker in your state, but still get hit by a car and require $100,000's of expensive operations.

True. However, insurance should be a choice. Nobody should not be compelled to buy a product they don't want. When you do this, no matter how you want to sweeten the pot, it is authoritarianism at it's worst.


The best ANYONE can do is get a rough guess as to individual risk, and let the law of large numbers do its thing.

That's how corporations and small businesses do it. Now, many are requiring their employees lose weight, stop smoking, etc. to reduce their costs of insuring them.


The ultimate costs are less to everybody because it minimizes the disruption and costs caused by getting sick/injured and not being able to pay for it.

I disagree. Those who cannot pay are already factored in the prices. When you make things cheaper at an individual level, the product gets used more and abused more. The costs can only go up.


Those costs would get shifted to you anyways, through a variety of market-mechanisms. Either you can pay for it up front at a total lower cost for society, or you can go the more expensive route, keep all the cost-shifting/sharing hidden, and end up paying more in the long run.

The only way to reduce these costs always fall of deft ears. The left will never allow true tort reform, relaxation of some regulations, increasing competition, and increases of co-pays for those on the public take.


Yeah, that's right, I just said that a form of socialism is better for economic growth.

Health care is not socialism. It is a choice.

[101A]

I completely agree. That doesn't mean it's the right way to proceed.



So you agree with me that this has nothing to do with convictions, but merely polls and special interests. Basically you deem it an aberration as much as I do. And I agree.



This is far from a 'new revelation'. If you follow what I was answering to, you'll notice this stems from the fact that somebody here wants these people to govern by polls.

This same Congress under a different executive passed fairly unpopular legislation in the past. The TARP comes to mind. Obviously that appealed to special interests, which these days rank higher than polls in a politician's preference.

That their priorities are aligned like that is neither new or surprising. But it is and has always been alarming. I think it needs to be pointed out that it's wrong, specially when somebody condones the practice.

Last, but not least, democracy is not populism. Some people don't seem to know the distinction these days.

:toast

[ElNono]

How do you reconcile these two posts?


Pretty much.
Neither.
I don't.
Why do you?


Yep, you are an Authoritarian Socialist/Marxist. You believe those who can spend more than their requirement should pay for those who cannot pay for themselves.

Are you sure you know how insurance works?

[RandomGuy]

Hmm.... I guess by your definition, stock holders of major capitolist corporations are socialists. I never thought of WalMart, Exxon, etc. to be socialist endeavors.

Indeed corporations are a form of socialism.

Just as insurance companies socialize the risk of loss from medical events, corporations socialize risk of capital loss from economic events.

Don't get me started on the lack of good corporate governancevin the US (although the US does a LOT better than many other countries). :lol


True. However, insurance should be a choice. Nobody should not be compelled to buy a product they don't want. When you do this, no matter how you want to sweeten the pot, it is authoritarianism at it's worst.

You are forced, by dint of the fact you MUST interact with the economy in general in the exchange of goods and services, to buy into all manner of things you "don't want". You just aren't aware of it.

The only thing that would change would be the manner in which you are forced to do it. Either you can have it up front, where problems can be dealt with in some rational manner, or have it all hidden where endemic inefficiencies will sap economic growth and overall standards of living without correction.

I would rather have everything up front and deal with the problems in a comprehensive manner.


I disagree [that insurance minimizes economic disruption]. Those who cannot pay are already factored in the prices. When you make things cheaper at an individual level, the product gets used more and abused more. The costs can only go up.

Consider the following:
Man without insurance saves a fair amount, then gets in a motor vehicle accident or cancer well beyond his abililty to pay for it. He must then default on his mortgage and his debts. So not only is the cost borne by the hospital and ultimately the insurance companies that actually DO pay, these costs get borne by the people who loaned him money. They must then turn around and charge more for capital than they would otherwise to recoupe THEIR losses.

Now, the people who loaned him money don't normally consider the "healthy" or not factor in their decisions, and couldn't have reasonably foreseen his accident/illness.

The cost shifting goes on regardless of what you think should happen.


The only way to reduce these costs always fall of deft ears. The left will never allow true tort reform, relaxation of some regulations, increasing competition, and increases of co-pays for those on the public take.

Please stop using the thoroughly debunked "if only they would allow tort reform, everything would be magically cheaper and solve all our problems" BS.

Tort reform is happening already, and every rational economic esimtate of the impact is that, while measurable, it is not the panacea always seem to imply it is. Sheesh. I think everybody at this point agrees that 1) it would do something and 2) it wouldn't do so much that it needs to be the a#1 priority.


Health care is not socialism. It is a choice.

????

That is a bit like saying "Eating is not socialism. It is a choice."

I really truly don't get what you are saying here.

[Duff McCartney]

The free market works when you let it.

No...it doesn't. Here's a question, are you opposed to U.S. companies outsourcing jobs overseas?

[Yonivore]

No...it doesn't. Here's a question, are you opposed to U.S. companies outsourcing jobs overseas?
I'm opposed to oppressive government regulation that drives companies to outsource and move operations overseas.

[ElNono]

I'm opposed to oppressive government regulation that drives companies to outsource and move operations overseas.

Really? It has nothing to do with the Chinese working for $1/hour?

[Wild Cobra]

No...it doesn't. Here's a question, are you opposed to U.S. companies outsourcing jobs overseas?
I don't like it, but they are doing what the government pushes them into doing. The tax system needs to be changes to bring employment back here. Tax consumption, not production.

[boutons_deux]

You simplistic fuckers are so duped by corporate/conservative "everything is the govt's fault" bullshit.

What you think will bring jobs back to USA is abolishing "oppressive" EPA, OSHA, contract law, employer-provided health insurance, consumer/product safety, minimum wage, unemployment insurance so Americans, can be ground down, contaminated, killed, and the environment with them, working like Chinese or Indians.

The only way jobs come back to USA is if Americans descend to the same low standard of living and working in fucked up environments as Chinese and Indians do.

Even then US capitalists (and corporate CFOs) know the real returns are from gambling in the financial casinos, not making widgets or being stuck managing complex, messy stuff like human beings.

[Duff McCartney]

It's obvious that Yonivore and Wild Cobra are both slurping the Republican cock. It has nothing to do with government and everything to do with keeping profits high and costs low.

