View Full Version : Health insurance co.'s dropping child only policies...
Belmont31R
09-22-10, 11:43
For the left leaning folks on here......"I told you so!".....:p
ObamaCare was designed to drive the cost of insurance up, and insurance companies are going to go out of business. They are but just in pieces now. Many insurance companies, instead of denying kids for prexisting conditions, are just not issuing ANY new policies that are child only to get around the law. They cannot afford to cover the cost of kids who knowingly are facing perhaps hundreds of thousands in medical bills or even a million +. They would have to charge so much no one could afford it. So instead of insuring some kids only policies they are resorting to doing none of them, and who gets to pick up the tab?
Rates have already started to go up much faster than they ever have as these companies brace for the impact as ObamaCare is starting to take effect.
I hope you are happy.
A move by insurance companies to stop selling child-only policies is drawing criticism ahead of Thursday, when the federal health overhaul will require insurers to cover sick children.
Aetna Inc., Cigna Corp., WellPoint Inc., Humana Inc. and UnitedHealth Group Inc.'s Golden Rule subsidiary say they will no longer sell new child-only policies. The new law requires them to accept applications from sick children on insurance policies that they sell, but doesn't require them to sell a policy individually to children in the first place. Insurers said children with pre-existing conditions will be able to apply for coverage on their parents' plans.
Read the rest of the article here: http://online.wsj.com/article/SB10001424052748704129204575506311917901960.html
I would argue that Obamacare and the current Private insurance industry are both equally evil.
I would argue that Obamacare and the current Private insurance industry are both equally evil.
Go ahead. I would like to hear it.
Insurance today is the product of decades of government regulation and meddling.
Yes that is true. But it is more than that.
Government regulation is a big part of the problem. Not being able to buy insurance across state lines for instance is a huge issue.
But so is the Misuse of insurance. Insurance for health should be like insurance for your car.
Do you call up your insurance company every time you need a new tire? Or a taillight burns out? Of course not. You call them when someone rear ends you and does real damage to your car.
But with health insurance we expect for them to pay every time we go to the doctor with the sniffles. This drives costs up everywhere.
Finally are the insurance companies themselves. They have entire departments who's job it is to try to avoid paying claims. Paperwork error, no claim paid. Forgot that you had something when you were 10? No claim paid. Treatment not on a narrow list of approved treatments? No claim paid.
Hell I can't even get insurance because I use a CPAP machine. That is right. A simple machine that keeps me from snoring is enough for them to deny me insurance.
The problem is not a simple fix. And the fix sure as hell isn't Obamacare. But it also isn't keeping things the way they are.
Yes that is true. But it is more than that.
Government regulation is a big part of the problem. Not being able to buy insurance across state lines for instance is a huge issue.
But so is the Misuse of insurance. Insurance for health should be like insurance for your car.
Do you call up your insurance company every time you need a new tire? Or a taillight burns out? Of course not. You call them when someone rear ends you and does real damage to your car.
But with health insurance we expect for them to pay every time we go to the doctor with the sniffles. This drives costs up everywhere.
I believe that this is mostly an outgrowth of government intrusion, starting with wage controls in WW2 and growing from there with mandates, regulation, etc.
Finally are the insurance companies themselves. They have entire departments who's job it is to try to avoid paying claims. Paperwork error, no claim paid. Forgot that you had something when you were 10? No claim paid. Treatment not on a narrow list of approved treatments? No claim paid.
I firmly believe this is a direct outgrowth or consequence of the intrusion of government and the expectation that they pay for everything. They have to pay so much out that they have to watch the claims and deny as much as possible to stay afloat. The situation of health insurance leads to this, not that the companies are evil to start. Look at the car insurance companies. While they do deny claims, they don't have whole departments dedicated to denying claims and avoiding responsibility. Why? Probably because they are not made the villains and made responsible for all the costs in society for cars, unlike health care. I firmly believe that if the health insurance market had been able to mature and grow like the other insurance markets, we would see similar behavior.
Hell I can't even get insurance because I use a CPAP machine. That is right. A simple machine that keeps me from snoring is enough for them to deny me insurance.
The problem is not a simple fix. And the fix sure as hell isn't Obamacare. But it also isn't keeping things the way they are.
No one claims that keeping it the way it is is the fix.
I was at the dentist the other day getting a crown on a tooth that broke due to a filling I got like 25-20 years ago. I was talking to the lady who runs the front desk and is also the part time helper at the chair (this guy runs a lean machine -- no hygienists and no fancy office -- plain jane). The subject of health insurance came up (after talking about 300 Whisper -- the dentist is a big time shooter and his front desk lady helps him track stuff down) and I mentioned our high deductible health insurance and HSA and she was wondering why we did that. She and her husband had been discussing it. I tried to explain the economics of it and my firm belief that 90-95% of Americans would be better off with such a plan and the country as a whole would benefit. She had a hard time understanding that she is probably paying several hundred dollars a month more for her $500-$750 deductible plan than my family pays for our $3000 deductible plan and that the difference goes into an HSA to cover that deductible and if we don't use it (only once when we had a baby did we ever meet it) we get to keep it instead of flushing it away to the insurance company. That is the sort of action that help fix the US system. Making people ultimately responsible for their own health care and having true disaster insurance only. (so-called high deductible plans -- $3k-$5k deductibles)
Yeah I think we agree on more than we disagree on.
But I do place more of the blame on the companies than you do.
Government intrusion has a lot to do with it, but Health insurance companies are some of the most profitable companies out there. This by itself isn't a bad thing. But knowing a number of people who work for Humana, I can tell you they are more worried about making more money than they are about doing the right thing.
Business is always a balancing act. You must turn a profit. As much of a profit as you can. But you are also responsible to your customers, especially in the case of insurance since your responsibility to your customers can determine life and death. I truly believe that the companies have lost sight of this.
Not being able to buy across state lines is the reason it was so damn exspensive in the first place. Created no competition for price/coverage!
Yeah I think we agree on more than we disagree on.
But I do place more of the blame on the companies than you do.
Government intrusion has a lot to do with it, but Health insurance companies are some of the most profitable companies out there.
I don't believe this is true. I posted a link several months ago before ObamainationCare passed that showed the profit margins of different parts of the health care industry.
I don't know if this is it but I just found this
http://larrycheng.com/2010/03/08/just-how-profitable-are-healthcare-insurers/
This by itself isn't a bad thing. But knowing a number of people who work for Humana, I can tell you they are more worried about making more money than they are about doing the right thing.
Business is always a balancing act. You must turn a profit. As much of a profit as you can. But you are also responsible to your customers, especially in the case of insurance since your responsibility to your customers can determine life and death. I truly believe that the companies have lost sight of this.
I agree that many have. But my contention is that that is the result of the system that they were put in. Other insurance types don't have this problem to the same extent but the same desire for profits and responsibility to shareholders and to customers exist there as well.
Anyway, the OP is dead on. The law of unintended consequences strikes again!
Not being able to buy across state lines is the reason it was so damn exspensive in the first place. Created no competition for price/coverage!
One of the reasons. There are many others, all with their roots in govt meddling and intrusion.
For example, mandates, and community rating both drive up costs.
Business is always a balancing act. You must turn a profit. As much of a profit as you can. But you are also responsible to your customers, especially in the case of insurance since your responsibility to your customers can determine life and death. I truly believe that the companies have lost sight of this.
As much as I agree with the underlying morality of your statement, it's not the ultimate responsibility of the company to have responsibility for the customers. It's the consumer's job to make sure that their product works for them and that they're buying it from a reputable company. When did personal responsibility start being other's responsibility? It's this very mindset that passed insurance laws, and ultimately ObamaCare, in the first place.
Belmont31R
09-22-10, 13:41
Yeah I think we agree on more than we disagree on.
But I do place more of the blame on the companies than you do.
Government intrusion has a lot to do with it, but Health insurance companies are some of the most profitable companies out there. This by itself isn't a bad thing. But knowing a number of people who work for Humana, I can tell you they are more worried about making more money than they are about doing the right thing.
Business is always a balancing act. You must turn a profit. As much of a profit as you can. But you are also responsible to your customers, especially in the case of insurance since your responsibility to your customers can determine life and death. I truly believe that the companies have lost sight of this.
First off most insurance companies are operating in single digit profits as a percent of their intake of money. They do make a lot of money but there are over 300 million people in the US, and maybe less than 10 big name insurance companies. If you do the math they are not making a whole lot of money off each person.