If the government is to blame, it's due to imposing things such as minimum wage, worker safety regulations, and employee healthcare. Things that are non existent in other countries in the world.

By your logic we should get rid of all those things because the government is forcing these companies to go overseas so they don't have to abide by any of those things to keep costs down.

Bottom line when it comes to insurance, it's a business, but you can't run a business when it comes to peoples lives. We're not talking about hamburgers and sneakers, we're talking about life. The insurance companies don't care about people, they just care about dollars because they run their companies like a business. Which they shouldn't do.

[DarrinS]

It's obvious that Yonivore and Wild Cobra are both slurping the Republican cock. It has nothing to do with government and everything to do with keeping profits high and costs low.

If the government is to blame, it's due to imposing things such as minimum wage, worker safety regulations, and employee healthcare. Things that are non existent in other countries in the world.

By your logic we should get rid of all those things because the government is forcing these companies to go overseas so they don't have to abide by any of those things to keep costs down.

Bottom line when it comes to insurance, it's a business, but you can't run a business when it comes to peoples lives. We're not talking about hamburgers and sneakers, we're talking about life. The insurance companies don't care about people, they just care about dollars because they run their companies like a business. Which they shouldn't do.


Hmmmm. They run their companies like a business?

Wow. What a concept.

Moron alert.

[Duff McCartney]

Hmmmm. They run their companies like a business?

Wow. What a concept.

Moron alert.

They should be running them like a non profit. You know where they don't make profits off of the health and misfortune of others.

[Wild Cobra]

They should be running them like a non profit. You know where they don't make profits off of the health and misfortune of others.
This id a free nation. If you believe such things, then get with like-minded people and start one yourself. You can probably get a government grant for start-up money.

Otherwise, stop bashing capitalism and the freedoms we enjoy.

[George Gervin's Afro]

This id a free nation. If you believe such things, then get with like-minded people and start one yourself. You can probably get a government grant for start-up money.

Otherwise, stop bashing capitalism and the freedoms we enjoy.

profit over life.. sums up the GOP nicely.

[Wild Cobra]

profit over life.. sums up the GOP nicely.
My God man.

People are free to do with thier money as they please. Without personal assets, would we have the health care system we have?

Rather than complain about the freedoms of this nation, put your money where your mouth is, or STFU.

[ElNono]

People are free to do with thier money as they please. Without personal assets, would we have the health care system we have?


You mean one of the most expensive in the world that provide diminished returns for that money? Or the one that leaves millions of people uninsured or underinsured? How about the one that causes over half of bankruptcies in the country? If it's such a good system, why does it dump the high risk people to a public funded system that both you and I have to pay for?

Is life just for those that can afford to stay alive? This is the very first question we need to answer.

Then we can discuss how to improve the status quo. But don't come telling me the status quo is fine and dandy.

[Wild Cobra]

You mean one of the most expensive in the world that provide diminished returns for that money? Or the one that leaves millions of people uninsured or underinsured? How about the one that causes over half of bankruptcies in the country? If it's such a good system, why does it dump the high risk people to a public funded system that both you and I have to pay for?
Will you please get off that soapbox and be constructive, rather than just ranting and raving?

This is a free nation. People are free to form a corporation. If you think there is a better way, then put your money where your mouth is rather than being an authoritarian bitch, telling people what to do with their money.

[ElNono]

Will you please get off that soapbox and be constructive, rather than just ranting and raving?

How about you answer the questions instead of deflecting them?


This is a free nation. People are free to form a corporation. If you think there is a better way, then put your money where your mouth is rather than being an authoritarian bitch, telling people what to do with their money.

Why does it has to be through a corporation? Why couldn't it be through, say, a cooperative? Plenty of non-profits out there that 'put their money where their mouth is'.

Explain to me how non-profits are 'authoritarian' and 'tell people what to do with their money'...

[Wild Cobra]

Why does it has to be through a corporation? Why couldn't it be through, say, a cooperative? Plenty of non-profits out there that 'put their money where their mouth is'.

Explain to me how non-profits are 'authoritarian' and 'tell people what to do with their money'...
You missed my point.

Stop complaining about the corporations. If you don't like how they operate, put in your own money with like minded individuals, and start your own non-profit. Stop trying to tell others how to operate. It's simple If you can make a more cost effective health care operation, you can put the others out of business, or force them to lower their costs.

Competition works!

I'm not saying non-profits are authoritarian. I'm saying you are!

[ElNono]

You missed my point.

Stop complaining about the corporations. If you don't like how they operate, put in your own money with like minded individuals, and start your own non-profit. Stop trying to tell others how to operate. It's simple If you can make a more cost effective health care operation, you can put the others out of business, or force them to lower their costs.

Competition works!

Works so well that we have one of the most expensive healthcare systems in the world that has diminished results to show for it.
It's so great that we have millions of people excluded from proper coverage!
If the free market is so great, why do they need to dump old people that are most likely to require the most coverage to a public funded system?
Perhaps the Free Market doesn't work that well for healthcare?

You can keep on singing the Free Market praises, but we have decades of history that prove you wrong as far as healthcare is concerned.

Is life just for those that can afford to stay alive? This is the very first question we need to answer.

And there are non-profits that attempted to compete. But corporations know how to dump prices temporarily to gain a market or drive competition out of business. The healthcare pie is too big to just walk away from it. That's exactly why you see the amount of lobbying that you see. Short of government intervention, you're not going to take these people out of the business.

I repeat, I don't like the current proposition any more than you do. But for real reform, we need to contemplate the fact that the currently for-profit corporation run system compounds the healthcare costs problem, not help it.

[Wild Cobra]

And there are non-profits that attempted to compete. But corporations know how to dump prices temporarily to gain a market or drive competition out of business. The healthcare pie is too big to just walk away from it. That's exactly why you see the amount of lobbying that you see. Short of government intervention, you're not going to take these people out of the business.

If that's what's stopping the non-profits, then simply petition congress making it illegal to sell health services at a loss.

[boutons_deux]

"Competition works"

In some markets, but not in for-profit health insurance.

"make a more cost effective health care operation"

barriers to entry are too high. That's why half-measures like insurance exchanges, restricted to within a state regulation jurisdiction, are doomed. They can't obtain the critical mass to cover even the no-profit low overheads.

A national public option for all (including employees free to stop their group insurance, rather than being forced to have the group plans "crammed down their throats") with a pool of tens of millions with a year, and over 100M in a couple of years.

To make a national public option competitive with for-profit employer group plans, 75% of the public option premiums are payable before tax, just like group plans. Why a tax break for-profit insurance but no tax-break for no-profit public option?

America loves self-starting entrepreneurs (a fucking myth) but self-employed entrepreneurs pay 18% more for the individual insurance vs same coverage for a group plan, AND pay for health insurance after taxes.

That tax policy exposes the entrepreneurial myth: "don't be sucker working for yourself, go work in some corp as a wage slave".

[ElNono]

If that's what's stopping the non-profits, then simply petition congress making it illegal to sell health services at a loss.

So now you want government regulation? Make up your mind.

[Wild Cobra]

So now you want government regulation? Make up your mind.
I never said some regulations weren't necessary. Selling a service below cost to break competition is an unscrupulous practice that I have no problem putting a stop to.

Thing is, I have never heard of what you speak of. I assume you're being honest, but for all I know, you're making it up.

What ever you want as a solution, I will not accept one that harms legitimate business practices. If you say a non-profit is the way to go, then look for solutions to that end instead of excuses why it cannot be done.

[boutons_deux]

"Selling a service below cost to break competition is an unscrupulous practice that I have no problem putting a stop to."

"Killing" the competition is as American as apple pie, as is killing, wars, and guns in general. In fact, it's every businessman's wet dream, to run a monopoly like Bill Gates' (Gates used a dirty trick to kill DR-DOS).

What's unscrupulous about a large corp selling at or below cost to kill the competition? dog-eat-dog predation is The Great American Way.

[ElNono]

I never said some regulations weren't necessary. Selling a service below cost to break competition is an unscrupulous practice that I have no problem putting a stop to.

Thing is, I have never heard of what you speak of. I assume you're being honest, but for all I know, you're making it up.

What ever you want as a solution, I will not accept one that harms legitimate business practices. If you say a non-profit is the way to go, then look for solutions to that end instead of excuses why it cannot be done.

Legitimate business practices makes sense where legitimate business make sense.
You diligently skipped over the part of my post where the free market has been historically unable to provide better care or lower costs for the amount spent on those business. What they have been able to do, however, is to show their profit growth year after year. So, as far as free market business go, they're doing real well. The thing is, unless you're a shareholder, do you care about their profits or you care about affordable and accesible care?

Again, you keep avoiding the question, but this is what this really amounts to:
Is life only for those that can afford to stay alive?

I suspect that your answer to this question is a resounding Yes, but you don't really have the balls to publicly say it. And this is intrinsically where we differ.

[Wild Cobra]

"Selling a service below cost to break competition is an unscrupulous practice that I have no problem putting a stop to."

"Killing" the competition is as American as apple pie, as is killing, wars, and guns in general. In fact, it's every businessman's wet dream, to run a monopoly like Bill Gates' (Gates used a dirty trick to kill DR-DOS).

What's unscrupulous about a large corp selling at or below cost to kill the competition? dog-eat-dog predation is The Great American Way.
Your knowledge of the Digital Research issues is obviously flawed. That said, I don't like Micro Soft, or their practices. However, you portrayal is wrong, and again you prove yourself a fool.

P.S...

I was using CPM in the late 80's.

[Wild Cobra]

You diligently skipped over the part of my post where the free market has been historically unable to provide better care or lower costs for the amount spent on those business.

That's because you want an absolute answer to a question that isn't that simple. I have stated several facets of this in the past. You refuse to acknowledge that lawsuits and regulations make the USA system one of the most expensive, and that those under foreign government care don't have the same legal recourse.

I will say this. I honestly believe that private, for profit systems, are more cost effective than a USA government bureaucracy administering the same care, under the same regulations and threat of suit.


What they have been able to do, however, is to show their profit growth year after year. So, as far as free market business go, they're doing real well. The thing is, unless you're a shareholder, do you care about their profits or you care about affordable and accesible care?

I'm sorry you don't care about others. I do. I don't know is any of my mutual funds carry any significant health care stocks, but I would never be unconcerned to the stock profits of others, just because I didn't have any. You continually take stances that are against the heart of America. How about moving back to your home nation. Take some of the other liberals here with you.


Again, you keep avoiding the question, but this is what this really amounts to:
Is life only for those that can afford to stay alive?

In some cases, yes. If we are just prolonging the natural process of death, then why should it come from others? If individuals who can pay for it, do, then fine. However, should others pay the cost, just because people are afraid of the next life?


I suspect that your answer to this question is a resounding Yes, but you don't really have the balls to publicly say it. And this is intrinsically where we differ.

It is yes. Thing is, I don't see health care as a right. I believe as a people, we have the morality to help others, but there is still only so much we can do, and nothing should be imposed on those who don't want to help others. What's next after your dream of covering everyone with 100% of all medical procedures available?

Buy everyone their own island?

To me, what you desire is about as practical as giving every US citizen 20 ounces of gold. There isn't enough in the world to do that.

[boutons_deux]

"Your knowledge of the Digital Research issues is obviously flawed. "

you go first with how Bill Gates and his lawyer father destroyed the OS competition. You're ideological bullshit is always entertaining.

[Wild Cobra]

"Your knowledge of the Digital Research issues is obviously flawed. "

you go first with how Bill Gates and his lawyer father destroyed the OS competition. You're ideological bullshit is always entertaining.
Once the OS was selected by IBM, game over. It became the industrial standard. This isn't that same as health care. Can we be done with this tangent now? If you wish to continue, start a new thread. These are my last words on the topic in this thread.

[ElNono]

That's because you want an absolute answer to a question that isn't that simple. I have stated several facets of this in the past. You refuse to acknowledge that lawsuits and regulations make the USA system one of the most expensive, and that those under foreign government care don't have the same legal recourse.

It's been repeatedly shown to you that lawsuits and payments to such lawsuits only account for 6% of the total spending on care. Furthermore, what you tout as the savior has already been implemented in the state of Texas, and has not produced the savings you claim.