Businesses have ZERO ethical responsibility to their customers outside of what the business agreement you entered into them said. A lot of people who get claims denied are because they are either lied on their application (fraud) or they were undergoing some experimental treatment that their insurance has no obligation to cover. Insurance is not in the business of funding medical experiments.
If they do deny a claim they should have paid for you can contact your state insurance controller, and they can levy fines against the company. You can seek recourse in court. You can go in front of a camera, and explain how the big bad insurance company denied your claim.
However if you take away the fraud and genuine denials VERY FEW people get denied treatment where the insurance company as at fault. Very few.
Insurance companies are not public entitlements. They have no obligation outside of what your contract says to do anything for you, and in a free market business has the right to refuse service to anyone for any reason. If they don't like your attire they can tell you to pound sand. If you are going to cost them money they should be able to tell you to pound sand unless they already agreed to pay for something.
And in every state I know of its the state that sets the coverage requirements for health insurance. Id be perfectly fine with a basic plan that covers catastrophic injury and disease only. Instead if I want health insurance I have to get a plan that covers all kinds of shit I don't want it to. I don't want it to cover my kids health checks and shots. Don't want it to cover a **** ton of things they are forced to, and that raises my rates. Government has stepped in between the insurance companies, and myself to tell both of us what our business agreement must contain. That costs me money.
Then you also have the "wonderful" government entitlements that cost me more money when it comes to my family's health care. Again, the government steps in and tells people what to do. In this case they set the rates doctors and hospitals are paid for services, and many times it can be as low as 1/5th of what my insurance pays. When a doctor treats a medicaid patient I end up paying part of that patients bill because it costs more to treat government plan people than they get paid to do it.
Then the government also tells medical care providers they have to treat anyone who walks in the door. That costs me money because I have to pay extra for all the people who don't pay for their care.
Believe it or not the government does control MOST of the medical industry. Insurance companies have very little say, and even less now. Their only recourse is to cut services and raise rates or go out of business. Either way the government wins, and right now the government wants 100% control. They are putting insurance companies in a position where its only a matter of time before they have to fold up. In every state I know of insurance companies have to get permission from the state controllers to raise rates, and they have show why its justified. They cannot simply raise rates on their own.
Businesses have ZERO ethical responsibility to their customers outside of what the business agreement you entered into them said.
While true, the problem with the insurance companies (health and otherwise) is that they have devised a system so convoluted there is no way of figuring out what you're really buying. Factor in that companies tend to buy the health insurance for the employee and it's even worse as you have no real say in what you get without changing jobs.
I also believe that healthcare should be a more compassionate business. It's obviously a pipe dream and doesn't go hand-in-hand with some people's Randian view of the world but get yourself involved a major medical issue and you'll agree, I promise.
Then the government also tells medical care providers they have to treat anyone who walks in the door. That costs me money because I have to pay extra for all the people who don't pay for their care.
How true this is. My wife works as an RN. Currently in a Cardiac ICU. From 2002-2009 she was in a general medical/surgical floor.
They have a whole slang for people who come in regularly. (Like "Frequent Flyers") People who don't care and don't have to pay and don't take care of themselves once discharged so they end up there again a few weeks or months later. People who are given free care, free medicine, and then go home and don't take the medicine and end up again at the hospital.
Or the one my wife said it felt like she was lonely so she came to the hospital and complained of chest pains (which promptly went away).
Belmont31R
09-22-10, 14:07
While true, the problem with the insurance companies (health and otherwise) is that they have devised a system so convoluted there is no way of figuring out what you're really buying. Factor in that companies tend to buy the health insurance for the employee and it's even worse as you have no real say in what you get without changing jobs.
I also believe that healthcare should be a more compassionate business. It's obviously a pipe dream and doesn't go hand-in-hand with some people's Randian view of the world but get yourself involved a major medical issue and you'll agree, I promise.
A company still has to get money from somewhere to be compassionate. If you want them to cover more things then your rates have to go up. That money doesn't come out of thin air.
Belmont31R
09-22-10, 14:11
How true this is. My wife works as an RN. Currently in a Cardiac ICU. From 2002-2009 she was in a general medical/surgical floor.
They have a whole slang for people who come in regularly. (Like "Frequent Flyers") People who don't care and don't have to pay and don't take care of themselves once discharged so they end up there again a few weeks or months later. People who are given free care, free medicine, and then go home and don't take the medicine and end up again at the hospital.
Or the one my wife said it felt like she was lonely so she came to the hospital and complained of chest pains (which promptly went away).
My wife is going through nursing school right now, and a good friend of hers is an EMT. She, the EMT, says around half the people they transport are regulars, and most of the time its BS made up reasons for calling for an ambulance. They are on a first name basis. Most of these people never pay for it, either. Thats why it costs 500-1k for a ambulance ride.
Obamacare has nothing to do with health care......... it is insurance care.
A company still has to get money from somewhere to be compassionate. If you want them to cover more things then your rates have to go up. That money doesn't come out of thin air.
This has nothing to do with what I posted.
Go ahead. I would like to hear it.
Insurance today is the product of decades of government regulation and meddling.
And I would say it is about corporate greed and some wealthy "suit" coming up with a way to make big money on people's misery.
And I would say it is about corporate greed and some wealthy "suit" coming up with a way to make big money on people's misery.
Is this something you truly believe, that there are people in the upper echelons of healthcare corporate management that revel in the suffering of others, seeking to get every last dollar they can?
It may be true. There may be evil corporate officers out there like that. I just can't imagine it is the norm, but maybe I'm just naive.
And I would say it is about corporate greed and some wealthy "suit" coming up with a way to make big money on people's misery.
Really? You really believe this? Care to share your evidence of this? There is lots of evidence to what I said about years of govt intrusion and meddling shaping (and destroying) the health care system
And I would say it is about corporate greed and some wealthy "suit" coming up with a way to make big money on people's misery.
Really? It's greed to offer to pay for someone's expenses while being payed relatively nothing in return?
A company can NOT offer a service for any length of time unless they make money on it. A company cannot, also, take unnecessarily high risks on a regular basis and expect to stay in business. Therefore, you have the rules for insurance. You can either live without insurance, paying your own bills if and when they arise, or you can have the fear you'll be unable to, pay a company a premium with the acknowledgment that they'll pay your medical bills, should they happen. Those are your two options.
People are stupid, arrogantly stupid, because they tend to focus on themselves and not the entire picture. Instead of realizing that insurance companies are a business designed to minimize semi-common costs through an equal-burden arrangement of its consumers, they blindly assume that they're some charitable deity from Heaven because they'll supposedly pay their medical bills. When something does go south (usually in the form of a document the individual signed, forgoing certain coverage, or a pre-existing condition coming to light) the fat, dumb, and broke individual blames the insurance company.
And then the government gets involved, meaning the company has to assume more responsibilities and more risks, resulting in less profits. Insurance companies are... companies (hence the name), whose purpose is to make money, therefore they have two options: raise premiums, or go out of business.
Life is not guaranteed. Health is not guaranteed. Money is not guaranteed. NOTHING is guaranteed, aside from death and taxes. People who think insurance should be "accessible" are delusional, uneducated idiots. If it's not accessible, or affordable, it's for a reason, and usually for a fiscally good one. Making it so only hurts consumers more, as everyone else ends up paying for it.
rob_s- Randian view? I'm impressed. Didn't know Gators were that edumacated.:p
Belmont31R
09-22-10, 17:03
And I would say it is about corporate greed and some wealthy "suit" coming up with a way to make big money on people's misery.
Actually they make money by people not being sick because then they don't have to fork out thousands or often times much more than that for their care.
Thats why they are selective in who they insure.
Oh and whats the other option? Some unelected "suit" in DC deciding what treatment you get?
Finally are the insurance companies themselves. They have entire departments who's job it is to try to avoid paying claims. Paperwork error, no claim paid. Forgot that you had something when you were 10? No claim paid. Treatment not on a narrow list of approved treatments? No claim paid.
I am a claims adjustor. The paperwork error is an error of the doctors office billing incorrectly. There are standards that are regulated by the government how to bill. If the claim isn't billed correctly it must be denied until the doctors office can follow the correct procedure. It's also only a certificate program that takes two semesters, in which case I'm dealing with the bottom of the barrel for the most part. 9 times out of 10 it's because they misspell your name, incorrect dob, or incorrect id # from your insurance card. What happens if you don't fill out the paperwork correctly for a sbr and send it to the ATF?