That you keep ignoring the facts is really irrelevant. Your proposed solutions to the problem have been attempted and do not work.


I will say this. I honestly believe that private, for profit systems, are more cost effective than a USA government bureaucracy administering the same care, under the same regulations and threat of suit.

You say it, and I honestly think you believe it. But reality does not agree with you. Then again, it doesn't have to be for-profit or the government. Not everything is black or white. Perhaps there's a private non-profit way to do this, or some other combination.


I'm sorry you don't care about others. I do. I don't know is any of my mutual funds carry any significant health care stocks, but I would never be unconcerned to the stock profits of others, just because I didn't have any. You continually take stances that are against the heart of America. How about moving back to your home nation. Take some of the other liberals here with you.

We simply care about different things. The last thing I'm concerned about is the stock profits of others. I am concerned, however, that those who are not as fortunate as you or I can be healthy and be productive members of this nation. That a temporary illness won't set them back 10 or 15 years.
And honestly, I'm going to do exactly the opposite of what you ask me to do. I'm going to apply for my American citizenship as soon as I'm qualified and I'm going to make sure I can vote to keep you, the ones that think stock profits rule over the wellbeing of a nation, in the minority.


In some cases, yes. If we are just prolonging the natural process of death, then why should it come from others? If individuals who can pay for it, do, then fine. However, should others pay the cost, just because people are afraid of the next life?

Have you ever heard of the Hippocratic Oath? Medicine is much more than a for-profit venture. We strive to have a healthy society of individuals so they can contribute to it, so we all can reap the benefits.


It is yes. Thing is, I don't see health care as a right. I believe as a people, we have the morality to help others, but there is still only so much we can do, and nothing should be imposed on those who don't want to help others. What's next after your dream of covering everyone with 100% of all medical procedures available?

I don't see healthcare as a right either. That said, I see it as an important pillar of a nation, much like security, or other services that the state provides for the well being of it's citizens. I'm actually a realist, and I understand that's impossible to provide everyone with 100% of all medical procedures, and stated so plenty of times (that you just to ignore it doesn't make it any different).

I also find it very hypocritical from you that you feel like lecturing me about not caring for other people then proceed to defend those that don't want to help others in the next paragraph. Again, I don't think you have thought this through very well.



Buy everyone their own island?
To me, what you desire is about as practical as giving every US citizen 20 ounces of gold. There isn't enough in the world to do that.

I don't think buying an island for everyone will be a betterment to society, no. I don't think handing gold to everyone is either. But I'm starting to get a feel that you really don't know what you're talking about, and that's probably why you felt those things are similar to affordable, accessible health care.

What would be next up would be another topic that I feel needs to be addressed at some point, and that is the spiraling costs of tertiary education. But that's a different topic for a different thread.

[Wild Cobra]

I don't believe the 6% figure, never seen any reliable sources. It is impossible for the direct and indirect costs to be that low. It costs doctors with many specialties $250k to $300k per year for insurance due to the legal system abuses. If that is only 6% the cost, then how much do you pay an hour for a doctor visit?

As for me getting a bit silly on the topic, it's simply because I am growing tired of the topic. Texas did not do tort reform correctly. To use them as an example, against me, is wrong. We have addressed this aspect before.

[Marcus Bryant]

Screw "cost" as a rationale for limiting potential legal liability from medical errors.

My God, can both major "sides" in this forum kill themselves off?

[boutons_deux]

"It is impossible for the direct and indirect costs to be that low."

To your ideological bias, of course. Facts can be ignored.

The tort-reform-as-making-diff-in-reducing-health-costs myth has been deflated by everyone who has looked at the stats.

The actual medical malpractice payouts are a tiny part of the total national health care cost, and then only a tiny portion of those are "frivolous". 6% of total health care costs way higher than any number I've ever seen.

"It costs doctors with many specialties $250k to $300k per year for insurance due to the legal system abuses"

Across 900K US doctors, the average malpractice insurance price is about $1000/month. iow, about the same avg price as the health insurance for a family of 4. Of course, the avg doctor makes a lot more than the avg family of 4.

[Wild Cobra]

The tort-reform-as-making-diff-in-reducing-health-costs myth has been deflated by everyone who has looked at the stats.

Not by any stats I've seen. Link please.


The actual medical malpractice payouts are a tiny part of the total national health care cost, and then only a tiny portion of those are "frivolous". 6% of total health care costs way higher than any number I've ever seen.

That is the direct cost associated with are sue crazy society. Have a figure for the indirect costs?


Across 900K US doctors, the average malpractice insurance price is about $1000/month. iow, about the same avg price as the health insurance for a family of 4. Of course, the avg doctor makes a lot more than the avg family of 4.
Never seen that before. Link please?

[Marcus Bryant]

Unless malpractice insurance can be shown to negatively impact the quality of care, why exactly is a putative "conservative" concerned about its cost?

[ElNono]

I don't believe the 6% figure, never seen any reliable sources. It is impossible for the direct and indirect costs to be that low. It costs doctors with many specialties $250k to $300k per year for insurance due to the legal system abuses. If that is only 6% the cost, then how much do you pay an hour for a doctor visit?

There's plenty of studies available if you're actually willing to change your mind on the subject, which you clearly are not:

http://www.cbo.gov/ftpdocs/49xx/doc4968/01-08-MedicalMalpractice.pdf
http://findarticles.com/p/articles/mi_qa3622/is_200804/ai_n31109179/?tag=content;col1

Article pointing to some more studies:
http://www.bloomberg.com/apps/news?pid=20601087&sid=az9qxQZNmf0o


As for me getting a bit silly on the topic, it's simply because I am growing tired of the topic. Texas did not do tort reform correctly. To use them as an example, against me, is wrong. We have addressed this aspect before.

It just so happens that you grow tired very quickly of topics where your ideals don't align with reality. This is one of those cases.

[ElNono]

Not by any stats I've seen. Link please.

That is the direct cost associated with are sue crazy society. Have a figure for the indirect costs?

Never seen that before. Link please?

Now you have the links. Are you going to read them?

According to the CBO, it's 2%... I grew it all a 4% considering it's a 6 year old report, but we both know that's being VERY generous.

[Marcus Bryant]

One would think a "conservative" would be hesitant to interfere with our common law tradition.

If the quality of care is generally improved by the cost of malpractice insurance, instead of negatively affected by the moral hazard of insurance, what's the problem?

[ElNono]

If the quality of care is generally improved by the cost of malpractice insurance, instead of negatively affected by the moral hazard of insurance, what's the problem?

He's not concerned with quality of care. He's concerned about protecting his little sand castle.

[ElNono]

Also, let's not forget that trial lawyers have a honest and legitimate business too.

Why do you want to take their business away?
Why are you an authoritarian, WC?

[Wild Cobra]

Unless malpractice insurance can be shown to negatively impact the quality of care, why exactly is a putative "conservative" concerned about its cost?
I assume you mean me...

LOL... I actually had to look up putative. Thanks for expanding my vocabulary.

I would like to see the costs go down. I am no expert at what makes the health care system work, but I do know it is far costlier than it should be. I am not opposed to the profits the people make. If someone wished to form nonprofit clinics and hospitals, I say, more power to them. I simply do not like the way our system of justice has been twisted, and we need some serious tort reform. We have an overreaching government, that often with good intent, makes things worse. I simply want to see a more relaxed system, and litigation only when there is just cause for it. I honestly believe that these two things are the first things that must be done to keep a free market health care system, and reduce costs substantially.

Think about this. If the government turns around and effectively runs health care, will you be able to sue at all? Part of the reason single payer systems work, is because you cannot sue the government for health care. They remove those costs on the system.

[Wild Cobra]

Also, let's not forget that trial lawyers have a honest and legitimate business too.

Why do you want to take their business away?
Why are you an authoritarian, WC?
Wow...

Trivial tit for tat...

I draw the line on some activities. Some trial lawyers are good decent hard working people, and champion honorable causes. Most are scumbags, not much better than pedophiles.

I have no respect for most trial lawyers. They are vultures looking for a kill.

[Marcus Bryant]

That's irrelevant to the discussion regarding insurance's role. Prices would likely fall, but still be in the zone where insurance was originally designed to function...as...ummm...insurance against catastrophic circumstances.

Yes. The primary problem is that health insurance is used to cover routine medical expenditures instead of the big ticket items.

Further, there are plenty of distortions in the health care industry wrought by governments in these United States, such as limits on the number of hospitals (which, of course, existing hospitals influence through the political process) and the exclusion of employer provided health care benefits form the income tax.

Naturally, the health care "reform" plan in the works today would simply double down on the existing flaws.

And naturally the major solutions before us are to increase the power of the state (and insurers) or the power of the insurers and providers.

I never thought I'd see alleged liberal Democrats push through a law which would mandate that working class and middle class families have to hand over a chunk of their income annually to Fortune 100 companies. But they are no longer the party's true constituency. Just like the small business owner and professional class are no longer the true constituency of the GOP.

[Marcus Bryant]

I assume you mean me...

LOL... I actually had to look up putative. Thanks for expanding my vocabulary.

I would like to see the costs go down. I am no expert at what makes the health care system work, but I do know it is far costlier than it should be. I am not opposed to the profits the people make. If someone wished to form nonprofit clinics and hospitals, I say, more power to them. I simply do not like the way our system of justice has been twisted, and we need some serious tort reform. We have an overreaching government, that often with good intent, makes things worse. I simply want to see a more relaxed system, and litigation only when there is just cause for it. I honestly believe that these two things are the first things that must be done to keep a free market health care system, and reduce costs substantially.

Think about this. If the government turns around and effectively runs health care, will you be able to sue at all? Part of the reason single payer systems work, is because you cannot sue the government for health care. They remove those costs on the system.

So instead of one flavor of fascism, you'd replace it with another.

[ElNono]

Yes. The primary problem is that health insurance is used to cover routine medical expenditures instead of the big ticket items.

Further, there are plenty of distortions in the health care industry wrought by governments in these United States, such as limits on the number of hospitals (which, of course, existing hospitals influence through the political process) and the exclusion of employer provided health care benefits form the income tax.

Naturally, the health care "reform" plan in the works today would simply double down on the existing flaws.

And naturally the major solutions before us are to increase the power of the state (and insurers) or the power of the insurers and providers.

I never thought I'd see alleged liberal Democrats push through a law which would mandate that working class and middle class families have to hand over a chunk of their income annually to Fortune 100 companies. But that is no longer the party's true constituency. Just like the small business owner and professional class is no longer the true constituency of the GOP.

Bingo

[ElNono]

Wow...

Trivial tit for tat...

I draw the line on some activities. Some trial lawyers are good decent hard working people, and champion honorable causes. Most are scumbags, not much better than pedophiles.

I have no respect for most trial lawyers. They are vultures looking for a kill.

It's not trivial at all. You want to force a legitimate business practice to be legislated away, even when you say there's a portion of those people that are 'good decent hard working people, and champion honorable causes'.

Now, I don't like trial lawyers any more than you do. And I spoke about meaningful tort reform as part of a complete overhaul. In that aspect, I've been completely consistent.

But when you call somebody an authoritarian, the first thing you need to do is look at yourself in the mirror.

[Wild Cobra]

Yes. The primary problem is that health insurance is used to cover routine medical expenditures instead of the big ticket items.

Further, there are plenty of distortions in the health care industry wrought by governments in these United States, such as limits on the number of hospitals (which, of course, existing hospitals influence through the political process) and the exclusion of employer provided health care benefits form the income tax.

Naturally, the health care "reform" plan in the works today would simply double down on the existing flaws.

And naturally the major solutions before us are to increase the power of the state (and insurers) or the power of the insurers and providers.

I never thought I'd see alleged liberal Democrats push through a law which would mandate that working class and middle class families have to hand over a chunk of their income annually to Fortune 100 companies. But that is no longer the party's true constituency. Just like the small business owner and professional class is no longer the true constituency of the GOP. Bingo
Well, here is something we agree on.