I am a claims adjustor.
AHHH Quick everyone. threat front! Engage!
Just kidding. Thankless Job I am sure with more BS from all sides than you ever want to deal with.
What happens if you don't fill out the paperwork correctly for a sbr and send it to the ATF?
Ironically they approved mine! But that is an anomaly. Just made for a funny choice of example in this case.
All jokes aside, I understand what you are saying. I was referring more to the fact that someone forgets to list something minor from their childhood and gets denied.
AHHH Quick everyone. threat front! Engage!
Just kidding. Thankless Job I am sure with more BS from all sides than you ever want to deal with.
Ironically they approved mine! But that is an anomaly. Just made for a funny choice of example in this case.
All jokes aside, I understand what you are saying. I was referring more to the fact that someone forgets to list something minor from their childhood and gets denied.
I figured that would be the easiest to understand and something jsut as strict, no gray area, your name matches exactly or it doesn't, it's a regulation to help cut down on fraud.
Oh and whats the other option? Some unelected "suit" in DC deciding what treatment you get?
Or don't get by looking at the budget. Atleast with insurers it's a board of doctors that review thousands upon thousands of pages of medical journals and tests of procedures performed by other doctors verifying if the now experimental treatment actually works. That's why if you get to play 20 questions with your doctor about every procedure and/or rx, especially if it's new. They are gathering data for the risks, symptoms, etc.
While true, the problem with the insurance companies (health and otherwise) is that they have devised a system so convoluted there is no way of figuring out what you're really buying. Factor in that companies tend to buy the health insurance for the employee and it's even worse as you have no real say in what you get without changing jobs.
Every policy and insurance company is different, it would be impossible to know exactly what you are buying when comparing bewtween insurance companies and policies. In the end you get what you pay for. You're better off sticking with a name brand like Blue Cross Blues Shield, Aetna, Humana, Healthamerica etc. It's worse from employer to employer because they can tweak the policy how they want to. It becomes a nightmare from state to state because each state has it's own laws. That is currently why you cannot buy insurance across state lines individually.
variablebinary
09-22-10, 19:21
We'll get single payer sooner or later
No one likes insurance companies as it is. Wont take much to tip things over, where the voters demand the current insurance scams be completely abolished or regulated out of existence.
arizonaranchman
09-22-10, 19:36
A fine example of how the idiocy of liberals knows absolutely no limits whatsoever. This was entirely predictable. Why would any business or individual allow this to happen? There's no incentive to cover children now, so they simply refuse to.
I can see that some day there'll be no incentive to even work if/when taxation hit's 90% like it has in the past and in other countries - why would you bother to work at this level of taxation? Liberals think you won't change your behavior and you'll just bend over and grab your ankles and pay the tax - yeah right.
Just like the Luxury Tax from several years ago... Let's stick it to the rich and tax yachts, planes and other such items at some outrageous level! Gee the companies all just left the country and the gov't now gets ZERO revenue from these items. Absolute morons...
PrivateCitizen
09-22-10, 20:25
Not shocking at all …
I can speak first hand that this kind thing is real and touches regular guys.
In May I got the notice from my provider of over a decade that my policy was cancelled due to the bulls**t named Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010.
My policy was a true major medical policy. It didn't cover sniffles. It didn't cover running to the doctor over every little thing like an oil change. Under the new Obama/.gov guidelines my policy was not sufficient because it didn't cover little boo-boos.
Apparently real insurance is no longer insurance.
It didn't matter that I was perfectly happy with my 100% (no copay), vanishing deductible, 10 million dollar lifetime cap policy per family member. It didn't matter that my provider was willing to sell it to me.
The Act single handedly eliminated real health insurance. Sadly, I am sure it is just the tip of the sword.
While true, the problem with the insurance companies (health and otherwise) is that they have devised a system so convoluted there is no way of figuring out what you're really buying. Factor in that companies tend to buy the health insurance for the employee and it's even worse as you have no real say in what you get without changing jobs.
This is true. I had a choice in providers when I started my new job, and literally spent weeks reading through documents, terms, and thinking up "what if" case scenarios. In the end I may as well has flipped a coin.
Hospitals/practitioners figure into this equation as well. Apparently spraying water into someone's ear to remove a ball of wax gets reported as a $485 "surgery". At least Blue Cross called them on it.
Not shocking at all …
I can speak first hand that this kind thing is real and touches regular guys.
In May I got the notice from my provider of over a decade that my policy was cancelled due to the bulls**t named Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010.
My policy was a true major medical policy. It didn't cover sniffles. It didn't cover running to the doctor over every little thing like an oil change. Under the new Obama/.gov guidelines my policy was not sufficient because it didn't cover little boo-boos.
Apparently real insurance is no longer insurance.
It didn't matter that I was perfectly happy with my 100% (no copay), vanishing deductible, 10 million dollar lifetime cap policy per family member. It didn't matter that my provider was willing to sell it to me.
The Act single handedly eliminated real health insurance. Sadly, I am sure it is just the tip of the sword.
Exactly what will happen to most policies. If it doesn't fall within a certain guideline set by Health and Human Services (they have been given an extreme amount of power), your policy will be canceled because it cannnot be offered by insurance any longer, even if you are happy with it, which a certain someone said you can keep, if you liked it :rolleyes:
We'll get single payer sooner or later
No one likes insurance companies as it is. Wont take much to tip things over, where the voters demand the current insurance scams be completely abolished or regulated out of existence.
We will. Prices will skyrocket so high that only the rich will be able to afford it and the few of us that work for the insurance companies. Hence why I'm sticking around instead of looking for a new job. Even our individual costs have doubled every year for the last 3 years.
Belmont31R
09-22-10, 21:56
This is true. I had a choice in providers when I started my new job, and literally spent weeks reading through documents, terms, and thinking up "what if" case scenarios. In the end I may as well has flipped a coin.
Hospitals/practitioners figure into this equation as well. Apparently spraying water into someone's ear to remove a ball of wax gets reported as a $485 "surgery". At least Blue Cross called them on it.
Well people do need to be consumers, and know what services they are getting cost before they have them done. Most people just whip out their insurance card, pay their co-pay, and then get a bill later not knowing how much its going to cost. No one shops around to see what clinics charge.
Its like going to buy a car, and finding out what it costs after you drive it off the lot. People will haggle to death over 100 bucks in price on a 30k car but think nothing about asking how much such and such is going to cost when it comes to medical issues.
Belmont31R
09-22-10, 21:58
Exactly what will happen to most policies. If it doesn't fall within a certain guideline set by Health and Human Services (they have been given an extreme amount of power), your policy will be canceled because it cannnot be offered by insurance any longer, even if you are happy with it, which a certain someone said you can keep, if you liked it :rolleyes:
The bottom line is you are going to be forced into high dollar plans, and then people will get pissy when they are paying $1500 a month for the cheapest acceptable plan under HHS's rules. Then people will demand something be done, and the answer from the left will be single payer.
This is working out exactly as planned, and a good percentage of the people have NO CLUE. This is a dagger straight through the heart of non-governmental health services. Just waiting for it to bleed out, die, and then the only one left standing is the government.
Moose-Knuckle
09-22-10, 22:08
Things are going according to plan. Just one of many social engineering plans implemented to bring about our decline.
I love to see all the sheep who really believed in Barry's plan of hope and change. :D
http://www.realclearpolitics.com/video/2010/09/20/cnbc_town_hall_questioner_to_obama_im_exhausted_of_defending_you.html
variablebinary
09-22-10, 22:16
We will. Prices will skyrocket so high that only the rich will be able to afford it and the few of us that work for the insurance companies. Hence why I'm sticking around instead of looking for a new job. Even our individual costs have doubled every year for the last 3 years.
That's the scam though.
No one knows how much a damn thing costs in healthcare, so costs keep going up because there is no market or competition to drive prices down.
Whole thing is a racket.
Healthcare reform should have abolished the insurance industry. My definition of universal healthcare is I get sick, I go to the doctor, give them my social and another piece of ID and that's it. I get the care I need and go home. No drama, no forms, or deductibles. Make it a tax like social security. You pay for it, and its there when you need it.
That is the way universal healthcare should work
Belmont31R
09-22-10, 22:16
Things are going according to plan. Just one of many social engineering plans implemented to bring about our decline.
I love to see all the sheep who really believed in Barry's plan of hope and change. :D
http://www.realclearpolitics.com/video/2010/09/20/cnbc_town_hall_questioner_to_obama_im_exhausted_of_defending_you.html
I've yet to meet anyone who still likes him nearly as much as they did 2 years ago, and tons more who are planning on voting for someone else. Even people who voted for him are starting to see who is going to be running against him, and they want to check out who the R's are going to be.
Well people do need to be consumers, and know what services they are getting cost before they have them done. Most people just whip out their insurance card, pay their co-pay, and then get a bill later not knowing how much its going to cost. No one shops around to see what clinics charge.
Its like going to buy a car, and finding out what it costs after you drive it off the lot. People will haggle to death over 100 bucks in price on a 30k car but think nothing about asking how much such and such is going to cost when it comes to medical issues.
I agree completely, and it is a lesson learned. I was so accustomed to the sign on the line and go aspect of MIL health care that I didn't think. This was a major hosptital by the way, and my provider did seem to give them shit about their "surgery" claim which brought down the bill and in turn my co-pay.
I've yet to meet anyone who still likes him nearly as much as they did 2 years ago, and tons more who are planning on voting for someone else. Even people who voted for him are starting to see who is going to be running against him, and they want to check out who the R's are going to be.
The loud praises (which were disturbing) in my office have been muffled in the last year. Many of the pictures (more disturbing) have also come down.
GermanSynergy
09-22-10, 23:52
A company still has to get money from somewhere to be compassionate. If you want them to cover more things then your rates have to go up. That money doesn't come out of thin air.
I can't WAIT to show this to a few left leaning colleagues that claim that Obama care is the solution to the world's ills..... They still haven't gotten back to me how it will be 'better", or "cheaper"....:rolleyes:
2.5 trillion in healthcare expenditures per year.
300 million people, maybe 1/3 to 1/2 are functional in the capacity of earning more than they get in government services. The basic albatross around the workers neck must be roughly 20k per year to carry the load for those who don't, or can't.
This is why care is rationed under single payer.
Because of our rates of obesity, smoking, drinking, and the general plantation-mentality, there isn't going to be a lot of care available to regular folks when they need it if the keys get tossed over to the federal government. People don't want to save money, they don't want to treat themselves or others right and they're going to get everything they deserve if they keep it up. They wanted the government involved and now they have it, good and hard.
Hell I can't even get insurance because I use a CPAP machine. That is right. A simple machine that keeps me from snoring is enough for them to deny me insurance.
I'm not your doctor, but quick question, do you happen to have Sleep Apnea which is why you have the CPAP? You don't have to answer on a public forum, but if you do, it's probably why you can't get insurance
From Wikipdia: http://en.wikipedia.org/wiki/Continuous_positive_airway_pressure
Positive airway pressure (PAP) is a method of respiratory ventilation used primarily in the treatment of sleep apnea, for which it was first developed. PAP ventilation is also commonly used for critically ill patients in hospital with respiratory failure, and in newborn infants (neonates). In these patients, PAP ventilation can prevent the need for tracheal intubation, or allow earlier extubation. Sometimes patients with neuromuscular diseases use this variety of ventilation as well. CPAP is an acronym for Continuous PAP, a variation of the PAP system which was first developed by Professor Colin Sullivan at Royal Prince Alfred Hospital in Sydney, Australia, in 1981.
From Wikipedia: http://en.wikipedia.org/wiki/Sleep_apnea
The term "sleep-disordered breathing" is commonly used in the U.S. to describe the full range of breathing problems during sleep in which not enough air reaches the lungs (hypopnea and apnea). Sleep-disordered breathing is associated with an increased risk of cardiovascular disease, stroke, high blood pressure, arrhythmias, diabetes, and sleep deprived driving accidents.[10][11][12][13][non-primary source needed] When high blood pressure is caused by OSA, it is distinctive in that, unlike most cases of high blood pressure (so-called essential hypertension), the readings do not drop significantly when the individual is sleeping.[14] Stroke is associated with obstructive sleep apnea.[15][non-primary source needed] Sleep apnea sufferers also have a 30% higher risk of heart attack or premature death than those unaffected.[16][dead link]
In the eyecare field it is also thought to be associated with some forms of glaucoma.
variablebinary
09-23-10, 01:28
2.5 trillion in healthcare expenditures per year.
300 million people, maybe 1/3 to 1/2 are functional in the capacity of earning more than they get in government services. The basic albatross around the workers neck must be roughly 20k per year to carry the load for those who don't, or can't.
This is why care is rationed under single payer.
Because of our rates of obesity, smoking, drinking, and the general plantation-mentality, there isn't going to be a lot of care available to regular folks when they need it if the keys get tossed over to the federal government. People don't want to save money, they don't want to treat themselves or others right and they're going to get everything they deserve if they keep it up. They wanted the government involved and now they have it, good and hard.
You don't just tax individuals, you also tax corporations that would instantly be receiving a de facto subsidy for essentially turning over all their health insurance overhead to the federal government.
This will alleviate a huge burden on companies. A company like Goldman would save hundreds of millions in the blink of an eye, and the USA would get more money to cover those that aren't paying into the system.
I've been paying for my own medical since I was 23 years old. The current system is shit, expensive, convoluted and doesn't address the fact that we have a public health crisis where a huge chunk of the nation has no health care, which affects the very core of the nation economically, politically and socially.
Serious question, why should 6% + of the GDP be taxed to pay for heart disease and diabetes which are nearly 100% preventable in adults?
The states just need to have broad leeway in how they regulate their healthcare systems. The system is expensive for a variety of reasons, namely because there is a "system" to begin with. You can't put people in a risk pool that have found the most long, drawn out and excruciatingly expensive (not to mention painful) ways to kick the bucket. It's like insurance for drunk driving CDL holders, doesn't exist.
Best as I can figure 25% of healthcare costs are legitimate accidents, acts of god/genetics, actual malpractice, and non-preventable end of life events. You can budget for that on a single-payer basis, any state could budget for that. But it is illegal to do that. The guy that said free healthcare is the most expensive thing you'll ever see was dead right.
What's best? Fee-for-service and no price discrimination allowed. If a doctor wants to discount for an individual who can't pay as much, that's OK, or if they want to take something in trade. Even with the current federal framework it would alleviate the burden of the system on the average joe. Make insurance an individual thing. I'm not opposed to some experimentation. Well run single payer could conceivably work very good at the state level without federal interference. I highly doubt it would work at the federal level just seeing what medicare and medicaid have done for cost containment, or lack there of.
Well people do need to be consumers, and know what services they are getting cost before they have them done. Most people just whip out their insurance card, pay their co-pay, and then get a bill later not knowing how much its going to cost. No one shops around to see what clinics charge.
Its like going to buy a car, and finding out what it costs after you drive it off the lot. People will haggle to death over 100 bucks in price on a 30k car but think nothing about asking how much such and such is going to cost when it comes to medical issues.
Except when you get your ear wax impaction, gum abscess, shingles flare, heart attack or whatever, you generally don't have desire or time to shop for best deal out there. You want that thing to be taken care of NOW and you'll won't go to the least expensive option; you'll go to whoever is open and will see you on moment's notice. You can shop for elective planned procedures and care, but not for urgent stuff that accounts for higher percentage of cost.
Healthcare reform should have abolished the insurance industry. My definition of universal healthcare is I get sick, I go to the doctor, give them my social and another piece of ID and that's it. I get the care I need and go home. No drama, no forms, or deductibles. Make it a tax like social security. You pay for it, and its there when you need it.
That is the way universal healthcare should work
That's not going to work unless you are ready to ration the care and stay in line to get what you need - and you'd be naive to think that wait times would be acceptable to John Q. Public. I worked in single payer system overseas, and I also worked in healthcare organization in US which was a microcosm of single payer system- where all you needed to do was to...produce your ID. First, you'll stand in line - long-long line of people that came in earlier, produced their socials and another pieces of ID...Since it would cost "nothing" to get care - no insurance premiums, no copays - it would open a door to unlimited access to healthcare, and that will overwhelm the system really fast due to prevailing societal contract. So, the only way that this system would work is if societal contract is changed.
Serious question, why should 6% + of the GDP be taxed to pay for heart disease and diabetes which are nearly 100% preventable in adults?
.
No, there are not "nearly 100% preventable", otherwise I wouldn't be fielding a question "how come I got a heart attack even though my cholesterol is fine" and "where my arrhythmia came from" etc. on nearly daily basis.