I have stressed at times that the out of pocket costs once you have insurance is too cheap. this makes people repeately abuse the system for a runny nose, or cramps, etc. at times just to get an excuse not to show up for work. When a docor's vist=it only costs a $10 to $25 co-pay... How many people even think twice before making a visit that the doctor bills the insurance company $1000+ for?

[Marcus Bryant]

I know I'd want to be able to hire a scumbag trial lawyer to go after an incompetent surgeon who fucked up the life of myself or a loved one and would prefer that a bunch of retards didn't vote in some limits on the legal liability of incompetent surgeons and their insurers.

[ElNono]

I know I'd want to be able to hire a scumbag trial lawyer to go after an incompetent surgeon who fucked up the life of myself or a loved one and would prefer that a bunch of retards didn't vote in some limits on the legal liability of incompetent surgeons and their insurers.

I also would like you to be the beneficiary of most, if not all of the proceeds from said trial. Unfortunately, that's not necessarily the case these days.

[ElNono]

Well, here is something we agree on.

I have stressed at times that the out of pocket costs once you have insurance is too cheap. this makes people repeately abuse the system for a runny nose, or cramps, etc. at times just to get an excuse not to show up for work. When a docor's vist=it only costs a $10 to $25 co-pay... How many people even think twice before making a visit that the doctor bills the insurance company $1000+ for?

It's not people that abuse the system. When a doctor bills $1000 to the insurance company, then it's the doctor that's abusing the system. And the insurance is complicit in paying back 'just' $500 for something that costs $100 tops (doctor saw the patient for 5 mins and wrote a prescription for a antibiotic).

[Wild Cobra]

It's not people that abuse the system. When a doctor bills $1000 to the insurance company, then it's the doctor that's abusing the system. And the insurance is complicit in paying back 'just' $500 for something that costs $100 tops (doctor saw the patient for 5 mins and wrote a prescription for a antibiotic).
Well, if the doctor is one that has to pay the $300,000 annual insurance, then that 5 minute visit already starts at $30 bux or more just to pay the insurance. Now that 5 minute visit probaly takes at least 15 minutes of the doctors time for prepping, reviewing records, writing records, prescription... Now we are up to at least $90 just for the doctor's insurance payment. Then there is paying the staff, rent, utilities, wages to self, etc as well.

How do you expect to change any of these billing practices just by getting the government more involved?

[Wild Cobra]

I know I'd want to be able to hire a scumbag trial lawyer to go after an incompetent surgeon who fucked up the life of myself or a loved one and would prefer that a bunch of retards didn't vote in some limits on the legal liability of incompetent surgeons and their insurers.
well, that's where I disagree with the tort reform that Texas has. I have said this before, have your forgotten?

I am against frivolous lawsuits.

Any medical procedure can have risk, not the fault or the doctor or hospital involved. I would say that most things people sue for should have no merit.

When there is real malpractice, I say the sky is the limit for compensation!

[Marcus Bryant]

What makes a lawsuit "frivolous"?

[ElNono]

Well, if the doctor is one that has to pay the $300,000 annual insurance, then that 5 minute visit already starts at $30 bux or more just to pay the insurance. Now that 5 minute visit probaly takes at least 15 minutes of the doctors time for prepping, reviewing records, writing records, prescription... Now we are up to at least $90 just for the doctor's insurance payment. Then there is paying the staff, rent, utilities, wages to self, etc as well.

How do you expect to change any of these billing practices just by getting the government more involved?

Have you read the links I provided? Because you keep on spewing the same bullshit it doesn't make it true. It would be a good start if we dispell the myths you keep on resorting to and we can actually move to meaningful conversation.

I'm also going to ask you where did you get that $300,000 annual insurance price, and how do you break it down to a per-patient cost. Links please.

[boutons_deux]

"Once the OS was selected by IBM, game over"

:lol, I knew you'd have it wrong. end of sub-thread

[Wild Cobra]

What makes a lawsuit "frivolous"?
I'm not going to attempt to define that here. It would be complicated.

[Duff McCartney]

As much as I would love to have universal health coverage, I don't even think you need to have that in order to drastically change the health care in this country.

Simply putting caps on the price of drugs and making it illegal for insurance companies to make a profit on basic care would be enough. It would lower the price of healthcare and insurance costs drastically!

http://www.slate.com/id/2145400/


After all, including legal fees, insurance costs, and payouts, the cost of the suits comes to less than one-half of 1 percent of health-care spending.

From a book by a law professor at UCONN.

Also, the United States should make preventative care a top priority. Helping prevent many of the illnesses would also drastically reduce the frequency of emergency room visits.

[Marcus Bryant]

I'm not going to attempt to define that here. It would be complicated.

Surely it can't be that difficult.

[Wild Cobra]

Surely it can't be that difficult.
I spend too much time here as it is. I simply am not willing to take the time required. I have better uses for my time. I have made some simple outlines in the past, I will leave it as that. Even if I took the time to explain, reference, etc. Would you accept it? I see continuing such an endeavor a simple waste of time. please accept that.

[Marcus Bryant]

If you've laid it out in the past, surely a brief description would be at your command and fit within your circumscribed time allotted for participation in this forum.

[ElNono]

If you've laid it out in the past, surely a brief description would be at your command and fit within your circumscribed time allotted for participation in this forum.

He'll be more than glad to explain to you all that is wrong with global warming. You just have to ask...

[Duff McCartney]

I spend too much time here as it is. I simply am not willing to take the time required. I have better uses for my time. I have made some simple outlines in the past, I will leave it as that. Even if I took the time to explain, reference, etc. Would you accept it? I see continuing such an endeavor a simple waste of time. please accept that.

From the same article I linked to.

"But a new study, released in May, demolishes that possibility. Dr. David Studdert led a team of eight researchers from Harvard School of Public Health, Brigham and Women's Hospital, and the Harvard Risk Management Foundation* who examined 1,452 medical malpractice lawsuits. They found that more than 90 percent of the claims showed evidence of medical injury, which means they weren't frivolous. In 60 percent of these cases, the injury resulted from physician wrongdoing. In a quarter of the claims, the patient died.

When baseless medical malpractice suits were brought, the study further found, the courts efficiently threw them out. Only six of the cases in which the researchers couldn't detect injury received even token compensation. Of those in which an injury resulted from treatment, but evidence of error was uncertain, 145 out of 515 received compensation. Indeed, a bigger problem was that 236* cases were thrown out of court despite evidence of injury and error to patients by physicians."