However, the essense of your question is correct - we can reduce cost tremendously if we take care of ourselves before SHTF. However, those are individual choices that we tend to NOT to make. Everybody who follows this thread - go look up an online BMI calculator, plug in your numbers and report here, and let's make a BMI distribution chart of M4C membership and see what happens...
Belmont31R
09-23-10, 22:18
Except when you get your ear wax impaction, gum abscess, shingles flare, heart attack or whatever, you generally don't have desire or time to shop for best deal out there. You want that thing to be taken care of NOW and you'll won't go to the least expensive option; you'll go to whoever is open and will see you on moment's notice. You can shop for elective planned procedures and care, but not for urgent stuff that accounts for higher percentage of cost.
Thats why its important to find a good doctor in the first place.
A heart attack? That would run well past the deductible, and in that case I doubt most people would really care how much it costs as long as they are properly treated.
My general point was that there are options out there people rarely use. My wife is going to have to have a minor surgery, and even though we are paying cash we asked about the different payment options. If you setup a payment plan prior to a surgery the hospital will do whatever they can to work with you. In our case the cost is low enough we are just paying for it up front but even if it was something like 50k they would work with us even if it takes years to pay it off.
My wife also had an ear wax impaction, and we simply asked what the cash rate is. If it didn't suit our expectations we could have gone somewhere else. We also belong to a local clinic co-op membership, and their rates are VERY reasonable. If we went somewhere else it would cost us 3-4X with insurance. However they are cash only at the time of service. People have little clue there is different rates based on how you are paying, and its often much cheaper to pay cash than lay out the insurance card. We only reserve insurance for things out of our immediate ability to pay like when one of my sons fell out of his high chair, and spent 3 days in the ICU with a small brain bleed. That was 15k, and insurance paid 12k of it. Thats what insurance should be there for not because you got a cold, ear wax in your ear, kids shots, ect.
I agree with an idea of being an educated consumer in regards to healthcare, but the nature of things often makes it difficult. You're right in regards to planned procedures, or tolerable problems etc, but it doesn't always work out. Within last year my wife had a shingles flare that I failed to recognize, and my kid had contact lense-associated conjunctivitis, both times requiring an eventual visit either after hours or on weekend. No amount of pre-planning and shopping could've fixed that.
variablebinary
09-23-10, 22:44
That's not going to work unless you are ready to ration the care and stay in line to get what you need - and you'd be naive to think that wait times would be acceptable to John Q. Public. I worked in single payer system overseas, and I also worked in healthcare organization in US which was a microcosm of single payer system- where all you needed to do was to...produce your ID. First, you'll stand in line - long-long line of people that came in earlier, produced their socials and another pieces of ID...Since it would cost "nothing" to get care - no insurance premiums, no copays - it would open a door to unlimited access to healthcare, and that will overwhelm the system really fast due to prevailing societal contract. So, the only way that this system would work is if societal contract is changed.
I lived in the UK for awhile, and conditions don't quite match what you describe. To be specific, I lived in Edinburgh, and the healthcare was quite good and wait times were no better or worse than what I experienced while in NYC.
As for the system being overwhelmed, because people, heaven forbid, get healthcare, this would be a short term problem. I wager the vacuum would be filled with a massive influx of healthcare professionals within a few years, because single payer would make healthcare one of the most stable careers in all the USA.
The system would be very much like it is now. Good doctors would be located in a place that ensures they cater to a certain caliber of patient. Inner city hospitals and clinics would be shit holes like they are now, because there in fact two issues: access and availability.
Belmont31R
09-23-10, 22:51
I agree with an idea of being an educated consumer in regards to healthcare, but the nature of things often makes it difficult. You're right in regards to planned procedures, or tolerable problems etc, but it doesn't always work out. Within last year my wife had a shingles flare that I failed to recognize, and my kid had contact lense-associated conjunctivitis, both times requiring an eventual visit either after hours or on weekend. No amount of pre-planning and shopping could've fixed that.
Well like I said earlier there is no perfect system but improving several different parts has an impact far greater than each individual improvement. Doing 5 things to improve health care would make a world of difference.
I lived in the UK for awhile, and conditions don't quite match what you describe. To be specific, I lived in Edinburgh, and the healthcare was quite good and wait times were no better or worse than what I experienced while in NYC.
Without trying to cross any lines of privacy: have you had any medical issues of significance to truly compare the systems? UK and EU systems are known for excellent accessibility to primary care providers. Try to see a specialist, or get imaging - the story might be different.
I have mentioned societal contract, which is a huge determinant of health care cost.
Here is a typical pathway for a patient presenting with chest pain to a primary care doc in UK: physical, ECG, most likely diagnosis established and as long as it is nothing huge, treatment is started, testing is ordered - whenever that test might happen - and follow-up appointment is provided. If, by any chance, you are found in need of open heart surgery, you may need to wait weeks to months unless the course is really unstable.
Here is the pathway for the same patient in US: physical, ECG, and unless clear noncardiac cause is established, then the best case scenario a stress test is made to happen within day-three, second best scenario cardiologist is asked to see patient in few days, and worst - patient is sent to ER where he is kept overnight to get $2000 nuclear test in the morning to tell him that is in fact was NOT his heart hurting. If, on the other hand, he does have trouble and needs open heart surgery, that would happen in no longer than 1 week, and usually much sooner. US consumer wants his healthcare immediately, with least amount of uncertainty and most amount of protection/retribution in case of negative outcome. That is a societal contract - "individual pursuit of happiness", which is quite different from "egalite, fraternite etc.". Try to tell baby-boomer "It is generally safe to wait for bypass surgery for 3 months as most patients will survive for 3 months" and see what happens...
As for the system being overwhelmed, because people, heaven forbid, get healthcare, this would be a short term problem. I wager the vacuum would be filled with a massive influx of healthcare professionals within a few years, because single payer would make healthcare one of the most stable careers in all the USA.
Healthcare is one of more stable careers in USA. The bottleneck will not be as much as workforce as in lines for tests, etc. as this is what consumer demands. Doctors reimbursement will go down - I deal with medicare daily - so I don't know what exactly would drive that influx.
The system would be very much like it is now. Good doctors would be located in a place that ensures they cater to a certain caliber of patient. Inner city hospitals and clinics would be shit holes like they are now, because there in fact two issues: access and availability.
And what exactly would keep good doctors in places that ensure they cater to certain caliber of patients? And, under principle of universal access, can "a place" choose "a caliber" of patient to cater to? After all, all that's needed to be catered to is social and ID...
I lived in the UK for awhile, and conditions don't quite match what you describe. To be specific, I lived in Edinburgh, and the healthcare was quite good and wait times were no better or worse than what I experienced while in NYC.
As for the system being overwhelmed, because people, heaven forbid, get healthcare, this would be a short term problem. I wager the vacuum would be filled with a massive influx of healthcare professionals within a few years, because single payer would make healthcare one of the most stable careers in all the USA.
The system would be very much like it is now. Good doctors would be located in a place that ensures they cater to a certain caliber of patient. Inner city hospitals and clinics would be shit holes like they are now, because there in fact two issues: access and availability.
I find myself agreeing with you much of the time, but not this time. Yes, single payer ensures stability, but what it really does is just take another private sector field and puts it under government influence. Everyone will have to march to the tune of one customer. And what happens if that one customer a.k.a. the government runs out of money and can't pay....?
You will find a lot of people trying to get into the field because of job security, but I don't think they will always be the best and brightest if you cap their ability to earn a living.
I fundamentally oppose single payer, because I got into this field to help people and to determine my own future. My prices are set by me and reflect what I believe the value of my services to be worth and by what people are willing to pay. I don't want to go through 8-10 years of additional schooling after high school just so some stupid **** bureaucrat can tell me that I should only get paid X dollars because they think that's all that service is worth. If I choose to give someone a discount or provide a free service, that is MY choice.
variablebinary
09-23-10, 23:37
Without trying to cross any lines of privacy: have you had any medical issues of significance to truly compare the systems? UK and EU systems are known for excellent accessibility to primary care providers. Try to see a specialist, or get imaging - the story might be different
Breast cancer screen
Brest cancer surgery
All breast cancer related med care
Open heart surgery
Heart med care
Dementia, and old age related "stuff"
All of the above happened to people near and dear to me at the time. All were treated well, got the care they needed in a timely fashion. Healthcare was administered in Edinburgh, Port Seton and Longniddry.