[Winehole23]

If you've laid it out in the past, surely a brief description would be at your command and fit within your circumscribed time allotted for participation in this forum.Pleaded exigency, but his complaint was lengthy.

[LnGrrrR]

It's really a Catch-22. Doctors are afraid of getting sued, so they run lots of expensive tests that aren't necessary. This drives up the price.

If they DON'T order all these tests, and something comes up, they face the possibility of being sued.

So then, the person only pays a small co-pay for a large amount of expensive tests, which get billed to the insurance co. They in turn raise rates... etc etc, until insurance is ridiculously expensive.

As bad as it sounds, I only see two ways of getting around the issue:

1) Making consumers face the real cost, and choose how much they wish to be tested - This seems a bit inhumane, as poor people might get screwed

2) Putting people on the government dole, but setting strict cost limits, or as idiots would call them, "death panels" - Extra cost for the taxpayer, but increases the chances that poor people could be given adequate tests to determine sickness

[ElNono]

It's really a Catch-22. Doctors are afraid of getting sued, so they run lots of expensive tests that aren't necessary. This drives up the price.

If they DON'T order all these tests, and something comes up, they face the possibility of being sued.

So then, the person only pays a small co-pay for a large amount of expensive tests, which get billed to the insurance co. They in turn raise rates... etc etc, until insurance is ridiculously expensive.

As bad as it sounds, I only see two ways of getting around the issue:

1) Making consumers face the real cost, and choose how much they wish to be tested - This seems a bit inhumane, as poor people might get screwed

2) Putting people on the government dole, but setting strict cost limits, or as idiots would call them, "death panels" - Extra cost for the taxpayer, but increases the chances that poor people could be given adequate tests to determine sickness

The very first reform on tort should be 'loser pays'. That right there would stop a barrage of lawsuits that are nothing more than a fishing expedition, plus it would recoup a doctor's money spent on defending himself.
It would also keep the valid lawsuits standing and able to get proper relief.
There always will be some instance of some lawsuit decided by a technicality that would throw off the fairness of it all a bit, but if we trust our justice system to be fair (and there's no indication that it isn't), then those should be the minority.

That said, I invite you to read the reports I posted in a previous post. You'll see that malpractice lawsuits and it's associated costs (defensive medicine, payments) really contribute minimally in the overall cost of healthcare. Certainly less than people think.

[RandomGuy]

Works so well that we have one of the most expensive healthcare systems in the world that has diminished results to show for it.
It's so great that we have millions of people excluded from proper coverage!
If the free market is so great, why do they need to dump old people that are most likely to require the most coverage to a public funded system?
Perhaps the Free Market doesn't work that well for healthcare?

There is a useful term/concept for anyone grappling with the concept of health insurance, or any other insurance for that matter.

"Adverse selection"

Basically the people who tend to need any type of insurance the most will be the ones most likely to buy that type of insurance.

Insurance companies, for their part will tend to control their losses (i.e. payouts) insofar as possible to maximize their profitability. This means:

"Aggressively" closing claims by paying as little as they can get away with, regardless of what is fair/reasonable.

"Recission" of policies, i.e. claiming the policy contract was "fraudulent on its face" and thus completely invalid, due to some minor oversight in the application that they magically find the instant you make a claim, but ignored for the six years you were paying them premiums.

[RandomGuy]

The very first reform on tort should be 'loser pays'.

You get injured in an accident at work.

You make a good faith claim on the workers' compensation insurance company.

They have millions of dollars to spend on lawyers, and deny your claim. You are now unemployed, unable to work, and bankrupt from medical bills.

How do you then enforce the perfectly valid contract? Sue them?

Beware of the Law of Unintended Consequences.

The problem with that particular reform is that the party with more resources to spend at trial WILL win eventually.

The deck is already stacked in favor of the party with more money.

[ElNono]

You get injured in an accident at work.

You make a good faith claim on the workers' compensation insurance company.

They have millions of dollars to spend on lawyers, and deny your claim. You are now unemployed, unable to work, and bankrupt from medical bills.

How do you then enforce the perfectly valid contract? Sue them?

Beware of the Law of Unintended Consequences.

The problem with that particular reform is that the party with more resources to spend at trial WILL win eventually.

The deck is already stacked in favor of the party with more money.

If you have a valid and legitimate case, there's no reason why your claim should be denied, or enforced by a judge when you sue.
You should take a look at the rich history of loser-pays abroad (or the "English rule" if you're in the UK). If it's just a way for the rich to abuse the poor, then why is it that social democracies in places like the Netherlands and Sweden use it? If it's so unfair to the middle class, why does people from Toronto all the way to Sydney put up with it?

There has been ample attempts to do away with it, specially in countries where the influence of american legal academics are stronger (mostly English-speaking countries). But they consciously reject the well known american alternative over and over again. Which really points to the durability of the rule.

The reality is that loser-pay discourages unnecessary litigation. It also does away with the extortion that is no longer so thinly veiled of strong-arming opponents into a settlement because of the prospective costs of the process or the risk of a fluke outcome. It also forces the parties to size up their prospects more realistically before suing.

It's by no means a perfect system. But it's a system that penalizes heavily frivolous lawsuits, and it's a more fair system overall.

[boutons_deux]

"Simply putting caps on the price of drugs"

The Repugs explicitly made it illegal for the feds as a single-buyer to negotiate drug prices with BigPharma. The business-friendly Repugs never met a consumer or citizen or employee they wouldn't fuck over to enrich or protect businesses.

"making it illegal for insurance companies to make a profit on basic care would be enough"

Operating health insurers as regulated public utilities in the interest of public welfare (as electricity and water used to be before deregulation fucked that up, too) makes a lot of sense. Making sense is adult, ain't go no fucking adults in DC. Health care and insurance are privileges to those rich enough to be raped by it, they aren't human rights.

[boutons_deux]

"lawsuits that are nothing more than a fishing expedition"

give us some "fishing expedition" stats in the context of the all medical malpractice suits, or STFU. Injury lawyers work on contingency, won't waste their time on fishing.