Mind you, someone in Manchester, or London may have an entirely different experience due to population size, immigrant population, unemployment, mobility, and poverty, which have an impact on the level of care, even in a single payer system.
variablebinary
09-23-10, 23:45
I fundamentally oppose single payer, because I got into this field to help people and to determine my own future. My prices are set by me and reflect what I believe the value of my services to be worth and by what people are willing to pay. I don't want to go through 8-10 years of additional schooling after high school just so some stupid **** bureaucrat can tell me that I should only get paid X dollars because they think that's all that service is worth. If I choose to give someone a discount or provide a free service, that is MY choice.
If a licensed physician wanted to opt out of the single payer network, they should be allowed to do so, but most wont, and the ones that do better be the best damn doctors by reputation on the planet.
Breast cancer screen
Brest cancer surgery
All breast cancer related med care
Open heart surgery
Heart med care
Dementia, and old age related "stuff"
All of the above happened to people near and dear to me at the time. All were treated well, got the care they needed in a timely fashion. Healthcare was administered in Edinburgh, Port Seton and Longniddry.
Mind you, someone in Manchester, or London may have an entirely different experience due to population size, immigrant population, unemployment, mobility, and poverty, which have an impact on the level of care, even in a single payer system.
I'd really be interested to know how long it took from diagnosis to open heart surgery time, just out of curiosity.
Breast CA is a time-sensitive surgery so I am not surprised.
Screening, meds, dementia is all primary care stuff; as I said, their primary care access is excellent - but this not what US populus wants.
Anyway, my belief is that single payer system can only exist under condition of specific societal contract, and American societal contract is not compatible with realities of single payer system, and I have not even started talking rescue care expenses vs. preventative care expenses...
If a licensed physician wanted to opt out of the single payer network, they should be allowed to do so, but most wont, and the ones that do better be the best damn doctors by reputation on the planet.
That's exactly my point. Most won't. They can't. Even the best damn doctors might find it to be financially unsustainable to go without single payer.
Nothing like subjugating someone economically.
If a licensed physician wanted to opt out of the single payer network, they should be allowed to do so, but most wont, and the ones that do better be the best damn doctors by reputation on the planet.
I believe this is a practice pattern for many EU countries, where doctors with reputation and special skills go private and charge fee for service. I fail to understand this: if fee for service is fine, then what's there to prevent private companies to sell a product (insurance) that would allow interested individuals to afford such fees at times of need - so is it really a single payer system?
That's exactly my point. Most won't. They can't. Even the best damn doctors might find it to be financially unsustainable to go without single payer.
Nothing like subjugating someone economically.
Absolute truth. I see private practices with 30-year-old community roots fold and seek employment. I personally don't care for private practice myself, but I find it disenheartening.
Or the one my wife said it felt like she was lonely so she came to the hospital and complained of chest pains (which promptly went away).
when I was in the FD and on ambulance rigs we had a few types like this they would have their bags packed no us by name every few months we would take them in ? just some made up symptom ? we would usually try to visit ? and do some things to try to keep them from going in which was about half the time it seemed ?
My grandfather had a few of those types as patients. Just part of life. But these days it costs a bit more money and they get a free "taxi" ride.
They sort of remind me of those furniture stores that have had the "going-out-of-business sale" running nonstop for the last 30 years.
variablebinary
09-24-10, 04:33
That's exactly my point. Most won't. They can't. Even the best damn doctors might find it to be financially unsustainable to go without single payer.
Nothing like subjugating someone economically.
The best doctors will have the skill and reputation to sustain a practice even under single payer. If there is a market for their ability, they should certainly be able to pursue it.
I doubt the top docs in the Hamptons are suddenly going to starve to death under single payer.
I've seen both sides, single payer and our shitty insurance scam system. I'd rather have single payer for several reasons. It isn't perfect, because nothing is. As a nation, we can afford it if we manage it correctly.
How do I know this? Because we already pay for everyone's health to begin with.
The Feds fund more than half of all health care spending in the USA. Taxpayers already pay a metric shit ton for other people's health care in the form of tax subsidies for private insurance firms to the tune of a $200 billion annually.
Think about that. You pay your insurance premiums and you pay for everyone else. How awesome is that? Why not dump the premiums, and just pay for everyones healthcare, which you already are.
All taxpayers give private insurance billions a year to provide health care for public employees (Cops, Teachers, Senators, The President). Why are you not entitled to the same care? You already pay for it.
Guess what, you already pay for every single uninsured resident that must use expensive emergency rooms. Preventive care is cheap as hell compared to emergency care. Single pay helps solve this
Every gang banger shot, cared for and follow-up visits are paid for by you, only you pay double, if not triple times, and they pay nothing, and you get nothing. I'd rather get something out of it.
Private insurance is a massive expense for all business. If we unloaded that burden, it would result in a massive injection of cash into the business world. More money to hire, expand, and invest. Wall Street projected profits would skyrocket overnight.
The costs to you, the taxpayer for other peoples insurance is not going away. It doesn't matter how many tax breaks are given. You WILL pay for everyone else's health costs, only you get dog shit out of it. John McCain is living a hell of a long time on your dime. Remember that when you see your next paycheck and see the taxes taken, and your insurance deductions.
I am fortunate, I have good health care via insurance. That doesn't mean I am in any way satistfied with the current system. Binary is 100% on the mark with his statements.
The biggest problem I have is the issue of "for profit" health care. The insurance companies and providers do in fact make cash on peoples misery. When I read of some CEO getting over 50 million in bonuses because his company did so well it makes me sick (no-pun). They make those profits from denying care, jacking up premiums, dropping people dying of cancer or other disease.
My parents retired about 10 years ago. The owned a small-medium sized company that they sold. They have been paying over $20,000 a year for their insurance. Many carriers don;t want the risk...it's about profit.
I also take issue at how Doctors and medical facilities in this country have to make so much for the care they give. I mean I don't care about a $20,000 salt water fish tank or the waterfall inside the ****ing clinic. All I want is care, and without long waits. Even with my plan I still have had to wait over 3 months to see some doctors.
Doctors around the rest of the world do not make anything near what American doctors make. It is no wonder we see so many foriegn doctors in this country. The medical schools are pushing out too few primary care doctors. Why is that? Because the students want a speciality where they make more money.
The healthcare system in the US sucks, and that is why it is rated so much lower than the rest of the western countries. Greed...all about greed.
ForTehNguyen
09-24-10, 07:30
these mean profits people speak of, if you look up the profit margin for health insurance providers, its an earthshattering 3%
hmm if the healthcare in the US is one of the lowest in the western countries why do people still fly to the US to get advanced care, even from their state healthcare? Why do we continue to win huge amounts of nobels and continue to innovate. Nah we just suck. Foreign doctors coming to the US? Im sure that has nothing to do with our schools being some of the best funded and most advanced medical schools and our facilities having the more advanced technology and innovation in the world. Nah they just want money.
Govt involvement with Medicare Medicaid (50% of every healthcare dollar spent) is helping ruin the market. They need to get out. But going to a system where 100% of healthcare dollars spent is from the govt is suppose to make it better?
Greed? I hope you realize that without this "greed" we would not have all this innovation and advancements in the medical field. You expect doctors to work for free or something? Only then will one not be "greedy"
The best doctors will have the skill and reputation to sustain a practice even under single payer. If there is a market for their ability, they should certainly be able to pursue it.
I doubt the top docs in the Hamptons are suddenly going to starve to death under single payer.
Variable, this is an idealistic thinking. I am telling you, good docs with community roots cannot sustain private practice these days. Private practice is in free fall under current reimbursement rules and legislation. "Docs in Hamptons" will have to charge exorbitant fees to sustain their practices - and only really wealthy will be able to afford this.
Think about that. You pay your insurance premiums and you pay for everyone else. How awesome is that? Why not dump the premiums, and just pay for everyones healthcare, which you already are.
You are incorrect in thinking that tax money and subsidies are the sole source of payment for "everyone else's care". Insurance premiums are a huge sources of that money. Non-for-profit hospitals charge private insurances triple the real cost of things to offset the losses assosiated with write-offs, maintenance, etc. - ask me how I know this. You get rid of private insurance premiums and expect all care be paid from taxes - you then expect those taxes to sky-rocket, or give away something in how care is administered and delivered. You tell me if our society will accept it...
.ll I want is care, and without long waits. Even with my plan I still have had to wait over 3 months to see some doctors.
.
This is exactly what I am talking about when I mention societal contract. Et, it is a norm in many developed countries to wait that long to see a specialist. Their systems - and, frankly, ours too - can't afford to have that many specialists. The difference is that there people swallow the wait, and here - they bitch about it.