Thanks to TX tort reform (aka screw the injured/dead patient), lawyers in TX won't touch many (legit, and most are legit as all stats show. 90K avoidable medical error deaths/year) medical malpractice claims now because they work on 30% contingency, and 1/3 of $250K isn't worth their time. Effectively, TX tort reform has slammed the courthouse door on legit victims.

[boutons_deux]

"Doctors are afraid of getting sued, so they run lots of expensive tests that aren't necessary"

Doctors also mark up the test costs by 100% (LabCorp or Quest charges them $75, you pay $150), so it's in their interest to order tests (there have been cases where docs own the labs, too, but I think most states make conflict-of-interest illegal).

As I've reported earlier, I had a quote for a procedure $137K if insured, $37K non-insured. Which price do you think represents the true cost to deliver the procedure? This situation leads me to believe there is a price list when the provider can bill the insurance company, and a much lower, negotiable price for non-insured.

[101A]

Rather than reply to a specific post, just thought I'd throw this out there.

Lots of griping and discussion about insurance company profits.

Blue Cross/Blue Shield (and all iterations of them - provide insurance to 100 million Americans) are non-profit.

[boutons_deux]

"Blue Cross/Blue Shield are non-profit."

Profits aren't the only non-care costs non-govt insurers incur.

If BCBS were run as efficiently as 5%-overhead-Medicare/Medicaid/VA, then BCBS would destroy the for-profit insurers.

[101A]

"Blue Cross/Blue Shield are non-profit."

Profits aren't the only non-care costs non-govt insurers incur.

If BCBS were run as efficiently as 5%-overhead-Medicare/Medicaid/VA, then BCBS would destroy the for-profit insurers.


That 5% number is bogus.

Because of the cost of treating Sick people, vs. healthy people - percentages are a bad barometer of efficiency.

Since I own a company that processes health insurance claims, I can speak directly to this.

It doesn't cost appreciably less to adjudicate a claim for a normal live birth at a hospital ($1,500), that it does to process a "routine" heart transplant ($150,000), although there is a 10,000% difference in their prices. So, if it costs me $26 to do either; one of them is a much higher percentage of costs (and can be disingenuously used to demonstrate inefficiency).

My company adjudicates 100 X's more births than heart transplants. Medicare pays for NO births - because only people over 65 have Medicare; who have EXPENSIVE procedures all the time. On a per claim basis, private companies are more efficient than Medicare.

[coyotes_geek]

If BCBS were run as efficiently as 5%-overhead-Medicare/Medicaid/VA, then BCBS would destroy the for-profit insurers.

Yes, things would be so much better if all insurance providers could be run as "efficiently" as the program with a $40 trillion dollar unfunded liability.................

[ElNono]

"lawsuits that are nothing more than a fishing expedition"

give us some "fishing expedition" stats in the context of the all medical malpractice suits, or STFU. Injury lawyers work on contingency, won't waste their time on fishing.

According to AMA, "Physicians are found not negligent in over 90 percent of cases that go to trial"... from here (http://www.ama-assn.org/ama1/pub/upload/mm/-1/case-for-mlr.pdf)

And frivolous lawsuits exist, wether you like it or not... if the fish you're after is big enough, you'll always have a lawyer willing to take the case.

[ElNono]

Rather than reply to a specific post, just thought I'd throw this out there.

Lots of griping and discussion about insurance company profits.

Blue Cross/Blue Shield (and all iterations of them - provide insurance to 100 million Americans) are non-profit.

Not since 1994, when... "the Blue Cross Blue Shield Association changed to allow its licensees to be for-profit corporations."... from here (http://en.wikipedia.org/wiki/Blue_Cross_and_Blue_Shield_Association)

[coyotes_geek]

I got curious about how many Americans are currently covered under non-profit insurance so I did some googling and found this (http://www.healthinsurancecolorado.net/blog1/2009/01/14/non-profit-does-not-necessarily-mean-low-cost/).

.....according to the data from the Alliance for Advancing Non Profit Health Care, 48% of Americans with private health insurance are covered by non-profit plans.....

Given that, and that the for-profit insurance providers have profit margins in the 3%-5% range, it doesn't look like "non-profit" is going to be the answer to this problem.

[101A]

Me = pwned.

Apparently (some) are still not-for-profit; not sure which ones.

[ElNono]

I got curious about how many Americans are currently covered under non-profit insurance so I did some googling and found this (http://www.healthinsurancecolorado.net/blog1/2009/01/14/non-profit-does-not-necessarily-mean-low-cost/).

.....according to the data from the Alliance for Advancing Non Profit Health Care, 48% of Americans with private health insurance are covered by non-profit plans.....

Given that, and that the for-profit insurance providers have profit margins in the 3%-5% range, it doesn't look like "non-profit" is going to be the answer to this problem.


Me = pwned.

Apparently (some) are still not-for-profit; not sure which ones.

101A, no big deal.

One thing that needs to be noted is that non-profit plans doesn't necessarily means that it's run by a non-profit company. A lot of these companies want to explicitly have some of the plans set to non-profit because of there are tax advantages to them. Doesn't mean that the company per se is a non-profit or doesn't have a profit motive behind it. Also, some plans are considered non-profit at the state level, but not at the federal level.

There are actually non-profit insurance companies out there if you look hard enough. Unfortunately, it's very difficult for them to compete with behemoths like Aetna, BCBS, etc because of volume and other things like advertising or even lobbying...

[coyotes_geek]

101A, no big deal.

One thing that needs to be noted is that non-profit plans doesn't necessarily means that it's run by a non-profit company. A lot of these companies want to explicitly have some of the plans set to non-profit because of there are tax advantages to them. Doesn't mean that the company per se is a non-profit or doesn't have a profit motive behind it. Also, some plans are considered non-profit at the state level, but not at the federal level.

There are actually non-profit insurance companies out there if you look hard enough. Unfortunately, it's very difficult for them to compete with behemoths like Aetna, BCBS, etc because of volume and other things like advertising or even lobbying...

Even the true non-profit insurance companies are going to operate under a profit motive. Non profits can go bankrupt just like anyone else can. The only difference between the for-profits and the non-profits are who the profits get passed along to, shareholders or policy holders.