Doctors around the rest of the world do not make anything near what American doctors make. greed.
Name another country where just to get your degree you need 8 years of undergrad and grad education at anywhere 10 to 60K per year of college and 50K per year of med school - and this is just to get to postgrad training where you get paid minimal wage for 3-8 years, and then when you done you are free to pay 50-100-150K in malpractice insurance premiums. Still think it is all greed?
ForTehNguyen
09-24-10, 09:20
put everyone on a high deductible plan and HSA, buyable across state lines, end all these stupid coverage mandates. This will make people pay attention to prices to get them to fall again.
I concede that we're already paying for metric tons of shit that we don't see. But, why should we? Just because we are already doing it, doesn't make it right to continue doing so under a slightly different "scheme".
You and I both know that the system doesn't get any more efficient under bureaucratic control. The payouts and benefits will be the subject of many political elections just as SS and medicare have. Costs will skyrocket, but levels of care will either drop or remain the same.
The best doctors will have the skill and reputation to sustain a practice even under single payer. If there is a market for their ability, they should certainly be able to pursue it.
I doubt the top docs in the Hamptons are suddenly going to starve to death under single payer.
I've seen both sides, single payer and our shitty insurance scam system. I'd rather have single payer for several reasons. It isn't perfect, because nothing is. As a nation, we can afford it if we manage it correctly.
How do I know this? Because we already pay for everyone's health to begin with.
The Feds fund more than half of all health care spending in the USA. Taxpayers already pay a metric shit ton for other people's health care in the form of tax subsidies for private insurance firms to the tune of a $200 billion annually.
Think about that. You pay your insurance premiums and you pay for everyone else. How awesome is that? Why not dump the premiums, and just pay for everyones healthcare, which you already are.
All taxpayers give private insurance billions a year to provide health care for public employees (Cops, Teachers, Senators, The President). Why are you not entitled to the same care? You already pay for it.
Guess what, you already pay for every single uninsured resident that must use expensive emergency rooms. Preventive care is cheap as hell compared to emergency care. Single pay helps solve this
Every gang banger shot, cared for and follow-up visits are paid for by you, only you pay double, if not triple times, and they pay nothing, and you get nothing. I'd rather get something out of it.
Private insurance is a massive expense for all business. If we unloaded that burden, it would result in a massive injection of cash into the business world. More money to hire, expand, and invest. Wall Street projected profits would skyrocket overnight.
The costs to you, the taxpayer for other peoples insurance is not going away. It doesn't matter how many tax breaks are given. You WILL pay for everyone else's health costs, only you get dog shit out of it. John McCain is living a hell of a long time on your dime. Remember that when you see your next paycheck and see the taxes taken, and your insurance deductions.
put everyone on a high deductible plan and HSA, buyable across state lines, end all these stupid coverage mandates. This will make people pay attention to prices to get them to fall again.
+1000000000
The above would shrink health care costs to much less than they are now. Then modify the system so that your bills get reported to the insurance company but the IC just gets it to apply to your deductible. They do not have to refuse payment and then the doctor has to rebill you (until you hit the deductible). Costs fall even more. Better yet, don't worry about telling the insurance company and just save your receipts and you can enter them in on the internet or send them in quarterly or something so that they can get applied towards your deductible.
And make those people getting free care pay what they can towards its. Make them responsible as much as possible.
Belmont31R
09-24-10, 10:15
I am fortunate, I have good health care via insurance. That doesn't mean I am in any way satistfied with the current system. Binary is 100% on the mark with his statements.
The biggest problem I have is the issue of "for profit" health care. The insurance companies and providers do in fact make cash on peoples misery. When I read of some CEO getting over 50 million in bonuses because his company did so well it makes me sick (no-pun). They make those profits from denying care, jacking up premiums, dropping people dying of cancer or other disease.
The best way to motivate someone is through money, and that means to get the best care you can get the people providing it need motivation. That motivation is cash.
My parents retired about 10 years ago. The owned a small-medium sized company that they sold. They have been paying over $20,000 a year for their insurance. Many carriers don;t want the risk...it's about profit.
What else should it be about? Charity? The for profit hospitals in the US are the best in the world.
I said earlier in the thread....most people who get denied or dropped coverage (not care) is because they either committed fraud by lying about their prexisting conditions or they got a procedure done that is experimental, and insurance is not in the business of funding medical experiments.
Insurance is not a public service. Don't like it? Don't buy it, find a different company, or don't like it and work with that you have. I don't get why people have this mindset that insurance owes them something for nothing, and they should just cover everyone no matter what they came in with or what treatments they are getting.
I also take issue at how Doctors and medical facilities in this country have to make so much for the care they give. I mean I don't care about a $20,000 salt water fish tank or the waterfall inside the ****ing clinic. All I want is care, and without long waits. Even with my plan I still have had to wait over 3 months to see some doctors.
Then go somewhere else. Be a consumer. You don't like the service you get at one place go somewhere else.
Doctors around the rest of the world do not make anything near what American doctors make. It is no wonder we see so many foriegn doctors in this country. The medical schools are pushing out too few primary care doctors. Why is that? Because the students want a speciality where they make more money.
Thats because the rest of the world is either socialized or 3rd world. Thats why they don't stack up to us.
The healthcare system in the US sucks, and that is why it is rated so much lower than the rest of the western countries. Greed...all about greed.
No...if you read the UN report that classifies us as being so much worse than other countries it says we are ranked lower because we do not have socialized medicine not because the uality of care is lacking. They ranked Columbia and other shithole countries better than us. Do you want to go to Columbia for a major surgery or do you want the best (for profit) hospital and doctors in the US. That UN report flat out said we have the best care in the world but are ranked lower because we do not have socialized medicine. That fact always gets left out when people bring up those dumb ass UN rankings.
Mine in red.
This attitude is what is wrong with America today. It used to be that when we saw someone successful, we aspired to be like them. Now, the attitude is that the person is a greedy, corrupt son of a bitch and that's how they got there. Somehow in this ****ed up world, success and ambition became evil.
Life presents us with many choices. Some you get to redo, many you don't. Want to **** around in high school and not graduate? Good luck, but the best you can hope for is $8-15 an hour for the rest of your life. Study hard, score well on the SATs, and graduate? You get rewarded with a decent college. FYI, me personally, while other kids were playing around aimlessly on the weekends, I was either at SAT class, volunteering at the hospital (over 350 hours during my junior and senior year in high school), studying for AP courses, or extracurricular sports teams. The same choices present themselves in college. You get a major in a useless field? Good luck finding a job. However, choose a field that is substantially harder to graduate from, i.e. engineering, medicine, dare I say...law, then you have a real chance at a comfortable life. Life is about choices. You cannot begrudge someone who has made the right or better ones, and then cry about how you don't have this and that when you made the wrong ones (speaking figuratively, not "you").
I'm going to address the point you made about your parents small business, but not "talking about them". Mine were also. Many people worked hard for over 20 years in small business, but squandered their profits away on useless things like fine cars and clothes. My parents were immigrants. They worked 17 years straight. No Joke. 365 days a year, 7 days a week without vacations. My sister and I helped them. The business stayed open rain or shine, sickness or health etc... We had one car and one TV. The TV we had for 15 years. It was analog, Zenith if you can still remember that brand. While everyone around us had 2-3 remote control TVs my parents made a choice to save. We didn't have a lot of the things most people consider necessary to live comfortably, but my parents live very comfortably now. They also spend 15-20K a year on health insurance, but they saved up and planned well knowing they would need the money later in life.
Most doctors start life with 150-200k or more in debt. Think, 4 years of undergraduate work plus room and board. 4 years of medical, dental, optometry, podiatry school tuition, plus room and board. Then there's the residency pay. You want to know what mine was as a fully graduated "doctor"? After 8 years of post-high school schooling, I made 25K my first year as a doctor seeing patients. I had to work weekends, Saturdays AND Sundays to make extra cash to live.
About the long waits to see a doctor on your plan. Have you ever considered that the plan limits who's on it and this unfortunately might create the waits? For example, here in Tucson, it is impossible to get on the plan for Pacificare/Secure Horizons as this company only allows a few big names to get all their patients.
As far as profits go, I'm not referring to my operation, but most medical doctors I know have profit margins of about 30% or less. It costs a lot to hire that many staff members and purchase that much equipment.
Lastly, life isn't fair, but it is what you make of it. Seize control of your future and don't count on anyone to hand you anything.
I also take issue at how Doctors and medical facilities in this country have to make so much for the care they give. I mean I don't care about a $20,000 salt water fish tank or the waterfall inside the ****ing clinic. All I want is care, and without long waits. Even with my plan I still have had to wait over 3 months to see some doctors.
Doctors around the rest of the world do not make anything near what American doctors make. It is no wonder we see so many foriegn doctors in this country. The medical schools are pushing out too few primary care doctors. Why is that? Because the students want a speciality where they make more money.
The healthcare system in the US sucks, and that is why it is rated so much lower than the rest of the western countries. Greed...all about greed.
ForTehNguyen
09-24-10, 11:16
+1000000000
The above would shrink health care costs to much less than they are now. Then modify the system so that your bills get reported to the insurance company but the IC just gets it to apply to your deductible. They do not have to refuse payment and then the doctor has to rebill you (until you hit the deductible). Costs fall even more. Better yet, don't worry about telling the insurance company and just save your receipts and you can enter them in on the internet or send them in quarterly or something so that they can get applied towards your deductible.
And make those people getting free care pay what they can towards its. Make them responsible as much as possible.
i was talking to someone that said their flu shots were covered under their plan. Doctor charged something like $300 for it. Why even bother the insurance company for a $15 flu shot I can get from Walgreens/CVS. Insurance should not be covering every single dang thing. Imagine if car insurance covered oil changes, holy crap oil changes would be expensive. Insurance is meant to protect you from catastrophic expense, by definition. Not paying for everything. I wouldnt be surprised if this flu shot coverage was state mandated.
Then people wonder why healthcare costs are out of control, because pricing isnt transparent because no one cares what they pay and as a result doctors dont care what they charge.
put everyone on a high deductible plan and HSA, buyable across state lines, end all these stupid coverage mandates. This will make people pay attention to prices to get them to fall again.
I couldn't agree more. As a small business, I have been on a HSA type plan since 1997, back when they were known as Medical Savings Accounts (MSA).
I have never yet exceeded my annual high deductable so all of my medical, dental, eye care, etc., expenses are coming out of my own pocket, albeit with pretax income. As a result, I ask a lot of questions and shop price.
jklaughrey
09-24-10, 12:27
If one took a Darwinian approach to health care, those that would be eligible would be the smallest demographic that would need it. Save any accidents or unforeseen issues beyond the individuals control. Socialize medicine, single payer ok. It would work but, it won't be accessible for all. If you have an incurable disease, well your out of luck comfort care only. Non treatable cancer, same deal. You abuse your body with drugs, alcohol, over eating, poor social choices, STD's etc, or you are a criminal that is classified as no parole, life, death penalty you get nothing. Just crawl into a hole and die. Born with disease, well no one wants a child to die but will saving them be a benefit for the collective society? In this way people will evolve as nature intended. It will also help with food shortages, over population and many other issues we are currently battling. Thinning of the herd is a good thing that happens constantly in the animal kingdom. Humans have just become to smart at subverting nature's plan. Perhaps we need a new black plague that is incurable. On another area, age limits on transplants and major surgery. If you reach a certain age deemed no longer socially viable and are unable to contribute to the society than you just live as long as nature intended.
Now hate me for saying these things, but it is the only foreseeable way I can figure out that socialization of our current health care could be solvent and not bankrupt our country even more. Who knows I might be deemed not suitable for treatment due to some incurable or debilitating illness. Oh well, needs of many outweigh needs of one or the few.
It is either this or a lottery system for death, like in "Logan's Run".
If a licensed physician wanted to opt out of the single payer network, they should be allowed to do so, but most wont, and the ones that do better be the best damn doctors by reputation on the planet.
If the government will give you a license :rolleyes:
variablebinary
09-24-10, 19:48
If one took a Darwinian approach to health care, those that would be eligible would be the smallest demographic that would need it. Save any accidents or unforeseen issues beyond the individuals control. Socialize medicine, single payer ok. It would work but, it won't be accessible for all. If you have an incurable disease, well your out of luck comfort care only. Non treatable cancer, same deal. You abuse your body with drugs, alcohol, over eating, poor social choices, STD's etc, or you are a criminal that is classified as no parole, life, death penalty you get nothing. Just crawl into a hole and die. Born with disease, well no one wants a child to die but will saving them be a benefit for the collective society? In this way people will evolve as nature intended. It will also help with food shortages, over population and many other issues we are currently battling. Thinning of the herd is a good thing that happens constantly in the animal kingdom. Humans have just become to smart at subverting nature's plan. Perhaps we need a new black plague that is incurable. On another area, age limits on transplants and major surgery. If you reach a certain age deemed no longer socially viable and are unable to contribute to the society than you just live as long as nature intended.
Now hate me for saying these things, but it is the only foreseeable way I can figure out that socialization of our current health care could be solvent and not bankrupt our country even more. Who knows I might be deemed not suitable for treatment due to some incurable or debilitating illness. Oh well, needs of many outweigh needs of one or the few.
It is either this or a lottery system for death, like in "Logan's Run".
There are plenty of countries like that out there. They are known as shit-holes.
jklaughrey
09-24-10, 21:00
Yes, I know. It is why I know we will never have socialized health care like the liberals would like. But you have to admit VB, it is an efficient approach.
There are plenty of countries like that out there. They are known as shit-holes.
LOL. Well played sir.
jklaughrey
09-24-10, 21:18
You applaud someone even though there is no argument...? This isn't a contest get a clue Brian.
You applaud someone even though there is no argument...? This isn't a contest get a clue Brian.
I found the comment funny, that is all. Don't get your panties in a bunch.
:D
jklaughrey
09-24-10, 21:51
The tone seemed serious, but I don't wear panties...boxers or commando only.
You applaud someone even though there is no argument...? This isn't a contest get a clue Brian.
There is no argument because your position doesn't deserve to be argued about, and I hoped folks ignored it, but VB didn't. And no, coming from a place that pretty much does what you suggest with resultant male life expectancy of 59 years, it is not an efficient approach.
At what point are you going to decide if the neonate is viable or not? How would you know that a baby who has to spend 2 months in NICU would not become valuable contributor to society?
Many cancers are not curable - but you can suppress them and give people years of life. There is no guarantee though, you'd have to try it and see what happens - who is going to decide who gets a shot and who doesn't?
... will saving them be a benefit for the collective society?
Devaluation of one individual's life and rights in favor of collective society's benefits is a hallmark of communist and socialist doctrine. I listened to this crap for 25 years of my life, "sacrifice one for benefits of many others" bullshit. It got old really fast. Get a grip.
jklaughrey
09-24-10, 22:02
Really? WTF. It is hypothetical in regards to the discussion. Jog On! If it offends you so much, don't read it your choice. Cheers!
I then misunderstood you - I thought that was your proposed solution and position, not hypothetical discussion. Sorry, mate, I get animated when memories of old homeland come up. Cheers!
jklaughrey
09-24-10, 22:13
Just pop off to the pub and order up a pint of dark and call it good.
Doctors reimbursement will go down - I deal with medicare daily - so I don't know what exactly would drive that influx.
One other addition I want to make based off your statement... Much noise is centered around greedy doctors wanting too much so people feel that its justified to cut their pay. Just so everyone understands, the entire medical community will take a pay decrease. Nurses, technicians, and staff people will all be affected.
As far as being greedy, many of my friends who are eye doctors in CA and AZ, made in 2006-07 the same annual wage that a top paid GM union worker made in assembling cars (I don't know what GM workers now make under the government/taxpayer ownership). Similar level of pay, but not a similar pension, or health plan. We used to joke that we should have just joined GM or some other union job instead of going through all that school.
On a side note, a few months ago, I was speaking with one of the top retinal surgeons here and he mused that if their office were to take a straight payment of $50 per patient visit, instead of having to jump through all the insurance hoops, they might break even. I was a bit surprised at this and asked why? He replied that they currently have about 30+ people on the payroll. Getting rid of billing medicare and insurance allow them to drop three or four full time insurance/medicare billing specialists. It would also allow them to ditch five to seven full-time technicians/nurses. The reason for this is that most insurance plans and medicare require different types of testing for each billed procedure/diagnoses. So to just streamline things in many practices, everyone gets everything (not literally), but his point was that a lot of useless testing is done to satisfy the billing requirements. Additional savings could be made in overhead costs due to reduction in paperwork, materials, and needed space.
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